Breakfast

Premier Session 1: Riding the Green Wave— Navigating the Intersection of Medical Marijuana, Politics, Medicine and Workers Compensation

• Speakers:

• Jeremy Buchalski, Wilson Elser

• Carlos Giron, Pain Institute of Georgia

• Ronald A. Mazariegos, Ambridge

• Jeremy Unruh, PharmaCann LLC

2018 brought a slew of changes to medical marijuana landscape.  With New York leading the charge in bringing medical marijuana to Workers Compensation, other states are following suit. While the grey area of the legality of medical marijuana still exists, more and more doctors, injured workers and legal authorities are starting to embrace this alternative treatment.  This session will explore the most recent developments in medical marijuana and Workers Compensation with a particular emphasis on legal issues, legislation, the carrier’s perspective and real world practical solutions to dealing with medical marijuana as a form of treatment in Workers Compensation. 

Break

Session 1 - 50 Claims Hacks in 50 Minutes — Highly-Original and Creative Claims Tips

• Speakers:

• Katie Hensley, Cottingham & Butler

• James Moran, Nyhan, Bambrick, Kinzie & Lowry, P.C.

• Michael Navarra, Rivers Casino/Midwest Gaming Inc.

What do you do when an opponent attorney just will not call you back? How about sending them a certified envelope, but "forgetting" to insert the letter? We guarantee you will get a call. An attorney, two risk managers, and a broker with a combined 75+ years in the industry reveal their most original, effective, and often hilarious tips for the first time. This fact-paced discussion is highly-interactive and a bit irreverent.

Session 1 - A 360 Degree View of the Psychology of Catastrophic Claims — Litigation, Medical, and Risk Management Strategies

• Speakers:

• Julie Fawson, Paradigm

• Brenna Hampton, Hanna, Brophy, MacLean, McAleer & Jensen

• James M. Poerio, Poerio & Walter, Inc.

• Stacy Whalen, Safety National Casualty Corporation

When catastrophic injuries, it is essential to identify a team with the right mindset.  Each member of the team must orient their thinking in light of the particular nature of the injury.  This presentation will focus on the psychology required of the defense team, including the handling claims professional, the carrier/ reinsurance professional, medical managers, and defense counsel. The defense team needs to be aware of their internal environment just as they need to be aware of the injured workers’ situation. The greatest cost efficiencies will be won through patience and perseverance, and will arise from an honest assessment of the injured worker to determine early on where the “tar pits” are in the case. Empathy for the injured worker has to be balanced by good business sense, but the two concepts are not mutually exclusive.  Having the right mindset is crucial to overcoming the various challenges posed by a catastrophic injury claim.

Session 1 - Construction Site Accidents — The Factors Involved in Determining Liability

• Speakers:

• Marie Cheung-Truslow, Law Offices of Marie Cheung-Truslow

• James A. Ruggieri, Higgins, Cavanagh & Cooney, LLP

• Samuel Wordeman, ARCCA, Inc.

• Mei Wright, CNA Insurance

According to OSHA, in 2016 over 21% of all work-related fatalities resulted from construction accidents.  This presentation will cover why/how most construction site accidents occur and what factors are involved in determining liability for any claimed injuries.  We’ll discuss incidents such as falls from elevations (ladders, scaffolding, roofs/leading edges, floor openings), falling objects, and same level falls (slips, trips), including case studies.  We will also look at the engineering codes and standards and applicable labor law for different scenarios.

Session 1 - Using Data Analytics to Drive Performance

• Speakers:

• Bob Bowman, The Wendy's Company

• Jayant Lakshmikanthan, CLARA Analytics

• Chris Mandel, Self Employed

• Duane Pifer, WTW

Workers compensation is intensely data driven, but data is only valuable when it is used to drive action centered on more informed-decision making principles. This session will take a very pragmatic look at the decision-making tools available to workers compensation professionals. The discussion will begin with an identification of key sources of data. This will be used to set the stage for showing how to transform existing information into action. Speakers will also look at data analytics and illustrate how past data can help explain what happened and why. The session will also address predictive modeling and show how data in the past can be used to predict the future. Speakers will also address artificial intelligence, machine learning, and automation.

