American Association of State Compensation insurance Fund
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CopperPoint Mutual Insurance Company
Phone: (602) 631-2000
Address: 3030 North Third Street
Phoenix, AZ   85012
Website: www.copperpoint.com

State Compensation Insurance Fund
Phone: 888-STATEFUNDCA
Address: 333 Bush Street
Suite 800
San Francisco, CA   94104
Website: www.statefundca.com

Pinnacol Assurance
Phone: (303) 361-4000
Address: 7501 East Lowry Boulevard
Suite 800
Denver, CO   80230-7006
Website: www.pinnacol.com

Hawaii Employers' Mutual Insurance Co. Inc.
Phone: (808) 524-3642
Address: 1100 Alakea Street
Suite 1400
Honolulu, HI   96813
Website: www.hemic.com

Idaho State Insurance Fund
Phone: (208) 332-2100
Address: 1215 West State Street
P.O. Box 83720
Boise, ID   83720-0044
Website: www.idahosif.org

Kentucky Employers Mutual Insurance
Phone: (859) 425-7800
Address: 250 West Main Street Suite 900
P.O. Box 83720
Lexington, KY   40507-1724
Website: www.kemi.com

Louisiana Workers' Compensation Corporation
Phone: (225) 924-7788
Address: 2237 South Acadian Thruway
P.O. Box 83720
Baton Rouge, LA   70808
Website: www.lwcc.com

Maine Employers Mutual Insurance Company (MEMIC)
Phone: (207) 791-3300
Address: 261 Commercial Street
P.O. Box 11409
Portland, ME   04104
Website: www.memic.com

Chesapeake Employers’ Insurance Company
Phone: (410) 494-2000
Address: 8722 Loch Raven Boulevard
P.O. Box 11409
Towson, MD   21286-2235
Website: www.ceiwc.com

SFM Mutual Insurance Company
Phone: (952) 838-4200
Address: 3500 American Boulevard West Suite 700
P.O. Box 11409
Bloomington, MN   55431-4434
Website: www.sfmic.com

Missouri Employers Mutual Insurance
Phone: (800) 442-0590
Address: 101 N Keene St
P.O. Box 11409
Columbia, MO   65201
Website: www.mem-ins.com

Montana State Fund
Phone: (406) 495-5015
Address: 855 Front Street
P.O. Box 4759
Helena, MT   59604-4759
Website: www.montanastatefund.com

New Mexico Mutual Group
Phone: (505) 345-7260
Address: 3900 Singer Boulevard NE
P.O. Box 4759
Albuquerque, NM   87109
Website: www.newmexicomutual.com

New York State Insurance Fund
Phone: (212) 312-7001
Address: 199 Church Street
P.O. Box 4759
New York, NY   10007
Website: www.nysif.com

Workforce Safety and Insurance
Phone: (701) 328-3800
Address: 1600 East Century Avenue Suite 1
P.O. Box 4759
Bismarck, ND   58506-5585
Website: www.WorkforceSafety.com

Ohio Bureau of Workers Compensation
Phone: (800) 644-6292
Address: 30 West Spring Street
P.O. Box 4759
Columbus, OH   43215-2256
Website: www.bwc.ohio.gov

CompSource Mutual Insurance Company
Phone: (405) 232-7663
Address: 1901 North Walnut Ave.
P.O. Box 53505
Oklahoma City, OK   73152-3505
Website: www.compsourcemutual.com

State Accident Insurance Fund (SAIF)
Phone: (503) 373-8000
Address: 400 High Street SE
P.O. Box 53505
Salem, OR   97312-1000
Website: www.saif.com

Pennsylvania State Workers Insurance Fund
Phone: (570) 963-4635
Address: 100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA   18505-5100
Website: www.dli.state.pa.us/swif

Beacon Mutual Insurance Company
Phone: (401) 825-2667
Address: One Beacon Centre
P.O. Box 5100
Warwick, RI   02886-1378
Website: www.beaconmutual.com

South Carolina State Accident Fund
Phone: (803) 896-5800
Address: P.O. Box 102100
P.O. Box 5100
Columbia, SC   29221-5000
Website: www.saf.sc.gov

Texas Mutual Insurance Company
Phone: (800) 859-5995
Address: 6210 East Highway 290
P.O. Box 5100
Austin, TX   78723-1098
Website: www.texasmutual.com

Workers Compensation Fund
Phone: (800) 446-2667
Address: 100 West Towne Ridge Parkway
P.O. Box 2227
Sandy, UT   84070
Website: www.wcfgroup.com

Washington Department of Labor and Industries
Phone: (360) 902-5800
Address: P.O. Box 44001
P.O. Box 2227
Olympia, WA   98504-4001
Website: www.lni.wa.gov

Wyoming Division of Workers Safety & Compensation
Phone: (307) 777-7159
Address: Cheyenne Business Center
1510 East Pershing Boulevard
Cheyenne, WY   82002
Website: wydoe.state.wy.us

Workers Compensation Board - Alberta
Phone: (780) 498-3999
Address: 9925-107 Street
P.O. Box 2415
Edmonton, AB   T5J 2S5
Website: www.wcb.ab.ca

