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Copyright © 2012 MECC All rights reserved 1

2. Aging Workforce – Challenges and Opportunities Fernando Branco M. D
Aging Workforce – Challenges and Opportunities Fernando Branco M.D. Medical Director Midwest Employers Casualty a Berkley Company
Hello to all and thank you for taking your time to attend this webinar – many of our accounts have asked for information and/or assistance on the topic of managing an aging workforce, so we wanted to offer a webinar on this topic and hope you find the information useful. My name is Gail Young…. And with me today is Patty Reineke… We ask that you mute your phones for this presentation, but please jot down any questions and we will be happy to take questions at the end..

3. Objectives Learn why our workforce is aging.
Know what drives the aging workforce to keep working.
Effects of aging.
Prevention and Solutions for keeping the aging worker safe.
Claims management
THE OBJECTIVES OF TODAYS PRESENTATION ARE… WE HAVE ALLOWED 1 HOUR AND ½, WHICH INCLUDES TIME FOR QUESTIONS AND ANSWERS– PLEASE HOLD YOUR QUESTIONS UNTIL THE END, BUT, IF IT CANNOT WAIT, PLEASE FEEL FREE TO ASK

4. Objectives Learn why our workforce is aging.
Know what drives the aging workforce to keep working.
Effects of aging.
Prevention and Solutions for keeping the aging worker safe.
Claims management.
Question and answer.
LET’S BEGIN WITH WHY OUR WORKFORCE IS AGING

5. Changing Demographics
2000
OUR DEMOGRAPHICS ARE CHANGING – IN 2000, THERE WAS ONLY ONE STATE WITH A POPULATION OF AT LEAST 18% 65 OR OLDER
States with at least 18% of the population age 65 or over.

6. Changing Demographics
IT IS PREDICTED, BY 2025, IT WILL BE EASIER TO COUNT THE STATES THAT DO NOT HAVE A POPULATION OF AT LEAST 18% 65 OR OLDER – ABOUT 9 0R 10- THE BOOMERS!

7. The Tidal Wave is Coming
Starting in 2012, nearly 10,000 Americans will turn 65 every day
Within the next decade, 40% of the U.S. labor force will be eligible for retirement
The total number of Americans over age 65 and eligible for Medicare will double to over 70 million within this generation
The population over age 85 will increase nearly five- fold, to almost 19 million, by mid-century
OR, IT MAY BE HERE… (GO THROUGH SLIDE)
I THINK AN AMAZING NUMBER IS THE OVER AGE 85 WILL INCREASE FIVE FOLD – WITH BETTER HEALTH HABITS, BETTER MEDICINE, PEOPLE WILL VERY LIKELY WORK LONGER

8. The Tidal Wave is Coming
Fewer younger workers coming into the labor force
Retirement age changing to 70 (Source: Bureau of Labor Statistics, 2010)
As many as 75% of older adults expect to work after age 70
VARYING STATISTICS AND ARTICLES SUGGEST THERE ARE FEWER YOUNGER WORKERS COMING INTO THE WORK FORCE.. ( GO TO SLIDE)

9. Objectives Learn why our workforce is aging.
Know what drives the aging workforce to keep working.
Effects of aging.
Prevention and Solutions for keeping the aging worker safe.
Claims management.
Question and answer.
LET’S MOVE TO WHAT DRIVES THE AGING WORKFORCE TO KEEP WORKING

10. Myths and Realities #1 Myth Reality Older workers don’t need to work.
Many older adults do not have adequate savings to support full retirement and can’t live at the standard of living for which they have become accustomed; therefore, many must work to support their lifestyle choices.
I WANT TO GO THROUGH A FEW MYTHS ABOUT AGING WORKERS IN TODAYS ENVIRONMENT ( GO TO SLIDE) IN ADDITION, LIFE SPANS ARE NOW EXTENDED RESULTING IN MORE WORRY THAN EVER ABOUT MONEY LASTING AND FRANKLY, WILL PROGRAMS OR FUNDS BE THERE?

