12 fireworks safety tips for a celebratory Fourth of July

The Fourth of July is an exciting time for friends and family to gather and celebrate America.

While most Independence Days are filled with fireworks, cookouts and parades, this holiday can also be one of the most dangerous.

On average, 280 people visit the emergency room every day around July 4th with fireworks-related injuries. According to the National Fire Protection Association, more fires are reported on July 4 than any other day of the year. On average, fireworks cause 1,300 structure fires, 300 vehicle fires and nearly 17,000 other fires resulting in injury each year.

The National Safety Council strongly advises leaving fireworks to the professionals and staying away from all consumer fireworks. However, if you are planning to set off your own fireworks this Fourth of July, below are some essential tips to keep your friends and family safe:

  1. Make sure setting off your own fireworks is legal in your area before you buy or ignite any fireworks.
  2. Make sure you have a large open area in which to set off your fireworks that is free of tree branches or power lines. Never light fireworks indoors or near people or animals.
  3. When purchasing your fireworks, avoid ones that are packaged in brown paper – those are typically made for professional displays and should not be used by amateurs.
  4. Never allow young children to play with or ignite fireworks; always ensure anyone under the age of 18 is accompanied by an adult when setting off fireworks.
  5. When lighting your fireworks, do not place any part of your body directly over the fireworks. Also, back up to a safe distance immediately upon lighting, and never light more than one firework at a time.
  6. If a firework has not been fully ignited, do not pick it up or try to re-light it.
  7. Never point or throw a firework at another person or animal.
  8. Be sure to keep a hose, bucket of water or fire extinguisher close by.
  9. Do not put fireworks in your pockets.
  10. Never shoot off fireworks from glass or metal containers.
  11. Once your fireworks have been ignited and set off, pour a bucket of water over the top before moving, handling or throwing the remains away.
  12. Remember that sparklers are also fireworks and should be handled carefully.

The above rules of thumb should be followed for any type of firework.

Celebrate responsibility this Fourth of July and follow the above safety tips when setting off any size firework.

An even better idea is to head to your local park with a blanket and some snacks and enjoy your area’s professional fireworks show!

Be Safe Ohio!

BWC, ODJFS: Online training to help injured workers

OhioMeansJobs webinars available for continuing education credit

By Tina Elliott, Director, BWC Return to Work Services

To help Ohio’s injured workers return to work, we’re continuing our partnership with the Ohio Department of Job and Family Services (ODJFS) through its OhioMeansJobs.com website.

A recording of our joint training series with ODJFS is now available online.

These webinars were designed to help providers, injured workers, BWC staff and managed care organizations better understand the resources available to help injured workers return to work. We also want people to know the OhioMeansJobs website can be used as a one-stop hub for return-to-work services.

To view the webinars, go to BWC Learning Management System and select Login or Need an Account. Once you log in, search for the following:

  • Adding Value for Job Seekers with LMI and OhioMeansJobs.com: Locating Information
  • Adding Value for Job Seekers with LMI and OhioMeansJobs.com: Career Direction and ExplorationContinuing Education

Each one-hour session offers one continuing education unit (CEU) for certified rehabilitation counselors, certified case managers and certified disability management specialists. This CEU credit is only valid through Aug. 19.

Session survey

If you already attended the live sessions, you’re welcome to review the videos and access the handouts as a refresher. However, you won’t earn new CEUs for retaking the same sessions. You must complete the session survey to obtain a certificate and credit for the CEUs.

Once you complete the course and the survey, your CEU information will be in your BWC learning center transcript. Within a few days, your certificate will also be available online.

If you have questions, please email us. Thank you for learning more about the tools and resources available on OhioMeansJobs.com. Together, we’re helping Ohio’s injured workers return to work and return to life.

Physician’s note: Start the back-to-work conversation

A first-appointment transitional plan can help an injured worker before the claim is approved

By Adam King, BWC Public Information Officer

Constance was working a late shift when she slipped and fell. She jarred her arm and wrist trying to catch herself and twisted her back as she landed awkwardly.

The Ohio Bureau of Workers’ Compensation (BWC) legally can’t start helping Constance until the injury is reported and a decision is made on allowing Constance’s claim.

But if Constance’s employer has a transitional work program in place, the doctor can immediately assess how to get her back to work safely and as quickly as possible. The employer can act without waiting for the claim allowance.

That’s the message David Holdsworth and Kimberly Kremer, technical medical specialists at BWC, conveyed during their seminar to provider staff during BWC’s 2019 Medical & Health Symposium. Employers who are proactive improve their injured workers’ outcomes.

“In almost every instance, that is better for the worker,” Holdsworth said of immediately implementing a transitional work plan. “The longer they’re off work, the less likely they are to return. When they’re back on the job, it creates stability in their family, finances and self-esteem.”

More than 50% of injured employees off work for six months or more never return to their original job. Companies lose their entire investment in onboarding and training. That’s thousands to tens of thousands of dollars or more. It also can mean the loss of a valuable team member and co-worker.

