All posts by artefact_admin

New Jersey, Workers' Compensation

Tomorrow Is Official Launch Day!

Well, here it is. After more than a year of building, Workers Compensation Psychological Network Launches tomorrow.

In what seems to come right out of Star Wars’s opening line – Long ago in a galaxy far away – Richard Filippone and Mary Ann Kezmarsky had a vision, a dream of doing something never before done anywhere in America. They realized that the workers’ compensation system in New Jersey for dealing with mental and behavioral health issues was an afterthought, at best, resulting in high costs for employers, frustration for insurers and angst for injured workers. Claims adjusters did not want to “buy a psych claim,” because of the fear that doing so sent the claim into a psychological black hole and created a lifetime annuity for some PhD.

Richard and Mary Ann, PhDs of the first order, themselves, knew there had to be a better way.

And thus was born a dream that becomes reality tomorrow.

At Workers Compensation Psychological Network you’ll find a network of Psychologists and Neuropsychologists, as well as Cognitive Behavioral Health and Biofeedback experts. The network covers all of New Jersey’s 21 counties, from Sussex in the north to Cape May in the south. All members of the network have been highly trained in New Jersey’s workers’ compensation system. They have learned what employers go through every time a worker is injured and misses time away from work. They’ve learned about experience modification and modified duty and how premiums are built. They know how important is the concept of MMI, Maximum Medical Improvement. And they’ve learned all this without checking their expertise and compassion at the door.

But that’s not all. In addition to building this unique network, Richard and Mary Ann have built the nation’s first totally electronic claimant referral portal and electronic health record system. Richard had another vision – no paper. This means that a referral can happen in a matter of minutes, saving claims adjusters hours, even days of time in finding the proper person to see a claimant.

So, tomorrow, at the New Jersey Self-Insurers Association annual conference, we launch. We couldn’t be happier

 

New Jersey, Upcoming Events

The John Geaney Seminar

John Geaney is a renowned New Jersey attorney focusing on workers’ compensation. He heads the workers’ compensation practice for Capehart Scatchard, and is a good friend of Workers Compensation Psychological Network.

John is the author of “Geaney’s New Jersey Workers’ Compensation Manual for Practitioners, Adjusters, and Employers,” and updates it annually. If you have anything to do with workers’ compensation in New Jersey, you need to have John Geaney’s Manual.

In addition to representing a great number of New Jersey’s foremost employers, writing a Lexis Nexis Top Blog and creating the aforementioned Manual, John, teaming with Millennium Seminars, puts on three seminars each year for New Jersey professionals specializing in workers’ compensation. The seminars are always full. Attendees keep coming back, which is a testament to the high regard employers and insurers have for John.

As I write this, Workers Compensation Psychological Network founders Mary Ann Kezmarsky and Richard Filippone are attending and exhibiting at one of John’s seminars in Mount Laurel, New Jersey.  There are more than 100 work comp pros here.

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They’ll also be exhibiting at the upcoming Annual Conference of the New Jersey Self-Insurers Association in Atlantic City at the end of the month where attendees will number nearly 300.

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Workers Compensation Psychological Network, with trained and certified workers’ compensation psychology professionals throughout New Jersey,  as well as an online claimant referral portal and electronic health record system, is gathering steam. We’ve been Beta Testing for a couple of months. Our official company launch is only two weeks away. To say we are excited doesn’t begin to describe it.

Upcoming Events, Workers' Compensation

Upcoming Events

Workers Compensation Psychological Network is making steady progress toward our official launch when we throw open the doors for business. We’re just finishing Beta testing, and if you’ve ever launched a new enterprise, then you know what that’s like. We expect to launch just in time for the New Jersey Self Insurers’ Association’s Annual Conference at Harrah’s Resort and Casino in Atlantic City on April 28 and 29. If you’re there, please stop by and say hello. You’ll find us at Table 42. We look forward to chatting.

The theme for this year’s Conference is “Drafting the Right Workers’ Compensation Team.” We’re hoping you’ll give us a chance to add a lot of value to your team!

Meanwhile, we’ll be exhibiting at Millenium Seminars’ One Day New Jersey Workers’ Compensation Seminar on April 14 at Doubletree Suites by Hilton in Mount Laurel, New Jersey. Please say “Hello” if you’re there. And it’s not too late to register for this highly worthwhile conference organized by our good friend John Geaney of the excellent Capehart Scatchard law firm.

We’d love to speak with you at either of these great events. Workers Compensation Psychological Network is the only state-wide network of clinicians who are highly trained and certified in dealing with those hard to handle workers’ compensation claims fraught with biopsychosocial issues. We aim for Recovery: Sooner, Faster, Smarter.

Best Practices, Research

Early Intervention: Good For The Injured Worker, And It Saves Money, Too

It’s long been known that workers’ comp claims in which behavioral health issues are present cost more than those without such issues. Often a lot more. This month’s issue of Health Affairs reports on a Canadian Study that found that the average cost for a “mental health high-cost patient” was roughly 33 percent greater than the average cost for other high-cost patients. The authors suggest that intervening early when behavioral health issues are first detected can mitigate these higher costs.

