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Abstract

Background: Neuroarthropathy is a complication of peripheral neuropathy commonly associated with diabetes mellitus. The actual trigger for a neuroarthropathy episode is unknown. If the inciting event occurred at work, causality of neuroarthropathy is difficult to determine.

Methods: In this study, the authors retrospectively reviewed workers’ compensation claims to identify patients with diabetes mellitus, peripheral neuropathy, and neuroarthropathy. The correlation between their health status and claims status was reported. The number of workers’ compensation denials for services already performed were compared between the groups.

Results: Over a five-year period, 412 patients were evaluated in a tertiary foot and ankle clinic with a worker’s compensation claim. There were five patients with neuroarthropathy, 16 with peripheral neuropathy, and 58 with diabetes. The number of patients whose claims required appeals were two, seven, and 14, respectfully. The number of appeals were seven, 17, and 29. For patients without the studied conditions, there were 95 patients that required 157 appeals.

Conclusion: Diabetes alone did not increase the number of appeals. However, the authors found that patients with peripheral neuropathy were 2.5 times more likely to have an appeal as compared to a patient without peripheral neuropathy. Patients with neuroarthropathy had three times more appeals than patients without neuroarthropathy. Neuroarthropathy and peripheral neuropathy are strong indicators of having increased appeals in patients with worker’s compensation claims. The delays and administrative burden of appeals are a financial burden on a practice.

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