Session 1 - Workers Comp in the Age of Technology

• Speakers:

• Cliff Belliveau, myMatrixx

• Matthew Condon, Bardavon Health Innovations

• Jennifer Morris Jones, Cranfill Sumner LLP

• Caryn Siebert, Gallagher Bassett Services, Inc.

Technology is no longer a novel concept, it is ingrained as an aspect of everyday life both at work and at home. From activity trackers and smart watches, to hydraulic prosthetics and stimulators, employees and employers are using technology in unprecedented ways. This presentation will include an overview of legal and medical breakthroughs along with challenges and strategic management of technological utilization in workers compensation claims. Specifically, it will focus on how technology can be used to monitor employee performance and safety, enhance post-injury care, and create additional opportunities for employees to return to work. We will also examine various issues and barriers, such as privacy, from both the employer and the injured worker point of view.

Lunch

Session 2 - Caring for the Total Worker

• Speakers:

• Michael Choo, Paradigm

• Robert Doherty, Evans & Dixon, LLC.

• Melissa Dunn, Self Employed

• Lindsay Huffman, Amerisure Mutual Insurance Company

The presence of a mental health condition predicts a longer duration of work absence. Successful treatment and return to work require a skilled interdisciplinary team working with a biopsychosocial approach to address the injured worker’s entire condition. This session will discuss the most effective model of care, which incorporates injured worker and physician engagement, consistent use of evidence-based medical guidelines, and multidisciplinary treatment managed by diagnosis clarification, coordinated care and informed monitoring interventions.

Session 2 - Maximizing the Productivity of an Aging Workforce

• Speakers:

• Jacqueline Gregory, Conroy Simberg

• Michele Punturi, Marshall Dennehey

• Robin Roeder, Sedgwick

Baby boomers are reaching retirement age and many are electing to continue working. Their reasons range from enjoyment and desire to stay active to economic struggles resulting from declining home values, low returns on 401k plans, or rising healthcare costs. This demographic shift is forcing companies to change the way they think about their workforce strategies including their workers compensation and disability programs. Older workers have much to offer in terms of their knowledge and experience. However, they come with a unique set of risks. In order to capitalize on the productivity and capabilities these aging workers have to offer, employers must recognize some of the age-related changes that these people undergo — such as deteriorating eyesight, hearing, flexibility, strength, balance, and reaction times. Workplace accommodations can be made to retain this experienced talent pool. This panel will examine some of the changes workers go through as they age, how these factors affect their performance and productivity, and ways to mitigate any declines and accentuate opportunities for improved productivity.

Session 2 - Medical Directors’ Discussion of the Next Medication Crisis

• Speakers:

• Tron Emptage, Optum

• Heidi Hanna, Auto-Owners Ins. Co.

• Marcos Iglesias, Travelers

• Jill Rosenthal, Zenith Insurance Company

While the opioid epidemic continues, and there’s still work to do, we are making strides in the battle to control opioid utilization and its overall cost toward a claim. We also know that opioids are not the only medications that increase risks and costs in claim management. So what’s next? What’s our next battle? This session will gather several managed care executives for an open discussion on the changing tides of medications and treatments in workers compensation. From specialty medications and alternative therapies, to compounds and weaning and tapering programs, they will provide insight on what they are seeing and where we need to expand our focus in 2019 and beyond.

Session 2 - Mitigation of Medicare Settlement Risk and Costs Through Clinical and Pharmacological Controls

• Speakers:

• James Anderson, Cattie & Gonzalez

• Rajiv Das, MD, Safeway Inc.

• Robert J. Finley, Hinshaw & Culbertson LLP

• Rafael Gonzalez, Cattie & Gonzalez

Whether you are submitting your Medicare Set Aside (MSA) to CMS for approval or not, mitigating your Medicare settlement risk and costs through clinical and pharmacological controls makes sense. There are a number of steps an employer/carrier/third party administrator can take to mitigate such risk and reduce costs. 

