Alternative pain management treatment lengthens claim duration, costs: report

An increasingly popular alternative treatment for injured workers suffering from chronic pain costs employers and insurers more in medical and indemnity and often surpasses the recommended treatment timeline, according to a report released Monday by the California Workers’ Compensation Institute.

So-called functional restoration programs, or FRPs, are described as “interdisciplinary” approaches used to treat injured workers whose conditions do not respond to traditional therapies. FRPs are part of California’s treatment guidelines as a treatment for chronic pain, and the recommended timeline is four to six weeks.

The institute’s analysis of 635 workers compensation indemnity claims showed that the median timeline for such treatment programs is eight weeks but aligns with utilization review approvals. The analysis also found that while California’s treatment guidelines include FRT as a chronic pain treatment, only 42.8% of such claims included a chronic pain diagnosis.

The claims are also more costly. Overall, FRP claims averaged $234,003, 59.3% more than non-FRP claims. In medical, such claims cost an average $127,816, about twice the $64,062 for non-FRP claims. FRP medical services alone averaged $59,106, or 72.6% of total outpatient payments. For indemnity costs, FRP claims cost an average of $87,855, versus $68,533 for non-FRP claims.

Attorney representation for such claimants is also common: 94% of them include litigation, compared with 50.8% of all indemnity claims.