Physical Therapy Liability. We firmly believe that knowledge is the key to patient safety.

Size: px
Start display at page:

Download "2001-2010. Physical Therapy Liability. We firmly believe that knowledge is the key to patient safety."

Transcription

1 Physical Therapy Liability We firmly believe that knowledge is the key to patient safety.

2

3 Contents PART ONE: CNA HealthPro Physical Therapy Closed Claims Analysis Introduction....7 Purpose...7 Database and Methodology....7 Scope...8 Terms....8 General Data Analysis....9 Analysis of Closed Claims by Insurance Source...9 Severity of Physical Therapist Closed Claims by Year Closed...10 Distribution of Closed Claims by Severity...11 Analysis of Severity by Location...12 Analysis of Severity by Allegation...13 Allegations by Category...13 Allegations Related to Improper Management over the Course of Treatment...14 Allegations Related to Failure to Monitor or Supervise Physical Therapy Closed Claim Scenario: Failure to Properly Monitor or Supervise Allegations Related to Improper Performance Using Therapeutic Exercise...16 Physical Therapy Closed Claim Scenario: Improper Performance Using Therapeutic Exercise Allegations Related to Improper Performance of Manual Therapy...17 Allegations Related to Inappropriate Behavior by Physical Therapist...18 Allegations Related to Equipment...19 Allegations Related to Improper Use of a Physical Agent...19 Physical Therapy Closed Claim Scenario: Improper Use of a Physical Agent Analysis of Severity by Injury...20 Comparison of Re-injury Versus Other Injuries...22 Analysis of Severity by Re-injury...23 Analysis of Re-injury by Affected Body Part...23 Allegations Related to Re-injury...24 Analysis of Claims Related to Burns...26 Analysis of Severity Related to Burns by Body Part...26 Analysis of Severity by Disability...27 Summary Analysis of Physical Therapist Assistant Closed Claims...28 Severity by Allegation...28 PTA and PT Closed Claims: Comparison of Top Three Elements by Severity Physical Therapy Closed Claim Scenario: Alleged Improper Care (a Success Story) Risk Control Recommendations...31 Risk Control Self-assessment Checklist for Physical Therapists...36 Your Role and Responsibilities in Managing a Professional Liability Claim...40

4 PART TWO: Healthcare Providers Service Organization Analysis of Physical Therapy License Protection Paid Claims January 1, 2001 December 31, Introduction Scope...43 Database and Methodology License Protection Paid Claims...43 Claims by Insurance Coverage Type...43 Claims by Licensure Type...44 Claims by Location...44 Allegations by Class...45 Allegations Related to Improper Management over the Course of Treatment...46 Allegations Related to Inappropriate Behavior...47 Allegations Related to Fraudulent Billing...48 Licensing Board Outcomes...49 Recommendations...50 PART THREE: Highlights from Healthcare Providers Service Organization 2011 Qualitative Physical Therapist Work Profile Survey...51 Introduction Survey Background and Methodology Summary of Findings...55 Topic 1: Respondent Demographics Physical Therapy Licensure...56 Gender...56 Age...56 Highest Level of Education...57 Topic 2: Practice Profile Location of Practice...58 Primary Language...58 Annual Continuing Education (CE) Requirements Topic 3: About the Claim Submitted Seeking PT Without a Referral...60 Years of Practice at Time of Incident...60 Patient Care Assistance...61 Certified in Practicing Specialty...62 Policy on Disclosure of Mistakes...62 Effect of Inadequate Staffing...63 Number of Patient Visits Scheduled per Single Appointment Session Time...64 Supervision of Others...65 Topic 4: Facility Profile When Claim Was Submitted Type of Medical Records...66 Risk Management Plan...66

5 PART ONE CNA HealthPro Physical Therapy Closed Claims Analysis

6

7 PART ONE: Introduction Through Healthcare Providers Service Organization (HPSO), CNA continues to be the nation s largest underwriter of professional liability insurance coverage for physical therapy professionals, with over 70,000 policies in force in In collaboration with our business partners at HPSO, we at CNA are dedicated to educating physical therapy professionals regarding professional liability risk exposures relevant to their practice. Part One of this report focuses on risks faced by physical therapists (PTs), whether they are insured as individuals or as employees of physical therapy practices. A subsection of Part One addresses the specific professional liability risk exposures for physical therapist assistants (PTAs) insured by HPSO/ CNA and other healthcare professionals providing services on behalf of a HPSO/CNA-insured physical therapy practice. Purpose We firmly believe that knowledge is the key to enhancing patient safety and managing risk. Our goal is to help PTs enhance the quality of their patient care services by providing fact-based risk management information and guidance. The risk management information presented in this report is based upon an analysis of closed professional liability claims that resulted in sizable settlements or adverse judgments. Part One focuses on closed claims in order to identify the types of incidents most likely to have resulted in significant consequences for patients, therapists and practices. By offering data analysis, risk control recommendations and a self-assessment checklist, we strive to encourage our insureds to examine their own clinical practice and policies, discern areas of possible improvement, and dedicate themselves to maximizing patient safety and minimizing risk. We believe that physical therapy professionals in every type of practice setting will find this report a valuable educational resource. Database and Methodology There were 3,889 professional liability closed claims and incidents attributed to CNA-insured physical therapy professionals in the HPSO program from 2001 through Professional liability claims were included in the final data set only if they - involved a licensed PT or PTA whether insured independently or through a PT practice or other healthcare professional providing services on behalf of a PT practice - resulted in a closure date between January 1, 2001 and December 31, resulted in an payment equal to or greater than $10,000 Closed claims with an payment of less than $10,000 were excluded for the reason that they typically reflect injuries that were less severe and/or resolved without extensive litigation. These criteria generated a data set of 552 closed claims. There were 477 closed claims asserted against PTs, 49 closed claims asserted against PTAs and 26 closed claims asserted against other healthcare professionals providing services on behalf of an insured PT practice. Findings for closed claims asserted against PTs or PTAs insured as individuals or by a PT practice, and against other healthcare professionals insured by a PT practice, are summarized in Figure 1 and Figure 2 (page 9). Findings for all closed claims meeting the criteria noted above and asserted against PTAs are summarized in Figure 23 and Figure 24 (pages 28 and 29). The methodology used in this report differs from the 2007 CNA Physical Therapy Claims Study and PT claims studies developed by other organizations. For that reason, it is not advisable for readers to compare findings in this report with those of other studies or reports. PART ONE CNA HealthPro and HPSO Physical Therapy Liability,

8 Scope Claim characteristics analyzed within the report include incident location, allegation, injury, re-injury and related disability. Also included is a summary review of closed claims comparing individually insured PTs with PTs providing services as employees of insured PT practices. Noted payments or expenses were paid by CNA on behalf of an insured and do not represent any additional amounts paid by employers, other insurers or other parties in the form of direct or insurance payments. This analysis reflects CNA data only and is not necessarily representative of all closed claims for PTs, PTAs and/or PT practices. The process of resolving a professional liability claim may take several years. Therefore, claims included in this report may have resulted from events that occurred prior to 2001, as long as the claim closed between January 1, 2001 and December 31, Terms For purposes of this report, please refer to the definitions below: - Allegation An assertion that the professional or organization has done something wrong or illegal, which has not yet been proven. - Expense payment Monies paid by CNA in the investigation, management or defense of a claim. - Incurred Costs or financial obligations, including payments and expense payments, resulting from the management and resolution of a claim. - Indemnity payment Monies paid by CNA to a plaintiff on behalf of an insured in the settlement or judgment of a claim. - Physical therapy practice (PT practice) An organization insured through the HPSO/CNA physical therapy program that provides professional physical therapy services and whose employees may include PTs, PTAs, PT aides, massage therapists, athletic trainers and other healthcare providers. - Referring practitioner A licensed independent healthcare provider other than a PT such as a physician, dentist, advanced practice nurse, physician assistant, podiatrist or chiropractor who is authorized to prescribe physical therapy treatments. PART ONE 8 CNA HealthPro and HPSO Physical Therapy Liability,

