Moore: Physiotherapists as Primary Treatment Providers | Workers’ Compensation News


Through James moore

Monday, September 20, 2021 | 0

Worker physiotherapists have received a tremendous amount of good press over the past two months. I had always believed that physiotherapists could treat certain injuries early on.

James moore

I have always been a supporter of physiotherapy. Check out these two previous articles I wrote years ago on the topic: Is Physiotherapy Really Worth It? and physiotherapists – most commonly seen by injured workers.

North Dakota becomes a test case

North Dakota has decided to step up and become the state’s test case for physical therapy. Workforce Safety & Insurance, a monopoly carrier, changed its law in August to allow physiotherapists to treat injured workers as the primary supplier. WSI even provided a brochure on how it would work in the mockup.

WSI website changed to PT

WSI considers the following types of practitioners to be eligible as primary care providers: MD, DO, APRN, PA, DC, DPM, OD, DDS, DMD, and PT. An injured employee may have only one primary treatment provider who will manage the treatment, assess functional abilities, and determine when the injured employee achieves maximum medical improvement.

WSI requires a referral for therapeutic treatment if the PTP is not a physiotherapist. Initial therapeutic treatment of a claim does not require prior authorization for the first 10 visits or the first 60 days of care, whichever occurs first. WSI calls this an initial window period.

WCRI Study: Comp Physical Therapists Cut Costs

I wasn’t going to write an article about a state endorsing physical medicine providers as the primary treatment providers. Next, the Workers Compensation Research Institute published a study that shows physical therapy is a major cost-cutting factor if treatment begins very early in the claim.

Among workers with low back pain who received manual therapy, early manual therapy (within two weeks of PT care) was associated with lower costs and shorter temporary disability duration compared to late manual therapy (after two weeks of PT care). Early manual therapy was also associated with a lower likelihood of receiving magnetic resonance imaging, injections for pain relief, and opioids compared to late manual therapy.

Will other states adopt the WSI program?

We will likely see more discussion in the future about expanding their role in treating injured workers as primary medical care providers.

This blog post is provided by James Moore, AIC, MBA, ChFC, ARM, and is republished with permission from J&L Risk Management Consultants. Visit the full website at

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