11. Myths and Realities #2 Myth Reality
Generally, the “aging workforce” is eagerly anticipating retirement, and will not work at all after reaching the typical retirement age.
Reality
Generally, “aging workforce” employees want to continue to work after reaching the typical retirement age.
AS WE CONTINUE TO LIVE MORE ACTIVE LIVES, ARE MORE HEALTH CONCIOUS THAN EVER BEFORE AND MANY OF OUR FRIENDS EXTEND THEIR WORK LIFE, RETIREMENT IS NOT ALWAYS AS DESIRABLE – WORK IS A FULFILLMENT FOR MANY

12. Social Security
Depending on your birthday, electing to take Social Security early at age 62 will have a reduction in benefits from anywhere from 20% to 30%
Social Security benefits are increased by a certain percentage if you delay your retirement beyond the full retirement age up to age 70. No additional benefits accrue past age 70
Social Security is not a factor in all businesses or industries but it is a very big driver for many and yet another reason why people want to continue to work, so include this as simply a fact in our world today

13. Myths and Realities #3 Myth Reality
Older workers are viewed negatively.
Reality
While there might be some who want to avoid an older worker, there are many instances where the preference is to seek out the knowledgeable, experienced worker as opposed to their younger colleagues.
I BELIEVE THIS REALITY - IN MANY INSTANCES , WITH THE EXCEPTION OF TRYING TO LEARN FUNCTIONALITY ON YOUR I PHONE – THEN YOU WILL LOOK FOR A YOUNGER WORKER AT THE APPLE STORE GENIUS BAR.. THERE IS A TENDENCY TO SEEK OUT THE MORE EXPERIENCED WORKER WHO WOULD LIKELY HAVE MORE INSIGHT INTO THE PROCESS OR PRODUCT

14. Primary Reasons For Working
THIS SLIDE IS ANOTHER VIEW AND BUCKETS BY AGE GROUP, THE REASONS WE HAVE BEEN DISCUSSING AS TO MOTIVATIONS FOR WORKING. INCOME IS THE PRIMARY DRIVER IN YEAR OLDS, WHILE WANTING TO STAY ACTIVE AND SOCIAL INTERACTION IS THE PRIMARY DRIVER IN THE YEAR OLD AGE GROUP

15. Reality
Workers > 55 are more productive (Source: Bureau of Labor Statistics; Meyers, 2007)
More likely to work through pain
Less likely to report an injury
Job satisfaction is slightly higher (Source: Galinsky, 2007)
A FEW OTHER REALITIES – OLDER WORKERS GREW UP IN A DIFFERENT CULTURE.. NOT ALWAYS, BUT MANY OLDER WORKERS – (go to slide) (GALINSKY IS A GERIATRIC PHYSICIAN ASSOCIATED WITH PURDUE)

16. A Black Hole?
“ Boomers make up over one third of the nation’s work force. They fill many of its most skilled and senior jobs. Thanks to their near-workaholic habits, they are among the most aggressive, creative, and demanding workers in the market today. Economists predict their exit will cause a great, sucking hole in the workplace universe.”
Source: Daniel Holden, Disaster Resource Guide
SO, IS THERE OR WILL THERE BE A BLACK HOLE? ACCORDING TO THIS QUOTE FROM DANIEL HOLDEN, …

17. Objective Learn why our workforce is aging.
Know what drives the aging workforce to keep working.
Effects of aging.
Prevention and Solutions for keeping the aging worker safe.
Claims management.
Question and answer.
I would now like to turn this over to Patty who will talk about the effects of aging..
WITH THIS PERCENTAGE OF THE WORKFORCE INCREASING, IT IS IMPORTANT TO BEGIN WITH UNDERSTANDING THE EFFECTS THAT AGING HAS ON OUR BODY.

