February 2011 Archives

The following report sheds light on a disturbing trend in disability fraud: Watch the CBS report: Fighting federal disability fraud. Apparently, quite a few federal workers have been double dipping -- to the tune of $25 billion.

More on the Berkley bionic legs. As seen on the Today Show earlier this week, high school basketball teammates are reunited -- one injured in a tragic shooting accident, the other now a world-class orthopedic surgeon. See the latest on how Berkley's bionic legs will be tested on one giant of a man and how the two hope to once again meet on the basketball courts to settle some old scores. Watch Robot legs may reunite teammates on basketball court.

USA Today reported on a sweep across South Florida targeting what the local police and the DEA call "pill mills." According to the report, on Wednesday, authorities arrested 22 people including four doctors, and seized dozens of expensive cars. The sweep is part of a nationwide crackdown on illegal pain management clinics that have sprung up over the past few years. The report names Florida the "oxycodone epicenter" citing that Florida medical practitioners purchased more oxycodone pills in the first six months of 2010 than all other states combined -- 41.3 million oxycodone pills. Florida leads the nation in prescription drug misuse. Read Florida raids target sellers of pain pills.

If you are as fascinated by the complexity of the human brain, as I am, then follow the efforts of Daniel Moran, PhD, associate professor of biomedical engineering and neurobiology at Washington University in St. Louis. He is working on the ability to achieve mind control over a paralyzed arm. Moran is working on a brain-computer interface (BCI), referred to as EECoGs (epidural electrocortiocography), or "...grids of disc-like electrodes that lie inside the skull but outside the dura matter, a membrane that covers and protects the brain."

If this scientist and his team of collaborators succeed in their next experiments, he'll connect his EECoG BCI to a new peripheral nerve-stimulating electrode that is currently in development. Connecting the two devices will create a neuroprosthetic arm, or "...a paralyzed arm that can move again because the mind is sending signals to peripheral nerves that stimulate muscles to expand or contract." This could be great news for people who are paralyzed.

Moran, together with another scientist, has developed a 32-channel EECoG supported on a sheet of plastic thinner than Saran Wrap that is placed on the dura and it sticks there like glue. He's looking forward to testing it with the virtual arm. He says that eventually, "...we'll have a little piece of Saran Wrap with telemetry. We'll drill a small hole in the skull, pop the bone out, drop the device in, replace the bone, sew up the scalp and you'll have what amounts to Bluetooth in your head that translates your thoughts into actions."

Wow. Science-fiction could be reality very soon. Imagine the possibilities. Fascinating and maybe a little bit scary!

For the full fascinating story, read Washington University in St. Louis. "Mind over Matter: EECoG may finally allow enduring control of a prosthetic or a paralyzed arm by thought alone."  Science Daily 19 February 2011.

Did you know that choosing an appropriate mattress is an important component of complex care management? Payers and providers are often unaware of the specialty items available in durable medical equipment, such as mattresses, that are designed to address specific conditions in complex care cases. Long term disability claims take up a significant portion of the workers' compensation medical spend, so it is a detail that should garner your attention.

There is a vast array of specialty rehab mattresses available to help manage specific conditions. There are mattresses designed to provide protection against wound development, assist with pulmonary problems and manage patients who are prone to sweating. Physicians often write prescriptions for expensive critical-care hospital beds while many less-expensive and more practical solutions exist.

Always consider the alternatives.

Complex workers' comp injuries require custom bedding solutions. Yet most prescriptions for mattresses in workers' compensation are limited to just one or two manufacturers or models. Before agreeing to a costly monthly rental for a critical-care hospital bed, consult with a specialty complex care provider who is familiar with the many specialty mattresses available. Chances are they can recommend a particular mattress that can help manage your patient's specific issues.

Specialty services offer more choices.

