Conference Coverage

Case Management Society of America / CMSA

The Case Management Society of America met in San Antonio and treated attendees to a visit to a working ranch.

FL Workers’ Compensation Claims Pros Celebrate 20th

The 20th anniversary of the Florida Workers’ Compensation Claims Professionals was held in Naples, FL.

National Work Comp Conference Looks to Future

Meeting to be Held in Las Vegas

The conference agenda for the National Work Comp conference coming to Las Vegas in November promises hot topics and a look into the future of comp.

Technology is driving everything these days and experts say that the comp system is being impacted at “lightning speed” and deciding what software will get the job done for you is a major challenge.

At this year’s national meeting the pre-conference session will bring in a panel of experts to discuss everything from “the cloud”, security issues and new developments.

It isn’t only technology that is in the future of workers’ compensation and the sometimes controversial speaker, Joseph Paduda and a panel of colleagues will take a hard look at what is coming down the road in the industry. Paduda, who is a principal with Health Strategy Associates in Madison, Conn will seek audience response in this opening general session.

The conference will feature the annual awards luncheon sponsored by myMatrixx. Companies who have turned around their costs through disability management programs will be recognized. The 2011 Theodore Roosevelt Workers’ Compensation and Disability Management Awards are presented by Risk & Insurance magazine. The conference will also include motivational and comedic speakers and the 2nd Annual National Workers’ Compensation Conference Executive Summit.

There is a large expo hall and numerous breakout session each year. To learn more about exhibiting contact Fred Kurst at 703-393-8304 or at fkurst@lrp.com. The conference is Nov. 9-11, 2011.

Trust, Leadership and Issues of the Day

Tom Nowak was the keynote speaker at the annual Southern Association of Workers’ Compensation Administers (SAWCA). One of the events was dinner at the Library of Congress. Attendees took a leisurely stroll past the Capitol to enjoy the event.

Heart of the Matter

Risk Manager Speaks of Trust,
Leadership and What Issues
Cause Him to Lose Some Sleep

By Ray Brasted
What does Tom Nowak lose sleep over? Catastrophes are what can make him toss and turn, or rather the possibility of a major event that insurers just aren’t ready to handle.

As Senior Vice President of AIG Risk Management, Inc. worrying is part of the job. “Floods and fires are happening everywhere. We seem to be living in a time when it is happening a lot. I don’t think the insurance companies have done enough to prepare,” Nowak told an audience of workers’ compensation administrators recently. “The insurance models to handle catastrophe are pretty but have they done enough?”, he questioned.

Nowak was one of the featured speakers at the Southern Association of Workers’ Compensation Administrators (SAWCA) conference, held in Washington, D.C. AIG was a prime sponsor of the meeting which was attended by administrators from southern states.

Speaking professionally as a risk manager and also as a family man dealing with personal medical issues among his own relatives, Nowak seemed to speak from the heart about what he sees happening in the industry.

On overcharges: We have audited workers’ compensation charges from Georgia, North Carolina, South Carolina, Tennessee and Texas and came up with 30% to 40% in savings. What was the matter with these bills? We hope they were just mistakes.”

On electronic filing: “We have to find a common language and make sure there is an interchange of data and information. There should be nothing that is proprietary about data. If there is, then we have a problem.”

On technology: “We live in the ‘I Want’ generation and we have to deal with that. We have to ask, why do you want it? Data cannot evolve into just another four letter word.”

On innovation: “We need to learn, once again, how to innovate and restore our country’s ability to develop new ideas.
On trust: “We have tried to legislate trust and it can’t be done. Trust occurs between people and workers’ compensation is about people.

On TPAs: Every claims adjuster should be licensed and certified in this industry and licensing regulations should have teeth for enforcement.

On physicians: “Peer review is important. Did the injured worker receive the required standard of care. Medicine is a combination of science and art and we need more doctors who want to treat the whole person. Physicians from different areas of expertise have to work together.

Nowak said his own experiences have formed some of his views on medicine. “I think the world of radiologists. A radiologist, who happened to be a woman, saved my wife’s life when she asked for a second opinion on an exam and breast cancer was discovered. My wife is doing fine, but if we had waited another year I would be telling a different story.”

Ed. Note: Tom Nowak holds the CPCU, ARM and CIDM designations and has an MBA from Pace University in New York. He also serves as an Adjunct Associate Professor of Insurance and Risk Management at the College of Insurance, New York City and teaches in the graduate and professional development programs there.

SAWCA membership includes 19 jurisdictions, 17 states, District of Columbia and the U.S. Virgin Islands. The states are Alabama, Arkansas, Delaware, Georgia, Kentucky, Louisiana, Maryland, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. Visit www.sawca.com to learn more.

