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Marta J Silakka RN, BSN, CCM, COHN-S, Nurse Case ManagerMay 18, 20224 min read

No X-Ray …. No Problem

Many members and injured workers have recently encountered what seems to be a common problem; presenting to an urgent care center and finding out there is not a radiology technician working that day. We can be quick to show our frustration and blame the center for poor staffing, but there is more to this than is assumed.

Radiology technicians are in HIGH demand right now! Are your kids wondering about a career path? Health-related careers are always a good choice and right now radiology techs are in demand and are at times changing employers for pay and benefit increases. Not to mention COVID…we can blame almost everything on COVID but in this case, many folks that were nearing retirement or looking for a change…COVID was their motivator. While many technicians have moved on or out of the industry; we will catch up as programs are actively training future radiology technicians.

We have heard from many members about this issue and at times some are making referral and treatment decisions based on this issue without calling us first. We always encourage a call to us prior to the injured worker seeking medical attention, but many members have become so versed in the process they no longer call. We understand that your call to us may offer the same referral for the treatment plan you may have pursued without the call, but the call is about more than that.

Reasons to call us prior to seeking medical treatment:

  • In the event of a life-threatening emergency always call 911 and follow up with us after emergency medical services have been initiated.
  • Your call to us to report an injury allows us to start our file and assist you prior to the arrival of any paperwork.
  • There are so many options for medical care and the call to us may show that starting out with a specialty vs an urgent care is the best plan as an example
  • Members are part of our Windham managed care program and treatment in most circumstances needs to be within the managed care network.
  • During this call, we may gather other pertinent information about the injury that will assist our team in managing the claim.
  • Members can now submit the Employers First Report of Injury to us online; this call is a great way for us to introduce the process to you.
  • Given the current situation with the lack of radiology technicians at some urgent care centers; the call to us is very important for planning medical care.

The title of my article…No X-Ray…No Problem…. yes, that can be the case! Because of the current situation, this is the top reason to give us a call right now prior to assisting your injured employee in seeking medical treatment.

  • Not all injuries require x-rays. The common assumption is they do but in reality, providers are driven by their thorough medical exam to determine if an x-ray should be ordered or not.
  • The Emergency Room always has x-rays, right? Yes, that may be true, but it is not the right choice for several reasons:
    • Emergency rooms are for emergencies – non-emergencies “clog” up the system and keep the flow of care from those that need it most.
    • Emergency room visits can cost up to 10 times more than an urgent care visit
    • Emergency room wait times can be endless. This means time lost from work for the injured worker as well as their ride in some cases.
    • Emergency room visits often end without answers; many patients not in an emergency situation will be evaluated and referred back to their primary care providers or other care settings.
    • Emergency rooms lead to more lost time from work. Not only is there the time spent at the emergency room but very often the provider will write the injured worker out of work rather than releasing them to light duty pending their re-evaluation with an outside provider. To sum this one up; a simple medical only claim can become a lost time claim for you; which ultimately may affect your Experience Modification Rate and your rebate.
  • If the x-ray is necessary and there doesn’t happen to be a technician on duty; what happens?
    • Providers who temporarily do not have x-ray capabilities have a plan in place. It may be having the x-ray done at another location. This is OK. A short drive to another facility for the x-ray is far less of a burden timewise and financially than a drive to the Emergency Room.
    • In the case of same-day treatment at 2 similar providers for the purpose of an x-ray doesn’t mean double the cost. The urgent care that assessed the injured worker will charge for the exam and the site that is used just for the x-ray will only charge for the x-ray.
    • The x-ray may be deferred to the next day; in this case, often the acute phase of the initial injury may have passed and a repeat exam shows the x-ray is no longer indicated.

We are certainly experiencing some crazy times recently between COVID-19 and shortages of some necessary items to high gas prices; lack of a radiology tech doesn’t have to be a problem. This is one thing we can help fix or at least have a solution that will not mean increased medical costs or lost time from work. Remember; we are here to assist with all things workers’ comp; especially these little bumps in the road. We are constantly communicating with providers and by being kept up on what they are dealing with we can better assist our members in always being able to access the highest quality medical care for your injured workers.

Give the Claims Team a call anytime at 603-224-2369; we are happy to help.


Marta J Silakka RN, BSN, CCM, COHN-S, Nurse Case Manager

As the Nurse Case Manager for the Workers Comp Trust; Marta oversees the medical management of the injured workers claims. She assists in referrals within the managed care network and maintains communication between the injured worker, medical providers, employers, and the claims team. Marta also writes for Drive: NH with a focus on health related issues and case management topics. Outside the office she enjoys cooking and organizing social functions for her friends and family as well as spending time with her dogs.