Carriers and managed care companies often outsource Durable Medical Equipment (DME), supplies and home health services to companies that use a network of local providers. These local providers typically service Medicaid patients. They are able to offer deep discounts on supplies because they work with just a few manufacturers and sell a limited number of products for the area they serve. A specialty service provider experienced in workers' compensation, on the other hand, has many relationships and access to thousands of rehab products designed for very specific conditions.

Specialty care mattresses translate to real savings.

It has been proven time and again that working with specialty providers in workers' compensation not only results in true savings in medical costs, but better outcomes for the patient as well. Mattresses are no exception. Next time your claimant has a script for a bed, be sure to call in the experts.

For more on this topic, read an article by Zack Craft, Resting Easy: Mattresses Make a Difference in Complex Care

And for an interesting visual demonstration on how one specialty air pressure mattress works to prevent pressure ulcers, watch this video by TheraTorr Medical Inc: 

It's always difficult to see anyone battle with an unexpected injury, but it is especially gut-wrenching when it's a child.

Caden Epps was only 2 years old when he was involved in a tragic accident in March 2010 leaving him paralyzed from the neck down. Little Caden darted out into traffic on a busy road and was struck by an oncoming vehicle. He was quickly airlifted to Halifax Medical Center in Daytona, FL and later transferred to Shands Children's Hospital in Gainesville, FL. The surgery to fuse together his 1st four vertebrae was a success, however, his recovery efforts would be long and very costly, as you can imagine.

Once the community heard of this unfortunate story, they quickly rallied behind the family in an effort to raise funds for Caden to get the help he needed -- and deserved! The Orlando Rage, a local semi-professional football team owned by Christopher Morrison of Pratt & Morrison, PA, held a charity game to raise funds for his rehabilitation therapy and for a special therapeutic chair -- none of which would be otherwise covered by insurance. Caden's father, Chad Epps, is also a player for the Rage.

After a successful fundraising event, Total Mobility and Modifications, TMS' sister company who also works with private pay, was contacted to help fulfill the need for Caden's new "toy" -- a mobile stander. Caden was "super stoked" when he first got into the chair. In addition to the benefits of standing, he was also able to move around and interact with other kids.

Here's a video of our Assistive Technology Specialist, Chris Rea, as he helped Caden into his chair for the first time. 

Step It Up Recovery, in Sanford, FL came along side the Epps family to continue the intense therapy Caden needed. Because of their efforts, Caden has regained the use of his arms -- something doctors said would be impossible.

To make a donation to Step It Up for Caden, simply visit their website.

See some of the remarkable progress in this video of Caden running on a treadmill with the help of the dedicated staff at Step It Up. Grab a few tissues before hitting play!

Peter Rousmaniere's article from last week, Into the Work Killing Ground (as it appears on Risk and Insurance Online) prompted me to revisit the topic of dangerous jobs.

Peter's article sheds light on the fact that this year marks the 100th anniversary of the enactment of a state workers' compensation plan. He calls out a few details that are hard to believe. Just 100 years ago, according to Peter, the U.S. work-related fatality rate was twice as high as England's. In 1907 in Pittsburgh, a young female lawyer by the name of Crystal Eastman, counted 536 work-related fatalities in the Pittsburgh area. He goes on to say that the entire state of Pennsylvania only reported 295 work-related fatalities that year. As usual, Peter illuminates interesting facts and details of our complex industry, this time focused on how our current system started.

Extreme Heights

And interestingly enough, Julie Ferguson at Workers' Comp Insider, just posted today Dangerous jobs: window washing at extreme heights. The photos included are spectacular and extreme for sure. Warning: if you are like me and have even the slightest issue with heights, some of the photos are difficult to look at without getting dizzy. Whew!

Some Worst Jobs Are Also Most Dangerous

Last month, the Huffington Post featured The 10 Worst Jobs in America 2011. No big surprise that some of the most physically demanding jobs like construction workers, roofers, iron workers and lumberjacks appear on this list. Of course, these jobs are also at the bottom of the pay scale.

