NWCDC Chairman's Message

Deadline Nears for NWCDC Speaker Proposals

Time is almost up for submitting speaker proposals for the 2016 National Workers’ Compensation and Disability Conference & Expo.
By: | February 4, 2016 • 3 min read
NWCDC 2014

Don’t miss the approaching deadline for submitting proposals to speak at the 25th annual National Workers’ Compensation and Disability Conference® & Expo.

NWCDC is attended by workers’ comp and disability management decision makers, including employers and a broad range of service providers.

Last year’s speakers and the ideas they presented at NWCDC in Las Vegas remained hot topics and received mentions in workers’ comp and disability management industry media and social media for many months following the conference.

The only way to qualify is to begin by meeting the deadline for submitting a session proposal idea. The deadline is Friday, February 26, with applications available on the conference website.

After being held in Las Vegas for many years, the conference will shift venues for 2016, taking place Nov. 30 through Dec. 2 at the New Orleans Ernest N. Morial Convention Center.

Potential topic proposals that NWCDC’s speaker selection committee is eager to evaluate include:

  • Injured employee advocacy strategies
  • Urine drug testing and its coordination with pharmacy benefit management strategies
  • The application of value-based care, including accountable care organization use.
  • Medical guidelines, and how best to apply them.
  • Occupational and non-occupational return-to work-strategies meeting ADA compliance.
  • Pharmacy formularies and claims management opportunities.
  • Psych claims and managing psych issues embedded within claims.

Those are just a few of the topic areas we are interested in hearing about from employers, vendors, attorneys, medical providers, regulators and other workers’ comp professionals. We are eager to hear other great topic ideas.

Overall, the conference looks for panels and individual speakers to present strategies that will help worker’s comp and disability claims payers solve claims challenges, teach best practices for selecting and managing service providers, or can enlighten on industry trends.

Presentation proposals can focus on new, innovative strategies that reduce injuries and costs. But risk managers, workers’ comp managers, and disability managers are also welcome, for example, to share their unique experiences with adopting tried-and-true practices at their companies.

Disability management strategies for workers’ comp and non-occupational drivers of employee absence are of interest to us.

If you or your company plans to submit a proposal for a session presentation, please keep in mind that we do prioritize those submissions that include an employer on the panel.

However, we also understand that not all presentations can include an employer speaker and we value the knowledge and information that other workers’ comp professionals serving the payer community bring to the conference.

Here is some advice to increase the potential for having your RFP selected:

  • Consider submitting multiple RFPs because we sometimes receive several proposals from different companies wishing to speak on the same topic. We may only select one presentation per topic in such cases. Submitting multiple RFPs provides an alternative when one of your ideas is a popular one among several submitters.
  • Select topics with relevance for a broad range of workers’ comp professionals. The greater the relevance and the stronger the speaker’s experience and knowledge, the greater the possibility of being selected.
  • Avoid submitting proposals that are mere product or service pitches featuring company personnel responsible for sales or marketing.

For further discussion on potential presentation content, feel free to contact Conference Chairman Roberto Ceniceros at (208) 286-1425 or rceniceros@lrp.com.

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at rceniceros@lrp.com. Read more of his columns and features.
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Aging Workforce

The Impact of the Changing Workforce on Disability

A new study suggests that both age and job tenure impact disability durations for injured workers.
By: | January 29, 2016 • 5 min read
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The aging of the workforce combined with the changing nature of work has led to some changes in disability durations. New information suggests steps employers can take to get faster returns to work for certain employees.

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“Findings indicate that age is a more important factor in disability duration than tenure; however, the relationship between age and disability duration varies based on tenure, suggesting that both age and tenure are important influences in the work disability process,” according to a new study.

Researchers looked at claims for a private workers’ comp insurer to analyze age of workers and tenure of work as they relate to disability durations.

The authors used data from Jan. 1, 2002, through Dec. 31, 2008. Only claims with at least one day of lost work time were included. The lost time comprised days for both partial disability and days of temporary total disability for workers aged 18 to 80.

A total of 361,754 claims were analyzed, of which 31 percent were for women, 50 percent had an annual income greater than $30,000, and 27 percent were involved in litigation.

The study looked at both age and job tenure — and the two in combination — in relationship to average lengths of time off for injured workers. It is one of the only studies that analyses how disability durations are affected by changes in the workforce.

“This is an especially important time to examine relationships among age, tenure, and the length of disability,” the authors noted. “At the same time that the workforce is aging, the typical career trajectory is also changing.”

According to the latest government statistics, the percentage of workers at least aged 55 is expected to be more than 25 percent in 2020 compared with just 12 percent in 1990.

Also changing is the length of time individuals typically spend at a single company. Instead of staying with one employer for an entire career, people now typically change their employers or careers several times. This is especially true for older male workers, where the median tenure for those 55 to 64 years old fell from 15.3 years in 1983 to 9.5 years in 2006.

“At the same time that the workforce is aging, the typical career trajectory is also changing.”

