It was a comment I never saw coming. A comment that, as difficult as it may seem, left me speechless for a number of minutes. Given the context in which the feedback existed it was truly an unexpected surprise. More importantly, it highlighted one of our industry's biggest challenges as we struggle to reform our culture and process.

Last week I wrote an article related to testimony by one of the attendees of the National Conversation Summit in Dallas, TX. It was titled, “The Conversation: “I Am So Thankful I Didn’t Get That Scooter“. By (almost) all accounts it was a positive tale; a severely injured woman who is thankful that she was able to restore some semblance of normalcy without being dependent on assistive equipment. It is a story that should be celebrated as an inspiration to others who are similarly challenged.

But, it turns out, not everyone was happy with my sharing of her account. One comment we received, from an angry injured worker (AIW), was predictable. There is a tiny contingent of AIW's who do nothing but criticize and complain, and they absolutely detest a story when someone obtains a positive outcome after their injury. We received a typically critical comment from one such person, which we did not publish as that particular individual has been banned from commentary here previously. I've got to give him an “A” for effort, however.

The second negative comment was the one that really sidelined me, and is representative of deep rooted issues in some sectors of workers' comp.

It appears I have really pissed off the Scooter Lobby.

We originally approved the comment for publication, and I issued a fairly sarcastic reply. After a very short period of reflection, we pulled both comments as I wanted to more fully delve into this issue in the form of this missive. The comment, now scrubbed of the posters identity, was as follows (careless misspellings and grammatical errors are original and as entered):

Bob,

Interstingl this has to be the first time a diagnosed incomplete quadriplegic I have ever heard of that now is walking because of the wisdom of an insurance system.  Also do you know the difference between a scooter,  power chair,  or any other type of assertive technology.  Reading this I’m wondering what agenda you have maybe the Propublica stuff us getting under your skin.  You might want to get you facts straight before you continue to write in this subject.  Ps interesting an injured work is such a novelty at a workers comp event.

For what it is worth, this was my initial response:

Wow, [Name Redacted], way to snark things up. I do know the difference between the items you mention (I am just not sure what “assertive” technology is); however, the worker said “scooter” and I quoted her accurately. Since you work for a company that sells scooters and other assistive equipment, your criticism rings a bit hollow.

Interesting, as we talked a lot at the Summit about vendors with paradoxical interests.

BTW – the definition of Incomplete Paraplegia is “Types of Incomplete Spinal Injuries. An incomplete lesion is the term used to describe partial damage to the spinal cord. With an incomplete lesion, some motor and sensory function remains.” I mention that because you seem to doubt her description of herself.

I am deeply surprised by your comment, as I did not attack the notion of people getting scooters at all. I simply relayed a positive and unexpected result. It is an inspirational story that makes just about everyone happy, except angry injured workers who hate any success story and the guy who would rather sell the scooter. The injured worker I discussed is today a professional in the industry, and I would expect would take offense at your insinuation she was merely a novelty. We had two injured workers in attendance, and their input was highly valued.

Your comment is a great example of the problems we have in the industry.

Based on the name and email address of the commenter and a quick review of LinkedIn, I was able to determine that the person who made this comment was the President and CEO of a company that sells scooters and other assistive equipment. Clearly the concept of someone doing well without his products struck a nerve.

First, he seems from his remarks not to fully trust the concept of an “incomplete quad” maneuvering without powered assistance. To clarify, the definition of Incomplete Quadriplegia includes the following: “An incomplete lesion is the term used to describe partial damage to the spinal cord. With an incomplete lesion, some motor and sensory function remains. People with an incomplete injury may have feeling, but little or no movement. Others may have movement and little or no feeling.”

So, “nanny nanny boo boo” to that notion.

Secondly, whether I personally know the difference between a scooter, power chair or my own arse is completely irrelevant. The individual about whom I wrote used the word “Scooter”, and I quoted her accurately. My only agenda is to point out that many things are possible with committed effort and positive outlooks – and that some of the people our industry serves do not need to be shuffled down the path of permanent disability dependence.

That final point, it seems, is the rub in this type of situation. While the vast majority of people in this industry toil honestly with excellent intentions, we inevitably face the dilemma of contrary incentives and potential bad actors. It is an undeniable fact; the people our industry deals with are injured, and almost everyone involved profits in some sense from those injuries.

Let me state unequivocally, there is nothing wrong with that. Profit is the motivator that ensures services will be available when needed. Even in the non-profit world, employees “profit” (in as they are financially rewarded) for the time they commit in supporting whatever goal the non-profit entity is designed to address. There is no problem with the reality of profiting from our industry activities; as long as we stay on the right side of a sometimes thinly defined ethical line.

The reality that we all potentially profit from others misfortunes comes with intense moral and ethical obligations not to abuse that situation. Profit can become a problem when it is pursued in spite of and contrary to positive outcomes for those we serve. Regarding the story I wrote, many people were happy the person had achieved so much on their own, while others apparently have blasted the fact that they couldn't sell her a f**king scooter.

Profit over principle will always fail in the long run.

Perhaps the person was overly sensitive because there has been massive fraud in the scooter sector in recent years. CBS News reported in 2013 that a nationally known outlet, “The SCOOTER Store”, filed bankruptcy and liquidated after Medicare revoked their contract for reimbursement. They report that, from 2009-2012, government auditors found The SCOOTER Store overbilled Medicare by as much as 108 million dollars for products that were not needed by their recipients.

I am not saying that all scooter outfits are fraudulent. I am not even saying scooters aren't necessary or helpful; they clearly are. But for someone to get angry because one person decided they were better off without one, that is indicative of a bigger issue. We spent a fair amount of time discussing the topic of vendors with paradoxical incentives at the Summit. Vendors that place profit over need; who provide services without true value, are going to be a challenge as we work to reform comp and its processes. Those processes and their related friction points represent transactional exchanges where money changes hands. We need to make sure that dough provides value for both the employer and injured worker, or it otherwise may not be currency well spent.

My own company is somewhat at risk in this venture. We sell multi-jurisdictional compliance information, as well as a variety of forms management products. We clearly benefit from the vast differences in jurisdictional processes and standards. If one of the goals of the Summit, to simplify some of the jurisdictional variations comes to pass, that competitive advantage will be lessened. It may hurt some of our products, and my company.

It still doesn't mean that we should not do the right thing.

So, it seems the first volley of protest has been fired, from no less than the industry's scooter contingent. It is a clear case of scooter rage. I imagine a host of angry scooter gangs hitting the highways to stop this progress. Of course, if they are coming from across the nation it will take them about three months to get here, but on the positive side they will collectively only take up one parking space when they finally arrive. Still, the indicative nature of the comment above highlights the challenges we face as an industry.

And another thing. My facts are as straight as they need to be sir, and I'll write about this as much as I damn well please.

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