Getting to Know
Your Risk Manager

Written by: Nikki Jackson, CPCU, ARM, CDMS

April 11th, 2022, risk professionals from around the world gathered in San Francisco to attend RISKWORLD, 2022.

This is an annual conference put on by the risk management society, also known as RIMS, whose mission is to educate, engage and advocate for the global risk community. Through the various events and sessions offered, there was a massive exchange of knowledge and experience between industry professionals. An emerging theme was the rapid change in the risk management role to accommodate new and evolving risks in accordance with shifting business strategies and priorities.

Before we dig into what this evolving risk management role looks like, let's talk about risk for a minute. Every organization faces various threats and needs to find strategies to manage those risks such as avoidance, reduction, transfer, and acceptance. Many of you reading this article are working with employers that retain a portion of each worker's compensation loss (usually 100K-1M deductible) and transfer excess onto an insurer. From a premium perspective, this is attractive for employers because of cash flow improvements (less up-front premium needed) and tax savings. Ultimately, the employer's annual goal is to have more premium savings than the cost of claims. Ultimately, it boils down to the employer's loss experience.

Some employers have a very large risk team with multiple risk managers, specialists, and analysts. Other employers might not have a risk team at all and the function of insurance contracts and such might fall under finance or human resources. If the retention and transfer example above sounds familiar, it's likely workers' compensation is only a small portion of the risks managed by the risk manager. They may even have the responsibility of communicating risk policies and processes for their entire organization! So, what you thought was just the management of workers' compensation, could include all casualty and human risks, in addition to other risks such as production, market risk, technology, relationship risk, legal/regulatory risks, etc. The pandemic brought many opportunities for risk managers to take a seat at the table and made a strong business case for enterprise risk management.

I'd recommend taking a closer look at the titles and job descriptions of your employer contacts to get a better feel for their roles. This will help you gain more perspective and understand where you fall within their realm of responsibility (see Risk Categories and Tools). Bonus: Understanding the responsibilities of your employer contacts may also impact the verbiage used in your email bodies and subject lines to foster better communication.

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EVENTS

	Webinar April 27, 2022 What You Need to Know When Managing Dental Claims Register >>
	Conference April 28, 2022 Executive in Workers’ Comp Conference, EWC 2022
	Webinar May 3, 2022 Diversity and Inclusion in Workers’ Compensation Register >>
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On March 30th, 2022, MTI America conducted a webinar about Physical Therapy vs. Pain Management: Shoulder and Knee Injuries hosted on WorkCompCentral. James Kercher, M.D., (Orthopedic Surgeon), Keith C. Raziano, M.D. (Pain Management), Laura Gorman, RN with MTI, and Susan Emerson, former GM of Delta Airlines, went head-to-head to discuss what happens when conservative treatment doesn't relieve pain. The panelists also discussed understanding when it is beneficial to refer to pain management and why communication with all stakeholders is essential.

The captivated audience learned so much during the webinar, they wanted to extend it for another hour.  In response, participants submitted their unanswered questions to MTI who collaborated with the panelists to provide the following answers: 

Is telemedicine alone useful? Is it sufficient? Should it even be done?

All of our panelists agreed telemedicine has been an excellent tool in workers' compensation to allow for the quick and convenient evaluation of injured or ill workers. Although not all medical situations are well-suited for telemedicine, where appropriate, telemedicine has proved to be an invaluable tool in facilitating compliance with treatment protocols. Gorman noted additional benefits such as decreased patient anxiety, a reduced risk of infection, and the elimination of transportation costs.

In pain management, Dr. Raziano commented it is very effective and useful, especially for follow up visits, in determining progression with therapy. In Dr. Kercher experience, it’s definitely sufficient for close to 90% of follow up cases and should be continued if possible.

On the topic of overcompensation, a participant said “to state a person puts more weight on one leg because of a problem in the other is fictious because when a person walks, they put all of his/her weight on one leg followed by all of their weight on the other. What may result is spending more time on the uninjured side which may lead to irritation or discomfort.” Do you agree?

Dr. Raziano agreed with this statement. The main reason is that I have seen a multitude of non-work-related injuries, and none have ever developed contralateral pathology that can reasonably be attributed to ‘overuse’. There are rare instances where this might be seen, but that typically would correspond to an injury on the contralateral side that is not quite as severe and will simply manifest later.

What are your thoughts regarding a Pain Management clinic that keeps prescribing opioids?

Dr. Raziano said his thoughts depend on the pathology being treated. There are many cases where a patient has suffered a very severe injury and required extensive surgical treatment. Cases of a failed multi-level fusion come to mind. There is a significant cohort of patients who continue with persistent nociceptive pain despite surgical intervention who respond to reasonably low doses of opioid, and this maintains their overall level of pain control while allowing for functionality.

In the absence of clear and reasonable pathology, ongoing opioid therapy is not indicated. Utilization of opioids (and any other treatment modality) should be analyzed in concert with the patient’s overall level of functionality in all cases.

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