9 General Data Analysis Analysis of Closed Claims by Insurance Source Figure 1 provides an overview of claim results based upon the type of insurance coverage. The first row describes claim results for PTs, PTAs and other healthcare providers who received their coverage through a PT practice. The second and third rows describe claim results of PTs and PTAs who were individually insured. This is the only chart that includes all 552 claims in the database. Figure 2 provides additional detail regarding the PT practices data reported in Figure 1. - The highest average paid and the highest average paid expenses involved PT practices. This result is expected, inasmuch as the coverage provided for a PT practice is the primary source (i.e., first dollar) of insurance coverage for the corporation, its employees and independent contractors. Conversely, individually insured PTs and PTAs may share financial responsibility with an employer, healthcare facility or others. - Individually insured PTAs had an average paid similar to that of individually insured PTs. - PTs experienced 80.5 percent of the closed claims within PT practices. - The average paid for individually insured PTs (Figure 1) was $11,966 lower than for practiceinsured PTs (Figure 2), while the average paid expense was $2,532 lower than for practice-insured PTs. Therefore, the average total incurred was $14,498 less for PTs with their own individual coverage than for PTs receiving coverage through a PT practice. Claims by Insurance Source for All Physical Therapy Professionals Chart reflects closed claims with paid of $10,000 1 Insurance type PT practice (PTs, PTAs and other professional designations) Percentage of closed claims Total paid Average paid Average paid expense Average total incurred 63.0% $29,297,441 $84,188 $24,524 $108,712 Individually insured PT 35.7% $14,272,033 $72,447 $21,612 $94,059 Individually insured PTA 1.3% $503,524 $71,932 $7,471 $79,403 Overall 100.0% $44,072,998 $79,842 $23,268 $103,111 Claims by Providers Insured by a PT Practice Chart reflects closed claims with paid of $10,000 2 Provider Percentage of practice-insured closed claims Total paid Average paid Average paid expense Average total incurred Athletic trainer 0.3% $350,000 $350,000 $23,521 $373,521 PT aide 6.6% $2,051,182 $89,182 $25,271 $114,453 PT 80.5% $23,635,663 $84,413 $24,144 $108,557 PTA 12.1% $3,210,596 $76,443 $26,962 $103,405 Massage therapist 0.6% $50,000 $25,000 $18,386 $43,386 Overall 100.0% $29,297,441 $84,188 $24,524 $108,712 PART ONE CNA HealthPro and HPSO Physical Therapy Liability,

10 Please note that from this point forward, the analysis solely reflects PT closed claims. Data inclusion and exclusion criteria are explained on page 7. Severity of Physical Therapist Closed Claims by Year Closed - While average paid varied considerably from year to year, the overall trend increased approximately 4 to 5 percent annually (as represented by the trend line) over the course of the 10-year period of the analysis. - The increases in 2004 and 2009 were based on the high number of closed claims with paid equal to or greater than $200, Average Paid Indemnity and Average Paid Expense by Year Closed Chart reflects closed claims with paid of $10,000 Average paid by year closed Figure 4 displays average paid expenses for PT closed claims that closed with no payment. The data include closed claims with paid expenses of one dollar or greater for each of the 10 years included in the analysis. A claim that resolved without an payment may incur costs associated with managing the claim. These costs, or claim expenses, include such items as attorney fees and costs incurred to investigate the claim. Claim expenses can vary due to the unique and sometimes complicated circumstances of each claim. While some individual claim expenses in these data exceeded $100,000, the 10-year average annual expense where there is no associated payment is $13,710. The claims included in this chart represent PT professional liability matters that were resolved as follows: - successfully defended on behalf of the PT, resulting in a favorable jury verdict - abandoned by the plaintiff during the investigative or discovery process - dismissed in favor of the defendant PT by the court prior to trial PART ONE 10 CNA HealthPro and HPSO Physical Therapy Liability,

11 Average Paid Expenses for Closed Claims with No Indemnity Paid by Year Closed 4 Average paid expenses Distribution of Closed Claims by Severity - Approximately 80 percent of the PT closed claims were resolved with an payment under $100, Only 0.4 percent of the PT closed claims incurred the policy limit of $1 million. These claims reflect treatment that resulted in severe injury and irreversible harm to the patient. Distribution of Closed Claims by Severity Chart reflects closed claims with paid of $10,000 5 Paid Percentage of closed claims $10,000 to $99,999 $100,000 to $249,999 $250,000 to $499,999 $500,000 to $749,999 $750,000 to $999,999 $1,000,000 PART ONE CNA HealthPro and HPSO Physical Therapy Liability,

12 Analysis of Severity by Location - The highest average paid resulted from closed claims that occurred in hospital inpatient PT areas. The high average paid for this complement of closed claims was driven by one claim that closed at the policy limit of $1 million. - The highest total paid resulted from closed claims that occurred in PT offices or clinics, followed by patient homes and hospital inpatient PT areas. 6 Analysis of Severity by Location Chart reflects closed claims with paid of $10,000 Location Percentage of closed claims Total paid Average paid Hospital inpatient PT area 1.9% $1,779,000 $197,667 Fitness center 0.2% $96,500 $96,500 Aging services facility 2.3% $973,911 $88,537 Acute medical/surgical hospital inpatient 1.0% $400,471 $80,094 PT office/clinic - non-hospital 82.0% $30,764,890 $78,683 Industrial/occupational health 0.2% $75,000 $75,000 School 2.7% $921,175 $70,860 Patient home 8.4% $2,716,749 $67,919 Acute rehabilitation hospital inpatient room/area 0.2% $50,000 $50,000 Hospital outpatient area 0.8% $115,000 $28,750 Practitioner office or private clinic 0.2% $15,000 $15,000 Overall 100.0% $37,907,696 $79,471 The highest average paid resulted from closed claims that occurred in hospital inpatient PT areas, while the highest total paid resulted from closed claims that occurred in PT offices or clinics. PART ONE 12 CNA HealthPro and HPSO Physical Therapy Liability,

13 Analysis of Severity by Allegation The analysis of allegations begins with Figure 7, which includes data for allegations by category. More detailed reviews are provided for categories of allegations that accounted for 5 percent or more of the PT closed claims. These categories include - improper management over the course of treatment, Figure 8 - failure to supervise or monitor, Figure 9 - improper performance using therapeutic exercise, Figure 10 - improper performance of manual therapy, Figure 11 - inappropriate behavior by the physical therapist, Figure 12 - equipment-related, Figure 13 - improper performance using a physical agent, Figure 14 Allegations by Category - Failure to properly test or treat the patient reflected the highest average paid, but accounted for less than 1 percent of the PT closed claims. Some examples of failure to properly test or treat the patient included - using excessive weight when testing patient functional capacity - extending traction beyond acceptable traction time periods - including improper exercises in the patient s treatment plan - advancing the patient s treatment plan too rapidly - Examples of environment of care included equipment not mounted properly on the wall and cluttered treatment area resulting in patient falls. - Improper performance using therapeutic exercise had the highest total paid at $10,600,774. The total paid was driven by how often this allegation occurred. This allegation category accounts for 26.6 percent of the PT closed claims. Severity of Allegations by Category Chart reflects closed claims with paid of $10,000 7 Allegation category Percentage of closed claims Total paid Average paid Failure to properly test or treat 0.8% $1,893,805 $473,451 Improper management over the course of treatment 11.3% $6,459,346 $119,618 Environment of care 1.5% $636,792 $90,970 Failure to supervise or monitor 15.9% $6,508,342 $85,636 Improper performance using therapeutic exercise 26.6% $10,600,774 $83,471 Improper performance of manual therapy 14.0% $5,360,466 $80,007 Inappropriate behavior by PT 5.7% $1,537,018 $56,927 Equipment-related 6.7% $1,576,538 $49,267 Improper performance using a physical agent 17.4% $3,334,615 $40,176 Overall 100.0% $37,907,696 $79,471 PART ONE CNA HealthPro and HPSO Physical Therapy Liability,

