2016 NWCDC

Technology Gives the Gift of Movement

Advanced medical technology is costly, but greatly improves quality of life for workers with catastrophic injuries.
By: | December 1, 2016 • 2 min read
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The ability to stand and walk unassisted is something most of us take for granted, but many catastrophically injured workers face a lifetime either confined to a wheelchair or relying on a prosthetic to help them move.

Luckily, advancements in medical technology are making movement easier.

Mark Sidney, VP, claims, Midwest Employers Casualty Co., and Clare Hartigan, project manager, Virginia C. Crawford Research Institute, Shepherd Center, discussed these advancements at a Thursday afternoon NWCDC session titled “The Bionic Claimant: Emerging Medical Technology’s Impact on Care and Cost.”

“Psychologically, being able to stand and look someone in the eye is a big deal.” — Clare Hartigan, project manager, Virginia C. Crawford Research Institute, Shepherd Center

Technology like myoelectric prostheses and exoskeletons can drastically improve quality of life for catastrophically injured workers, restoring some functionality and a sense of independence.

But this high-tech equipment comes with a hefty price tag.

Myoelectric devices, which use sensors and bioelectric signals to move the limb, can cost as much as $100,000. Exoskeletons are in the same ballpark, and this doesn’t include maintenance or the cost of replacing a device every five years or so.

“The difference in cost between a standard prosthetic and a myoelectric can be $1 million over the lifetime of a claim,” Sidney said.

More long-term studies are needed to prove the medical necessity of this technology, but the benefits are already clear.

“Just being able to get up and move leads to muscle strengthening and improved blood cholesterol and glucose levels,” Hartigan said.

“Psychologically, being able to stand and look someone in the eye is a big deal.”

To determine when a myoelectric device or exoskeleton is appropriate, workers’ compensation professionals should look at the patient’s lifestyle. What type of activities do they do? Are they more happy indoors or out? How often will they use their device?

Ultimately, it comes down to whether or not this advanced machinery will enable them to do things that are impossible with standard devices.

Katie Siegel is a staff writer at Risk & Insurance®. She can be reached at [email protected]
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2016 NWCDC

Addressing Behavioral and Social Issues

Identifying and understanding an employee's behavioral and social issues will enhance recovery.
By: | December 1, 2016 • 2 min read
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Understanding how an employee feels about their job and their surroundings can hold one of the keys to their recovery, according to a workers’ compensation medical expert.

And using a three-pronged approach to addressing a disabled worker’s recovery helps return employees to the job faster, said Dr. Marcos Iglesias, vice president and medical director at The Hartford.

To improve success, add new approaches to better identify and understand an employee’s behavioral and social issues, Iglesias said during a mega session, “Preventing Prolonged Disability by Assessing and Eliminating Psychosocial Barriers,” at the NWCDC on Thursday morning in New Orleans.

About 10 percent of claims have one or more psycho-social elements, yet they account for 60 percent of costs. The bio-psycho-social model Iglesias presented gives claims managers keys to empower injured employees to return to function.

First, identify the employee’s expectation of recovery by simply asking, “When do you think you’ll return to work?” If the response is more than 14 days, the patient may be at risk of delayed recovery.

Follow up questions can then identify additional issues such as unfounded beliefs about the injury or care, catastrophic thinking and fear of future events, Dr. Iglesias said.

Another barrier could be an employee’s perceived injustice related to the injury and treatment. To identify if an employee is laboring under a possible misconception, ask why they think the injury happened.

Questions about the patient’s condition, he said, should steer away from pain and focus on function: “What are you able to do today that you couldn’t do last week?”

Employees must feel empowered to recover. Passivity, a belief that someone else such as a doctor or spouse, is in control of the injured worker’s return to work could be a red flag, Dr. Iglesias said.

Ask: “What do you like about work; what about your job do you look forward to?”

Disabled workers identified as at risk may benefit from a team of dedicated coaches who offer a functional restoration program that addresses not only medical concerns but also any behavior and social barriers that hamper return to work, he added.

Juliann Walsh is a staff writer at Risk & Insurance. She can be reached at [email protected]
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Hot Hacks That Leave You Cold

Cyber risk managers look at the latest in breaches and the future of cyber liability.
By: | December 1, 2016 • 5 min read

Nationwide_SponsoredContent_1016Thousands of dollars lost at the blink of an eye, and systems shut down for weeks. It might sound like something out of a movie, but it’s becoming more and more of a reality thanks to modern hackers. As technology evolves and becomes more sophisticated, so do the occurrence of cyber breaches.

