Study Shows Surgery Rate in CA Higher than WA...Financial Motivation?

Joe Paduda's recent column discusses a recent study showing the significantly higher rates of back surgery (fusion) in CA than in WA, where the threshold is far higher than in CA before significant surgery can be approved under workers' compensation.  We agree with the tone of the article, where there is financial motivation to do surgery and a low threshold (California requires only a second opinion, similar to Montana's low threshold), surgery takes place.  In many cases, the patient outcome is unfortunately unchanged from the condition/complaints before the surgery, and in unfortunately too many cases there are complications such as infections that lead to significantly worse outcome than had surgery not been performed.

This particularly difficult in Montana, where the Supreme Court has ruled that subrogation against physicians practicing under WC is not allowed, and subrogation against the at-fault third party is not allowed as a matter of public policy if and until the injured worker is made whole.  Given the definition of benefits provided under workers' compensation, led by the payment of 66 2/3 % of the worker's pre-injury weekly wage, subject to the state annually adjusted max rate, a significantly injured worker can never be made whole for "claims made and unmade, compensated or not".  This does not conform to industry and state norms and makes Montana a significantly more costly jurisdiction for workers' compensation than other states.

Read Mr. Paduda's article at: