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"Going Paperless in Workers' Compensation Claims Management," "Emerging Legal Issues," "60 Tips in 60 Minutes"--these and 25 other seminars provided provocative and thoughtful discussions for the more than 750 participants at the 13th Annual National Workers' Compensation and Disability Conference, held in Chicago, Nov. 17?19, 2004.

The seminars covered key workers' comp categories such as claims management, cost reduction and loss prevention, integrated disability management, key injuries and conditions and legal issues. The seminars were designed to present information that the workers' compensation professionals, from claims managers to physicians, might encounter in their day-to-day operations, and want to learn to perform better.

For example, the Medicare Set-Aside seminar presented on the second day "was critical for me," she said, because SEPTA has been trying to put together a strategy for handling claim delays. "We can change our strategy. There are alternatives," she said. Most important, "it gave us a way to shut down the claim."

She was also especially interested in the integrated disability management sessions, such as the seminar that presented the second annual Health Care Cost Market Survey. The results of the survey of more than 770 companies showed that companies clearly plan to shift more in the direction of prevention, and expect employees to take more responsibility for their own health.

Health-productivity management initiatives will play key roles, even though only a bit more than half (56 percent) of the respondents reported they already have or are planning to add health-productivity management programs. Regardless of what plans companies adopt, their efforts will still demand a new health partnership between employees and their employers.

Romero also pointed to lost productivity as an issue SEPTA's been addressing--a common workers' comp dilemma. "The problem is, what works at one company won't necessarily work at another," she said. "Every year they come up with a slightly different idea. It's interesting to hear what other people are doing because we're always looking for new ideas," she said.

PROMOTING A SAFETY CULTURE

"How Kendall Jackson Reduced Strain Injuries by Over 40 Percent Utilizing Proactive Pre-Injury Strategies," was a seminar under the banner of "cost reduction and loss prevention."

According to Dennis Downing, president of Future Industrial Technologies, who presented the seminar, reducing a company's rising workers' compensation costs isn't as simple as popping in a safety video and pressing play.For employers to truly benefit from their safety initiatives, they must use a hands-on approach. (For more information, please see article on page 23.)

The legal seminars, among other issues, examined how the Americans with Disabilities Act and the Family and Medical Leave Act would affect workers' comp programs, and also whether the Medicare Secondary Payer Act--also known as Medicare Set-Asides--could hold up settlements. During the "Emerging Legal Issues" seminar on the first day of the conference, three practicing employment law attorneys--Matthew B. Schiff, Richard S. Powell and Sharon Murphy--discussed their current cases and the trends they see appearing on the horizon. The speakers hailed from Illinois, California and Indiana, so they were able to provide the attendees with a spectrum of the comp challenges in their respective states.

Schiff, a 13-year veteran of the conference, said the issues he is watching are Medicare Set-Asides, apportionment between work-related and nonwork-related causes, the "frequent filer" problem, overlap and conflict with the American with Disabilities Act and the Family Medical Leave Act, and the graying workforce.

Murphy and Powell added their insights on these and other issues. Murphy, for example, focused on bad faith damages, Internet scheduling and board submissions and the Indiana Workers' Compensation Board's jurisdiction. She also discussed her recent recommendation to the American Bar Association for legislative changes concerning the impact of the Medicare Secondary Payer Act on settlements. Powell, who has represented entities before the California Workers' Compensation Appeals Board and California courts, focused upon the key issues in California's 2004 legislative reform efforts, which have attracted nationwide attention.

FIRST TIMERS WEIGH IN

Tony Pisciotta, vice president for claims at Arthur J. Gallagher & Co. of New York, as a first-time participant, said that, "If I could come away with one or two things I could use Monday morning I believe it's worthwhile."

And it was. In his job he manages different aspects of claims issues for several national accounts, from claims coding to answering claim questions. He picked up all sorts of claims management tips from the popular seminar, "60 Tips in 60 Minutes."

"It was excellent, and fun at the same time, and the bell going off reminded me of the debates," he said. He was also especially impressed with Richard Pimentel, senior partner with Milt Wright & Assoc., a perennial conference favorite, having attended Pimentel's "Return to Work: The Incentive/Disincentive Management Connection" Thursday seminar.

"The key to decreasing lost work days is communication," Pisciotta said, reflecting on what he learned in the seminar. "Everyone has to be firing on all cylinders with communication--the doctor, lawyer, adjuster, broker, claims person and supervisor back at the shop--to get the people back to work right away."Pisciotta intends to attend the conference next year.

Terry Beal, an orthopedic surgeon from the Central Texas Orthopaedic Clinic in Killeen, Texas, also a first timer, attended the conference with specific questions in mind. "I'm a general orthopedist so I do a lot of individual medical evaluations, which are becoming a bigger part of my practice," Beal said, adding that he was looking to get an insurance-industry perspective.

Beal said he wanted to know if there were standards attached to certain types of industries. For example, should a hospital worker fall in a lab and claim he injured his hand, wrist, shoulder, neck and knee, are all those injuries consistent with that type of fall?

Beal asked whether there are set standards of injury for falls. "It's hard to sort out all those injuries," he said. "People will expand on it, so I have to use my own judgment, especially in disputes with the carrier and supervisor--can all these body parts be involved?"

Seeking answers, Beal attended the Thursday afternoon keynote address titled, "Going Beyond the Headlines: The Real Cost Drivers in Workers' Compensation," by Tom Leamon, director of Liberty Mutual's Research Institute for Safety. Beal had a chance to discuss those questions with Leamon after his presentation.

SUSAN GUREVITZ is a freelance writer who frequently contributes to Risk & Insurance®.

January 1, 2005

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