Workers Compensation Board of British Columbia (WORKSAFEBC)
Phone: (604) 273-2266
Address: P.O. Box 5350 Station Terminal
P.O. Box 2415
Vancouver, BC   V6B 5L5
Website: www.worksafebc.com

Manitoba Workers Compensation Board
Phone: (204) 954-4321
Address: 333 Broadway
P.O. Box 2415
Winnipeg, MB   R3C 4W3
Website: www.wcb.mb.ca

WorkSafeNB
Phone: (506) 632-2200
Address: 1 Portland Street
P.O. Box 160
Saint John, NB   E2L 3X9
Website: www.worksafenb.ca

Workers Compensation Board of Nova Scotia
Phone: (902) 491-8999
Address: 5668 South Street
P.O. Box 1150
Halifax, NS   B3J 2Y2
Website: www.wcb.ns.ca

Prince Edward Island Workers Compensation Board
Phone: (902) 368-5680
Address: 14 Weymouth Street
P.O. Box 1150
Charlottetown, PE   C1A 7L7
Website: www.wcb.pe.ca

Saskatchewan Workers Compensation Board
Phone: (306) 787-4370
Address: 200 - 1881 Scarth Street
P.O. Box 1150
Regina, SK   S4P 4L1
Website: www.wcbsask.com

Puerto Rico State Insurance Fund Corporation
Phone: (787) 793-5959
Address: G.P.O. Box 365028
P.O. Box 1150
San Juan, PR   00936-5028
Website: www.cfse.gov.pr
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Latest Newsletter

A Hidden Challenge in Workers' Compensation

By Dr. John Robinton, Medical Director, Neurodiagnostics, One Call Care Management

* One Call Care Management is the sponsor of the Claims Management Track at the 2018 AASCIF Annual Conference.

Electrodiagnostic Tests

Electromyography (EMG):

In this test, the physician inserts a small needle into the muscles to assess general health of the muscle and to test if the nerve supplied to that muscle is intact. Muscle activity is evaluated both while the muscle is at rest and during voluntary contraction.

 

Nerve Conduction Studies (NCS): These exams are essentially a quantitative measurement of nerve function. A mild electrical stimulation is applied directly over the nerve(s) in increasing strength to elicit a response from motor and sensory nerves.

Electromyography (EMG) and nerve conduction studies (NCS), known as electrodiagnostic tests, are valuable tools used for locating and evaluating the type and severity of muscle and/or nerve damage in injured workers. When performed correctly by properly trained and credentialed providers, accurate EMG and NCS results provide physicians with a baseline and roadmap to determine next steps in treating the injury.

The hidden challenge with these studies is the inconsistency with which non-prequalified physicians and non-physicians perform the tests and interpret the results. One study, presented at an annual conference of the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), confirms this notion. Of the 140 EMG and NCS reports reviewed,

68 percent were not medically useful due to lack of adherence to AANEM guidelines, incomplete examination information, and data inconsistency and unreliability.

Today, entry into the field of electrodiagnostic medicine remains barrier free, and the quality of EMG and NCS providers continues to vary. To combat this challenge, it is crucial to employ guidelines and solutions to ensure the medical usefulness, quality, and accuracy of EMG and NCS tests. Following are some key factors to consider:

  • Credentialed EMG/NCS Provider Network—AASCIF members should consider the utilization of a specialized network with a stringent pre-qualification process. This approach can help to ensure that only highly trained neurologists and physiatrists are utilized who, in many cases, specialize in workers’ compensation claims. The credentialing process should include requirements such as the submission of sample reports to be reviewed by a medical director for quality, accuracy, and compliance with the National Guidelines for Electrodiagnostic Testing and Reporting. Additionally, board certification in neurology or physical medicine rehabilitation, or a certificate of completion from an accredited residency program in one of these fields, should be required to join the network.
  • Ongoing Quality Improvement and Review Program—Due to the persistent challenges in EMG and NCS testing, AASCIF members should see to it that any network panel developed or provided by a vendor has a well-established ongoing quality program to review reports and bills to ensure continual adherence to quality guidelines and proprietary standards. Through this program, deficiencies can be detected and corrected to improve outcomes on a prospective basis.

In workers’ compensation, more than half of EMG tests are performed by providers who have not undergone a pre-qualification or credentialing process, which results in the poor testing quality noted earlier.

A comprehensive quality improvement and review program can certainly provide a retroactive analysis of testing provided on a particular case, but perhaps even more importantly, can also look at the relative quality of EMG and NCS tests conducted both inside and outside of a given network panel.

This type of process allows for an objective opinion of whether the EMG or NCS was appropriately performed and if the exam is medically useful, while simultaneously providing real time feedback to service providers so they can pursue continuous improvement and provide the highest quality testing possible in the future. This proactive approach is a key step in helping to stem the flow of poor quality, ineffective tests, which are unfortunately all too common in the industry today.

Regardless of the approach used to develop a highly skilled EMG and NCS testing panel, AASCIF members should make certain that best practices such as those noted in this article are utilized to optimize the quality of care for injured workers by providing the necessary rigor and structure for an accurate and timely diagnosis.

For the management of EMG and NCS testing in the workers’ compensation field, an accurate, prompt, and complete diagnosis is the first step toward an effective treatment plan, rapid recovery, and favorable early return-to-work outcomes.

 

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