Also, the Robert Wood Johnson Foundation’s Health Policy Snapshot, published in March 2013, examined the prevalence of mental disease in the U.S., and described how early treatment and intervention can improve lives and ultimately lower related health care costs.

Patients and payers are best served when screening occurs during the first month of any workers’ comp claim involving head injury or when the claimant is depressed, overly anxious or fearful. These can delay return to work and increase the cost of the claim. Intervening early leads to Recovery: Sooner, Faster, Smarter.

Financial, Return To Work, Workers' Compensation

Workers’ Comp State Laws Can Lead To Depression For Injured Workers

According to the Bureau of Labor Statistics’ (BLS) Consumer Price Index calculator, what you bought for $100 in 1973 would today cost $533.82. Despite this, during that same period wage growth for the median hourly worker grew by less that 4%. 

That’s how yesterday’s Workers’ Comp Insider’s blog post begins. Fifty States, Fifty Different Laws underscores the sobering reality that many hourly workers in America live perilously close the edge of the financial cliff, one crisis away from homelessness.

The Insider’s post analyzes “The Uncompensated Worker,” a Special Report from WorkCompCentral’s Peter Rousmaniere. The highly readable, but detailed, report illustrates how workers in every state take a pay cut when injured and out of work. Because all state laws are different, the pay cut can be minimal in a few states and catastrophic in many others.

At Workers Compensation Psychological Network, we see workers who, in addition to struggling to recover from a work injury, are also walking on the edge of an economic razor blade. These workers are deeply fearful that their injuries might lead to their families being forced to bunk under a bridge. Mr. Rousmaniere’s report shows that even short-term injuries can lead to deprivation. For instance, a 50-state chart at the end of the report shows that if an injured worker incurs only a brief disability – say, three, six or ten days – some of the provisions of New Jersey’s workers’ comp law (the calendar days waiting period before indemnity can begin, for example), will force a pay cut of 28% for that period.

As psychologists and neuropsychologists, we are mindful that helping these vulnerable people return to work as quickly as medically possible could spell the difference between financial stability and financial disaster. The mental health benefits of such an outcome are, quite frankly, immeasurable.

That’s why our overarching goal is now and always will be Recovery: Sooner, Faster, Smarter. 

Testing, Workers' Compensation

There Is A Need For Better Psychosocial Intervention In Workers’ Compensation

This morning, Workers Comp Insider, the Grand Daddy of workers’ compensation blogs, published an illuminating post focusing on why workers’ comp claims professionals wait far too long to engage qualified psychologists.  This, from the opening of Are We Only Paying Lip Service To Psychosocial Issues In Workers’ Compensation?:

It is a cliché in the workers’ comp industry that claims adjusters never want “to buy a psych claim.” Perhaps that’s why they rarely resort to psychologists until the horse is out of the barn and grazing four pastures over. By then it’s a last resort kind of thing.

The Insider goes on to say that claims payers and psychologists just don’t understand each other. It chides those claims adjusters who settle for asking only the basic questions suggesting that “digging deep” and

peeling the injured person’s personality onion to discover what really matters will allow for early detection of those relatively rare cases where speedy referral to a qualified psychologist might make all the difference.

We couldn’t agree more, yet lest we with the PH. D.s after our names begin to feel too comfortable, we come in for some sharp criticism, too. Most of us “know not even the first thing about workers’ compensation and give every indication of being proud of it.” Ouch.

The blog post suggests that we and the payers need to come together to build a system that works for everyone and that if claims adjusters are attuned to the subtle nuance inherent in a good conversation with an injured person, then perhaps certain signs will become apparent that indicate early psychological intervention is warranted.

Part of that coming together requires trust on both sides. The Insider suggests that a sign of trust on the side of the payers would be to adopt a  policy that “entrance into a payer network should not be determined solely by a license to practice and the forced acceptance of a ridiculously low fee. Quality and results matter.”

Finally, the post tells payers that they have a whole lot of educating to do, education that should start today. Why?

Because identifying early and resolving quickly the factors that have the potential to turn physical injuries into mental health problems will save employers, the folks who pay the bills, a significant amount of money and adjusters, whose goal it is to put the toothpaste back in the tube, considerable otherwise wasted time.

That, in a nutshell, is why we created Workers Compensation Psychological Network. To partner with payers for the betterment of injured workers to build a better system – Sooner, Faster, Smarter.

Brain Injury, Testing

Neuropsychological Testing reports – What they should be saying about injured workers!

As a neuropsychologist with over 37 years of neuropsychological testing experience I have a keen appreciation for the time and cost of neuropsychological testing. A key question to me is what value does this expensive assessment have to the injured worker or to his payor of medical services?

In answering this question I am reminded of a case several years ago as Clinical Director of Cambridge Rehabilitation Services. Called on to consult by a private disability insurance carrier, this man had been a top salesman in New Jersey for a national company for many years. Unfortunately he suffered a brain injury from which he physically recovered but left him with mild cognitive impairments. The referral included his medical reports and a Neuropsychological Test report. This report was not from a local neuropsychologist but by a leading expert from New York. The expert, well published and a professor, made many correct observations and conclusions about my patient.   However, it was my belief that the report missed the mark on informing his disability insurance carrier about his rehabilitation potential in terms of return to work.

