Tuesday, November 17, 2015

What is Hot in Workers Compensation?

Henry Tillman once said that "the saying 'getting there is half the fun' became obsolete with the advent of commercial airlines." I am not sure who Mr. Tillman is, in fact no one seems to know. But, I am doubting that Mr. Tillman has travelled lately. I spent the better part of yesterday (12 hours starting at 04:30) in a seeming remake of Trains, Planes and Automobiles, making my way from suburban Florida to rural West Virginia. 

I do mean rural. We are staying at an amazing venue in the beautiful West Virginia mountains. But, a trip to the local mall last night for a few forgotten items was instructive. The local mall is anchored on one end by K-Mart and on the other end by an auto parts store. "Toto, I've a feeling we're not in Kansas anymore!" But what we really need, education, intellect, and expertise on workers' compensation, our attendees and speakers have brought with them to this idyllic, beautiful, and yes rural, environment. 

I am here for the Southern Association of Workers' Compensation Administrators. This is an amazing group of thought leaders from across the country. Among them are the administrators and leaders from 20 jurisdictions. The latest state to join the group was Maine, which some might struggle with given the word Southern in the name. But "Southern" may be just a state of mind?

National gatherings like this are eye-opening. They provide a unique opportunity to appreciate what is going on in various jurisdictions. It was at a SAWCA event that I first heard of states requiring electronic medical billing. Other ideas I have been exposed to at SAWCA events include the Texas drug formulary, the Oklahoma Opt-out, Georgia pill-mill efforts, Colorado Marijuana impairment measurement science, and New Mexico Marijuana reimbursement struggles. This is a short list, but the point is that each state is at the forefront of something. Each of those will likely be discussed in my state eventually, and it is good to know what has already occurred. 

A careful listener at a SAWCA event will come away with perceptions of what is hot in workers' compensation. A fair measure will come from the program and agenda. But another measure will come from the conversations around a meal or beverage break. The "us to" and the "that would never work in _____" comments usually lead into illuminating comments about what is hot in other jurisdictions. 

SAWCA is unlike any other education organization to which I have belonged. It programs each convention with key note speakers, like so many others. But a major portion of the programming is provided by standing committees on substantive workers' compensation concerns. These committees each program a portion of the program independently. Thus, it is a "what's hot" in both a macro and micro sense. 

Having now had my full measure of "half the fun" just getting here, I am anticipating what the week will bring. We begin today with a Board meeting. Experience tells me that our agenda will be punctuated with "war stories" from the latest tribulations of various jurisdictions, but we will also do the business that keeps SAWCA running. 

On Wednesday, we kick off the program with advice for the new and newer administrators. The title is "How Long Does the Honeymoon Last?" Coincidentally, this will be held in the Eisenhower Room here at the hotel, a program for leaders in that room has certain poetic appeal. Workers' compensation administrators and industry experts will discuss the challenges of undertaking leadership roles in this industry. With new roles and responsibilities may come some period for a learning curve, and the issues is how long that period may last. What can regulators do to get up-to-speed rapidly, and be ready when that honeymoon is over?

The second general session will be presented by the Management Information Systems (MIS) Committee. We have all seen success in the endeavor to bring modern technology to bear on administering workers' compensation systems. Industry and government alike have been driven to leverage technology for both better performance and cost savings. Each peak we best provides us an amazing vista on the path travelled, but usually an equally amazing view of the path ahead. With each achievement, we can pause for the pat on the back, but we can also see new peaks to challenge. Technology is ever-changing and state systems have to be prepared to ascend those next peaks. 

With an array of MIS experts we will discuss this from multiple aspects. First, the challenges of keeping systems current with consumer needs. Workers' compensation administrators have many consumer constituents, recovering workers, employers, insurance companies, rate-making organizations and departments, and the state's public. There are many with an interest in workers' compensation. Second, how do agencies re-tool, that is make major hardware or software changes, to keep up with developing technology and the customer's needs?