18. Deconditioning with aging
Bone
osteoporosis
Joints
cartilage degeneration
synovial atrophy
ankylosis
Musculoskeletal
atrophy, decreased strength 1%/day with strict bed rest, 10-20%/week, plateau at 25, recovery takes 2x as long(Mueller 1970)
contractures

19. Deconditioning with age
Cardiovascular
increased rest HR
decreased SV, Q
decreased a-v O2
decreased plasma volume
Body Composition
decreased LBM
increased body fat
Genitourinary
increased PVR
increased calculus formation
decreased urine concentration
difficulty voiding

20. Deconditioning with age
Respiratory
decreased VC, no change in total lung capacity
Ventilation/perfusion mismatch
Neurological
compression neuropathies
decreased balance, coordination
sleep disturbance
decrease visual acuity
increased auditory threshold
depression/anxiety

21. Deconditioning with age
Gastrointestinal
decreased appetite
decreased bowel motility
decreased gastric secretion
Endocrine
decreased glucose tolerance
decreased thermoregulation
decreased androgens
decreased growth hormone
decreased PTH

22. Performance with age Running decrease by 1% per year from 25 to 60 y
Swimming decrease by 1% per year from 25 to 75 y. Depends also on skill, peformance can last longer.
Cycling 0.7 % per year from 20 to 60 y
Most athletics perfomances declines steady during middle age and older age due to decreased endurance and strength

23. Aging
VO2max decrease by 10% per decade, starting late teens on females and early 20’s on males
Older endurance athletes with high-intensity training VO2 declines very little
Difficult to differentiate between biological aging and physical inactivity
Strength decrease due to physical inactivity and decrease in muscle mass from reduction of protein synthesis and loss of fast-twich fibers

24. Aging Temperature less regulatory due decrease in sweating
Altitude affects less with aging
Aging starts early teens and twenty’s
Bodyfat increase due to
Increased intake
Decreased physical activity
Reduced ability to mobilize fat

25. Risks of Aging Increased risk of falls Increased muscle weakness
33% of all injuries over workers over 65
14% if all fatalities result from falls
Increased muscle weakness
Increased prescription side effects
Increased risk of MVAs
TO EMPHASIZE THE IMPORTANCE OF FALL PREVENTION.
Falls: Muscle weakness, balance, vision IN COMBINATION WITH medication side effects – WE KNOW ALMOST ALL EMPLOYERS HAVE EXPOSURE TO THE RISK OF FALLS, INCLUDING YOUR EXPOSURE DUE TO SO MANY DIFFERENT POSITIONS BEING EMPLOYED BY THE CITY.
MAKES THIS AN IMPORTANT AREA OF PREVENTION.

26. Aging Worker Injuries
Top 5 Types of Injuries that impact aging workers
Rotator Cuff Sprains
Lumbar Disc Disease
Brain Injuries
Carpal Tunnel Syndrome
Knee Cartilage injuries
WE WILL GO OVER THE COST LATER IN THE PRESENTATION BUT I WANTED TO PASS ON THIS LIST TO SEE IF THIS IS CONSISTENT WITH WHAT YOU ARE SEEING IN YOUR CLAIMS AND LATER GAIL WILL TALK ABOUT WHAT OPPORTUNITIES EXIST TO AVOID THESE INJURIES.

27. Objectives Learn why our workforce is aging.
Know what drives the aging workforce to keep working.
Effects of aging.
Prevention and Solutions for keeping the aging worker safe.
Claims management.
Question and answer.

28. Solutions Reduce and minimize heavy lifting.
Reduce static standing time.
Improve walking and working surfaces.
Improve illumination.
Review office ergonomics.
Eliminate work on ladders.
WHILE THESE SUGGESTED SOLUTIONS ARE NOT NEW, THEY BEAR REPEATING AND REQUIRE CONTINUOUS REVIEW AND ACTION WHERE APPROPRIATE. WITHOUT CONTINUOUS REVIEW OF EXPOSURES, THERE IS THE POSSIBILITY THE EXPOSURE REMAINS WITHOUT CORRECTION. THE CORRECTIONS ARE NOT ALWAYS EXPENSIVE BUT REQUIRE A FRESH EYE ON EACH AREA OF WORK SPACE AND THE WAY THE WORK IS DONE. EXAMPLE OF A FAIRLY EASY SOLUTION - PROVIDE COLOR CONTRAST ON RAMPS AND STAIRS. ARE THERE HANDRAILS ON ALL STAIRWAYS? CAN YOU REDUCE THE AMOUNT LIFTED – SMALLER CONTAINERS, BREAKING UP THE LIFTING ACTIVITY BY THE WAY THE WORK IS STRUCTURED? ARE SUPERVISORS WATCHING FOR PROLONGED STANDING? ARE REGULAR ERGONOMIC REVIEWS CONDUCTED AND TRAINING PERIODICALLY DONE? ANOTHER GOOD PLACE TO START EVALUATION IS TO LOOK AT CLAIM TRENDS TO TARGET SPECIFIC WORK AREAS.
Keep floors clear, dry and cushioned.

