Dr. Gary M. Franklin on Preventing Small Injuries from Becoming Catastrophic Claims

At an NWCDC 2019 mega-session, Dr. Gary M. Franklin discussed strategies that keep acute pain from becoming chronic and which can prevent your next catastrophic claim.
By: | November 7, 2019

A worker suffers a minor back injury at work. After being issued a prescription for acute pain, they are expected to return safely and swiftly after temporary disability. 

This is a best case-scenario.

Often times, the reality of what occurs between the injury and the expected turn to work date is far more dramatic, and the road to recovery suffers many missed exits. 

While preventing injuries is the number one priority for workers’ compensation managers, keeping temporary disability from turning into long-term or even permanent is at the forefront of employers’ minds. 

At the 2019 National Workers’ Compensation and Disability Conference, Dr. Gary M. Franklin, medical director, Washington State Department of Labor and Industries presented during mega-session, “Disability Prevention: What’s Needed to Keep Routine Claims from Deteriorating.”

He talked utilizing Washington State’s strategies nationally and how to keep minor injuries just that… minor. 

Disarm the Disability Time-Bomb

To prevent an everyday claim from becoming a catastrophic case that results in life-long disability or even death, it’s important to prevent acute pain from becoming chronic pain. 

“An injured worker with back pain on disability for two weeks is a workers’ comp heart attack waiting to happen,” said Dr. Franklin. 

“Once you get to three months disability, that’s the definition of chronic pain. Preventing the transition from acute pain to chronic pain is the critical thing to pay attention to.”

Preventing chronic disability can be achieved by providing the best workers’ compensation health care possible. 

Squash Unnecessary Risks 

While the opioid epidemic is a major problem within workers’ compensation, it’s not the only threat that comes with unqualified caregivers, according to Dr. Franklin. 

Unnecessarily prescribed opioids increase a worker’s chance of addiction, but other faulty medical instructions and procedures can skyrocket the risk of disability. 

“Have you ever heard of failed brain surgery syndrome? No. You’ve only heard of failed back-surgery syndrome,” said Dr. Franklin, using comedy to drive home a harsh reality that unqualified doctors are a major threat to workers’ compensation. 

Threats to disability include unnecessary prescriptions as well as over-utilized and unregulated medical equipment. 

While the federal government regulates prescriptions, they do not regulate workers’ compensation programs and medical equipment. Unregulated medical equipment and devices can result in its misuse by doctors and patients, resulting in further injury. 

Think Outside the Box… and the Workplace 

To improve outcomes, Dr. Franklin says to look outside the lines, including looking to your partners. 

“Washington State legislatures and governments expect all agencies to work together. We all work together on things like opioid guidelines for the entire state. It’s really important to look outside your span of control. Who can you work with to improve results?”

Washington strategies that can be leveraged nationally include footing the bill for the best services, identifying efficient methods to detect workers at risk of long-term disability, and incentivize delivery of occupational health care. 

Treating disability prevention like a health care system and not an insurance model can help build trust with injured workers, incentivize best care delivery and ultimately improve outcomes in the workplace and at home. 

“You are the last line of defense against bad care. As such, you are like a public health official whose role is to protect workers from losing their productive life in their community.” &

Emily Spennato is a former staff writer with Risk & Insurance.

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