Break

Session 3 - #RiskManagementIsWatchingYou - Tweeting, Hashtagging, and SnapChatting through the Trove of Social Media Avenues

• Speakers:

• Amanda Persicketti, Corvel Corporation

• Michael Petrie, Social Detection

• Wendy Smith, Morgan & Akins, PLLC

• Linda Youngerman, Lockton Companies, LLC

The explosion of social media and technology is constantly creating new challenges for customers, insureds, risk managers, insurers, and TPAs in terms of privacy and confidentiality. Social media has also created new channels of communication for the insurance community to discover fraudulent claims. This session will explore how successful social media investigations have been in reducing fraudulent claims, new tactics of tapping into social media and the future of social media in risk management and claims. We will also discuss the potential risks associated with releasing seemingly confidential information, and the new legal struggles in proving insurance fraud in workers compensation cases.

Session 3 - Disaster Recovery in Workers Compensation

• Speakers:

• Lisa Anne Bickford, Coventry

• Mark Lechowicz, Gallagher Bassett Services, Inc.

• G. Steven Murdock, IFMK Law, Ltd.

• Jennifer Wolf , International Association of Industrial Accident Boards and Commissions (IAIABC)

The hurricanes, flooding, and wildfires seen during 2017 and 2018 have forced the workers compensation industry to reexamine what should be done to aide claimants, providers, and stakeholders affected by natural disasters. Hear about Texas’ regulatory response to Hurricane Harvey, as well as California’s approaches to disaster planning and response. This presentation will also discuss work-related injury considerations before and after a disaster strikes, ideas for strategic disaster planning, and regulatory considerations during disaster recovery.

Session 3 - Initial Intake to Final Settlement – A Blue Print for Your Workers Compensation Catastrophic Claim

• Speakers:

• Amy E. Bilton, Nyhan, Bambrick, Kinzie & Lowry, P.C.

• Beth Hostetler, Albertson's LLC

• Denise Segovia , Acuity Insurance

• Paul Sighinolfi, Ametros Financial Corporation

• Kathleen Wyeth, AF Group

A catastrophic workers compensation claim is devastating for both the claimant and the claimant’s family. The management of such claims also requires a high level of expertise on the part of the claims handlers. Join our lively, veteran panel as we go through case examples and address the various touch points where the claim handler’s decisions will have the greatest impact on the ultimate resolution of the claim. Our panel’s comprehensive analysis will include best practices for the defense of the claim and provide various  options for giving  Medicare’s interests reasonable consideration in the settlement. Learn about alternatives to the traditional CMS-approved MSA such as the Compromise MSA, Evidence-Based Medicine MSA, and MSA Legal Opinion. Conditional payment resolution techniques and tips will also be discussed as well as tips for the identification of Medicare Part C and D plan claims. This session will also delve into  the administration options for management of future medical funds, Social Security disability offsets, and Special Needs Trusts. Attendees will leave the session well versed in techniques to assist in the claims handling of a catastrophic workers compensation claim from initial intake to final settlement.

Session 3 - That Can't Be Right! - Addressing Controversial Diagnoses and Treatments

• Speakers:

• Robert J. Barth, Barth NeuroScience

• Gregory McKenna, Gallagher Bassett Services, Inc.

• William Pipkin, Austill, Lewis, Pipkin & Maddox, P.C.

Controversial diagnoses such as fibromyalgia, neuropathic pain, CRPS/RSD, and post-concussion syndrome create challenges for all involved. The clinical standards for medical causation are receiving closer scrutiny and the spread of objective medical guidelines is providing a broader range of tools for claims professionals and lawyers. Learn how to harness the latest clinical research and use objective diagnostic protocols to gain the leverage needed to eliminate or mitigate controversial medical diagnoses. Learn how to identify and respond to requests for controversial treatments that remain standard practice despite the fact that research shows they do not improve outcomes and will likely do more harm than good. Hear about outcome-based approaches involving ancillary providers. Participate in a discussion about how to advocate treatments that are not only more cost effective for the employer/carrier but are more likely to result in better outcomes and improved function for the injured worker.

Session 3 - Ways to Positively Affect Workers Compensation Claim Outcomes

• Speakers:

• Suzanne McTeague, Sedgwick

• Thomas Ryan, Self Employed

• Michael Sullivan, Michael Sullivan & Associates

Workers compensation remains the grand bargain between injured workers and employers today. However, it is not without its blemishes, and many stakeholders continue to look for ways to improve this state-driven, statutory system. There is much speculation around newly adopted or pending state legislation and what impact these laws and regulations will have on the injured worker. Similarly, employers are continually reviewing, approving, and implementing new organizational programs and initiatives. While both of these avenues may ultimately prove to be effective, some will take time to produce results. Regardless of these longer-term legislative discussions or employer initiatives, it is important to consider the current needs of injured workers and place their well-being at the center of all claims activities. There are a number of steps that can positively affect outcomes for the injured worker and the employer. This session will share proven and practical strategies and tactics designed to achieve improved claims results.

