Looking out for aging workers

May is Older Americans Month

By Stephanie McCloud, Administrator/CEO, Ohio Bureau of Workers’ Compensation

Americans are living longer, and they’re working longer too. Today, one in every five American workers is over 65, and in 2020, one in four American workers will be over 55, according to the U.S. Bureau of Labor Statistics.

At the Ohio Bureau of Workers’ Compensation (BWC), we have 71 workers over the age of 65; 18 are over the age of 70. We truly appreciate our older workers and the years of service to our agency and the people of Ohio.

We recognize the value they bring to our agency, and the contributions of mature workers in general to the work force. They bring skills and knowledge to the workplace honed by decades of service and experience. They are dependable and productive. They have a strong work ethic. They mentor our younger workers.

At BWC, our core mission is to protect Ohio’s workers and employers through the prevention, care and management of workplace injuries and illnesses. Workplace safety is a critical component of that mission, especially when it comes to our more seasoned workers. They are more susceptible to injury because of age-related challenges – decreases in mobility and sensory functions, reduced strength and balance, and longer reaction times.

When a 25-year-old worker falls on the job, for instance, she might bruise a knee. For a 70-year-old worker, it’s potentially a broken hip and a long recovery.

Older workers helped build our great state, and we want to keep them active, healthy and engaged in their work. We’re a charter partner in the STEADY U Ohio initiative to curb the epidemic of slips, trips and falls among older Ohioans. (One in three older adults will fall this year, according to the Ohio Department of Health.) These are the leading causes of worker injury, and they most often strike workers 45 and older (like me!).

These incidents are costly. The total estimated cost of falls among Ohioans aged 65 and older (medical costs, work loss) is nearly $2 billion annually in Ohio, according to the Ohio Department of Health. Most are preventable. At Steady U, workers and employers can find tips, tools and resources designed to reduce these incidents.

We urge all Ohioans to join us in creating a culture of safety across this state. Safe workplaces mean fewer, if any, injuries on the job, as well as steady production and lower costs for employers. And they mean more workers can go home healthy each day after their shift.

We are here to help. We have experts, grant dollars and other resources to make Ohio a safer place. To learn more, contact us at 1-800-644-6292 or visit our Division of Safety & Hygiene web page.

Work comp doc: ‘Look at patients holistically’

Counseling, coaching help patients overcome ‘behavioral barriers’ to recovery

By Tony Gottschlich, Public Information Officer

The human body is more than a machine. And when it breaks down, simply repairing the parts won’t get it running again, especially when fear and poor coping skills are involved.

That was the message Friday from the chief medical officer for the Ohio Bureau of Workers’ Compensation (BWC) during a lecture entitled, “Integrating Behavioral Health into Injury Treatment,” at the Greater Columbus Convention Center.

“We need to look at patients more holistically and we need to have the tools to do that effectively,” said Terrence Welsh, MD, speaking at the fourth annual Ohio Workers’ Compensation Medical & Health Symposium. “If we don’t do that we are missing the boat, and we’re not going to accomplish what we set out to accomplish – getting our patients healthy again and back to work and life.”

Speaking to an audience of health care practitioners from across the state, Welsh said health care providers must incorporate a multifaceted approach to better understand and treat patients struggling to recover from injury. He said a “bio-psycho-social” model of care, “accepts that the mind and body influence each other.”

Welsh spoke of a tool BWC initiated last year called the Health and Behavioral Assessment and Intervention services rule, or HBAI. Under the rule, the agency will pay for counseling and coaching sessions that help injured workers overcome negative thinking, poor coping skills, lack of motivation and other behavioral barriers to recovery.

“These things actually work,” said Welsh, who is board-certified in physical medicine and rehabilitation, electrodiagnostic medicine and pain medicine. “There is evidence these services can improve outcomes.”

He cautioned the rule does not apply to mental illness and psychological disorders, but to naturally occurring emotional responses that many people experience following a serious injury.

In an interview before his lecture, Welsh said research shows behavioral barriers have three times or more the impact than pain alone in slowing an injured person’s recovery. That’s why it’s important to address barriers before they spiral into something more serious, such as depression and substance abuse.

