By Darren Barr, Vice President of Product Management, One Call
If an injured worker’s recovery were a storybook, diagnostic imaging acts as an introduction, setting the stage for the entire journey. Completing a diagnostic scan itself is just a first step; extracting critical insights comes next. At One Call, we’ve taken a classic claims tool and re-imagined it for modern solutions – an Age of Injury (AOI) report to help you devise the best recovery plan possible.
Age of Injury Explained
An AOI report provides much-needed clarity into causation and the timeframe of an injury. In an AOI report, an independent radiologist can determine whether an injury may be something new or pre-existing. These insights can help you get to the truth of an injury, baselining pre-existing conditions and allowing for a more focused treatment plan.
To create an AOI report, a highly trained, subspecialized radiologist reviews the original diagnostic images and medical report, then ultimately provides a medical opinion that addresses causation. The reviewing radiologist categorizes the individual findings within a body part into five major categories. In some cases, injuries may fall into more than one of these groups. For instance, an injured worker may have a chronic injury that’s been exacerbated by a workplace incident, reflecting an acute or chronic situation.
An AOI report also provides the following:
- Findings from the original medical report
- Type of study conducted by reviewing radiologist
- Reviewing radiologist position (concurs or disagrees) on the original reading
- Summary of findings, highlighting what is pre-existing and what is new
- Comprehensive clinical information in a more concise, easy-to-understand format
One Call’s enhanced AOI program has seen a 98% success rate in determining the aging aspects of injuries we review.
PepsiCo Case Study
For a great example of AOI’s effect on the workers’ compensation space, we turn to PepsiCo. A multi-national company that refers to their employees as “industrial athletes,” PepsiCo sought to significantly reduce return-to-work timelines. To accomplish this, they knew they needed to:
- Get clear injury determinations
- Eliminate overtreatment
- Achieve baseline medicine
- Partner with the right clinicians and case managers
PepsiCo was familiar with leveraging AOI results and had experienced some early successes. The company’s leadership began examining individual cases, focusing on specific injuries and body parts. This continued until PepsiCo decided to formally launch a pilot program. The early outcomes yielded a significant decrease in cost and recovery time. In 2021, and following the pilot program’s success, PepsiCo launched a comprehensive AOI program with One Call. This program enabled automated triggers to initiate AOIs on all appropriate files. Upon identification, diagnostic images and medical reports are transmitted to a subspecialized radiologist for an independent AOI.
PepsiCo requests medical imaging early in the recovery process to ensure line of sight into their employees’ injuries. Paired with an AOI, they created a powerful program allowing claims professionals and physicians to make faster, more confident decisions about treatment. This approach avoids weeks, or even months, of unnecessary treatment and transitional duty, giving the injured employee more optimism and less frustration during their recovery.
PepsiCo’s savings with AOI have significantly outweighed the initial program costs – with some of the largest savings occurring within surgical cases. For example, when an employee needs surgery due to a bicep rupture, the physician and claims examiner receive appropriate information to make surgical decisions within days, rather than waiting two-three months for physical therapy before moving to surgery. This quick action leads to a positive domino effect – a proper recovery plan is created, the injured worker receives necessary surgery earlier, the appropriate amount of physical therapy is prescribed, and the employee returns to work faster.
How does AOI benefit everyone?
While PepsiCo’s story is impressive, it’s important to note this type of success isn’t exclusive to large, multi-national corporations. AOI translates to businesses of all sizes, saving time and money for the employee, the company, the claims examiner, and everyone in-between. In addition to avoiding unnecessary treatment, providing clarity around the injury earlier improves clinician and injured worker communication, reducing frustration. AOI also:
- Establishes an employee’s baseline health – noting that the baseline isn’t always “zero” (e.g., full range of motion, no pain)
- Identifies underlying conditions, allowing for possible health and wellness coaching
- Provides a better idea of how an injury may be connected to pre-existing conditions, comorbidities, or lifestyle choices
- Enables adjusters to have more input into medical decisions
- Plays a key role in litigation and settlement of cases
AOI benefits injured workers by getting them back to full duty (and pay) quicker. In an inflationary economy, this point is key.
We all want better communication, ethical treatment plans, peace of mind, and a full recovery for injured workers. AOI plays a key role in achieving these goals. Employers like PepsiCo are experiencing the benefits right now, and so can you.
To get started, contact One Call’s team today.
Partner Post:
This is a sponsored post from WorkCompWire marketing partner One Call.