“The more we rely on technology, the more everything becomes interconnected,” said Jackie Lee, associate vice president, Cyber Liability at Nationwide. “We are in an age where our car is a giant computer, and we can turn on our air conditioners with our phones. Everyone holds data. It’s everywhere.”

Phishing Out Fraud

According to Lee, phishing is on the rise as one of the most common forms of cyber attacks. What used to be easy to identify as fraudulent has become harder to distinguish. Gone are the days of the emails from the Nigerian prince, which have been replaced with much more sophisticated—and tricky—techniques that could extort millions.

“A typical phishing email is much more legitimate and plausible,” Lee said. “It could be an email appearing to be from human resources at annual benefits enrollment or it could be a seemingly authentic message from the CFO asking to release an invoice.”

According to Lee, the root of phishing is behavior and analytics. “Hackers can pick out so much from a person’s behavior, whether it’s a key word in an engagement survey or certain times when they are logging onto VPN.”

On the flip side, behavior also helps determine the best course of action to prevent phishing.

“When we send an exercise email to test how associates respond to phishing, we monitor who has clicked the first round, then a second round,” she said. “We look at repeat offenders and also determine if there is one exercise that is more susceptible. Once we understand that, we can take the right steps to make sure employees are trained to be more aware and recognize a potentially fraudulent email.”

Lee stressed that phishing can affect employees at all levels.

“When the exercise is sent out, we find that 20 percent of the opens are from employees at the executive level,” she said. “It’s just as important they are taking the right steps to ensure they are practicing what they are preaching.”

Locking Down Ransomware

Nationwide_SponsoredContent_1016Another hot hacking ploy is ransomware, a type of property-related cyber attack that prevents or limits users from accessing their system unless a ransom is paid. The average ransom request for a business is around $10,000. According to the FBI, there were 2,400 ransomware complaints in 2015, resulting in total estimated losses of more than $24 million. These threats are expected to increase by 300% this year alone.

“These events are happening, and businesses aren’t reporting them,” Lee said.

In the last five years, government entities saw the largest amount of ransomware attacks. Lee added that another popular target is hospitals.

After a recent cyber attack, a hospital in Los Angeles was without its crucial computer programs until it paid the hackers $17,000 to restore its systems.

Lee said there is beginning to be more industry-wide awareness around ransomware, and many healthcare organizations are starting to buy cyber insurance and are taking steps to safeguard their electronic files.

“A hospital holds an enormous amount of data, but there is so much more at stake than just the computer systems,” Lee said. “All their medical systems are technology-based. To lose those would be catastrophic.”

And though not all situations are life-or-death, Lee does emphasize that any kind of property loss could be crippling. “On a granular scale, you look at everything from your car to your security system. All data storage points could be controlled and compromised at some point.”

The Future of Cyber Liability

According to Lee, the Cyber product, which is still in its infancy, is poised to affect every line of business. She foresees underwriting offering more expertise in crime and becoming more segmented into areas of engineering, property, and automotive to address ongoing growing concerns.”

“Cyber coverage will become more than a one-dimensional product,” she said. “I see a large gap in coverage. Consistency is evolving, and as technology evolves, we are beginning to touch other lines. It’s no longer about if a breach will happen. It’s when.”

About Nationwide’s Cyber Solutions

Nationwide’s cyber liability coverage includes a service-based solution that helps mitigate losses. Whether it’s loss prevention resources, breach response and remediation expertise, or an experienced claim team, Nationwide’s comprehensive package of services will complement and enhance an organization’s cyber risk profile.

Nationwide currently offers up to $15 million in limits for Network Security, Data Privacy, Technology E&O, and First Party Business Interruption.

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Products underwritten by Nationwide Mutual Insurance Company and Affiliated Companies. Not all Nationwide affiliated companies are mutual companies, and not all Nationwide members are insured by a mutual company. Subject to underwriting guidelines, review, and approval. Products and discounts not available to all persons in all states. Home Office: One Nationwide Plaza, Columbus, OH. Nationwide, the Nationwide N and Eagle, and other marks displayed on this page are service marks of Nationwide Mutual Insurance Company, unless otherwise disclosed. © 2016 Nationwide Mutual Insurance Company.

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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 Nationwide. The editorial staff of Risk & Insurance had no role in its preparation.




Nationwide, a Fortune 100 company, is one of the largest and strongest diversified insurance and financial services organizations in the U.S. and is rated A+ by both A.M. Best and Standard & Poor’s.
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