Barriers that have the greatest impact on delayed recovery include:

  • Catastrophic Thinking: The tendency to ruminate about irrational worst-case outcomes. This can increase anxiety and prevent the injured worker from taking action, such as completing their rehabilitation treatment program.
  • Perceived Injustice: The injured worker’s belief that nothing will ever make up for what happened to them, and they didn’t do anything to deserve their situation.
  • Fear/Avoidance: The avoidance of movement and activity in an attempt to reduce pain. Studies show that this barrier generally results in both chronic pain and a disengagement from meaningful activities, which prolongs disability and may lead to depression.
  • Disability Beliefs: Injured workers’ expectations about recovery and their ability to manage returning to work. Studies show that an individual’s perceptions of the impact of their condition can have more influence on lost time, levels of impairment and activity levels than actual physical or medical indicators.

HBAI covers one health and behavioral assessment and up to six hours of intervention sessions per 12-month period. A number of licensed health professionals may provide the treatment, including physicians, chiropractors, psychologists, social workers and counselors.

For more information, click here.

Is marijuana medicine?

By Mark Pew, Senior VP, Product Development & Marketing at Preferred Medical. He will present Is Marijuana Medicine? at BWC’s Medical & Health Symposium Saturday, April 27 at 7:30 a.m.

As society and workers’ compensation try to answer that question, there are some clarifying questions that need answers first. That’s especially true on such a polarizing subject where state policy and public opinion continue to have their say.

The initial question should be:how is “medical marijuana” defined? Which then takes you to a list of sub-questions:

  • Is it the whole plant?
  • Is it extracts of specific chemicals like THC or CBD?
  • Is it organic (“natural”) or synthetic (“man-made”)?
  • Is it smoked, vaped, eaten, or an oil that is ingested or rubbed on a body part?
  • Is it just for a specific list of qualifying conditions or open to interpreted needs?
  • Does a physician need to recommend it as “reasonable and necessary” treatment or is it up to the patient (injured worker) to determine for themselves?
  • Is it grown at home, advised by a budtender at a dispensary or tightly controlled from seed to sale?
  • Is the dosing, duration, frequency and formulation determined by the patient or a clinician?

Every state has its own answers, whether on program website FAQs or from how it works in everyday practice. States with more recent programs, like Ohio Medical Marijuana Control Program[i], generally have more attempts at controls. But if you have seen one state medical cannabis program, well, you have seen one medical cannabis program. In other words, every state is different.

Once past that initial question, the next is whether “medical” is a scientific or anecdotal adjective that precedes “marijuana.” Some physicians, pharmacists and policymakers (including the National Institutes of Drug Abuse[ii]) believe the science has not clearly proven the medical benefit. The DEA still believes it is yet unproven because, given the chance in August 2017 to re-classify marijuana from Schedule I (i.e., illegal),the agencyaffirmed that “right now, the science doesn’t support” it[iii].

Other physicians are demonstrating by their recommendations they believe it is medicinal. The FDA believes that at least CBD is medicinal by approving Epidiolex in June 2018[iv]. And then you have people with various medical conditions, including chronic pain, that offer anecdotal proof it helps them or someone they know where FDA-approved medications and treatments do not. Their evidence is compelling, especially to mainstream and social media. Similar to the various definitions of medical marijuana, opinions vary greatly whether it is a proven medical treatment. It is obvious that preconceived biases – for or against – heavily influence individual opinions.

Clear as mud? Good. Because that is our country’s current crossroads. Setting aside individual opinions, 46 of 50 states[v] have decided in favor of medical use, and that is unlikely to be reversed. So the answer to the original question –is marijuana medicine? – is a very firm … maybe.

[i]https://www.medicalmarijuana.ohio.gov/
[ii]https://www.drugabuse.gov/publications/research-reports/marijuana/letter-director
[iii]https://ww3.workcompcentral.com/columns/show/id/0e042b1bfc0820f83bd3e33dabf6001f38e8a066
[iv]www.fda.gov/newsevents/newsroom/pressannouncements/ucm611046.htm
[v]http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx

BWC’s Medical & Health Symposium begins today

Attendance increases more than 350% in four years

By John Annarino, Chief Medical and Health Officer

Our 2019 Ohio Workers’ Compensation Medical & Health Symposium with its theme, Comprehensive Care for Injured Workers, begins today and runs through late Saturday afternoon.

