Workers Comp Matters

With the rise of artificial intelligence, it makes sense to think about the use of AI analytics in Workers’ Compensation case outcome management. What types of tools lead to efficient claim management, including shorter claim durations and better outcomes? Guest Ryan Murphy has spent his career understanding and developing case management systems. As vice president of product at the third-party Workers’ Comp benefits administrator CorVel Corporation, he works with clients and analyzes and develops solutions that remove friction and deliver successful resolutions for clients and work. We’ve come a long way from the days of “snail mail” and faxes. Today’s tech allows case management specialists to incorporate operational efficiency technology and help workers and employers resolve cases and get injured workers back to their lives. But as Murphy explains, tech isn’t a replacement for human communication and compassion, it’s a partnership. Data analysis, data aggregation, and claim summarization can help human case managers reach better conclusions faster. Every industry is being transformed by emerging technologies, Workers’ Comp is no exception. Be a part of the future today. If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Mentioned in This Episode: Previous episode of Workers’ Comp Matters, “A New Approach to Workers’ Comp: Being Nice?” with Claire Muselman Learn more about your ad choices. Visit megaphone.fm/adchoices

Mental health plays a big role in workplace efficiency and safety, but it seems employers and employees view the topic differently. Guest Joseph Toppe, a longtime journalist and managing editor of the insurance news website PropertyCasualty360.com shares an interesting study from Pie Insurance. In recent years, employee mental health has become a more prominent issue. You don’t see the physical injury, but the injury may be there just the same. Where do employers see the risks of mental health, and how does that compare to workers’ needs? Employers and employees don’t agree. There’s a disconnect over workplace mental health that needs to be addressed. There needs to be a discussion. You can’t see a mental health injury the way you see a physical injury, but those injuries are real. And the evolution of AI and automation is only adding to the employee stress. In small businesses, especially, claims for mental health injuries are on the rise. Do you understand this new frontier? Workers’ Comp doesn’t end with “slips, trips, and falls.” If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Resources: Articles by Joe Toppe “Most U.S. Employers Say Mental Health Issues Contribute to Worker Absences,” by Joe Toppe “New Report From Pie Insurance: Small Businesses Safety Priorities Shifting as Employee Needs Evolve, Survey Show” Pie Insurance Learn more about your ad choices. Visit megaphone.fm/adchoices

It’s not you, the Workers’ Compensation system has changed over time, and not always for the best. Guest Christopher Godfrey, with a long career in Workers’ Comp, including his current role as research director at the Workers'​ Injury Law & Advocacy Group (WILAG) and a lengthy stint running the office of Compensation Programs at the U.S. Department of Labor, offers some insights. Where a non-adversarial atmosphere used to prevail within Workers’ Comp, Godfrey worries it has been driven toward a confrontational system with a struggle for unilateral control. That isn’t how a program aimed at making injured workers whole and getting them back to work started out. Also concerning Godfrey is a lack of funding for the Federal Employees’ Compensation Program, making it difficult for injured federal workers to even find a doctor willing to accept them as patients. In both state and federal systems, Workers’ Comp is being buffeted by politics. Godfrey notes the government shutdown, a slowing employment environment, and even the potential for a stock market bubble threaten the system. Economics and politics can build hurdles that trickle down to how insurance companies and Workers’ Comp plans operate. Godfrey shares his personal concerns and describes what WILAG is doing today to protect the rights of injured workers. If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Mentioned in This Episode: Previously on Workers’ Comp Matters, guest Kenneth Feinberg, “’A Patriotic Obligation;” Kenneth Feinberg and the 9/11 Fund” Learn more about your ad choices. Visit megaphone.fm/adchoices

Hot enough for ya? Guest Sebastian Negrusa Ph.D. is a researcher at the Workers’ Compensation Research Institute (WCRI) and the co-author of the recent WCRI study “Impact of Excessive Heat on the Frequency of Work-Related Injuries.” What role does excessive heat in the workplace play in employee injuries? Turns out, it’s a lot. In temperatures of more than 90 degrees, the risk of injury on the job increases by a significant 5%-6%. Excessive heat, the study finds, impairs both cognitive and physical abilities, leaving workers more likely to make mental and physical errors and suffer injuries at work. Part of an employer’s duty is to prevent injuries at the workplace, and Negrusa’s study aims to help employers better understand the added risk in high-temperature environments. Some states and the federal government are currently looking at workplace heat standards and safeguards. Hear what occupations and employee groups are most vulnerable to these stressors and how employers can protect workers on the job (and what Workers’ Comp attorneys need to look for when representing injured workers). If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Mentioned in This Episode “Impact of Excessive Heat on the Frequency of Work-Related Injuries,” WCRI, by Sebastian Negrusa, Olesya Fomenko, Vennela Thumula “Heat-Related Illnesses in the Workplace—A WCRI FlashReport,” WCRI, by Vennela Thumula, Olesya Fomenko “Florida Blocks Heat Protections for Workers Right Before Summer,” NPR “‘It’s Getting Hotter’: Bill Aims to Implement Strategies to Protect Outdoor Workers in High Temps,” Boston 25 News Learn more about your ad choices. Visit megaphone.fm/adchoices

