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Contributing Author: Nicole Usher, Sr. Director of Operations, Apricus
Amputations due to catastrophic work-related injuries or complications like infection can be life-changing events for employees that often call for the use of prosthetics to not only get back to work, but also return to the life they enjoyed pre-injury. Prosthetic devices replace all or part of an extremity, and can be simple and utilitarian, such as prosthetic toes that are usually hidden in a shoe but vital for a person’s balance and ability to walk. Prosthetic innovations have a long history, and in our modern era can be complex with multiple joints, like a robotic arm with shoulder, elbow, and wrist. Some are highly specialized and can be crafted for activities like running or swimming or playing music.
Each prosthetic is custom-made for an individual and often requires multiple moldings and adjustments. An injured employee may have to wait six months to a year or more for swelling to subside before they can be properly fitted. They may need additional surgery or therapies to prepare, and some will need a new prosthetic as time passes and their disabilities progress or change. And no prosthetic lasts a lifetime, so replacements will eventually be necessary. Given this, much planning is needed to avoid wasting money on recasting or excessive wear and tear.
An amputation can also be one of the costliest type of workers’ compensation injury, both in terms of lost time and long-term expense. While orders for prosthetics are rare compared with other types of specialty devices, costs can range from a couple thousand dollars to well over $50,000. Working with experienced prosthetic providers is critical to control costs and achieve the best possible outcome for each injured employee.
Manufacturers specialize in certain types of prosthetics, and each injured employee must receive a complete, comprehensive evaluation to assess their unique needs to support potential return to work and activities of daily living, hobbies, and lifestyles. Were they a painter, piano player, or did they enjoy skiing or cycling? Do they need more than one type of device? Aesthetics are also important and help a person feel “whole” again after a catastrophic injury. Amputations can carry significant, lifelong feelings of grief and finality, and the psychological and emotional benefits to returning to your perception of your old self cannot be overstated.
The Complex Nature of Prosthetics Coordination
In many cases, because of the nature of a catastrophic injury like an amputation, the injured employee has already been sent to the hospital. Typically, a prosthetic service provider will be brought on early in the process and will work with a specialty coordinator to begin communicating with key stakeholders. This includes the adjuster along with the treatment team, discharge staff, or catastrophic case manager to ascertain the injured employee’s services, equipment, and supply needs.
Involving a specialty coordinator experienced with prosthetics to procure equipment can help the treatment team sort through the myriad of choices to identify the devices that best meet the injured employee’s needs. These specialists can also design a plan to meet the patient's requirements and compare the benefits of various approaches. They are experienced in evaluating the challenges that might remain after fitting a device and can work with all parties to achieve the best level of success. In addition, reliable providers will offer maintenance and warranties, and a quality specialty coordinator will check in with the injured employee to make sure a prosthetic is in good repair and in compliance with its warranty.
Prosthetic Advancements Offer Enhanced Experiences
The improvements in prosthetics we’ve seen over the years have been extraordinary. For injured individuals, seeing themselves with their future prosthetic, resuming their everyday lives, can not only improve the grieving process but also decrease their chance of rejection.
An amazing and diverse array of prosthetics is now possible, thanks to technologies such as 3D printing to craft lightweight, cost-effective shapes and haptic devices that provide sensory feedback to their user. In the future, the ongoing advancements in technology will result in even better solutions to the traumatic events of amputation and improvements to prosthetics. The advancement in bioengineering and prosthetics is nothing short of astonishing. For example, myoelectric technology uses electrodes to allow an amputee’s existing neuromuscular system to control a prosthetic arm or hand, moving and flexing it just as before. Electronic skin is being developed to provide nerve feedback in hands and fingertips. The world of prosthetics can even include augmented reality, so that amputees can become familiar with a device during the potentially long wait to receive it.
What more will the future bring? We expect to see the growing mastery over fine motor skills as the robotic movements become smaller and ever more precise. These amazing developments in technology will provide even better solutions to the traumatic event of amputation through evolving prosthetic improvements.
Nicole Usher has 15 years of experience in the workers’ comp industry and has held multiple leadership positions including roles in finance, quality, and operations. As an operational leader, Nicole promotes innovative ways to provide superior client experiences that adhere to the complex nature of the industry, state regulations, and the needs of claims professionals.
Nicole is also a regular contributor to our Specialty Solutions Spotlight where portions of this article originally appeared. To ask and find the answers to more work comp specialty questions visit our website and subscribe to our monthly series email.
www.apricusinc.com
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About The Author
About The Author
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Nicole Usher
Nicole Usher has 15 years of experience in the workers’ comp industry and has held multiple leadership positions. As an operational leader, Nicole promotes innovative ways to provide superior client experiences that adhere to the complex nature of the industry, state regulations, and the needs of claims professionals. She is also the author of a three-part series on hospital discharge planning, of which the above piece is a synopsis from part one. To read more from the series on how hospital discharge planning can improve workflows and outcomes, visit: www.apricusinc.com/hospital-discharge-planning.
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