ACOEM COVID-19 GUIDELINES AND WORKERS’ COMPENSATION: INJURED WORKERS WITH COVID-19 AND THEIR TREATMENT: WHAT YOU NEED TO KNOW

Medical Treatment Guidelines are important for Injured Workers.   Medical Treatment Guidelines provide instructions to Physicians as to how and what to request as far as treatments and testing.

ACOEM has issued COVID-19 Guidelines. Recently, there were updated COVID Guidelines on 8/19/20.

This article will discuss the ACOEM COVID-19 Guidelines with respect to workers’ compensation.

What Is ACOEM?

ACOEM is the abbreviation for the American College of Occupational and Environmental Medicine.  ACOEM a physician-led organization that focuses on the health of workers, safety of workplaces, and quality of environments.

Why Are ACOEM Guidelines Important?

Per a News Release of 5/27/20 from the California Department of Industrial Relations, notes that “the Division of Workers’ Compensation (DWC) supports this guidance and plans to adopt and incorporate the ACOEM Coronavirus (COVID-19) Guideline into the Medical Treatment Utilization Schedule (MTUS).”

 As An Injured Worker, Why are These Guidelines Important?

The Guidelines are important because they will give you insight as what testing and treatment will be approved on an industrial basis.  Items not recommended by the Guidelines may not be approved by Insurance Company Utilization Review Programs.

What Are the ACOEM Recommended Testing for COVID?

Testing recommended in the ACOEM Guides are PCR testing, Antigen Testing, and Antibody Testing of Blood Serum.   The first two will be recommended.  The third will be subject to possible UR denial. It is to be used for certain purposes.  ACOEM Covid-19 Guidelines, 8/19/20.

What are the ACOEM Recommended Diagnostic Imaging for COVID?

X-Rays are recommended. Note: abnormalities show 10-12 days out from infection.

CT Scans are recommended.  ACOEM Covid-19 Guidelines, 8/19/20.

What Medications that are Recommended or Not Recommended for Use for COVID-19?

Hydroxychloroquine is not recommended for the treatment of patients with COVID-19 after the first three days of symptoms. There is no recommendation for or against use of Hydroxychloroquine in the first three days of symptoms ACOEM Covid-19 Guidelines, 8/19/20.

Chloroquine is not recommended for the treatment of patients with COVID-19 after the first three days of symptoms. There is no recommendation for or against use of Chloroquine in the first three days of symptoms. ACOEM Covid-19 Guidelines, 8/19/20.

Hydroxychloroquine or Chloroquine for Widespread Prophylaxis are not recommended. ACOEM Covid-19 Guidelines, 8/19/20.

Azithromycin is not recommended for the adjunctive treatment of selective patients with more severe COVID-19.  There is no recommendation for or against it use within the first three days. ACOEM Covid-19 Guidelines, 8/19/20.

Favipiravir has: no recommendation for or against the use for COVID-19. ACOEM Covid-19 Guidelines, 8/19/20.

Lopinavir / Ritonavir is recommended in combination therapy but is not recommended as a solitary treatment. ACOEM Covid-19 Guidelines, 8/19/20.

Remdesivir is recommended for the supervised treatment of selected patients with COVID-19. ACOEM Covid-19 Guidelines, 8/19/20.

Interleukin 6- Inhibitors are recommended for the treatment of selected patients with COVID-19. ACOEM Covid-19 Guidelines, 8/19/20.
Convalescent COVID -19 Antibodies have no recommendation for or against the use. ACOEM Covid-19 Guidelines, 8/19/20.

Glucocorticosteroids are provisionally recommended for the treatment of COVID 19, There are other indications of use that may occur in the context of treatment of COVID-19 for example asthma or COPD. ACOEM Covid-19 Guidelines, 8/19/20.

Interferon Beta-1b: recommended adjunctive use is recommended for treatment of selected patients with COVID-19. ACOEM Covid-19 Guidelines, 8/19/20.

Ribavirin is recommended for adjunctive use of ribavirin for treatment of selected patients with COVID-19 ACOEM Covid-19 Guidelines, 8/19/20.

Zinc is recommended for potential prevention of more severe disease well as treatment of patients for COVID-19. ACOEM Covid-19 Guidelines, 8/19/20.

Vitamin D is recommended for potential prevention of more severe disease as well as treatment for patients with COVID-19. ACOEM Covid-19 Guidelines, 8/19/20.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

OCCUPATIONAL MEDICINE, OCCUPATIONAL MEDICINE DOCTORS AND WORKERS’ COMPENSATION: INJURED WORKERS BEING TREATED OR EVALUATED IN AN OCCUPATIONAL SETTING: WHAT YOU NEED TO KNOW

In the field of medicine, there is a specialty that addressed work injuries, Occupational Medicine.