The study looks at the interplay between age and tenure and length of disability durations. It was published in the Journal of Occupational and Environmental Health and based on research by several academics and Dr. Glenn S. Pransky, director of the Liberty Mutual Research Institute’s Center for Disability Research.

“Age-related changes in recovery time after any type of condition are likely to play a major role in this relationship, but to the extent that other factors might also influence this relationship might have the potential to inform interventions and treatment plans,” the report states. “With the continued aging of the workforce and the changing nature of career paths, furthering our understanding of how and why age and tenure influence the work disability process is important.”

Results

Previous research has shown disability duration increases with age, along with the likelihood of work-disability recurrence. The chances of never returning to work also increase with age.

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The authors speculate that may be due to biological changes associated with aging and a higher incidence of comorbidities that complicate recovery.

Also, there is evidence that older workers may have less access to rehabilitation services, employers may not encourage older workers to return to work, and older workers may be in industries with fewer opportunities for accommodations to facilitate return to work.

Studies also indicate the length of disability generally decreases the longer a person spends at a job. However, the results of the study indicate that does not necessarily hold true for older workers.

For workers on the job less than five years, disability duration increases with age until age 70 when the length of disability decreases slightly to age 80. The same is true of workers with more than 10 years on the job — until age 70.

“Prior to age 70, as tenure increased, the predicted length of disability decreased; however, after age 70, as tenure increased, the predicted length of disability began to increase,” according to the study. “In general, the highest predicted length of disability was for the oldest workers with high tenure, whereas the shortest predicted length of disability was for younger workers with the lowest tenure.

The authors found that when taken separately, the relationship between age and length of disability was stronger than the relationship of job tenure and disability duration. However, when the tenure relationship was adjusted for age, the relationship was significantly different than unadjusted for age.

“The predicted length of disability was the shortest for midlife workers with high tenure compared with low tenure,” the study said. “For workers in the typical retirement ages of 65 to 70, the predicted length of disability was found to vary very little across the tenure groups, but by age 80, the predicted length of disability varied by approximately a week, with lower tenure workers having a shorter predicted length of disability than high-tenure workers.”

The authors speculated that older workers on the job longer may feel secure enough in their positions to stay out of work longer after an injury or illness. But older workers on the job a short time might try to return to work sooner for fear of losing their jobs and their inability to find additional work.

Implications

“From a clinical perspective, our results point to the need to gain a better understanding of the factors leading to the relationship between age and the length of disability,” the authors noted. “Age-related changes in recovery time after any type of condition are likely to play a major role in this relationship, but to the extent that other factors might also influence this relationship might have the potential to inform interventions and treatment plans.”

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Employers may be less willing to provide appropriate accommodations for older workers to return to their jobs, according to the authors. Also, older workers might need more support from their companies to navigate the workers’ comp system.

“These workers might be less familiar with the resources available to them and might not have strong organizational and supervisor relationships to rely on,” the authors explained. “From an intervention perspective, it might be important to identify what types of programs and policies would be most helpful in these workers’ RTW process.”

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at riskletters@lrp.com.
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Sponsored: Liberty Mutual Insurance

The Doctor as Partner

Consulting clinical expertise can vastly improve disability and absence management outcomes.
By: | January 4, 2016 • 6 min read

Professionals helping employees return to work after being on disability or a leave of absence face many challenges. After all, there is a personal story behind each case and each case is unique.

In the end, the best outcome is an employee who returns to the job healthy and feeling well taken care of, while at the same time managing the associated claim costs.

Learn what most employers want from their group disability and life benefits program.

While many carriers and claims managers work toward these goals, in the end they often tend to focus on minimizing costs by aggressively managing claims to get the worker back on the job, or they “fast track” claims, approving everything and paying little attention to case management.

Aggressively managed claims can leave many employees and their doctors feeling defensive and ill-at-ease, creating an adversarial relationship that ultimately hinders return to work and results in higher direct and indirect employee benefit costs for the employer. Fast track or non-managed claims can lead to increased durations, costs and workforce productivity issues for employers.

Is it possible to provide a positive employee benefit experience while at the same time effectively managing disability and lowering an employer’s overall benefit costs?

A Unique Approach

Yes.

Liberty Mutual Insurance’s approach to managing disability and absence management focuses on building consensus among all stakeholders – the disabled employee, treating physician, employer and insurer. And a key component of this process is a large team of consulting physician specialists, leading practitioners from a variety of specialties, highly regarded experts affiliated with leading medical universities across the country.

“About 16 years ago, our national medical director, Dr. Ed Crouch, proposed that if we worked with a core group of external consulting medical specialists – rather than sending most claims for Independent Medical Evaluations – we could do a better job making disabled employees and their attending physicians comfortable, and therefore true partners in producing better disability management outcomes and employee benefit experiences,” said Tim Kastrinelis, senior vice president, Distribution Partnerships at Liberty Mutual Benefits.

“In this way, our consulting physician and the attending physician are able to work with the disability case manager, the employee and the employer to deliver a coordinated, collaborative approach that facilitates a productive lifestyle and return to work.”

