County limits staff’ comp claims with movement seize tech — GCN

County limits staff’ comp claims with movement seize tech — GCN

Data sharing helps North Carolina detect workers’ comp fraud

County limits workers’ comp claims with motion capture tech

Monmouth County, N.J., is using a solution that combines biomechanical data from motion capture cameras with an artificial intelligence-based movement algorithm to detect falsified or exaggerated injury and workers’ compensation claims.

The newly patented technology from AvaSci, employs the same technology films and video games use to produce avatars to measure a person’s range of motion. The county screens people before they’re hired and after they’ve been awarded workers’ comp or disability payments to determine a baseline of their motor abilities. That way, when they claim a new injury or the worsening of an existing one, the county courts can objectively compare a new video analysis with the baseline and determine the validity of a new claim.

Historically, such analyses have been subjective, with claimants and the county each bringing their own medical professionals to court to argue their sides, said Michael Fitzgerald, county counsel. “The objectivity lends an incredible credence to what this brings to the table,” Fitzgerald said.

The current state of the art for measuring a joint’s range of motion is a goniometer, which AvaSci founder Joe Luciano says is not terribly accurate because it relies on humans to determine the exact joint position. By contrast, the AvaSci Injury Evaluation (AIE) tool connects with motion-capture cameras  and collects 100 frames per second and about 150,000 data points in one capture, he said.

“Our accuracy of where that data is less than 1 millimeter in space, and we provide a synchronized video so you can see the subject … along with the avatar, along with the data,” Luciano said. This means that a judge can see a video of the claimant moving the affected body part alongside an avatar of the movement to indicate smooth vs. jerky motion. The systems is also capturing consistency of speed and the range of motion based on Chronbach’s alpha, a measure of scale reliability.

The resultant charts for raising and lowering the arm, for example, show either a smooth oval of movement and a corresponding numeric score indicating a healthy claimant or a shape with a divot that indicates where an injury has occurred, persists or has worsened.

“We deter false claims,” Luciano said. “When people know there’s a chance they could get caught, they don’t file.”

What’s more, AIE can help workers prevent injuries from happening in the first place. In Monmouth County, job candidates in fields with a higher probability of injury undergo pre-employment evaluations/ergonomic assessments – something AIE has been augmenting. As a result, employees can learn how to do strenuous jobs safely.

“We really do want to move toward the injury avoidance,” Fitzgerald said. “If we can attend to exaggerated claims, that certainly reduces the expense to the governmental entity … but if you can avoid an injury, you avoid the expense and the employee isn’t injured. That’s a win-win.”

Monmouth County, which is self-insured, spent $5.6 million on expenses related to workers’ comp in 2020. Part of that includes reopeners, which, according to New Jersey law, means that someone collecting disability pay can return to court at set time intervals and claim that the injury has worsened and ask for a higher payment. In 2018 – the most recent data available – the state had its highest number of reopeners at 6,456 since 1990.

“We see very often these claims go on and on literally for a decade,” Fitzgerald said. “We see this technology being used at the time of the reopener so if the person feels they have an increase in their disability or injury, when they come back, we’ll have an interesting comparison of you vs. you.”

AvaSci asks job candidates in areas with a higher probability of injury to sign a release allowing the company to collect and store – currently in a database but soon in the cloud, Luciano said – their motion capture data and analysis. They go to Hackensack Meridian Health, which has a motion capture studio that AvaSci uses. (The company also offers portable three-camera systems for doing captures in the courtroom or doctor’s offices.)

The capture takes about 10 minutes, and preliminary results from the analysis are immediate. It takes AvaSci about a week to prepare a 60- to 70-page document to be used in court hearings, but the goal is to not even go to court in the first place, Luciano said.

“The largest benefit is that you want to get claims down. You don’t want to be going to court for any of this,” he said.

Workers’ comp spending has risen 23% in the past decade, but research shows that 54.3% of claims are either feigned or exaggerated.

“It’s a place where most states are practically still using calligraphy as opposed to computer strokes,” Fitzgerald said of workers’ comp. “This really does both provide objectivity, but it also is an incredible application of technology to a previously incredibly subjective arena.”

About the Author

Stephanie Kanowitz is a freelance writer based in northern Virginia.

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