Up to 40 percent common tests to determine nerve and muscle function of injured workers may be inaccurate, according to research by Parsippany, NJ-based One Call Medical.

The firm spotlighted problems with nerve conduction studies (NCS) used to evaluate the function of the motor and sensory nerves, and electromyography (EMG) used to examine health of muscles and nerves controlling the muscles.

One Call, which does diagnostic testing for workers' compensation said its research was based on information gathered from studies performed by providers outside of the One Call Medical network.

When EMG and NCS are performed incorrectly injured workers may undergo unnecessary surgeries, or may not undergo surgery when they should, according to the company.

Without high quality standards and qualified test administrators, care is substandard, return to work is delayed, and payors are exposed to hundreds of thousands of dollars in additional claims costs, One Call said.

The concern said that research has shown that carpal tunnel syndrome is the leading diagnosis for lost time at work and noted that a misdiagnosis or incorrect treatment plan dramatically impacts the length of time an injured worker may be out of work.

It cited figures from the National Council on Compensation Insurance, that on average a well managed carpal tunnel syndrome claim typically costs about $8,000, while a poorly managed claim costs nearly $37,000.

Dr. John Robinton, One Call Medical's medical director and chairperson of the Neurodiagnostic Medical Advisory Board, said, "The good news is, we know that by carefully selecting a highly qualified physician provider network and implementing a continuous quality improvement program, accuracy can be improved which leads to better patient return to work outcomes."

As an example, he said, monitoring limb temperature is essential to obtain an accurate reading. "Through extensive quality improvement initiatives, we've been able to improve compliance with this basic guideline from 14 percent in 1999 to 83 percent in 2008."

Call Medical Said there are steps, which can be taken that can solve the problem of inaccurate EMG and NCS testing.

The company said it has reacted by creating a network of neurologists and physiatrists who are credentialed on the quality of their reports.

First Call also mentioned development of quality standards through its Medical Advisory Board and implementing a quality improvement program of ongoing monitoring.

One Call Medical, Inc. (OCM), is a specialized Preferred Provider Organization.

Special Reports /

Many Comp Injury Tests Flawed, Says Oversight Firm

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