14 Figures 8 through 14 examine in detail the categories of allegations that accounted for 5 percent or more of all the PT closed claims. They are organized from highest to lowest average paid, as listed in Figure 7. The percentages are based on the number of claims for the specific category. Allegations Related to Improper Management Over the Course of Treatment - This allegation category produced the following findings: - The average paid of $119,618 for closed claims was 50 percent higher than the average paid of $79,471 for all PT closed claims. - Failure to report changes in the patient s condition to the referring practitioner represented the highest average paid. - Failure to cease treatment when the patient experienced excessive/unexpected pain constituted the highest total paid. - Example of improper management of a surgical patient: A middle-aged man had undergone a hip arthroscopy and was referred for physical therapy by his surgeon. The patient canceled several sessions for vague reasons, and did not return to continue therapy. He reported to his surgeon that the PT had placed him prone, flexed his knee and extended his hip. The patient and surgeon alleged that, as a result of this therapy, the patient s hip was dislocated, requiring additional surgery. The claim was settled for over $200, Severity by Allegations Related to Improper Management over the Course of Treatment Chart reflects closed claims with paid of $10,000 Allegation Percentage of closed claims Total paid Average paid Failure to report patient s condition to referring practitioner 9.3% $1,397,125 $279,425 Failure to cease treatment with excessive/unexpected pain 29.6% $2,649,500 $165,594 Improper management of surgical patient 16.7% $962,721 $106,969 Failure to follow referring practitioner orders 20.4% $804,500 $73,136 Failure to complete proper patient assessment 14.8% $440,500 $55,063 Injury during training for assistive devices or equipment 5.6% $140,000 $46,667 Failure to refer/seek consultation 3.7% $65,000 $32,500 Overall 100.0% $6,459,346 $119,618 PART ONE 14 CNA HealthPro and HPSO Physical Therapy Liability,

15 Allegations Related to Failure to Monitor or Supervise - Failure to supervise or monitor other providers during patient care had the highest average paid in this allegation category. - Failure to monitor the patient during treatment had the highest total paid. - Example of failure to monitor or supervise: A female patient had nearly completed her course of treatment with the PT for therapy to her strained left quadriceps. In preparation for her continuing home-exercise program, she was asked to perform a leg stretch that involved putting her leg on the table. The PT was standing directly in front of the patient, but was unable to catch her when she lost balance and fell to the floor. She suffered a fractured femur requiring surgical insertion of a femoral rod. The claim was settled in excess of $350,000. Severity by Allegations Related to Failure to Monitor or Supervise Chart reflects closed claims with paid of $10,000 9 Allegation Percentage of closed claims Total paid Average paid Failure to monitor or supervise other providers 9.2% $688,750 $98,393 Failure to monitor patient during treatment 85.5% $5,733,592 $88,209 Failure to maintain proper infection control 1.3% $27,500 $27,500 Failure to respond to patient 2.6% $40,500 $20,250 Failure to supervise patient assessment 1.3% $18,000 $18,000 Overall 100.0% $6,508,342 $85,636 Physical Therapy Closed Claim Scenario: Failure to Properly Monitor or Supervise A 45-year-old patient was referred to physical therapy with a history of traumatic brain injury, limited use of his extremities, and contractures of his left elbow and shoulder. Therapy was prescribed due to his decreased ability to perform activities of daily living, decreased range of motion and reduced functional mobility. The patient attended aquatic therapy twice a week, during which time his physical therapist would typically work with him one-on-one in the pool. The patient was occasionally permitted to walk on his own alongside the pool while holding the handrail. At the time of the incident, the patient was unattended in the pool, but a lifeguard was on duty and the patient was wearing a flotation device around his chest attached to a lead rope. The physical therapist was assisting another client when the physical therapy aide noticed the patient was completely submerged. The physical therapy aide immediately pulled the patient out of the water and performed cardiopulmonary resuscitation. It was determined that he had been submerged for several minutes before the physical therapy aide rescued him. The patient eventually began breathing on his own and was transferred to a hospital by ambulance. Acute hospitalization lasted approximately one month, while he was treated for adult respiratory distress syndrome and aspiration pneumonia. Following hospitalization, the patient was admitted to a rehabilitation facility, where he required high levels of oxygen until his discharge. The patient suffered permanent lung damage and functions at approximately 50 percent of normal lung capacity. He resides in an assisted living facility, due to the level of care required on a daily basis. The patient and his wife sued the insured PT and the owners of the pool, alleging negligence of a dependent adult and failure to monitor the patient during treatment. The claim was settled in the high six-figure range. PART ONE CNA HealthPro and HPSO Physical Therapy Liability,

16 Allegations Related to Improper Performance Using Therapeutic Exercise - As noted in Figure 7, improper performance using therapeutic exercise was the category with the highest total paid. - Injury during gait or stair training accounted for the highest average paid. - Improper technique reflected the highest total paid and the highest percentage of closed claims. - Examples of claims that alleged improper performance using therapeutic exercise: - A patient with a history of balance issues performed an exercise that required her to stand on one leg without being supported or braced while moving the alternate leg over an object. - Patients suffered injuries resulting from exercises that were too advanced or aggressive, based upon their medical history. - A PT conducting a functional capacity exam (FCE) required a male patient with an injured arm and a pre-existing neck injury to lift a weight that was heavier than the lifting requirement for the patient s job. The patient was later diagnosed with cervical herniation and underwent spinal fusion surgery. The claim settled for an amount in excess of $200, Severity by Allegations Related to Improper Performance Using Therapeutic Exercise Chart reflects closed claims with paid of $10,000 Allegation Percentage of closed claims Total paid Average paid Injury during gait or stair training 12.6% $2,296,500 $143,531 Improper positioning 3.1% $367,500 $91,875 Injury from restrictive or elastic bandage/support/brace 0.8% $90,000 $90,000 Improper technique 35.4% $3,998,564 $88,857 Injury during active resistance or assistive range of motion exercises 15.0% $1,424,859 $74,993 Injury during endurance activities 12.6% $1,046,464 $65,404 Injury during resistance exercise or stretching 17.3% $1,248,387 $56,745 Injury during aquatic exercise/therapy 3.1% $128,500 $32,125 Overall 100.0% $10,600,774 $83,471 PART ONE 16 CNA HealthPro and HPSO Physical Therapy Liability,

