A coalition of advocates to transform workers' compensation and disability management is sprouting up across the country. It is now active in 10 states. If you seriously want workers' comp to serve employee and employer better, check this out.
With more than 20 years in workers' comp, I've never detected a genuinely grassroots pulse. But here it is. Reform generally means legislation, and the "Sixty Summits" coalition has no legislative agenda, not yet. The coalition is seeking another kind of reform: to change our professional expectations and norms.
Sixty Summits aims to dramatically change the way in which a worker, her doctor, her employer and the insurer behave about disability. The current mode, thickly woven into professional practice, allows and even encourages self-destructive conflict.
The coalition's de facto leader says we need to "propagate a new model in people's minds," not just for workers' comp but also for nonwork disability. As it is, hundreds of thousands of Americans each year become needlessly disabled from a productive life.
That leader would be Wayland, Mass.-based physician Dr. Jennifer Christian. Her fervor has animated a wave of collaboration to hold at least 60 summit meetings throughout the country. "Disability is a team sport, but we have not been playing as a team," Dr. Christian says.
Dr. Christian is board certified in occupational and environmental medicine and has worked for insurers and employers.
Among the other players in the coalition is Robin Nagel, who runs Kaiser Permanente's disability management program. "Workers' compensation has been a train wreck," Nagel says. She's involved in California and Oregon workers' comp issues.
In Minnesota, Scott Sexton of CorVel Corp., the managed-care firm, wants his state's planned summit to recognize the "incredibly helpful" stay-at-work/return-to-work guide that the American College of Occupational and Environmental Medicine published last year.
Another coalition supporter, Kathy Diaz, runs a self-insurance pool in New Mexico. "Case law has prohibited spontaneous, direct contact between doctor and employer," she notes.
After one summit in Albuquerque, N.M., in September 2006 for 75 stakeholders, workers' comp regulators distributed the ACOEM guide. Diaz, Sexton and Nagel are pushing for programs to educate doctors on how to talk with their adult patients about life at work.
Dr. Robert Orford, a physician with a Mayo clinic in Phoenix, hits on a common theme: The need "to increase awareness of how rarely work disability is medically required." He wants an Arizona summit to lead to specific steps to remove contention.
Christian and her several hundred colleagues are seeding soil, expecting much grass, some flowers and a few apple trees, but no oaks initially. This is an authentic grassroots strategy. It could work. I expect soon to see regulators trying harder to demilitarize the disability war zone in workers' comp.
The coalition is partly spurred by two shifts in professional circles. One is the decision of organized occupational physicians to become more active in pushing their perspective. The other is the growing influence of integrated disability managers in large employers.
Both of these groups see how poor, conflict-laden decisions about disability hamper or even wreck erstwhile productive lives. Confidently, they aim to change how we behave about work and disability, regardless of cause and severity.
PETER ROUSMANIERE, a Vermont-based consultant and writer, is the workers' comp columnist for
Risk & Insurance®.
May 1, 2007
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