At the 2015 Harbor Health MPN Medical Director meeting, Dr. John Robinton from One-Call discussed concerns around the use of neurodiagnostic studies. This focused on the use of nerve conduction studies and EMGs. EMGs and nerve conduction studies can provide information about the site of the pathology, the causal relationship to work, and the severity of the pathology. One main concern around these studies is the fact they are often over used by medical providers. Some of the other concerns include: Who does the studies? There are credentialing organizations for someone to be board certified to conduct EMGs and to
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At the 2015 Harbor Health MPN Medical Director Meeting, Dr. Ted Blatt from Harbor Health discussed some of the best practices for physicians in the workers’ compensation system and how outcomes-based networks are changing workers’ compensation. Some of his best practices recommendations included: Engage the patients in thinking about their recovery, not about disability. Focus on rehabilitation and not limitations. Look to establish a partnership with the claims administrator and the employer. Physicians need to accept accountability for the management and outcome of the case. They cannot wash their hands on the outcomes. Good communication must be maintained with all
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Dave North from Sedgwick opened the Harbor Health Systems 2015 MPN Medical Directors meeting with a keynote address discussing the need for change in our approach to workers’ compensation claims handling. It is important for us to keep perspective of the scope of what we do in workers’ compensation.  Every day in California, 850 people will report a workers’ compensation injury. Our role is to be there to help those people recover from those injuries and resume their lives. From the moment a claim is first reported, the injured worker is already embedded in the system. Someone has already made
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At the 2015 California Coalition on Workers’ Compensation Conference, Denise Zoe Algire from Safeway and Dr. Lawrence Miller from Anthem Workers’ Compensation presented a session entitled California MTUS: Past, Present Future. The primary goal of adopting treatment guidelines should not be cost containment. The primary goal should be to expedite the injured worker receiving the appropriate treament.  The MTUS guidelines have been in place for a number of years and they are specific to California.  Treatment guidelines should follow evidence-based medicine, which is healthcare based on clinical studies of which treatments are the most effective for different conditions. Recently, we
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At the 2015 California Coalition on Workers’ Compensation Annual Conference, Dr. David Hall and Marc Liebowitz from the law firm Laughlin, Falbo, Levy & Moresi presented a session titled, “Psych/Stress Claims – How Not to Go Crazy Just Because Your Employee Did.” This session addressed the interplay between medical and legal issues in California with the defense and timely resolution of psychiatric claims. Understanding what drives a psych claim: Money. Time away from work. Resonse to physical injury. Frustration at work. Catalyst for non-industrial issues to be aggrivated or exacerbated. Certain personality types lend themselves to someone who will file
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An all-star cast was in place to discuss the medical marijuana trend at the SAWCA 67th Annual Convention. Paul Tauriello, Colorado Director of Workers’ Compensation, opened the session with an overview of Colorado’s medical marijuana industry, which ended the 2014 year with sales of approximately $386 MM. He noted that getting qualified applicants for law enforcement and related positions has been tough due to drug testing requirements and that this could be a concern in the future. Paul introduced Michael Newman, a 21-year old student who overcame cancer and used FDA-approved Marinol to control his nausea while fighting and overcoming
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At the 2015 California Coalition on Workers’ Compensation Annual Conference (CCWC), a panel discussed the pros and cons of a state-adopted pharmacy formulary. Panelists included Dr. Bernyce Peplowski and Alex Swedlow from CCWC and Brenda Wood and Karen Caterino from Healthcare Solutions. A workers’ compensation formulary is designed to be specific for industrial injuries and provides a list of drugs that will be reimbursed without prior authorization or adjuster approval. Drugs not included in the formulary require pre-authorization prior to being dispensed. If the formulary is set up properly, it will reduce administrative burden and costs and ensure that the
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Wednesday, July 22nd was an action-packed day at the SAWCA 67th Annual Convention. The day began with cyber discussions led by Bary Dalton from Federal Reserve Bank – Richmond, and Susan Gordon from Zurich NA. This session provided insight on the current cyber threats and why this has emerged so quickly in the marketplace. As businesses try to connect to customers, suppliers and other users, they have expanded their potential access points thereby expanding the opportunities for hackers to penetrate businesses information and data systems. The expected insurance growth in cyber and cyber-related insurance will increase from approximately $2 billion
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At the 2015 California Coalition on Workers’ Compensation Annual Conference, a panel discussed the huge disparity in claims costs between northern and southern California.  The panel consisted of: Alfonso Moresi – Commissioner, Workers’ Compensation Appeals Board and partner in law firm Laughlin, Falbo, Levy and Moresi Richard Newman – Chief Judge for the California Department of Industrial Relations Mark Priven – Principal with Bickmore Risk Services The litigation rates in Southern California are much higher than the rest of the state, accounting for approximately 75% of the total court opening filings statewide. Along the same lines, the number of workers’
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The 2015 California Coalition on Workers’ Compensation Annual Conference (CCWC) kicked off with a Legislative and Political Update presented by Paul Yoder and Jason Schmelzer from CCWC. In the last year, there have been four out of 40 members of the State Senate who were suspended for misconduct. This resulted in the Democrats losing their super majority in the Senate. Governor Brown is in his fourth and final term as Governor. Although he does not plan on running for any additional political offices, he has almost $20 million in campaign funds in the bank. He retains a 52% approval rating
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