17 Physical Therapy Closed Claim Scenario: Improper Performance Using Therapeutic Exercise A 9-year-old child with cerebral palsy, who had undergone extensive surgery for correction of bilateral ankle contractures, was referred for physical therapy following removal of the casts from both of his legs. In addition to his surgery, the patient had a history of balance problems, as well as pain and weakness on his right side. The patient was wellknown to the therapist, who had provided his care prior to surgery. The patient was correctly placed in bilateral orthotics that maintained the proper position of his ankles during his treatment. The physical therapist positioned the patient on a therapy ball placed against the wall, with chairs on both sides for added stabilization. The patient held the therapy ball handle with his left hand, and with his right hand tossed objects into a basket as instructed by the therapist. The physical therapist remained with the patient continuously, standing on his left side during the exercise. The patient suddenly slipped to his right and was momentarily unable to reach out to the chair to stabilize himself. The physical therapist reached him and eased him to the floor. The patient immediately complained of pain in the back of his right knee. He was diagnosed with a non-displaced fracture of the right tibia and placed into an over-the-knee cast of the right leg. The physical therapist expert review was positive regarding the choice of exercise and confirmed that the exercise did not require two persons. However, the expert noted that, in view of the patient s history of right-sided weakness and pain, the physical therapist could have anticipated that if the patient were to fall, it would be to the right. Therefore, the therapist would have been better positioned to the patient s right during the exercise. The orthopedic expert opined that the orthotic acted as the fulcrum point of the fracture and that the fall was the cause of the injury. The orthopedic expert did not believe the fracture would lead to permanent injuries or joint deformity, and the fracture healed successfully. Given the facts of the case and the very sympathetic presentation of the child, the decision was made to attempt to settle the claim. The settlement was in the low six-figure range. Allegations Related to Improper Performance of Manual Therapy - Injury during passive range of motion had the highest average paid in this category. - Example of improper performance of manual therapy: The PT was treating a patient for lumbar arthritis and chronic sciatica by performing a piriformis stretch, which required the patient to lie on her back while the PT drew the knee upward toward the opposite shoulder. The patient had undergone right total hip replacement surgery approximately six years prior to this incident. She had a history of possible right hip instability and reported difficulty getting on and off the toilet due to right hip pain. During the exercise, the patient reported that she felt a sudden pain and experienced a pop in her right hip. Although the PT did not hear or feel a pop, the patient was unable to move her hip and could not sit or transfer immediately after the treatment. The patient was transferred to the hospital where she underwent a repeat right hip replacement. The claim was settled in excess of $150,000. Severity by Allegations Related to Improper Performance of Manual Therapy Chart reflects closed claims with paid of $10, Allegation Percentage of closed claims Total paid Average paid Injury during passive range of motion 13.4% $783,000 $87,000 Injury during manual therapy - improper technique 67.2% $3,604,000 $80,089 Injury during traction 10.4% $529,125 $75,589 Injury during connective tissue manual therapy or massage 9.0% $444,341 $74,057 Overall 100.0% $5,360,466 $80,007 PART ONE CNA HealthPro and HPSO Physical Therapy Liability,

18 Allegations Related to Inappropriate Behavior by Physical Therapist - Failure to follow organizational policy represented the highest average paid. - Abuse or misconduct by the PT reflected the highest total paid and the highest percentage of inappropriate behavior claims. - Closed claims relating to a PT s failure to notify the referring practitioner of the modified treatment plan involved the provision of services to patients that went beyond or differed from what the referring practitioner had prescribed. The following examples illustrate this type of allegation: - The referring practitioner ordered therapy only to the patient s cervical spinal area, but the PT provided treatment to the cervical and lumbar spine areas without discussing this additional therapy with the referring practitioner. The PT persisted despite the patient s complaints of severe lower back pain. The patient suffered lower back injuries requiring hospitalization and extensive rehabilitation. - The PT received an order to treat a patient s fractured wrist twice a week for six weeks. However, the PT continued the therapy for several months without discussing the treatment with the referring practitioner. The patient suffered a permanent 40 percent loss of mobility in the treated wrist. - The referring practitioner ordered specific treatment modalities to the patient s ankle following surgery that involved insertion of hardware. The PT added several modalities including electrical stimulation without discussing them with the referring practitioner. These additional treatments resulted in severe burns, which required significant additional treatment. - Allegations related to inappropriate behavior by the PT represented 5.7 percent of all PT closed claims in the analysis, as shown in Figure Severity by Allegations Related to Inappropriate Behavior by Physical Therapist Chart reflects closed claims with paid of $10,000 Allegation Percentage of closed claims Total paid Average paid Failure to follow organizational policy 11.1% $205,000 $68,333 Failure to notify referring practitioner of modified treatment plan 18.5% $296,019 $59,204 Physical, sexual, emotional abuse and/or misconduct 70.4% $1,035,999 $54,526 Overall 100.0% $1,537,018 $56,927 PART ONE 18 CNA HealthPro and HPSO Physical Therapy Liability,

Jamie Crouse. Legal Aspects of Exercise and Sport. Malpractice in Physical Therapy. April 30, 2013

Jamie Crouse. Legal Aspects of Exercise and Sport. Malpractice in Physical Therapy. April 30, 2013 Jamie Crouse Legal Aspects of Exercise and Sport Malpractice in Physical Therapy April 30, 2013 Bellamy, J. (n.d.). Retrieved from http://www.apta.org/ptcareers/roleofapt/ Physical Therapy Claim Study.

More information

Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario

Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Page 1 Closed Automobile Insurance Third Party Liability Bodily Injury Claim Study in Ontario Injury Descriptions Developed from Newfoundland claim study injury definitions No injury Death Psychological

More information

OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES

OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY PROTOCOL GUIDELINES General Therapy Guidelines 1. Therapy evaluations must be provided by licensed physical and/or occupational therapists. Therapy evaluations

More information

Injury Prevention for the Back and Neck

Injury Prevention for the Back and Neck Injury Prevention for the Back and Neck www.csmr.org We have created this brochure to provide you with information regarding: Common Causes of Back and Neck Injuries and Pain Tips for Avoiding Neck and

More information

Proving Causation and Damages in Spinal Fusion Cases

Proving Causation and Damages in Spinal Fusion Cases Page 1 of 7 Ben Brodhead on proving causation and damages in spinal fusion cases. Friend on Facebook Follow on Twitter Forward to a Friend Proving Causation and Damages in Spinal Fusion Cases By: Ben C.

More information

Orthopaedic Spine Center. Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs

Orthopaedic Spine Center. Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs Orthopaedic Spine Center Graham Calvert MD James Woodall MD PhD Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs The cervical spine consists of the bony vertebrae, discs, nerves and other structures.

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F910691. TERRY FOSTER, Employee. TYSON SALES & DISTRIBUTION, Self-Insured Employer

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F910691. TERRY FOSTER, Employee. TYSON SALES & DISTRIBUTION, Self-Insured Employer BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F910691 TERRY FOSTER, Employee TYSON SALES & DISTRIBUTION, Self-Insured Employer CLAIMANT RESPONDENT OPINION FILED NOVEMBER 20, 2013 Hearing

More information

Coding and Billing for Physical Therapy and Occupational Therapy Services

Coding and Billing for Physical Therapy and Occupational Therapy Services Coding and Billing for Physical Therapy and Occupational Therapy Services -CPT Codes-97000 series -Timed Based Codes -Service Based Codes -CMS - "8" Minute Rule -ICD-9 codes -CCI edits -HCPCS(DME) MODALITIES

More information

UTILIZING STRAPPING AND TAPING CODES FOR HEALTH CARE REIMBURSEMENT:

UTILIZING STRAPPING AND TAPING CODES FOR HEALTH CARE REIMBURSEMENT: UTILIZING STRAPPING AND TAPING CODES FOR HEALTH CARE REIMBURSEMENT: A GUIDE TO BILLING FOR SPIDERTECH PRE-CUT APPLICATIONS AND TAPE Billing and coding taping and strapping services can be a complex issue.

