NWCDC 2018: What's on the Minds of Policymakers for This Year and Beyond?

Las Vegas, NV (WorkersCompensation.com) – A large crowd greeted speakers for a lively discussion on “Policymaker Perspectives” Wednesday, including speakers Abbie Hudgens; Administrator, TN Bureau of Workers' Compensation; Frank McKay; Chairman, GA State Board of Workers' Compensation; and Jennifer Wolf Horejsh; Executive Director, International Association of Industrial Accident Boards and Commissions (IAIABC).

Medical care was a big topic that concerns all key stakeholders in the industry. It is one of the most significant cost drivers in work comp claims, Wolf Horejsh said. 

Telemedicine was also discussed. We can’t use telemedicine as a complete replacement for in-person exams when it comes to work comp, and patients as a whole, Hudgens said. TN could work through related legislation this year covering that topic.

“There are proper places for these auxiliary medical providers, but we need to make sure it isn’t a replacement for (in-person) providers, she said.” When you see a document with the practitioner’s name, and they haven’t seen the patient at all, that is a problem.

Several states are working through the issue of telemedicine and where it belongs, Wolf Horejsh said. 

For what is shaping Georgia’s work comp issues, McKay said there is a shortage of primary care providers in work comp, so sometimes things are stretched thin with nurse practitioners, physician assistants, etc.

And on the subject of outcome-based reimbursement for services, it is an enormously complicated issue, Hudgens said. She also referenced TENN Care, in which doctors are sometimes reimbursed based on the outcomes.

“We want to reward the doctor who does surgery when it is needed, but also practices conservative care when it is appropriate,” she said. 

McKay also spoke on presumption in Georgia, and people in careers including firefighting.

Looking at causation can be a real challenge, he said. Presumptions are hard with PTSD from shooting events, and first responders who are there to help, who see a lot of really difficult things. If you are the president, worker or employee in a situation involving a violent incident, a lot of states have passed presumption laws for that, but GA hasn’t.

But, some employers in the state have stepped up to help with, say, ten sessions with some sort of counseling entity, if the worker is hit with a tragedy or struggle they can’t cope with on their own. In incidents of violence in the workplace, sometimes counselors offer help on a voluntary basis in the short-term.

It is a good step, but we still have work to do on it, McKay said of GA.

He gave an example of a community in GA where a flood came through a cemetery, and some of the bodies had come up and out of their caskets. One of the city sanitation workers who had to deal with the situation developed PTSD and increased incidents of nightmares. The case was pursued and challenged up to the state supreme court, who said it was a legislative issue. In GA, the psychological injury has to stem from a physical injury to obtain work comp benefits.

Wolf Horejsh asked the pair what they would undertake in the work comp industry next year if they could be fearless in one issue. Hudgens mentioned WorkersCompensation.com President and CEO Bob Wilson’s suggestion from a presentation a few weeks ago…

Looking at standardizing First Report of Injury (FROI) forms would be a priority for Hudgens, and McKay agreed.

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