Military Wounded Return, Seeking Opportunities

Laureen Doloresco of the VA Hospital in Tampa sounded a warning to Rehabilitation Nurses attending an annual conference in Florida.

Military Wounded Require a New Approach to Rehabilitation and Community Rentry.

Soldiers are surviving explosions in war at a much higher rate than ever before. Compared to the Vietnam injured who did not arrive in a U.S. hospital for up to 45 days, the solider wounded in Iraq is home in four days, according to Laureen Doloresco, MN, Associate Chief, Nursing Service for Spinal Cord Rehabilitation at James A. Haley Veterans’ Hospital in Tampa.

As a result injured military require more attention and careful diagnosis to their post-trauma care. “We have a new screening process in place to diagnose traumatic brain injury and post traumatic stress syndrome,” Doloresco told rehab nurses at their Florida State Conference held in Orlando. “The sheer force of roadside bombs can affect multiple areas of the body,” she noted.

The home made bombs often contain sharp objects designed to scatter as shrapnel. The blast itself often causes massive blunt trauma to the body. “Forty percent of the soldiers injured (in Iraq) suffer a crush injury,” Doloresco said. The result is that from one blast there are often multiple injuries, an average of four. “Traumatic brain injury is the signature injury with one fourth of the soldiers evacuated from the war zone sustaining TBI.”

In cases where the brain injury is not readily apparently, it often is not diagnosed until after the individual has returned home and family members notice a difference in personality.

From such cases, the Veterans’ Administration has developed a poly-trauma rehabilitation program designed to work with multiple injuries. There are four trauma centers in the United States; Tampa, FL, Minneapolis, MN, Palo Alto, CA and Richmond, VA.

Because of the national awareness and controversy over the war in Iraq, all of the Veterans Hospitals are working under a microscope from the media, politicians and the public. “And that is as it should be,” Doloresco said, although she admitted that it does a lot of stress and staff burnout.

The Veterans’ Administration has changed the way it operates to meet the needs of the “Millennium Generation” those in their early twenties. The VA has put in internet cafes, provides 24-7 visiting hours and, in Tampa, opened the Fisher House to provide a home away from home for military family members. There is also an assigned recovery coordinator for each patient.

Doloresco said that family members sit in on therapy sessions, provide input into care and learn how to perform procedures at home. “We are getting hyper-vigilance from the families,” she told the rehabilitation nurses.

The Veterans’ Administration has also taken on the role of providing the needed training an emotional support of the medical staff who work in the VA setting. “As rehabilitation nurses, we can expect to be providing care for these young men and women for many years to come. The greater lesson is that it is one way we can continue to honor our heroes,” Doloresco concluded.

Severely Injured Soldiers Will Require More Rehabilitation

Rehabilitation Nurses meeting in Orlando were educated on the rehabilitation needs of returning soldiers who have sustained limb loss. Shown are past presidents of FSARN.

Rehab Wars: Working with Returning Amputees

Kevin Carroll, is a prosthetist and researcher who has worked closely with returning injured soldiers from Iraq and Afghanistan. He is Vice President of Prosthetics for the Hanger Corporation and shared his knowledge and experience with attendees at the annual Florida State Association of Rehabilitation Nurses (FSARN) recently.

Carroll said that the war in Iraq is fought with roadside bombs that result in blasts that cause multiple amputations and brain injury. Returning soldiers with those types of injuries can require several years of rehabilitation to function well in society on prosthetic limbs.

“We have had soldiers who were blown up who spent two years in their power chair,” Carroll said, noting that often the high end and expensive prosthetic limbs remain in a closet, unused. “We asked them, are you willing to move away from the chair,” Carroll said.

If the person who has multiple amputations is willing, there is a commitment that has to be made that includes using low-tech, short legs to build up muscle strength, coordination and balance. “Then we start using longer prostheses and at the same time, we teach them how to fall, because they will,” Carroll noted.

He included video of some of his patients learning to walk up and down stairs, on grass, an escalator and on a hilly golf course. There are also lessons in how to fall and how to get up…. and how to get used to the stares when going out in public.

“The military wants to spend money to help the soldiers,” Carroll pointed out, but he added that a $120,000 limb doesn’t do any good if the individual is not taught how to use it correctly. When the individual does learn, the results can be amazing.

Rehabilitation nurses at the conference expressed awe at seeing young soldiers playing golf, driving manual shift sports cars and running races on their above-the-knee prostheses.

When asked what they could do, Carroll told the rehab nurses to let the insurance companies know the time and dedication it will take to rehabilitate individuals with multiple limb loss and medical complications from bomb blasts. “These young men and women just need to know there is someone in their corner,” he told the audience.

Ed. Note: Kevin Carroll, MS, CP, FAAOP is Vice President of Prosthetics at Hanger, an author and researcher. He is based in Oklahoma City, OK.