This week I find myself in New Orleans at the ABA Workers' Compensation Committee Mid Winter meetings. This year is a unique event, as it represents the first time that two separate sections of the ABA, The Labor and Employment Law Section (LEL) and the Tort, Trial and Insurance Practice Section (TIPS) have combined to jointly host this seminar. This meeting represents a true cross section of the workers' comp legal community, with attorneys and interested parties from all areas of the country.
The seminar picked up on a popular topic from last years LEL section's mid winter meeting in Tucson, AZ, that dealt with return to work issues. This year the meeting launched with a session entitled “A Return to ‘Return to Work Programs' – Success Stories In States Where Return To Work Happens And It Works”. Moderator Greg Presmanes lead a panel on discussions relating to what works in RTW. As noted, this session was conducted because of continuing strong interest shown after last years discussions.
Another session, entitled “The Perfect Pain Trifecta: Pain for the Worker, Pain for the Medical Provider, and Pain for the Employer/Carrier Paying the Bill – Where We Are Going With Chronic Pain Management, Narcotic Medication Contracts, and Follow Up Drug Testing”, the featured speakers were noted workers' comp columnist Peter Rousmaniere and Suzanne Novak, MD, PhD. Dr. Novak is President of Austin Outcomes Research, Inc. Rousmaniere and Novak, along with Moderator Jane Stone, and panel members Malcom Crosland and H. Dill Battle gave participants an outstanding insight to current trends and new thoughts in this area.
Early discussions centered on the dangers of long term opioid use, and the danger of use of opioids in patients with a tendency to depression or personality disorders. According to Dr. Novak, Americans apparently consume 80% of the global supply of opioids, including 99% of the world's hydrocodone. They constitute just 4% of the world's population. In fact, Novak indicated abuse has risen 71% between 1997 and 2002. She discussed a wide range of symptoms that patients on these drugs experience (personally I learned more about hypogonadism than I ever wanted to), as well as alternatives to consider when the current methods are not working.
Rousmaniere cited this topic as the only area within the treatment spectrum in workers' comp where patients can die. According to him, 50% of workers comp claims costs are related to ongoing pain management and medications. He indicated that insurers are doing a better job of monitoring this area with the effective use of PBM's and Utilization Reviews, but the list of what they do wrong “is longer” than what they are doing right on this topic. He indicated that insurers do not pay for 2 of the least expensive methods to help treat chronic pain; counseling and exercise. In addition he covered several basic areas that insurers should look at to both provide improved care and reduce costs in this area. (You may hear our CompTalk Radio interview with Peter Rousmaniere on this topic here).
As with previous conferences of this nature that I have attended and written about, this is a well conceived and executed series of meetings. This group in particular does an outstanding job of bringing all sides to the table to discuss and understand the various viewpoints they might have. And of course, the national scope of the mid winter meetings brings a multi-jurisdictional flavor that is often lacking in regional affairs. The last day of meetings will be Friday, March 13th, where for the first time the hosts have scheduled topics to address specific needs of the “young attorney”. That also promises to be an equally interesting day here in “The Big Easy”.