More information

.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description

.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can

More information

THE LUMBAR SPINE (BACK)

THE LUMBAR SPINE (BACK) THE LUMBAR SPINE (BACK) At a glance Chronic back pain, especially in the area of the lumbar spine (lower back), is a widespread condition. It can be assumed that 75 % of all people have it sometimes or

More information

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or 1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual

More information

MEDICAL MALPRACTICE CASE RESULTS

MEDICAL MALPRACTICE CASE RESULTS CASE RESULTS INFORMATION Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case. Nor does it mean that we

More information

The Physiotherapy Pilot. 1.1 Purpose of the pilot

The Physiotherapy Pilot. 1.1 Purpose of the pilot The Physiotherapy Pilot 1.1 Purpose of the pilot The purpose of the physiotherapy pilot was to see if there were business benefits of fast tracking Network Rail employees who sustained injuries whilst

More information

Herniated Disk. This reference summary explains herniated disks. It discusses symptoms and causes of the condition, as well as treatment options.

Herniated Disk. This reference summary explains herniated disks. It discusses symptoms and causes of the condition, as well as treatment options. Herniated Disk Introduction Your backbone, or spine, has 24 moveable vertebrae made of bone. Between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep

More information

If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time.

If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time. If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time. You may be worried about your future, both in respect of finances and

More information

Surgery for cervical disc prolapse or cervical osteophyte

Surgery for cervical disc prolapse or cervical osteophyte Mr Paul S. D Urso MBBS(Hons), PhD, FRACS Neurosurgeon Provider Nº: 081161DY Epworth Centre Suite 6.1 32 Erin Street Richmond 3121 Tel: 03 9421 5844 Fax: 03 9421 4186 AH: 03 9483 4040 email: paul@pauldurso.com

More information

.org. Herniated Disk in the Lower Back. Anatomy. Description

.org. Herniated Disk in the Lower Back. Anatomy. Description Herniated Disk in the Lower Back Page ( 1 ) Sometimes called a slipped or ruptured disk, a herniated disk most often occurs in your lower back. It is one of the most common causes of low back pain, as

More information

FRESNO COUNTY EMPLOYEES RETIREMENT ASSOCIATION. Applicant Name: JOHN DOE Appointment Date: 01-01-10

FRESNO COUNTY EMPLOYEES RETIREMENT ASSOCIATION. Applicant Name: JOHN DOE Appointment Date: 01-01-10 FRESNO COUNTY EMPLOYEES RETIREMENT ASSOCIATION REFERRAL FOR INDEPENDENT MEDICAL EXAMINATION Applicant Name: JOHN DOE Appointment Date: 01-01-10 Time: 3:00 p.m. Date Name of Doctor Address Dear Dr.. On

More information

Neck Injuries and Disorders

Neck Injuries and Disorders Neck Injuries and Disorders Introduction Any part of your neck can be affected by neck problems. These affect the muscles, bones, joints, tendons, ligaments or nerves in the neck. There are many common

More information

Sciatica Yuliya Mutsa PTA 236

Sciatica Yuliya Mutsa PTA 236 Sciatica Yuliya Mutsa PTA 236 Sciatica is a common type of pain affecting the sciatic nerve, which extends from the lower back all the way through the back of the thigh and down through the leg. Depending

More information

Inpatient Rehabilitation Facilities (IRFs) [Preauthorization Required]

Inpatient Rehabilitation Facilities (IRFs) [Preauthorization Required] Inpatient Rehabilitation Facilities (IRFs) [Preauthorization Required] Medical Policy: MP-ME-05-09 Original Effective Date: February 18, 2009 Reviewed: April 22, 2011 Revised: This policy applies to products

More information

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MULTNOMAH ) ) ) ) ) ) ) ) ) ) ) )

IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MULTNOMAH ) ) ) ) ) ) ) ) ) ) ) ) IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF MULTNOMAH 1 GLENDA MONROE, v. Plaintiff V. JAMES MAKKER, M.D.; EAST PORTLAND SURGERY CENTER, LLC; and PROVIDENCE HEALTH SYSTEM - OREGON, an

More information

Back & Neck Pain Survival Guide

Back & Neck Pain Survival Guide Back & Neck Pain Survival Guide www.kleinpeterpt.com Zachary - 225-658-7751 Baton Rouge - 225-768-7676 Kleinpeter Physical Therapy - Spine Care Program Finally! A Proven Assessment & Treatment Program

More information

PLANTAR FASCITIS (Heel Spur Syndrome)

PLANTAR FASCITIS (Heel Spur Syndrome) PLANTAR FASCITIS (Heel Spur Syndrome) R. Amadeus Mason MD Description Plantar fascitis is characterized by stiffness and inflammation of the main fascia (fibrous connective [ligament-like] tissue) on the

More information

John Coronis v. Granger Northern Inc. (April 27, 2010) STATE OF VERMONT DEPARTMENT OF LABOR

John Coronis v. Granger Northern Inc. (April 27, 2010) STATE OF VERMONT DEPARTMENT OF LABOR John Coronis v. Granger Northern Inc. (April 27, 2010) STATE OF VERMONT DEPARTMENT OF LABOR John Coronis Opinion No. 16-10WC v. By: Sal Spinosa, Esq. Hearing Officer Granger Northern, Inc. ATTORNEYS: For:

More information

Lumbar Disc Herniation/Bulge Protocol

Lumbar Disc Herniation/Bulge Protocol Lumbar Disc Herniation/Bulge Protocol Anatomy and Biomechanics The lumbar spine is made up of 5 load transferring bones called vertebrae. They are stacked in a column with an intervertebral disc sandwiched

More information

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT CONTINENTAL CASUALTY CO., INSURANCE CARRIER RESPONDENT

More information

ILIOTIBIAL BAND SYNDROME

ILIOTIBIAL BAND SYNDROME ILIOTIBIAL BAND SYNDROME Description The iliotibial band is the tendon attachment of hip muscles into the upper leg (tibia) just below the knee to the outer side of the front of the leg. Where the tendon

More information

SPECIFIC DATA FIELD INSTRUCTIONS

SPECIFIC DATA FIELD INSTRUCTIONS SPECIFIC DATA FIELD INSTRUCTIONS NAIC NUMBER: Enter the five-digit numeric company code supplied by the National Association of Insurance Commissioners. A convenient source is page 1 of the company statutory

More information

Adult Forearm Fractures

Adult Forearm Fractures Adult Forearm Fractures Your forearm is made up of two bones, the radius and ulna. In most cases of adult forearm fractures, both bones are broken. Fractures of the forearm can occur near the wrist at

More information

Joint Replacement 101. Ohio Valley Medical Center and East Ohio Regional Hospital Pre- surgical Class for Total Joint Replacements

Joint Replacement 101. Ohio Valley Medical Center and East Ohio Regional Hospital Pre- surgical Class for Total Joint Replacements Joint Replacement 101 Ohio Valley Medical Center and East Ohio Regional Hospital Pre- surgical Class for Total Joint Replacements Ohio Valley Medical Center and East Ohio Regional Hospital are both certified

More information

IN THE NEBRASKA COURT OF APPEALS. MEMORANDUM OPINION AND JUDGMENT ON APPEAL (Memorandum Web Opinion)

IN THE NEBRASKA COURT OF APPEALS. MEMORANDUM OPINION AND JUDGMENT ON APPEAL (Memorandum Web Opinion) IN THE NEBRASKA COURT OF APPEALS MEMORANDUM OPINION AND JUDGMENT ON APPEAL (Memorandum Web Opinion) KIRCHER V. THE MASCHHOFFS, LLC NOTICE: THIS OPINION IS NOT DESIGNATED FOR PERMANENT PUBLICATION AND MAY