29. Solutions Remove clutter. Use large video displays.
Use hands-free telephone equipment.
Avoid above shoulder work.
Ergonomic interventions to reduce discomfort.
AGAIN, THESE ARE NOT NEW, BUT ARE THEY REGULARLY REVIEWED? DO SAFETY MANAGERS WORK WITH A COMMITTEE WITHIN THE ORGANIZATION LOOKING FOR CONTINUOUS IMPROVEMENT IDEAS? ARE YOU TAKING FULL ADVANTAGE OF ALL SOURCES – YOU WORK WITH MIDWEST EXPERTS, SUCH AS OUR LOSS AND SAFETY PREVENTION CONSULTANT AND OUR SPECIALTY PRACTICE LEADERS SUCH AS PUBLIC ENTITY AND HEALTHCARE - A POTENTIAL SOLUTION MAY BE TO HAVE OTHER MEMBERS IN THE ORGANIZATION PARTICIPATE WITH SAFETY INSPECTORS TO OBSERVE VARIOUS JOBS AND HOW THE WORKER IS PERFORMING THE VARIOUS TASKS – PATTY IS GOING TO EXPLORE OTHER PREVENTION IDEAS AND INJURY FACTS

30. Prevention Corporate wellness programs Reduce sick leave
Increase productivity
Decrease rates of illness and injury
Helps speed recovery
Source: Mercer Human Resources Consulting, 2007
I’M NOT SURE WHAT KIND OF CORPORATE WELLNESS PROGRAMS THOS E OF YOU ATTENDING MAY HAVE, BUT I KNOW WE ARE WORKING ON IMPROVING OUR OWN WELLNESS PROGRAM HERE AT MECC AND A WORK IN PROGRESS.
I THINK IT IS IMPORTANT TO REMEMBER THE OLD SAYING “ A OUNCE OF PREVENTION IS BETTER THAN A POUND OF CURE”
MANAGING PRE-EXISTING CONDITIONS AND LIVING A HEALTHY LIFESTYLE WILL HELP WITH SPEED UP HEALING IF AN INJURY DOES OCCUR.

31. Most Costly Higher cost due to higher severity and not frequency
Higher indemnity costs due to higher wages
Older IWs received 26% more in temporary benefits per day than workers ages 20-34
MORE EXPERIENCED WORKERS……
DEPENDING ON WHERE YOUR CLAIMS DOLLARS ARE GOING. YOU CAN LOOK AT WHERE PREVENTION WOULD HAVE THE MOST IMPACT.
AND THEN DECIDE ON WHERE YOU WANT TO INCREASE THE PREVENTION.

32. Frequent Injuries What is causing the injuries?
Intolerance
Disease
Consider fitness for duty evaluation
HERE WE NEED TO FIGURE OUT IF AN EMPLOYEE IS PHYSICALLY UNABLE TO DO A JOB (THEIR BODY WILL NOT TOLERANT IT) OR IF THEY HAVE A PRE-EXISTING CONDITION WHICH WOULD CONTRIBUTE TO THEM BEING HIGH RISK FOR INJURY IN A CERTAIN JOB.
FOR PREVENTION:
CAN A EVALUATION BE PERFORMED TO ENSURE THEY CAN PHYSICALLY DO THE JOB THEY ARE BEING GIVEN WITHOUT AN INCREASED EXPOSURE TO BECOMING INJURED.