Let’s talk about the “exclusive remedy,” what it means, why Workers’ Comp matters, and the exceptions. The concept of exclusive remedy is based on the principle that in exchange for care and benefits, a worker injured on the job may surrender some options for additional remedies. If you’re covered by Workers’ Comp, the ability to challenge the employer in court for injuries and pain and suffering may be limited. Workers’ Comp is the remedy. We are covered by Workers’ Compensation because that can be a good thing, but we may give up the right to sue. Ideally, it’s a fair deal for workers and employers. “The Great Bargain.” But there are twists and turns. Negligence, bad faith, family medical leave needs, disabilities, “double compensation,” and third-party interests all add to the puzzle. When does an injured worker get the “green light” to seek compensation outside of the exclusive remedy? And what about non-injury damages like defamation, malicious prosecution, slander, or mental anguish? Or what if a “leased” employee (think temp agencies) is hurt? While the exclusive remedy simplifies the management of workplace injuries in many cases, it’s not always as clear as it seems, and it’s important to know where the exceptions lurk. The goal is always to make injured workers whole. Every case matters. If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Mentioned in This Episode: Green v. Wyman-Gordon Foley v. Polaroid Longever v. Revere Copper & Brass Inc. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hosts Alan and Judson Pierce reflect on nearly two decades of the Workers Comp Matters podcast with an examination of unusual or bizarre claims and cases. A reminder, while some of these cases may have puzzling or humorous elements on their face, it’s never funny when a person is hurt. We may wonder what people were thinking when these incidents happened, but we can learn from each case. For starters, always expect the unexpected. An employee who thought her boss provided gluten-free pizza was actually fed pizza with gluten in it (what followed after her Workers’ Comp claim was denied is educational and clever). Or an octogenarian, part-time attorney who slipped and fell when he was summoned from his home office to a workplace office and claimed it was an exception to the “going and coming” rule? How about the “personal comfort doctrine” and the breakfast sandwich incident? These and other unusual cases spotlight both employee behavior and how Workers’ Comp rules vary by state. They may challenge the way you view your own cases. This episode is well worth your time. If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Referenced Links: Thomas A. Robinson blog, WorkCompWriter.com Walter A. Zerofski's Case, Masscases.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Being a good lawyer is a lot about great storytelling. Unfortunately, that’s often not taught in law school. Facts build the case, but effective storytelling wins the case. Guest Robert Mattson is an experienced corporate communications leader and coach. But his skills go beyond that. He acts in and writes plays. He is also the founder and principal at Intrigue Communications and Coaching. He helps people not simply communicate but also tell a story. When you’re in front of a jury or arbitrator, you’re performing. It’s part of our everyday lives. Are you consciously telling the story that will help your client achieve the best outcome? Facts are vital. No argument there. But having the skills to help your audience understand those facts, embrace them emotionally, and understand what they are hearing is every bit as important. Mattson explains how understanding how stories are told makes you a better communicator. It’s more than an art, it’s a science. (Plus, he shares the three most important words in storytelling.) If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

Guest Michael C. Duff, professor at the St. Louis University School of Law, explores the evolving field of mental health injuries in the Workers’ Comp world. Stress and workplace trauma is real, and recognition of these injuries is developing, but there are still complicating factors. Did workplace stress cause a heart attack, or was there underlying heart damage? What constitutes post-traumatic stress, and at what point did that stress occur on the job? There’s a lot to unpack. Daily on-the-job stress versus something truly unusual at the workplace; cumulative versus traumatic stress; faking versus real injury; causation; and privacy (HIPAA) all factor into a decision regarding compensation. We all know a broken arm when we see it. But understanding a damaged mind can be tricky. First responders, air traffic controllers, and factory workers all face stresses, but not all stress is the same. Hear how jurisdictions differ in their view of psychological injury Workers’ Comp claims. If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at JPierce@ppnlaw.com. Mentioned in This Episode: Agis v. Howard Johnson Co. Previous Appearance on Workers Comp Matters, “For Every Wrong, A Remedy? When A Workplace Event Harms A Family” Previous Appearance on Workers Comp Matters, “Presumptions in the Age of Covid-19” Learn more about your ad choices. Visit megaphone.fm/adchoices