More information

Occupational Therapy

Occupational Therapy Occupational Therapy I. Policy University Health Alliance (UHA) will reimburse for occupational therapy when it is determined to be medically necessary and when it meets the medical criteria guidelines

More information

Physical Therapy. Physical Therapy Payment Policy Policy number M.RTH.02.120301 effective 10/01/2015. Page 1

Physical Therapy. Physical Therapy Payment Policy Policy number M.RTH.02.120301 effective 10/01/2015. Page 1 Physical Therapy I. Policy University Health Alliance (UHA) will reimburse for physical therapy when it is determined to be medically necessary and when it meets the medical criteria guidelines (subject

More information

Schiffert Health Center www.healthcenter.vt.edu. Neck Pain (Cervical Strain) COMMON CAUSES: QUICK TREATMENT : NECK PAIN TREATING NECK PAIN:

Schiffert Health Center www.healthcenter.vt.edu. Neck Pain (Cervical Strain) COMMON CAUSES: QUICK TREATMENT : NECK PAIN TREATING NECK PAIN: Schiffert Health Center www.healthcenter.vt.edu Patient Information: Neck Pain (Cervical Strain) COMMON CAUSES: Neck pain may be triggered by a specific event, such a sport injury or motor vehicle accident.

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F608015. AMANDA VOLKMANN, Employee. SONIC DRIVE-IN, Employer

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F608015. AMANDA VOLKMANN, Employee. SONIC DRIVE-IN, Employer BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F608015 AMANDA VOLKMANN, Employee SONIC DRIVE-IN, Employer FARMERS INSURANCE EXCHANGE, Carrier CLAIMANT RESPONDENT RESPONDENT OPINION FILED

More information

Patient Intake. Insurance Information

Patient Intake. Insurance Information Patient Intake First Name: Last Name: Initial: Home Address: City: State: Zip: Home Phone: Work Phone: Cell Phone: Email: Social Security #: Birth Date: Age: Sex: Male Female Occupation: Employer s Name:

More information

The type of cancer Your specific treatment Your pre training levels before diagnose (your current strength and fitness levels)

The type of cancer Your specific treatment Your pre training levels before diagnose (your current strength and fitness levels) Exercise and Breast Cancer: Things you can do! Cancer within the fire service is one of the most dangerous threats to our firefighter s health & wellness. According to the latest studies firefighters are

More information

Herniated Lumbar Disc

Herniated Lumbar Disc Herniated Lumbar Disc North American Spine Society Public Education Series What Is a Herniated Disc? The spine is made up of a series of connected bones called vertebrae. The disc is a combination of strong

More information

2009 Medical Malpractice Claims Report

2009 Medical Malpractice Claims Report 2009 Medical Malpractice Claims Report Department of Commerce & Insurance November 1, 2009 Table of Contents 2009 Tennessee Medical Malpractice Report INTRODUCTION...2 I. REPORTING ENTITIES...3 II. REPORTING

More information

American Heritage Life Insurance Company

American Heritage Life Insurance Company Policy GVAP1 pays the following benefits for covered on and off the job accidental injuries that result within 90 days (180 days for Accidental Death or Dismemberment) from the date of the accident. A

More information

Cervical Spondylosis (Arthritis of the Neck)

Cervical Spondylosis (Arthritis of the Neck) Copyright 2009 American Academy of Orthopaedic Surgeons Cervical Spondylosis (Arthritis of the Neck) Neck pain is extremely common. It can be caused by many things, and is most often related to getting

More information

GENERAL ADMISSION CRITERIA INPATIENT REHABILITATION PROGRAMS

GENERAL ADMISSION CRITERIA INPATIENT REHABILITATION PROGRAMS Originator: Case Management Original Date: 9/94 Review/Revision: 6/96, 2/98, 1/01, 4/02, 8/04, 3/06, 03/10, 3/11, 3/13 Stakeholders: Case Management, Medical Staff, Nursing, Inpatient Therapy GENERAL ADMISSION

More information

Lower Back Pain An Educational Guide

Lower Back Pain An Educational Guide Lower Back Pain An Educational Guide A publication from the Center of Pain Medicine and Physiatric Rehabilitation 2002 Medical Parkway Ste 150 1630 Main St Ste 215 Annapolis, MD 21401 Chester, MD 21619

More information

Preparing for a Deposition

Preparing for a Deposition Combined Sections Meeting 2013 January 21-24, 2013, San Diego SESSION HANDOUT Preparing for a Deposition Speakers Michael Loughran, Mary Ryan 15 pages total Whether a case goes to court or is settled before

More information

SAM KARAS ACUTE REHABILITATION CENTER

SAM KARAS ACUTE REHABILITATION CENTER SAM KARAS ACUTE REHABILITATION CENTER 1 MEDICAL CARE Sam Karas Acute Rehabilitation The Sam Karas Acute Rehabilitation Center is a comprehensive and interdisciplinary inpatient unit. Medical care is directed

More information

Patient Information. Lumbar Spine Segmental Decompression. Royal Devon and Exeter NHS Foundation Trust

Patient Information. Lumbar Spine Segmental Decompression. Royal Devon and Exeter NHS Foundation Trust Lumbar Spine Segmental Decompression Royal Devon and Exeter NHS Foundation Trust Patient Information Lumbar Spine Segmental Decompression Reference Number: TO 05 004 004 (version date: June 2015) Introduction

More information

What are Core Muscles?... 2. A Healthy Lumbar Spine...3. What is Low Back Pain?...4. Rehabilitation...6. Stages of Rehabilitation...

What are Core Muscles?... 2. A Healthy Lumbar Spine...3. What is Low Back Pain?...4. Rehabilitation...6. Stages of Rehabilitation... Table of Contents What are Core Muscles?... 2 A Healthy Lumbar Spine...3 What is Low Back Pain?...4 Rehabilitation...6 Stages of Rehabilitation...7 Pain Management....................... 8 Heat/Ice What

More information

Accident Coverage Details

Accident Coverage Details Accident Coverage Details Choose Level 1 or Level 2 Benefits Accident Coverage provides 24-hour coverage or off-the-job coverage. Select the level of coverage that best meets your needs and budget. BENEFITS

More information

Musculoskeletal System

Musculoskeletal System CHAPTER 3 Impact of SCI on the Musculoskeletal System Voluntary movement of the body is dependent on a number of systems. These include: The brain initiates the movement and receives feedback to assess

More information

Total hip replacement

Total hip replacement Patient Information to be retained by patient What is a total hip replacement? In a total hip replacement both the ball (femoral or thigh bone) side of the hip joint and the socket (acetabular or pelvic

More information

Herniated Cervical Disc

Herniated Cervical Disc Herniated Cervical Disc North American Spine Society Public Education Series What Is a Herniated Disc? The backbone, or spine, is composed of a series of connected bones called vertebrae. The vertebrae

More information

New York State Workers' Comp Board. Mid and Lower Back Treatment Guidelines. Summary From 1st Edition, June 30, 2010. Effective December 1, 2010

New York State Workers' Comp Board. Mid and Lower Back Treatment Guidelines. Summary From 1st Edition, June 30, 2010. Effective December 1, 2010 New York State Workers' Comp Board Mid and Lower Back Treatment Guidelines Summary From 1st Edition, June 30, 2010 Effective December 1, 2010 General Principles Treatment should be focused on restoring

More information

Home Phone#: Mobile #: Email Address: Sex: M F Date of Birth (mm/dd/yyyy): / / Name of Emergency Contact: Relationship: Home Phone: ( )

Home Phone#: Mobile #: Email Address: Sex: M F Date of Birth (mm/dd/yyyy): / / Name of Emergency Contact: Relationship: Home Phone: ( ) Patient Information Date: First Name: Address: Surname: City: Postal Code: Home Phone#: Mobile #: Email Address: Sex: M F Date of Birth (mm/dd/yyyy): / / Name of Emergency Contact: Relationship: Home Phone:

More information

Information on the Chiropractic Care of Lower Back Pain

Information on the Chiropractic Care of Lower Back Pain Chiropractic Care of Lower Back Pain Lower back pain is probably the most common condition seen the the Chiropractic office. Each month it is estimated that up to one third of persons experience some type

More information

Passive Range of Motion Exercises

Passive Range of Motion Exercises Exercise and ALS The physical or occupational therapist will make recommendations for exercise based upon each patient s specific needs and abilities. Strengthening exercises are not generally recommended

More information

.org. Achilles Tendinitis. Description. Cause. Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel.