33. Fitness for Duty
“Voluntary participation in strenous physical activity on a regular basis is an unusual pattern of behavior that is not observed in most aging animals” Jack H. Wilmore “Physiology of Sport and Exercise”

34. Exercise Prescription
Endurance Training similar gains in healthy individuals regardless of age
Take in consideration comorbidities as Diabetes Mellitus, degenerative bone and joint disease, cardiovascular disease
Walking, chair and floor exercises, aquatic therapy

35. Rotator Cuff Injuries
More prevalent with age (by age 67 30% have bilateral tears) (Source: Svendsen, 2004)
Strong evidence for age and BMI
Some evidence for force/repetition and force/posture
NEJM, 2008
More likely to be treated with conservative care. THE TEARS MAKE A SURGICAL REPAIR HARDER WITH A LOWER CHANCE OF SUCCESS.
ONE ROTATOR CUFF REPAIR CAN QUICKLY TURN INTO A SECOND OR A THIRD AND RESULT IN A REVERSE SHOULDER ARTHOSCOPY.
ROTATOR CUFF REPAIRS ARE ONE AREA THAT IS TIME SENSITIVE. IF YOU HAVE AN ACUTE TEAR, THE LESS TIME THAT PASSES THE HIGHER CHANCE OF SURGICAL SUCCESS. CHRONIC ROTATOR CUFFS TEARS ARE AN ENTIRELY DIFFERENT STORY. THE TISSUE IS VERY DIFFICULT TO REPAIR ONCE IT HAS PULLED BACK DUE TO DEGENERATION. (IT NOT LONGER FITS TOGETHER LIKE A PUZZLE PIECE)

36. Knee Pain Osteoarthritis Internal derangements
Very strong evidence for age and BMI (also prior injury)
Internal derangements
Strong evidence for BMI
Not for age
LOAD BEARING JOINTS SUCH AS THE KNEE ARE THE MOST IMPACTED BY BMI.
“INTERNAL DERANGEMENTS” WHICH ALSO CAN BE PART OF THE NORMAL AGING PROCESS – NOT NECESSARILY AN ACUTE INJURY………..
MAKE SURE CAUSING FACTOR ADDRESSED

37. Spinal Canal Stenosis Common in age 60+
Ligaments, bone and discs narrow the canal
LET ME SET UP THIS PICURE FOR YOU. THIS IS A CROSS-SECTION IF YOU CUT THE BODY IN HALF AND LOOKED DOWN. THE SPINOUS PROCESS IS THE POINTY PART YOU FEEL IF YOU RUN YOU HAND ALONG YOUR SPINE.
IF YOU LOOK AT THE HOLE IN THE MIDDLE OF THE PICTURE THIS IS THE CANAL THE SPINAL CORD GOES THROUGH.
THE DISC SITS ON THE KIDNEY BEAN SHAPED PORTION OF THE TOP OF THE BONE. WITH DDD THE DISC CAN FLATTENED OUT AND START OF TAKE UP PART OF THE HOLE, ARTHRITIS CAN FORM AT THE PEDICLE AND ALSO START TO TAKE UP SOME OF THE ROOM OF THE HOLE. THE LIGAMENTS ALSO THICKEN FURTHER SHRIKING THE SPACE FOR THE SPINAL CORD. THIS IS CALLED STENOSIS, IT IS PART OF THE NATURAL AGING PROCESS AND OCCURS IN ALMOST EVERYONE OVER THE AGE OF 60.
SOMETIMES SURGERY MAY BE BENEFICIAL BUT YOU WILL NEED TO DETERMINE IF IT IS PART OF THE AGING PROCESS OR DUE TO A WORK RELATED INJURY.

38. DDD “Degenerative disc disease” Is NOT a disease or medical condition
46-93% asymptomatic patients
It is a radiographic finding unrelated to symptoms
YOU CAN SEE THE DISCS BETWEEN THE BONES IN THIS PICTURE.
AGAIN THIS IS A PART OF THE NORMAL AGING PROCESS AND WILL SHOW UP ON RADIOLOGIC STUDIES.