The Self-Insured and Insurance Committee will focus as usual on the involvement of risk in workers' compensation. The risk allocation needs are complex, and can be vastly different for business and government entities. The Committee has brought an industry expert, Scott Richbourg, to focus our thoughts on how public entities are regulated as self-insureds. These are often large employers, and as government entities may have unique challenges. How regulators monitor these and other self-insureds presents challenges and bears attention.  

Alan Greenspan once said "I know you think you understand what you thought I said but I'm not sure you realize that what you heard is not what I meant." There are barriers to effective communication in the world of workers' compensation. The SAWCA Adjudication Committee and Administration & Procedure Committee will host a frank discussion of where our communications break down. Employer, carrier, and regulator participants will involve the audience in a frank discussion of better communications, challenges, and solutions. 

On Thursday, one of the great challenges of modern workers' compensation will take center stage. There are many instances in which a recovering worker's benefits may be seen as wholly the responsibility of the employer. In other instances, the disability may be seen as a result of more than one condition or event. States have moved to statutory models that may allow determinations of responsibility between work events and non-work, apportionment, and between multiple work events, contribution, that may not have occurred at the same employer. The statutory changes that allow consideration of such issues have brought challenges to adjudicators and the regulators and administrators of workers' compensation systems. 

In the current era of workers' compensation, hot topics seem to always include constitutional issues. An amazing panel of experts will address the recent Pennsylvania Commonwealth Court decision in Protz. Whether in terms of fee schedules, treatment guides, impairment guides or more, state laws rely on documents that are compiled by other government agencies and private organizations. The Pennsylvania court recently found constitutional infirmity in such a delegation. While it is a focused state court decision, applying a specific state constitution, the decision raises questions for all workers' compensation administrators. 

Workers' compensation is the matriarch and patriarch of a sometimes dysfunctional family. One challenge in this family is that two of the siblings, medicine and the law, seem to consistently find a way to disagree. Some are genuine disputes on a foundational level, while others sometimes seem to be the equivalent of a "he's touching me" argument in the bask seat of the "family truckster" as we attempt to traverse our collective way to the nirvana of Wally World. SAWCA welcomes J. Osbahr, III, MD, a Member of the Board of Trustees with the American Medical Association. The relationship and perspective of the medical community will be the focus. This is expected to lead to a discussion of why systems face low populations of ready, willing, and able physicians to aid recovering workers. 

Friday will cap the week. The learned and articulate Chief Judge of Kentucky will provide an overview of recent appellate cases there. Some feel that the Kentucky Supreme Court has seemingly thrown the stare decisis baby out with the bathwater in recent decisions. Whether there a role for stare decisis in workers' compensation will make for an interesting discussion. 

The programming concludes with Bob Wilson of WorkersCompensation.com moderating a panel discussion of "things that make you go Hmmmmm." This avant garde prognosticator on all things workers' compensation will query regulators and industry experts alike. Edification on many burning questions of "why" and "how" on issues like Marijuana, medicine, and legal procedure may be on the agenda as panelists take the "hot seat" and Mr. Wilson has his chance to cross-examine. 

This is the promise of the agenda, a menu of interesting offerings that may represent what is hot in workers' compensation. I will be blogging live from the SAWCA All Committee Conference this week, trying to take in the substance of the programs and the ensuing conversations. 

Then Friday I will begin the return trip with high hopes of avoiding traffic jams, road construction, my smart phone's seemingly vengeful selection of dirt-road routes, long TSA lines, delayed flights, over-stuffed luggage bins, flight durations too short for delivery of even a simple bottle of water to each passenger, and more. Isn't travelling fun?

After all, if getting there is half the fun, is trying to get home the other half? And if those two are true, does that mean that all the "fun" is in the travel, leaving no fun for the destination? Well, I said the program was interesting and compelling. I will hope that somehow it also includes some fun. Perhaps getting there is half the fun, getting home is half the fun and being there is half the fun? Math was never my strong suit.  

Live from West Virginia, it SAWCA ACC!

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