Spine Foundation—2016 Summit Keith Rosenblum, MS, MPA, MPH, CPCU, ARM, CSP Sr. Strategist, Workers’ Compensation Risk Control Lockton Companies

Workers’ Compensation & Spinal Disabilities Billions U.S. National Health Expenditure: $3 Trillion Annual U.S. Spinal Disability: $600 Billion U.S. Workers’ Comp: $100 Billion WC Spinal-Related Disability: $35 Billion g\loss control\2016\spine foundation\rosenblum spine foundation:20496

Workers’ Compensation Potential Contribution Impacting the 10 x 25 Initiative $35 billion annual spinal disability spend—more effectively influenced in workers’ compensation than in the general population. A concerted effort within the insurance industry could positively impact 20 – 30 % of the Foundation’s 10 x 25 reduction objective. g\loss control\2016\spine foundation\rosenblum spine foundation:20496

Consistently Small Percentage of WC Claims Drive Most Costs Approximately 2 to 4% of workers’ compensation claims = approximately 50% of loss dollars. The majority have a spinal injury component. Delayed recovery is the one common denominator among most of these large losses. Unresolved chronic pain is the primary proponent of delayed recovery. g\loss control\2016\spine foundation\rosenblum spine foundation:20496

Current Technology Pain is a very personal and subjective experience. Imaging and neurodiagnostic technology is helpful but not in most cases of chronic pain. Traditional technologies frequently offer little diagnostic information about nociceptive or neuropathic pain mechanisms. Ruling out structural changes is important. Considering emotional and cognitive factors is imperative. g\loss control\2016\spine foundation\rosenblum spine foundation:20496

The Specialists Dilemma Factually, most of all WC emerging spinal chronic pain cases get referred to specialists without a complete health and behavioral workup. Specialists are then left to sort out diagnoses. This is not core to their practices and is a wasteful use of talent. g\loss control\2016\spine foundation\rosenblum spine foundation:20496

Insurance Industry’s Opportunity to Take the Lead As the risk management and insurance industry increasingly accepts the emotional and cognitive aspects of chronic pain, the more effective medical assessment and treatment will become for injured workers. The insurance industry is working vigorously to channel patient care to PCPs and specialists who practice evidence-based medicine. It is a very difficult process that has yet to be mastered. g\loss control\2016\spine foundation\rosenblum spine foundation:20496