3 min read
Dr. Nonweiler Answers a Claims Adjuster's Questions:
Question:
What led you to focus your orthopedic practice on sports medicine and how does this guide your approach to conducting an IME?
Answer:
Blake Nonweiler, M.D.
Orthopedic Surgeon
Sports medicine and the athletic injuries are especially interesting to me. I enjoy being around athletes, both recreational and otherwise, and helping them return to what they love after an injury. Orthopedic injuries, particularly sports injuries, are sustained based on the mechanism of injury, and these intricacies determine the pathology sustained. This is important in IME's as causality, or whether the work injury actually resulted in the pathology, is of primary importance.
Question:
You have extensive experience treating conditions of the hip, knee, and shoulder. In the context of workplace injuries, what are some of the most common cases you see?
Answer:
For the hip, common injuries include fractures, bursitis, and labral tears. For the knee, I often see strains, meniscus tears, and ACL tears. For the shoulder, common cases include strains, rotator cuff strains or tears, and labral tears.
Question:
What information do you find most helpful prior to conducting an IME?
Answer:
A cover letter that outlines the claimed, accepted, and/or denied injuries, along with the specific questions that the claims professional wants answered. It is very difficult to produce a quality IME report when I only receive medical records without a date of injury, the work injuries in question, and the questions that need to be answered to move the case along.
Question:
Workplace injuries can sometimes require surgical intervention. How do you determine when surgery is appropriate versus when conservative treatment may be sufficient?
Answer:
In general, surgery is appropriate when conservative treatment has failed. Orthopedics treats pain and functional limitations, which are different for every individual. Surgery is usually indicated when conservative treatment has failed, or the pain and functional limitations are such that the patient doesn't want to live with them, and the results of the surgery are expected to be good.
Question:
Orthopedic medicine continues to evolve with new innovations and technologies. Which advancements have you found that are most beneficial, or are you most excited about, with regard to evaluating injured workers?
Answer:
The future of regenerative medicine is in its infancy but has wonderful promise for the future. It is incredibly exciting to think that one day we may be able to inject a cocktail of biologics in different parts of the body to repair the tendon, cartilage, etc. The use of robotics is currently used in joint replacement, and the expectation is that this technology will expand to other orthopedic operations. With that expansion, we will be able to perform surgeries more precisely than we can today.
Dr. Blake Nonweiler, MD, is an orthopedic surgeon with over 35 years of experience in the medical field. He specializes in orthopedic surgery, shoulder and elbow sports medicine, foot and ankle sports medicine, and hip and knee sports medicine.
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A Previous "Ask the Doctor" Response
In our previous "Ask the Doctor" blog, Dr. Ballard explains how he collaborates with employers and workers to promote a healthy and safe workplace.