We’re pleased that more than 800 health care practitioners, staff and legal professionals statewide will be attending our two-day event at the Greater Columbus Convention Center.

We’ve been planning our multi-disciplinary event for about a year. We can’t wait to connect with our attendees and exhibitors! This year’s symposium offers continuing-education opportunities with credits, taught by well-respected experts on leading health and medical issues that affect us all – at work and at home.

Our 2019 symposium brings medical and health specialists together with legal professionals to learn how we can better solve far-reaching issues such as managing pain and opioids, chemical dependency and how to recognize traumatic brain injury symptoms before it’s too late. Improving collaboration and trust with our health-care community is another vital issue, as is chiropractic medicine’s role in workers’ comp and occupational medicine.

How we got started

The journey to today’s successful symposium began four years ago. I challenged our Medical and Health division’s leadership to plan an event for health care providers focusing on pain. My vision for this educational event came after a quarterly pharmacy meeting and an in-depth discussion on pain medication. Most of the original planning team members worked on our 2019 Medical & Health Symposium.

Our goal for the symposium – then and now – is to address health care issues facing Ohio’s injured workers. For example, we know the overuse of opioid medication affects Ohio’s workers and their families. To learn more, listen to Chris Hart, an Ohio pharmacist, tell his story of chemical dependency and recovery on Friday followed by a question-and-answer session on Saturday.

In addition, Saturday’s provider clinical education sessions discuss medical marijuana with Mark Pew, who is better known as the Rx Professor; Reggie Fields of the Ohio State Medical Association and Robert Stutman, one of America’s highest-profile Drug Enforcement Agency special agents. Former judge Jodi Debbrecht-Switalski reviews the paradigm of liabilities for the medical profession with the drug epidemic.

How far we’ve come

Debi Kroninger, our chief of medical operations, leads the symposium’s planning team. I’ve learned our first symposium in 2015 had 177 providers registered, with continuing education opportunities for a limited number of professions.

Today, we offer continuing education for attorneys, chiropractors, nurses, occupational and physical therapists, rehabilitation counselors (CCM, CDMS and CRC*), physicians and psychologists. Experts nationwide are learning about our innovative approaches and programs in caring for Ohio’s workers. For example, we already have eight speakers who are asking to present at next year’s event.

For increased learning opportunities, the symposium offers two educational tracks – the provider staff forum (Friday) and provider clinical education (Friday and Saturday). We feature the session Becoming a World-Class Carrier – BWC Medical Initiatives that will Take Us There in both tracks. Freddie Johnson, chief of medical services and compliance, along with Dr. Terry Welsh, chief medical officer, and Debi lead the session.

In addition, take time to network with the symposium’s exhibitors that include health care companies, state agencies, boards, associations and others.

How to contact us

Registration is free. If you have questions, call the provider contact center at 1-800-644-6292, option 0-3-0, or email medsymposium@bwc.state.oh.us.

Together, join us in our journey of providing innovative and quality health care for Ohio’s injured workers, their families and communities. We look forward to seeing you today and/or Saturday at our 2019 Medical & Health Symposium!

*Certified case manager, certified disability management specialist, certified rehabilitation counselor

Better health, straight from the tap

By Melissa Vince, BWC Public Relations Manager

There are few things in life more important to us than O2 and H2O. Air and water. We can’t survive without them.

Let’s focus on water. Its benefits are innumerable, as long as it’s clean and safe. That’s the goal of Governor DeWine’s H2Ohio water quality initiative. The initiative is part of the governor’s budget and seeks to invest in long-term solutions to ensure safe and clean water across Ohio.

Clean, safe water is such an important part of our overall health that it’s one of the areas we encourage Ohioans to focus on when they join Better You, Better Ohio!™, our health and wellness program for Ohio’s workforce.