Here is a recent video depicting the 10 most dangerous jobs, according to the Bureau of Labor statistics: 

Dog Deaths Spur Activists

Okay, so this doesn't fit the dangerous theme, it is just a strange and sad workers' compensation story. A gentleman has applied for workers' compensation benefits citing "post-traumatic stress" after killing 100 sled dogs last April. The incident has caused animal activists to pick up a fight to ban or boycott dog sled rides. Apparently dog sledding is a popular activity in wintery vacation spots. It is referred to as recreational mushing. Read Activists target dog sled rides after dog deaths, as it appears in Atlanta Journal-Constitution online.

Complex care specialists at Total Medical Solutions hear stories every day where simple facts were overlooked that amount to thousands of dollars on a claim. Carriers: how many little facts do you think fall through the cracks on your complex workers' comp claims? Even though complex claims make up a small percentage of claims overall, they account for a significant amount of your workers' comp costs.

Permanent disability claims typically incude things like costly power equipment along with home and vehicle modifications. These are to be expected. However, overlooking simple facts can add significant costs to the claim very quickly.

A few real examples of missed facts

A claimant hand selected an extreme outdoor power chair because he lives in a rural area and enjoys hunting with his buddies. When the new chair arrived, the claimant realized his new power chair did not fit into his van. It was just a few inches too tall. Now, the carrier is faced with having to make costly modifications to his van, or purchase a new one. This will cost the carrier between $60,000 and $90,000.

In another case, the claimant picked out his own modified van, the carrier approved the purchase, the van was delivered, only to find that it did not fit into the claimant's garage. Now the carrier must make costly modifications to the garage, after just spending $80,000 on a new van. A visit to the claimant's home to check a few simple facts would have saved the carrier about $40,000.

Another claimant was undergoing physical therapy three times weekly for lack of sensation and paralysis. A brief home visit by a complex care specialist uncovered the fact that the claimant had left side abduction due to sitting in a wheelchair that was too wide and too tall. A smaller, lighter and more functional wheelchair was recommended. Not only is the claimant sitting more comfortably, she no longer needs physical therapy. This simple change is sure to save the carrier significant costs from related complications later on in the claim.

A simple solution: hire a complex care specialist

It pays to work with a company that specializes in complex claims. A company who specializes in complex claims is familiar with all the nuances of power equipment, home modifications and vehicle modifications. A complex care specialist understands the critical nature of working with patients who have suffered life-changing injuries and require customized care.

Ask questions. Save money.

Carriers should expect a complex care specialist to ask a lot of questions:

Is the patient male or female?
How old is the patient?
What are their living conditions?
What kind of support system does the claimant have?
What are the claimant's expectations?
How long has the claim been active?
What is medically necessary?

For more information on how a complex care specialist can help you manage your complex claims, call Total Medical Solutions, 800-700-9393. 

At the Assistive Technology Industry Association Conference in Orlando, Hank Torres of Round Rock, Texas, set the Guinness World Record for the fast hands-free typing. He became a quadriplegic almost 30 years ago after a hang-gliding accident.

"The razor-toothed piranhas of the genera Serrasalmus and Pygocentrus are the most ferocious freshwater fish in the world. In reality they seldom attack a human."

This is the very phrase Hank had to master to set the record at 83.09 seconds.

Hank had some pretty innovative computer products to help guide him to this victory.

TrackerPro is a computer input device that takes the place of a mouse for individuals with little or no hand movement. It looks similar to a webcam and follows a small dot placed on the user's forehead, glasses or hat. TrackerPro is dedicated assistive technology designed exclusively for people with limited use of their hands. Swype provides to input text on any screen by recognizing one continuous finger or stylus motion across the keyboard.

What makes Hank's usage of this technology so unique is his choice of "stylus" -- a Sip-Puff mouth switch. "I'm not only handicapped; I'm handi-capable" Hank says thanks to the technology. Witness this impressive accomplishment in the video below.