Many Injured Workers, during the course of their treatment or as part of their evaluation process, encounter doctors who specialize in the field of Occupational Medicine.  In sum, Occupational Medicine Doctors play a variety of roles in workers’ compensation cases. Occupational Medicine Doctors provide treatment to injured workers in the form of being Primary Treating Physicians.  Some of them also act in the capacity as Qualified Medical Evaluators.

Occupational Medicine is also known as Occupational and Environmental Medicine. Therefore, an abbreviation of OEM may come up with respect practitioners.   Further, there is an American College of Occupational and Environmental Medicine.  This organization represents various health care professionals in Occupational and Environmental Medicine.   The College has the abbreviation of ACOEM. Also, the College generates various publications such as the ACOEM Guidelines.  ACOEM Treatment Guidelines are used within the California Workers’ Compensation System.  It is a Board Certified Specialty.

This article will discuss Occupational Medicine, Occupational Medicine Doctors, the Role of Occupational Medicine Physicians within Workers’ Compensation and what Injured Workers should expect when seeing an Occupational Medicine Physician.

Is There a Controversy Concerning Occupational Medicine?

Occupational Medicine, in my opinion, is a controversial field.   The reason being is that, in the treating capacity, Workers only see Occupational Medicine Doctors when they have already had an industrial claim.

A book noted that it was “a disconcerting fact that workers’ compensation fails to compensate most occupational injuries and illnesses, including fatalities. Only a small fraction of occupational diseases is covered by workers’ compensation, and only a small fraction of people suffering from occupational illnesses ever receives workers’ compensation benefits. Either by law or by practice, compensation in many states is particularly limited for occupational diseases. A recent study suggests that workers’ compensation insurance absorbs only 21% of the true costs of occupational injuries and illnesses. Many workers’ compensation laws now prevent or discourage the recognition of occupational diseases. The efforts of many industries and their insurers to deny claims lead to the failure to compensate workers who have occupational diseases. Another important contributing cause is the limited information available to physicians.” The Practice of Occupational Medicine, LaDou, Harrison (2006).

In sum, because Occupational Medicine Doctors do not treat individuals who are initially coming in for regular treatment issues, they most likely never encounter individuals who have potential industrial injury cases. As a result, individuals will most likely not be  advised their treating doctor that their condition is work-related.  In this author’s opinion, the only way that Occupational Medicine Doctors can improve the rate of participants in the workers’ compensation for industrial injuries is to perform educational programs to General Practitioners or Family Medicine Doctors, In doing so, their knowledge of industrial injury causation would be passed on to front line treaters.

What Is Occupational Medicine?

Per the American Medical Association, “Occupational and environmental medicine… is the medical specialty devoted to the prevention and management of occupational and environmental injury, illness and disability, and promotion of health and productivity of workers, their families and communities.”

The AMA notes that “[t]he term “environmental medicine” …”addresses the impact of chemical and physical stressors on individuals and groups.”

What is an Occupational Medicine Doctor?

Per the DIR, Occupational Medicine Physicians “have knowledge in a number of clinical areas and expertise in a wide variety of disciplines. Occupational medicine focuses on comprehensively preventing and managing illness and injury among workers. An occupational medicine physician typically has expertise in:  The harmful effects of chemicals, metals, gases, and pesticides) and other workplace hazards, such as radiation and noise (Toxicology) Fitting the job to a person (Ergonomics) Musculoskeletal injuries including back, neck, and extremities Hearing loss Disorders of the lung, such as asbestosis, silicosis, and work-related asthma (Pulmonary) Work-related cancers (Oncology) Infectious diseases in the workplace, including blood borne pathogen exposures and tuberculosis Preventing illness and promoting wellness (Preventive Medicine)”

They can act in the capacity of QME.  Their QME code MPO.

Where Do Injured Workers Encounter Occupational Medicine Doctors? How Do They Operate?

In most circumstances, in the event of an injury in the workplace, many Employers will send workers to get treatment at an Industrial Clinic.   A number of Industrial Clinics employ Occupational Medicine Doctors to provide treatment.

Sometimes, Injured Workers may see Occupational Medicine Doctors in the capacity of QME.

In either circumstance, I have found that these doctors act as “gatekeepers.”  They appear to refer the Injured Workers out to the various medical specialties that are needed to treat or assess the various conditions.   In sum, they will refer Injured Workers out to necessary medical specialties such as orthopedics or internal medicine.   In my practice, they seem to point people in the right direction for treatment.   Also, they appear to be very capable of making an AMA impairment guide assessment at the most basis level.  By this, I mean that they are familiar with the various charts of the AMA Guides and are able to generate an impairment.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information. Click Here.

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