The free program offers health and wellness coaching and other resources for employees of businesses that have 150 or fewer workers. Healthy employees are less prone to injury. And, when they are injured, they’re usually able to recover more quickly.

You can learn more about the program and register here. If you’re eligible, you’ll have access to:

  • Free health assessment and biometric screening.
  • Disease management and health coaching.
  • Monetary incentives for participating and more!

ActiveHealth Management – our partner in offering the Better You, Better Ohio! program – also has many free health and wellness resources available to anyone. This includes items like a monthly newsletter and webinars covering a variety of health and wellness topics, including the importance of H2O.

The fact sheet below covers the benefits of H2O, how much you need and tips for drinking enough every day.

Better health – it starts straight from the tap.

Medical & Health Symposium, April 26 – 27: Offers continuing education, register now

By Dr. Terrence Welsh, BWC Chief Medical Officer and Deborah Kroninger, Chief of Medical Operations

We invite you to attend our fourth annual Medical & Health Symposium. Our first-ever Friday, Saturday conference on April 26 – 27 at the Greater Columbus Convention Center features continuing education for health-care practitioners and legal professionals.

We are dedicating several sessions to the opioid epidemic. Pharmacist Chris Hart shares his journey of chemical dependency to recovery, including relapse. On Saturday, Hart provides an open question-and-answer session giving attendees an opportunity to Ask an Addict. Dr. Sanford Silverman, a pain clinic medical director, will discuss two epidemics: opioids and pain.

Robert Stutman, one of America’s highest profile Drug Enforcement Agency special agents and formerly “the most famous narc in America” (New York magazine), tells how our current drug epidemic differs from previous generations. He also describes actions that can be taken to better identify and prevent prescription drug misuse/abuse and diversion.

Former Judge Jodi Debbreacht-Switalski speaks about one of the most compelling cases for action to mitigate liability resulting from the worst drug epidemic our country has ever seen in her session titled, Your Name is on the Bottle.

In addition, Mark Pew and Reginald Fields discuss medical marijuana in their presentations Is Marijuana Medicine? and Everything Physicians Must Know about Medical Marijuana in Ohio.

The symposium also features speakers on traumatic brain injuries, patient collaboration and chiropractic care. Here’s the brochure that explains each session in more detail and gives speaker bios as well as conference logistics.

For staff who manage the day-to-day operations of workers’ compensation processes and workflows, we’re offering an educational track, the provider staff forum, on Friday.

Register
today and plan to attend. We look forward to seeing you April 26 – 27 in Columbus!

Note: View the conference website for updated information on continuing education.

Go beyond resolutions with Better You, Better Ohio!

By Erik Harden, BWC Public Information Officer

Now that we’re nearly a month into 2019, we’re curious how people are doing on their New Year’s resolutions.

Some folks may be following it to varying degrees, some may have abandoned theirs (no judgment here) and some may not have come up with theirs (hey, it isn’t like procrastination is illegal).

No matter which of these groups you fall in, our Better You, Better Ohio!™ health and wellness program for Ohio’s workforce may be an option for you. If you’re eligible, you’ll have access to:

  • Free health assessment and biometric screening.
  • Disease management and health coaching.
  • Monetary incentives for participating and more!

More than 5,000 people have already taken advantage of the program! Want to see if you’re eligible? Visit the Better You, Better Ohio! webpage to learn more about eligibility requirements and request to enroll.

Even if you’re not eligible to apply, ActiveHealth Management – our partner in offering the Better You, Better Ohio! program – has many free health and wellness resources. This includes items like a monthly newsletter and regularly scheduled webinars covering a variety of health and wellness topics.

If you’re already passionate about health and wellness, you could become a wellness champion in your workplace. We’ve also partnered with ActiveHealth to create a Wellness Champion Guide to assist in making your workplace healthier.

To bring this full circle, resolutions can be a way start down a path to health and wellness. Better You, Better Ohio! can help you make health and wellness a permanent mindset. Have questions about the program? Send an email to BWCBetterYouBetterOhio@bwc.state.oh.us.