Break

Session 4 - Aggressive Claims Handling

• Speakers:

• Steve Carman, Celadon Trucking

• Judith Cole, K2 Industrial Services, Inc.

• Kirsten Kaiser Kus, Downey & Lenkov LLC

• Claire Muselman, Self Employed

• Leslie Rodgers, Cincinnati Insurance Company

Join our experienced panel to discuss ways to aggressively move and close your claims throughout all phases of litigation. We will address key strategies for what to do in the first 48 hours of notification of a claim, bold investigation techniques, ways to move injured employees to a medical release in an efficient manner and how to craft settlements by using the evidence to your best advantage.

Session 4 - Innovative Structured Settlement Programs with Improved Metrics and Analytics

• Speakers:

• James Ebel, Sedgwick

• Anna Koehler, Arcadia Settlements Group

• Kristi Weaver, CCMSI

The structured settlement market continues to change dramatically. Without innovative metrics and analytics to update and align company programs, claims executives and staff are unlikely to achieve related operating efficiencies. This panel will use recent studies to highlight current discontinuities and opportunities for immediate operational improvement and "safe-harbor" governmental compliance.

Session 4 - Maximizing the Value of Medical Care with Advocacy Programs

• Speakers:

• Andrea Buhl, Sedgwick

• Darin Hampton, International Paper

• Brian Palmer, Alliant Insurance Services, Inc.

The medical care and recovery environment of an injured worker largely determine the outcome of the claim. Effectiveness is driven by how quickly care is administered and the appropriateness of the treatment that is provided. Recovery is also dependent upon claims philosophy, employee engagement, co-morbidities, psycho-social issues, and pain management. Employers are placing less emphasis on cost reduction and more emphasis on injured worker experience using empathy and advocacy techniques. Advocacy is a concept that has been introduced in recent years as a way to reduce claims costs and improve the overall claims experience. While taking many forms, advocacy programs are rooted in making the injured employee a priority and showing concern for the individual’s overall health and well-being. Advocacy proponents claim that this approach not only improves injured worker satisfaction, but can also create financial dividends by reducing litigation rates, medical costs, and claim durations. The session will provide a practical, in-depth look into leading advocacy programs and their resulting performance.

Session 4 - PTSD Claims from First Responders

• Speakers:

• Brad Gronke, Gallagher Bassett Services, Inc.

• Rich Lenkov, Downey & Lenkov LLC

• Alexander Obolsky, Health and Law Resource, Incl

Employers are increasingly responding to drug overdoses, assaults, shootings and other traumatic events. Are those claims always compensable? What are the practical issues dealing with such claims? This panel of workers’ compensation professionals will give you real world takeaways for dealing with this complex issue.
 

Session 4 - Workers Compensation Pain Management Alternatives

• Speakers:

• Sherie Gekiere, Amerisure Mutual Insurance Company

• Shana Margolis, M.D., Shirley Ryan Ability Lab

• Paul Peak, Sedgwick

• Kim Pfingstag, International Paper

The opioid epidemic in the U.S. has led the industry to rethink pain management and assess response to injured workers. Most experts will agree that long-term opioid use is not an effective pain management solution and does not substantially improve an injured worker’s function over time. In many cases, the pain of an injury drives medical treatment, increases disability duration and extends time away from work. Ultimately, the injured worker continues to suffer and often does not attain the optimal quality of life and level of productivity desired. Today, risk managers, claim professionals, medical experts, and pain specialists are beginning to collaborate and put forth alternatives to pain management using a multi-disciplinary approach with an emphasis on putting the injured worker’s interests and well-being at the forefront. In this session, speakers will look at issues such as how to get in front of pain; ways to improve patient understanding of pain components; the importance of employee engagement; and alternative pain management treatments including yoga, meditation, acupuncture, and behavioral therapy treatments.

Cocktail Reception