Physicians, Holdsworth and Kremer said, play a crucial role, too. During a first visit, the physician should ask Constance if her employer has a transitional work plan. She might not know. She might not think it applies to her injuries. But having that initial communication can speed up the recovery process.

The physician determines whether Constance can safely return to work and in what capacity. Taking on temporary transitional work duties will allow her to heal as her capacity to work increases.

It turns out Constance’s employer has a transitional work plan in place and has already assessed the physical requirements for every job position. It’s an easy process for her employer to identify which work tasks Constance can perform based on her restrictions. The employer offers Constance the modified job duties and she accepts. She’s able to keep working even as her workers’ comp claim is under review.

Once BWC allows the claim, Constance’s physician has several more options to support her efforts to get her back on the job. These vocational rehabilitation programs include remain at work, job retention and return to work.

Remain at work: Constance has missed work, less than eight days, and is now back at work. But she’s experiencing difficulties and might lose more time. Constance, her physician or her employer can identify her job difficulties and ask the employer’s managed care organization (MCO) to request specialized services so she can keep working. Her physician sets her work limitations and rehab needs, and the MCO authorizes the services. These are usually on-site and can include transitional work therapy, physical evaluation or restoration, job modifications, tools and equipment and job retraining.

“One of the first services in remain at work might be transitional work services,” said Kremer. “A physical or occupational therapist comes to the job site to provide interventions that help the worker adjust to the job’s physical demands.”

Job retention: Constance has been off work for more than eight days (which makes her workers’ comp claim a lost-time claim. This means she is drawing temporary total compensation or salary continuation). She returns to work and is still having difficulty doing her original job. Her physician and employer identify her issues returning to full duty and ask the MCO for a vocational rehab referral. Constance must voluntarily agree to the interventions.

Return to work: Constance has not been able to return to work, and there’s a question whether her injuries will allow her to do her job. A vocational rehabilitation manager works with the MCO and BWC to see if Constance can return to her original job or modify her role within the company. If not, they will work with her to find a new employer where the goal is to restore Constance to a similar level of work and earnings. Constance doesn’t need to be at full health to be a return-to-work participant if she can benefit from the services and is likely to return to work as a result.

“At any stage of injury recovery, BWC’s vocational rehabilitation programs offer avenues for workers to achieve their original quality of life or close to it,” Holdsworth said. “Returning to work is critical to an employee’s well-being, and that’s why it’s important for the employer, physician and MCO to be strong partners in their recovery.”

For more information about these programs, email our Rehab Policy team at Policy.R.1@bwc.state.oh.us or call our Customer Contact Center at 800-644-6292 and ask for Rehab Policy.

Walking the walk: BWC, Ohio connect recovery to employment at the Kennedy Forum

By Dr. Terrence Welsh, BWC Chief Medical Officer, Forum panel member

I was honored to be a part of last week’s Kennedy Forum 2019 in Chicago! The mission of this annual event is to create lasting change in the way mental health and addictions are treated in our healthcare system.

The forum envisions parity in access to services, transparency in communication and a better understanding and perception of these brain diseases by the public. It addressed accomplishing these goals through healthcare integration, improved technology, and brain health and fitness.

Workplace well-being

The focus this year was on workplace well-being, specifically as it relates to mental illness and substance use. The forum recognized the work we’ve done in our Substance Use Recovery and Workplace Safety Program, which supports businesses that hire workers in recovery.

It also recognized Ohio Governor Mike DeWine’s support for this program and the Recovery Ohio Plan he launched as attorney general. The governor’s commitment to workers in recovery breaks through stigma, injects hope, and rebuilds families and lives.

I participated in a panel discussion entitled, “Walking the Walk: Prioritizing Mental Health in Your Hiring and Managing Processes.” The panel featured an amazing group, including Dr. Kelly Clark, Past President, American Society of Addiction Medicine; Geralyn Giorgio, Talent Acquisition, Johnson and Johnson; Carol Kivler, MS, CSP, CMT, national mental health speaker and mental wellness advocate, and David Quilleon, Senior VP, Best Buddies International.

BWC Chief Medical Officer Terry Welsh, far right, stands with panel members of “Walking the Walk” at the Kennedy Forum June 11.

Opioids and our workforce

It’s humbling to hear about the magnificent work these people and their organizations are doing, but also encouraging to know Ohio is a leader in finding solutions to the impact of opioids on our workforce. BWC and Ohio are definitely “walking the walk.”

Chicago Mayor Lori Lightfoot addresses an audience at the Kennedy Forum.

As Chicago Mayor Lori Lightfoot, who addressed the forum, said so well, “It takes courage to address these issues, and we ultimately need to see ourselves in the people we serve.”

The dividends are to our businesses, our workforce, our communities. All of us have been affected, and all of us can be a part of breaking the stigma associated with mental health and substance use disorder.

Taking the first step

None of us can “walk the walk” without taking the first step. I want to thank all of those in recovery and our business community for having the courage to do so. I hope others will follow their lead. To quote Dr. Martin Luther King Jr., “You don’t have to see the whole staircase, just take the first step.”

 

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