WC1: Ethics and Good Faith Claims Handling: Playing by the Rules and Avoiding Complications
In the management of complex and litigated workers’ compensation claims, adjusters must work effectively with attorneys representing the interest of their mutual clients, as well as defer to their expertise to ensure claim investigation and resolution strategies and tactics are both ethical and permissible under law. For instance, some investigations not only crossed the line in terms of ethics, but also violated state laws leaving clients with substantial penalties and reputational damage. A leading workers’ compensation defense attorney and an attorney whose practice focuses on ethics will examine a number of problematic workers’ compensation cases and their outcomes. They’ll also review conflicts of interest and flag potential issues with attorney-client privilege, negotiations with plaintiffs and their attorneys, and problems that can arise in the settlement and closure process. The presenters will affirm the value of building relationships with plaintiffs and their counsel around mutual respect, among other best practices for establishing dialogues to facilitate better outcomes for both parties.
General Counsel & Co-Managing Shareholder
Adelson, McLean, APC
Joe Gjonola, Esq.
Roxborough Pomerance NYE & Adreni
WC2: The Benefits of Telemedicine for Work Comp Self-Insurers
Telemedicine has the potential to significantly reduce the cost of workers compensation claims for self-insured employers by enabling medical providers to use digital technologies to provide care without an in-person visit. For remote or late-night workers, having a clinician come to them via a virtual visit is often more convenient than an evening run to the ER. Smartphones, laptops, and tablets can all be utilized to quickly connect doctors and claims adjusters to the injured workers at a fraction of the cost of the traditional visit. The National Council of Compensation Insurance estimates that at least 7 million telehealth encounters occur around the United States each year, and the telemedicine market will continue to grow by at least 6% annually. This session will provide a cost-benefit analysis of using telemedicine in self-funded workers compensation programs.
Vice President of Managed Care Operations
TRISTAR Managed Care
W3: RIGHT TREATMENT – RIGHT TIME – RIGHT PROVIDER: Driving Down Musculoskeletal Spend for Self-Funded Employers
This presentation will deliver a solution-based strategy around controlling the ENTIRE musculoskeletal spend for self-insured employers. Trending, musculoskeletal claims are the highest cost to employers in workers comp and in the Top 3 for health benefits. When the base-line physical health of aging employees (and their beneficiaries) is the primary contributor to musculoskeletal breakdown, then early detection and mitigation is the most impactful solution to save money, reduce claims and ensure the resiliency of your workforce. We will discuss methodology and outcomes around early intervention and appropriate care paths as the driving principles in managing the total cost of musculoskeletal risk.
Sheila Denman, M.A., M.S., P.T.
ATI Worksite Solutions
W4: Wearable Technologies: Implications for Self-Insured Employers
Advances in IoT technology are helping to make the workplace inherently safer for self-funded employers. Using wearable and embedded sensors, workers can be tracked to prevent injury from falls, heavy machinery or overexertion. Other types of wearable sensors can be used to monitor breathing, toxic gas exposer, heart rate, posture and motion. The devices are being used inside factories as well as during search and rescue, firefighting and other first responder situations. This session will provide an overview of wearable technology components and devices, addressing the benefits and challenges for self-funded employers with a focus on using them to enhance worker safety. The session will also address privacy concerns, data security and the current regulatory environment.
Senior Principal, National Practice, Integrated Casualty Consulting
Willis Towers Watson
Vice President, National Product Leader - DME and Complex Care | Rehab Engineer
One Call Care Management
2nd Vice President, Forensic Laboratory
WC5: Medical Marijuana: The Antidote to Opioid Addiction?
With opioid use and abuse by injured work comp claimants becoming an increasing concern among self-insured employers, medical marijuana is being considered as a possible alternative because of its purported medical benefits and allegedly low risk of addiction. But even though 33 states and the District of Columbia have legalized marijuana for medical purposes, it remains illegal federally, which poses numerous challenges for employers considering covering it for their injured workers. This session will explore the pros and cons of substituting medical marijuana for opioids in the treatment of occupational injuries; impairment at work; conflicting legislation and court rulings; and what the future holds for self-funded employers.
Vice President Government Affairs
VP of Clinical Programs, National Product
One Call Care Management