.org. Achilles Tendinitis. Description. Cause. Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel. Achilles Tendinitis Page ( 1 ) Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel. The Achilles tendon is the largest tendon in the body. It connects your

More information

An analysis of physical. therapist professional. liability claims. and risk management. recommendations. December 1, 1993

An analysis of physical. therapist professional. liability claims. and risk management. recommendations. December 1, 1993 An analysis of physical P H Y S I C A L T H E R A P Y C L A I M S S T U D Y therapist professional liability claims and risk management recommendations December 1, 1993 through March 31, 2006 Physical

More information

Non-Surgical Treatments for Spasticity in Cerebral Palsy and Similar Conditions by Susan Agrawal

Non-Surgical Treatments for Spasticity in Cerebral Palsy and Similar Conditions by Susan Agrawal www.complexchild.com Non-Surgical Treatments for Spasticity in Cerebral Palsy and Similar Conditions by Susan Agrawal Children with cerebral palsy and other conditions that affect muscle tone often present

More information

State of Connecticut Insurance Department

State of Connecticut Insurance Department State of Connecticut Insurance Department Commissioner Thomas R. Sullivan P.O. Box 816 153 Market Street Hartford, CT 06142-0816 (860) 297-3801 www.ct.gov/cid Connecticut Medical Malpractice Annual Report

More information

SPINAL FUSION. North American Spine Society Public Education Series

SPINAL FUSION. North American Spine Society Public Education Series SPINAL FUSION North American Spine Society Public Education Series WHAT IS SPINAL FUSION? The spine is made up of a series of bones called vertebrae ; between each vertebra are strong connective tissues

More information

Transmittal 55 Date: MAY 5, 2006. SUBJECT: Changes Conforming to CR3648 for Therapy Services

Transmittal 55 Date: MAY 5, 2006. SUBJECT: Changes Conforming to CR3648 for Therapy Services CMS Manual System Pub 100-03 Medicare National Coverage Determinations Department of Health & Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) Transmittal 55 Date: MAY 5, 2006 Change

More information

State of Connecticut Insurance Department

State of Connecticut Insurance Department State of Connecticut Insurance Department Commissioner Thomas B. Leonardi P.O. Box 816 153 Market Street Hartford, CT 06142-0816 (860) 297-3801 www.ct.gov/cid Connecticut Medical Malpractice Annual Report

More information

ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS

ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS Summer Watersports Camp All-Sports Camp Baseball Camp Basketball Camp Golf Camp Sailing Camp Soccer Camp Softball Camp Tennis Camp Volleyball

More information

Employees Compensation Appeals Board

Employees Compensation Appeals Board U. S. DEPARTMENT OF LABOR Employees Compensation Appeals Board In the Matter of MICHAEL D. JONES and DEPARTMENT OF DEFENSE, FORT KNOX HIGH SCHOOL, Fort Knox, KY Docket No. 02-835; Submitted on the Record;

More information

State of Connecticut Insurance Department

State of Connecticut Insurance Department State of Connecticut Insurance Department Commissioner Katharine L. Wade P.O. Box 816 153 Market Street Hartford, CT 06142-0816 (860) 297-3801 www.ct.gov/cid Connecticut Medical Malpractice Annual Report

More information

Clinical guidance for MRI referral

Clinical guidance for MRI referral MRI for cervical radiculopathy Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine for a patient 16 years or older for suspected: cervical radiculopathy

More information

The Malpractice Lawsuit:

The Malpractice Lawsuit: The Malpractice Lawsuit: Process and Prevention Advocate Health Care 7 th Annual Advocate Trauma Symposium Wyndham Lisle - Chicago November 18, 2010 Rogelio Lasso The John Marshall Law School BACKGROUND

More information

Rehabilitation. Rehabilitation. Walkers, Crutches, Canes

Rehabilitation. Rehabilitation. Walkers, Crutches, Canes Walkers, Crutches, Canes These devices provide support through your arms to limit the amount of weight on your operated hip. Initially, after a total hip replacement you will use a walker to get around.

More information

[Cite as State ex rel. Tracy v. Indus. Comm., 121 Ohio St.3d 477, 2009-Ohio-1386.]

[Cite as State ex rel. Tracy v. Indus. Comm., 121 Ohio St.3d 477, 2009-Ohio-1386.] [Cite as State ex rel. Tracy v. Indus. Comm., 121 Ohio St.3d 477, 2009-Ohio-1386.] THE STATE EX REL. TRACY, APPELLEE, v. INDUSTRIAL COMMISSION OF OHIO; AUTOZONE, INC., APPELLANT. [Cite as State ex rel.

More information

Return to same game if sx s resolve within 15 minutes. Return to next game if sx s resolve within one week Return to Competition

Return to same game if sx s resolve within 15 minutes. Return to next game if sx s resolve within one week Return to Competition Assessment Skills of the Spine on the Field and in the Clinic Ron Burke, MD Cervical Spine Injuries Sprains and strains Stingers Transient quadriparesis Cervical Spine Injuries Result in critical loss

More information

Guidelines for Medical Necessity Determination for Occupational Therapy

Guidelines for Medical Necessity Determination for Occupational Therapy Guidelines for Medical Necessity Determination for Occupational Therapy These Guidelines for Medical Necessity Determination (Guidelines) identify the clinical information MassHealth needs to determine

More information

A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)

A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) Introduction Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a phenomenon that more commonly affects older males. It is associated

More information

Student Accident Insurance Platinum Protect TABLE OF EVENTS

Student Accident Insurance Platinum Protect TABLE OF EVENTS Student Accident Insurance Platinum Protect TABLE OF EVENTS Injury as defined, resulting in; Section 1 Permanent Disabilities (In each case the Injury suffered must be Permanent). Compensation Payable

More information

Catholic Mutual..."CARES"

Catholic Mutual...CARES Catholic Mutual..."CARES" BACK INJURY LOSS CONTROL FOR HEALTH CARE FACILITIES Occupational back injuries are a major loss exposure in the health care industry. Serious back injuries can result when employees

More information

Interpreting Physical Therapy Notes

Interpreting Physical Therapy Notes Interpreting Physical Therapy Notes Sending a patient to physical therapy does not always guarantee that they are going to receive the same treatment. In fact, the same patient with the same diagnosis

More information

SOAH DOCKET NO. 453-04-4583.M2 TWCC MR NO. M2-04-0846-01 ' ' ' ' ' ' ' DECISION AND ORDER I. JURISDICTION, NOTICE, AND VENUE

SOAH DOCKET NO. 453-04-4583.M2 TWCC MR NO. M2-04-0846-01 ' ' ' ' ' ' ' DECISION AND ORDER I. JURISDICTION, NOTICE, AND VENUE SOAH DOCKET NO. 453-04-4583.M2 TWCC MR NO. M2-04-0846-01 FIRST RIO VALLEY MEDICAL, P.A., Petitioner V. AMERICAN HOME ASSURANCE CO., Respondent BEFORE THE STATE OFFICE OF ADMINISTRATIVE HEARINGS DECISION

More information

Decision of the Appeal Division

Decision of the Appeal Division Decision of the Appeal Division Number: 98-1053 Date: June 30, 1998 Panel: Laura Bradbury Subject: Request for re-opening a claim factors for consideration The worker is appealing the Review Board findings

More information

Open Discectomy. North American Spine Society Public Education Series

Open Discectomy. North American Spine Society Public Education Series Open Discectomy North American Spine Society Public Education Series What Is Open Discectomy? Open discectomy is the most common surgical treatment for ruptured or herniated discs of the lumbar spine.