I went over the test data and concluded that the expert, retained by claimant’s attorney on behalf in his disability claim, presented a very static view of his capabilities.   As with many Neuropsychological Test reports I have reviewed over the years, several critical work related questions went unaddressed. The expert simply opined the claimant had suffered cognitive impairments and that returning to his job “as is” was not possible. With the simple “yes he is disabled” conclusion, a disability “payout” was inevitable with this report in hand.

After an interview with the claimant, I imagined a very different outcome for him, one that he was eventually very pleased with in the long term.

My report to his insurance carrier pointed out several missing factors left unaddressed in the prior report.

  • Job related cognitive limitations – The specific cognitive changes causing his loss of work functions
  • Potential benefits of rehabilitation efforts– the specific interventions and their projected benefits to improving his work product
  • Emotional and motivational factors– the personality factors which could be tapped into and leveraged to assist him in perservering with a rehabilitation program that would assist him in accepting personal changes
  • A specific time line for return to work and projected costs– a detailed outline of the time and cost of the rehabilitative efforts.

His insurance carrier offered him our cognitive rehabilitation program in lieu of a full and permanent disability payout, with the option of the payout if the program failed. He chose the rehab offer.

Our team of a neuropsychologist, speech pathologist and cognitive therapist went to work on an intensive basis with interventions in his work environment itself. Remediation efforts attacked his critical cognitive weaknesses that blocked him from success and within 3 months he returned to work. While his work output was still diminished (after all he had been national top salesman for several years, allowing quite a bit of leeway), he was happy he could see himself successful earning a living, competing in the workplace as he always had.

The full cost of our cognitive rehab program was less than 4 months of the disability payments that would have been paid to him had our interventions not been successful! A net win-win for all.

 

 

Pain

Pain Pathways and Treatment Options

In our last blog post (link to post), we focused on chronic pain and suggested that New Jersey’s workers’ comp claim system did a poor job of helping injured workers who are chronic pain sufferers to recover.

But there are two kinds of pain injured workers face: Chronic and Acute. The first step in pain management is knowing which is afflicting the patient. Seems simple? It’s not. Make a mistake here, and you can harm the patient.

WCPN Psychologists first perform a comprehensive evaluation to determine the level and type of pain. Then, working in active a steady communication with the patient’s physical health provider, they begin a targeted treatment plan to help restore the patient to high functionality.
But what’s in that “comprehensive evaluation?” How do they assess the current mental well-being of the patient, so the best treatment plan can emerge?

Well, first of all, there’s no black box. No Wizard behind the curtain.

Together, we and our patient begin the assessment journey. First, we need a good history. This includes an individual and family medical history, as well as the patient’s educational history. The fancy name for this is a “Biopsychosocial Assessment (BA).” Here are some of the things that go into conducting the BA:

  1. We need to identify and gauge the role of pre-existing conditions.
  2. We discover the patient’s levels of anxiety and depression.
  3. We consider the patient’s personality factors that might be affecting his or her perception of pain in daily life.
  4. We review prescription medication use or abuse.
  5. By listening closely, we cull out the patient’s pain history.
  6. We identify specific functional behaviors the patient’s pain is affecting.
  7. Through all of this we introduce appropriate coping skills and the concept of medication reduction. Here, the patient begins to learn about the Mind-Body relationship, after which, as part of treatment, we can begin Awareness Training.

Through a good Biopsychosocial Assessment and follow-on treatment, our constant goal is helping our injured worker patient walk down Recovery Road and return to work as soon as health allows. WCPN Psychologists aim for Recovery: Sooner, Faster, Smarter.

Pain

Chronic Pain: No Sunday Stroll In The Park

Pain is part of the human condition. We all know that. However, some people know it more than others. They’ve drawn the short end of the pain stick. For them, pain is chronic, a constant uninvited guest at the table.
At Workers Compensation Psychological Network, New Jersey’s only network of trained and certified workers’ comp psychology clinicians, we often see patients who are afflicted with chronic pain. For these patients, chronic pain can lead to depressive reactions that subsequently influence their subjective experience of pain levels and what they consider to be “tolerable” functional capabilities. These injured workers are lost in a maze.

Some were sufferers even before their workers’ comp injury, which worsened the condition. Others developed chronic pain following the injury. Regardless, many of these patients have difficulty returning to work. A clinician’s role should not be to suggest to these patients that their pain is not real, because it is. Rather, working closely with the patient’s physician and claim adjuster, clinicians should provide common sensible, compassionate treatment so patients can move down Recovery Road with a steady return to work trajectory.

The current system for treating injured workers with mental health issues, especially chronic pain, is not properly focused on a speedy return to work. It is overly fragmented and often appears to employers, claim adjusters and injured workers to be a treatment black hole. Indeed, there is an urgent need for a more systemic and integrated approach in which there is a constant focus on returning to work in some appropriate capacity. We call this recovery that is sooner, faster and smarter.

New Jersey’s injured workers and the men and women who employ them deserve nothing less.