Our military and public service veterans deserve our best. Guest Alex Dell is a longtime Workers’ Compensation and Veterans Affairs compensation attorney, often representing injured public servants or military veterans. He’s also a former Division One hockey referee. In both roles, Dell explains how taking a broad view is crucial. The key, he says, is to avoid “tunnel vision.” Learn to see issues from multiple angles. Take in the whole picture. In hockey, keep an eye out for penalties behind the play, and when a worker is hurt, especially a military veteran, watch for multiple claims to pursue as you seek to best represent your client. When we talk about veterans’ claims, we’re looking at three areas: pension benefits, compensation for injuries, and “DIC” benefits, the dependency and indemnity claims for families who lost a loved one or who have a loved who was disabled. It can get tricky, and there are unscrupulous “representatives” eager to trick potential clients into making payments that are already covered by the compensation programs. Representing public servants and veterans is nuanced. Some disabilities aren’t physical. Post traumatic stress disorder (PTSD) may not be evident at first but can manifest itself later. That’s still a real disability, and vets deserve compensation to help them recover. Some veterans may not even know help is available even a decade or more after service. And clients may also not understand a VA “denial” isn’t the end of the road. There are alternatives and appeals. Do you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear? Contact us at JPierce@ppnlaw.com Mentioned in This Episode: Pro Hac Vice Article, “Presumptive Evidence Of Causation In Workers’ Compensation Claims Related To World Trade Center Rescue, Recovery And Cleanup Operations” “Your Intent to File a VA Claim,” U.S. Department of Veterans Affairs “The Michigan Goal,” YouTube Learn more about your ad choices. Visit megaphone.fm/adchoices

How will AI help us help workers injured on the job? What voids will AI help us fill as we work to help people get back to work and life? Treatment authorizations, document delivery, and automation of mundane tasks such as signature acceptance help an injured person get back on the job faster and speed operations for the adjuster. Let’s work together. As guests from digital communications platform Gain Life Tycho Speekenbrink and John Peters explain, claims are complicated. But automation can help speed the process by analyzing how prior cases and even patient locations have worked in similar cases. Today’s tech can help both sides eliminate bottlenecks, including routine treatment approvals, medical appointment scheduling, even transportation to and from care. Hear how AI can accelerate and simplify the process. Can AI help adjusters get past routine tasks and learn a little bit about empathy and collaboration, things that work for both the worker and the adjuster? Workers’ Comp is struggling to get past the old “snail mail” and paper files era. Hear how AI can advance reaction time and attract new, younger, talent that has grown up in the digital age. The systems aren’t yet perfect, but you don’t want to be left behind. Change (for the better) is coming. AI won’t replace adjusters and attorneys, but it will help them do their jobs better. Mentioned in This Episode: “AI Sparks New Era In Empathetic Workers' Comp Claim Management,” PropertyCasualty360, by Tycho Speekenbrink and John Peters (free registration required) OpenAI ChatGPT Google Gemini AI Coursera Learn more about your ad choices. Visit megaphone.fm/adchoices

Let’s talk about alternative medicine and coverage under Workers’ Comp’s hodgepodge of rules. Guest Maya Rashid is a recent graduate of Penn State Law and the winner of the College of Workers’ Compensation Lawyers’ student writing competition with her article “Revitalizing Recovery: Exploring Workers’ Compensation Coverage of Alternative Medicine.” Fighting for clients seeking treatment through alternative medicine under Workers’ Comp? Even traditional medicine can get tangled in case law and treatments, but when it comes to alternative medicines, where do you, and your clients, stand? It’s a confusing issue, trying to figure out how injured workers can choose their own care and recovery path versus what insurers and jurisdictions determine is “reasonable.” The word “reasonable” varies across jurisdictions. Not to mention the confusion of medical bill coding. If you, and your clients, are confused, you aren’t alone. Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode opens a new topic for the Workers Comp Matters podcast: repetitive stress injuries, sometimes referred to cumulative trauma, acquired on the job. What happens to someone when someone develops a workplace injury, physical or mental, that can’t be traced back to a single, isolated event? Or what if the injury is the result of cumulative trauma developed under multiple employers? Bodily wear and tear, the result of daily repetitive labor, is real. Think of the brick mason on his knees for decades or the mechanic crawling under vehicles and lifting heavy items, or the carpal tunnel injuries from working at a keyboard week in and week out. These injuries pose challenges when asked for a “date of injury” on a claim form. For attorneys representing victims of repetitive stress, clarity is key, explaining clearly to the investigator that there is no single date. The injuries were the result of the entire period of labor. Lawyers need to think creatively to fully communicate that the injury is the direct result of the workplace. We all “break down” as we age. For a successful claim, attorneys must show that the traumatic “wear and tear” injury is a direct result of the workplace, not simply the result of ordinary aging. Mentioned in this Episode: Massachusetts Zerofski Case Learn more about your ad choices. Visit megaphone.fm/adchoices