More information

Spinal Cord Injury Education. An Overview for Patients, Families, and Caregivers

Spinal Cord Injury Education. An Overview for Patients, Families, and Caregivers Spinal Cord Injury Education An Overview for Patients, Families, and Caregivers Spinal Cord Anatomy A major component of the Central Nervous System (CNS) It is 15 to 16 inches long, and weighs 1 to 2 ounces

More information

HOPE EXERCISE RECOVERY RESOURCES RELATIONSHIPS INFORMATION REHABILITATION PREVENTION SELF ADVOCACY RELATIONSHIPS MOVEMENT. A Stroke Recovery Guide

HOPE EXERCISE RECOVERY RESOURCES RELATIONSHIPS INFORMATION REHABILITATION PREVENTION SELF ADVOCACY RELATIONSHIPS MOVEMENT. A Stroke Recovery Guide INFORMATION REHABILITATION PREVENTION SELF ADVOCACY RECOVERY HOPE A Stroke Recovery Guide RELATIONSHIPS MOVEMENT RESOURCES RELATIONSHIPS EXERCISE www.stroke.org CHAPTER FOUR Movement and Exercise Moving

More information

Degenerative Lumbar Scoliosis with Stenosis Successfully Treated with Cox Distraction Manipulation

Degenerative Lumbar Scoliosis with Stenosis Successfully Treated with Cox Distraction Manipulation Cox Technic Case Report #92 (sent February 2011 2/8/11 ) 1 Degenerative Lumbar Scoliosis with Stenosis Successfully Treated with Cox Distraction Manipulation Presented By Robert E. Patterson Jr., D.C.

More information

WORKERS COMPENSATION INTAKE FORM

WORKERS COMPENSATION INTAKE FORM WORKERS COMPENSATION INTAKE FORM related injury? No Yes INSURANCE INFORMATION RELEASE By clicking this box,i hereby authorize ABA Physical Therapy Associates to release to my Insurance company/attorney,

More information

Today I will discuss medical negligence following a number of recent high profile cases and inquests.

Today I will discuss medical negligence following a number of recent high profile cases and inquests. Tipp FM Legal Slot 29 th May 2012 Medical Negligence John M. Lynch, Principal Today I will discuss medical negligence following a number of recent high profile cases and inquests. Firstly, what is Medical

More information

THE MEDICAL TREATMENT GUIDELINES

THE MEDICAL TREATMENT GUIDELINES THE MEDICAL TREATMENT GUIDELINES I. INTRODUCTION A. About the Medical Treatment Guidelines. On December 1, 2010, the NYS Workers' Compensation Board is implementing new regulations and Medical Treatment

More information

Current Concepts of Low Back Pain. Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS

Current Concepts of Low Back Pain. Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS Current Concepts of Low Back Pain Terry L. Grindstaff, PhD, PT, ATC, SCS, CSCS 28% population reports LBP in past 3 months (CDC 2010) 60% recurrence rate (Turner et al, 1992) Low Back Pain Low Back Pain

More information

Workers Compensation Law Update April 2012

Workers Compensation Law Update April 2012 Workers Compensation Law Update April 2012 Sean C. Pierce Carr Allison Court of Civil Appeals of Alabama Maxim Healthcare Servs. v. Freeman, 2012 Ala. Civ. App. LEXIS 91 (Ala. Civ. App. April 13, 2012)

More information

ROTATOR CUFF HOME EXERCISE PROGRAM

ROTATOR CUFF HOME EXERCISE PROGRAM ROTATOR CUFF HOME EXERCISE PROGRAM Contact us! Vanderbilt Sports Medicine Medical Center East, South Tower, Suite 3200 1215 21st Avenue South Nashville, TN 37232-8828 For more information on this and other

More information

.org. Shoulder Pain and Common Shoulder Problems. Anatomy. Cause

.org. Shoulder Pain and Common Shoulder Problems. Anatomy. Cause Shoulder Pain and Common Shoulder Problems Page ( 1 ) What most people call the shoulder is really several joints that combine with tendons and muscles to allow a wide range of motion in the arm from scratching

More information

Medical History Questionnaire

Medical History Questionnaire Medical History Questionnaire Name: Date: Allergies (including latex): List all medications that you are currently taking, either prescription or non- prescription. Please specify dosage and length of

More information

Guide to. For Connecticut Private Sector Employees

Guide to. For Connecticut Private Sector Employees Guide to Workers Compensation For Connecticut Private Sector Employees NEW ENGLAND HEALTH CARE EMPLOYEES UNION DISTRICT 1199, SEIU 77 Huyshope Avenue, Hartford, CT 06106 860-549-1199 September 2009 Workers

More information

Off the shelf orthoses are commonly used to treat conditions such as foot and ankle sprains, minor shoulder injuries and to provide back support.

Off the shelf orthoses are commonly used to treat conditions such as foot and ankle sprains, minor shoulder injuries and to provide back support. Orthotic Bracing: Why and How Orthotic braces, or orthoses, are used to provide support to a weakened body part or joint. While many times they are worn for a short period of time, usually after an injury

More information

State of Connecticut Insurance Department

State of Connecticut Insurance Department State of Connecticut Insurance Department Commissioner Thomas B. Leonardi P.O. Box 816 153 Market Street Hartford, CT 06142-0816 (860) 297-3801 www.ct.gov/cid Connecticut Medical Malpractice Annual Report

More information

Clinical Care Program

Clinical Care Program Clinical Care Program Therapy for the Cardiac Patient What s CHF? Not a kind of heart disease o Heart disease is called cardiomyopathy o Heart failure occurs when the heart can t pump enough blood to meet

More information

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT GREG STURTZ, HF No. 277, 2000/01 Claimant, v. DECISION YOUNKERS, INC., Employer, and LIBERTY MUTUAL INSURANCE CO., Insurer. This is a workers

More information

solutions Accidents happen an unintentional-injury death occurs every 4 minutes and a disabling injury every 1 second. 1 GROUP

solutions Accidents happen an unintentional-injury death occurs every 4 minutes and a disabling injury every 1 second. 1 GROUP GROUP solutions Accidents happen an unintentional-injury death occurs every 4 minutes and a disabling injury every 1 second. 1 1 Injury Facts 2010 Edition, National Safety Council. GVAP1 GROUP ACCIDENT

More information

PATIENT INFORMATION FORM

PATIENT INFORMATION FORM 737 Pearl Street, Suite 108 Phone: 858.456.2114 Fax: 858.456.2103 www.abilityrehabsd.com PATIENT INFORMATION FORM Please print and complete ALL items. If an item doesn t apply, put N/A Patient Name: Age:

More information

Calcaneus (Heel Bone) Fractures

Calcaneus (Heel Bone) Fractures Copyright 2010 American Academy of Orthopaedic Surgeons Calcaneus (Heel Bone) Fractures Fractures of the heel bone, or calcaneus, can be disabling injuries. They most often occur during high-energy collisions

More information