The result of Dr. Crouch’s initiative has produced positive results for the clients of Liberty Mutual Insurance. This consensus building approach to managing disability with consulting physician expertise has helped achieve industry leading client retention results over the past decade. In fact, 96 percent of Liberty Mutual’s group disability and group life clients renew their programs.

LM_SponsoredContent“By getting all stakeholders on the same page and investing heavily in consulting physician specialists, we have been able to lower claim costs and shortened claim duration for our group disability policyholders. …In the end, it’s a win-win for all.”
–Tim Kastrinelis, Senior Vice President, Distribution Partnerships, Liberty Mutual Benefits

A Collaborative Approach

In the case of complex disability medical health situations, Liberty Mutual’s disability case managers play a vital role in seeking additional expertise—an area where the industry’s standard has been to outsource the claimant for independent medical examinations.

However, Liberty Mutual empowers its disability case managers with the ultimate responsibility for the outcome of each claim. The claimant and the case manager stay together throughout the life of the claim. This relationship is the foundation for a collaborative approach that delivers a better employee benefit experience and enables the claimant to return to work sooner; which more effectively controls total disability claim and absence costs.

Sending a disabled employee with complex medical needs to an external specialist may sound like a cost-effective path, but it often comes at the cost of sacrificing the relationship and trust built between the employee and case manager. The disabled employee must explain their medical history to a new clinician, which he or she is often reluctant to do. The attending physician may be uncooperative as this move can appear to question his or her treatment plan for the employee.

As a result, the entire claims process takes on an adversarial atmosphere, building major roadblocks to the ultimate goal of helping the claimant return to a productive lifestyle.

Liberty Mutual takes a different approach. Nearly 100 physicians representing more than 30 medical specialties are available to consult with its medical and claims professionals, working side-by-side with case managers.

More than 95 percent of these consulting physicians are in active practice, and therefore up-to-date on the latest clinical best practices, treatment guidelines, therapies, medications, and programs. Most of these physicians are affiliated with leading medical universities across the country. “We recruit specialists from around the country, getting the best from such prestigious institutions as Harvard, Yale, and Duke,” said Kastrinelis.

These highly-credentialed physicians help case managers focus on providing the support needed for the disabled employee to successfully return to work as quickly as appropriate. Their collaborative work with the attending physicians provides the behind-the-scenes foundation that leads to a positive claimant experience, results in a better outcome for the claimant, and more effectively reduces total claim costs.

Coordinated Care Plan

When one of these consulting physicians reaches out to an attending physician, there’s an immediate degree of respect and high regard for his or her opinion. This helps pave the way to working together in the best interest of the employee, improving treatment plans and return to work results.

In this process, the claimant is not sent to yet another doctor; instead, the consulting specialist works with the attending physician to help fill in the gaps of knowledge or provide information that only a specialist would have. Although not an opportunity to direct care, these peer-to-peer discussions can help optimize care with the goal of helping the employee return to work.

The attending physician may have no knowledge of the challenges the employee faces in order to return to work. A return to work plan created in concert with the specialist, disability case manager, employer, and attending physician can set expectations and provide the framework for a proactive and effective return to a productive lifestyle.

“Our consulting physicians bring sophisticated medical expertise to the discussion, and help build consensus around a return-to-work plan, helping us more effectively impact a claim’s outcome and costs, and at the same time provide a better claimant experience,” said Kastrinelis.

“We can work more collaboratively with the attending physician, manage expectations, and shepherd the employee through the process much more effectively and in a much more high-touch, caring, and compassionate manner. Overall, we’re able to produce better outcomes as a result of this consensus building approach.”

Better Outcomes

“Our approach – including the use of consulting medical experts – helped us significantly reduce disability costs over two years for one large health service company,” notes Kastrinelis. “We cut average short-term disability claim durations by 4.2 days in that time, while increasing employee satisfaction with our unique disability management model and collaborative, partnership approach.

How did Liberty Mutual’s unique approach lower claim costs, reduce disability duration and improve the benefit experience for one customer?

“By getting all stakeholders on the same page and investing heavily in consulting physician specialists, we have been able to lower claim costs and shortened claim duration for our group disability policyholders,” said Kastrinelis.

“Plus, we, the employee, and the employer also get the bonus of creating a better employee benefit experience. This model has shaped our disability and absence management program to more aptly reflect our core mission of helping people live safer, more secure lives. In the end, it’s a win-win for all.”

How does Liberty Mutual provide a superior employee benefit experience?

Tim Kastrinelis can be reached at timothy.kastrinelis@libertymutual.com. More information on Liberty Mutual’s group disability and absence management offerings can be seen at https://www.libertymutualgroup.com/business-insurance/business-insurance-coverages/employee-benefits.

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This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Liberty Mutual Insurance. The editorial staff of Risk & Insurance had no role in its preparation.




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Liberty Mutual Insurance offers a wide range of insurance products and services, including general liability, property, commercial automobile, excess casualty, workers compensation and group benefits.
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