Approaches to Care for Catastrophic Cases

• Jurisdiction: California,United States
• Citation: Vol. 32 No. 2
• Publication year: 2019
• Author: Betty Ottman, RN, CCM
• topic: Business of Law,Contracts,Insurance Law,Health Law,Personal Injury Law,Civil Procedure,Workers Compensation

Approaches to Care for Catastrophic Cases

Betty Ottman, RN, CCM

San Francisco, California

Historically, the management of catastrophic cases has followed the same trajectory as non-catastrophic industrial cases. However, this model does not promote a predictable optimal outcome. A 2014 study examined a different model for managing catastrophic injuries that shows better results.

What constitutes a catastrophic injury? This category includes traumatic brain injury, complex multiple trauma, spinal cord injury, severe burns, and amputations of an extremity. Moreover, a catastrophic case will often include a combination of these diagnoses. Fortunately, only 1 percent of all industrial injury cases are catastrophic, but they make up at least 20 percent of the costs of all cases (Miller, "The Impact of Catastrophic Cases on Workers Compensation Medical Loss Reserves"). The catastrophically injured face significant lifelong medical and custodial expenses. These costs are higher now than ever before due to newer lifesaving techniques and medical innovations.

Currently, the industry standard for a catastrophic case is for the carrier to have a traditional case management company and...