39. Normal Aging
Consider the significance (or lack thereof) of many commonly ordered diagnostic tests, especially spinal and joint imaging
Rotator cuff
Internal knee derangements
Spinal canal stenosis
“DDD”
Second opinions for surgical recommendations
MANY OF THESE CONDITIONS ARE ASYMPTOMATIC AND FOUND ON DIAGNOSTIC TESTING BUT NOT NECESSARILY THE CAUSED OF THE COMPLAINTS THE INJURED WORKER IS EXPERIENCING.
THIS IS WHY THE CLININCAL EXAM SHOULD MATCH THE OBJECTIVE TESTING. IF A PERSON DOES NOT HAVE SYMPTOMS THAT CORRELATE WITH THE FINDINGS, THE PAIN IS MOST LIKELY NOT RELATED TO THE FINDING AND THEY ARE SIMPLY INCIDENTAL.

40. MRI: Asymptomatic pts Disc degeneration age 30 = 30% age 60 = 80%
Disc bulging %
Disc prolapse %
Herniated disk is found on magnetic resonance imaging in 9% to 76% of asymptomatic patients; bulging disks, in 20% to 81%; and degenerative disks, in 46% to 93%. (Kinkade, AFP, 2007)
PEOPLE WITH NO BACK PAIN.
THINK OF A JELLY DONUT.
DEGENERATION IS WHEN THE DONUT BECOMES KIND OF FLAT, NOT SO FRESH LOOKING ANYMOE
BULGING IS THE WHEN THE JELLY STARTS TO COME OUT, DOESN’T DRIP BUT MAY START TO TAKE SOME OF THE ROOM OF THE SPINAL CANAL.
PROLAPSE OR DISC HERNIATION IS WHERE THE JELLY ACTUALLY COMES OUT AND PRESSES ON THE NERVE. THIS IS WHY DOCUMENTATION OF LEG PAIN OR RADIATING PAIN FROM THE BACK IS IMPORTANT. SURGERY CAN REMOVE THE DISC HERNIATION AND RELIEVE THE PRESSURE ON THE NERVE. BUT IF THAT’S NOT WHERE THEY’RE HAVING PAIN, IT MOST LIKELY WILL NOT HELP. 40

41. MRI: Appropriate Use Strong neurologic signs Red flags
Objective findings
Red flags
Persistent symptoms > 4-8 weeks
Patients should understand that imaging is to rule out serious conditions and to expect degenerative findings.

42. MRI: Inappropriate Use
Over-use of imaging studies risks:
Reinforcing the suspicion of serious disease
Magnifying the importance of nonspecific findings and
Labeling patients with spurious diagnoses
Creates fear
Magnifies unimportant findings –could lead to additional, possibly unnecessary interventions THAT ARE NOT REASONABLE AND NECESSARY
Gives some kind of diagnosis which may not be the true problem -- Increases rationalization for medications
TESING BY ITSELF IS NOT ENOUGH. THE PHYSICAL EXAM MUST CORRELATE WITH WHAT IS SEEN ON THE FILMS.
I AM GOING TO TURN THIS BACK OVER TO GAIL TO TALK TO YOU A LITTLE BIT MORE ABOUT MANAGEMENT OF THESE TYPES OF CLAIMS.
END

43. Objectives Learn why our workforce is aging.
Know what drives the aging workforce to keep working.
Effects of aging.
Prevention and Solutions for keeping the aging worker safe.
Claims management.
Question and answer.
What can we take from this information and put into claims management

44. Management of Claims Investigation: Causation Caused by work?
Symptoms at work?
Shoulder
Knee
Low back
INVESTIGATION IS THE CORNERSTONE OF CLAIM HANDLING AND MITAGATION. WHETHER YOU ARE A SELF ADMINISTERED ACCOUNT OR HAVE A THIRD PARTY ADMINISTRATOR, THE MORE INFORMATION YOU KNOW ABOUT THE WORKFORCE, REQUIREMENTS OF EACH POSITION AND OBTAINING ALL THE INFORMATION IN THE FIRST COMMUNICATIONS IS PARAMOUNT. GATHER ALL INFORMATION ON THE INJURY ITSELF AND ALL YOU CAN ABOUT PRE EXISTING CONDITIONS AND ANY CO EXISTING CONDITIONS. THERE MAY WELL BE PRE EXISTING CONDITIONS . A THOROUGH INVESTIGATION WILL ALLOW YOU TO PROVIDE INFORMATION TO THE PHYSICIAN TO ASSIST IN DETERMINING WHETHER THE ACTIVITY ON THE JOB WAS THE CAUSE AND BENCHMARK IF IT IS A TEMPORARY AGGRIVATION. THERE ARE JURISDICTIONS THAT ALLOW FOR WORSENING OF CONDITION AT A LATER DATE FOLLOWING THE INITIAL INJURY AND YOU WANT TO BE IN POSITION TO DEFEND OR DENY IF NOT REALTED TO THE WORK INJURY. KNOWLEDGE OF CO EXISTING CODITIONS ALLOWS THE CLAIM HANDLER TO DETERMINE WITH PHYSICIANS WHAT THE TREATMENT PLAN SHOULD BE TO AVOID AN ELONGATED CLAIM.

45. Management of Claims Investigation
Gather as much medical and activity information as possible
Only use relevant information for compensability decision
Use the same process regardless of age
Beware of appearance of age discrimination
Presumption claims
JURISDICTIONS VARY ON WHETHER AN INJURED WORKER HAS CHOICE OF PHYSICIAN, OR IF THEY CAN PETITION FOR CHANGE OF PHYSICIAN AT A CERTAIN POINT DURING THE CLAIM. BUT BY PROVIDING THE INITIAL PHYSICIAN WITH AS MUCH INFORMATION AS POSSIBLE, IT CAN ASSIST IN APPROPRIATE DIAGNOSIS AND TREATMENT. THEY SHOULD BE PROVIDED WITH DETAILED MEDICAL INFORMATION AND SPECIFICS ON THE REQUIREMENTS OF THE POSITION. THIS IS PARTICULARLY IMPORTANT ON BACK, SHOULDER AND KNEE CLAIMS FOR THE REASONS DISCUSSED PREVIOUSLY.. IN JURISDICTIONS WHERE THERE ARE CLASSES OF EMPLOYEES AND PRESUMPTION IS ALLOWED, BENCHMARKING THE MEDICAL STATE OF THE EMPLOYEE AT VARIOUS TIMES THROUGHOUT THEIR EMPLOYMENT BECOMES A BEST PRACTICE.

46. Management of Claims When do you think you will return to work?
Conversations with employees
Early intervention
Transitional duty program is key
No different from other ages
Individualized
Close follow up
FIRST QUESTION TO AN INJURED WORKER IS WHEN DO YOU THINK YOU WILL RETURN TO WORK – IF MORE THAN 10 DAYS, THIS IS A FLAG..WHILE RETURN TO WORK IS ALWAYS DISCUSSED AND KNOWN TO BE PERHAPS THE SINGLE BEST STRATEGY IN MANAGING A CLAIM, THE IMPORTANCE OF PROVIDING TRANSITIONAL/MODIFIED WORK IF NECESSARY, CAN BE THE GAME CHANGER… WHILE IT IS KNOWN, IT IS STILL SURPRISING HOW MANY BUSINESSES HAVE NOT TAKEN THE TIME TO REALLY EVALUATE HOW TO STRUCTURE THE WORK TASKS TO BE ABLE TO ACCOMMODATE AN INJURED WORKER..

47. Communication Stay in touch Talk about health in general
A process by which information is exchanged between individuals through a common system of symbols, signs, or behavior: exchange of information
Stay in touch
Talk about health in general
This is important to the older patient
They want to remain active
Emphasize function, not pain
FREQUENTLY… IN COMMUNICATION, FOCUS ON IMPROVING FUNCTION FOR BOTH WORK AND THEIR PERSONAL LIFE AS WELL

48. Thank You!!!