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2017 NWCDC

Looking Back: Workers’ Compensation Changes in 2017

Injured workers and their employers search out ways to combat chronic pain, but they’re not always in agreement on the best solutions.
By: | December 6, 2017 • 3 min read

Prescription drugs and other methods of chronic pain relief have been at the center of workers’ comp conversations for years, whether it’s something as controversial as opioids and marijuana or it’s deciding where injured workers can fill their prescriptions.

Over the past year, these hot topics have led to decisions that could impact the workers’ comp industry moving forward.

The Marijuana Debate Continues

Twenty-nine states and the District of Columbia have legalized the use of medical marijuana. Legislation on this taboo drug is under rapid change, leaving many wondering where that leaves workers’ comp.

In Maine this year, the state legislative committee was urged to reconsider regulatory framework surrounding recreational marijuana.

Under the law, businesses wouldn’t be able to reject applicants for testing positive for marijuana because the applicant might use the drug for medicinal purposes. Employers wouldn’t be able to fire an employee for a positive drug test after an incident of injury. Instead, the employer would be tasked with proving the employee was impaired on the job.

In Massachusetts, for example, a woman was offered a position on the condition she passed a mandatory drug test, but she was using medical marijuana for Crohn’s disease. The employer said it wouldn’t be a problem but fired her regardless.

Twenty-nine states and the District of Columbia have legalized the use of medical marijuana. Legislation on this taboo drug is under rapid change, leaving many wondering where that leaves workers’ comp.

In July, the court ruled that under Massachusetts law her use of medical marijuana was “as lawful as the use and possession of any other prescribed medication.”

The employer had to prove she was impaired on the job to justify letting her go.

Additionally, workers’ comp carriers and insurance organizations have made a move toward accepting medical marijuana practices.

Liberty Mutual implemented a formalized claims-review process to evaluate workers’ comp requests for medical marijuana this year. Safety National teamed up with third-party vendors to distribute manufactured medical marijuana patches and gels.

Combatting the Opioid Epidemic

The opioid epidemic was declared a public health emergency in October, and to combat this growing crisis, some insurers and pharmacies are limiting coverage of opiate-based prescriptions.

Cigna announced it will not cover OxyContin prescriptions — the most common cause of opioid-related overdose and death — for customers on employer-based health plans. CVS limited opioid prescriptions to a seven-day supply.

The Workers’ Compensation Institute found that overuse and misuse of opioids resulted in mixed results depending on the state, showing that while some states are cutting the number of opioids prescribed to injured workers, other states are still prescribing more.

A study published by the Journal of the American Medical Association found a link between legalized medical marijuana and opioid-related deaths. States that legalized medical marijuana saw a 25 percent decrease in deaths from opioid overdoses.

Workers’ Choice in Pharmacy

At the end of the day, however, injured workers still need to fill their pain relief prescriptions. This year, a handful of states faced the question: Should employees get a choice in pharmacy?

In Kentucky, the law permits workers to choose their own medical provider, however one company faced a hiccup when their injured workers turned to Injured Workers Pharmacy (IWP), a mail-order business that sells medications on a lien basis. When the insurer refused to pay, the employees turned to the law.

The court ruled in favor of the workers, allowing them to choose their own pharmacy with impunity.

Yet, in Louisiana, a worker who turned to IWP to fill his prescriptions, was denied. The judge ruled in favor of the employer, stating that under state law, pharmacy choice in a workers’ comp case belongs to the employer.

And these states are not the only ones facing this growing issue. Workers and pharmacies continue to bring cases against employers in the hopes of bypassing the insurer’s pharmacy of choice. &

Autumn Heisler is digital producer and staff writer at Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession: Curt Gross

This director of risk management sees cyber, IP and reputation risks as evolving threats, but more formal education may make emerging risk professionals better prepared.
By: | June 1, 2018 • 4 min read

R&I: What was your first job?

My first non-professional job was working at Burger King in high school. I learned some valuable life lessons there.

R&I: How did you come to work in risk management?

After taking some accounting classes in high school, I originally thought I wanted to be an accountant. After working on a few Widgets Inc. projects in college, I figured out that wasn’t what I really wanted to do. Risk management found me. The rest is history. Looking back, I am pleased with how things worked out.

R&I: What is the risk management community doing right?

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I think we do a nice job on post graduate education. I think the ARM and CPCU designations give credibility to the profession. Plus, formal college risk management degrees are becoming more popular these days. I know The University of Akron just launched a new risk management bachelor’s program in the fall of 2017 within the business school.

R&I: What could the risk management community be doing a better job of?

I think we could do a better job with streamlining certificates of insurance or, better yet, evaluating if they are even necessary. It just seems to me that there is a significant amount of time and expense around generating certificates. There has to be a more efficient way.

R&I: What was the best location and year for the RIMS conference and why?

Selfishly, I prefer a destination with a direct flight when possible. RIMS does a nice job of selecting various locations throughout the country. It is a big job to successfully pull off a conference of that size.

Curt Gross, Director of Risk Management, Parker Hannifin Corp.

R&I: What’s been the biggest change in the risk management and insurance industry since you’ve been in it?

Definitely the change in nontraditional property & casualty exposures such as intellectual property and reputational risk. Those exposures existed way back when but in different ways. As computer networks become more and more connected and news travels at a more rapid pace, it just amplifies these types of exposures. Sometimes we have to think like the perpetrator, which can be difficult to do.

R&I: What emerging commercial risk most concerns you?

I hate to sound cliché — it’s quite the buzz these days — but I would have to say cyber. It’s such a complex risk involving nontraditional players and motives. Definitely a challenging exposure to get your arms around. Unfortunately, I don’t think we’ll really know the true exposure until there is more claim development.

R&I: What insurance carrier do you have the highest opinion of?

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Our captive insurance company. I’ve been fortunate to work for several companies with a captive, each one with a different operating objective. I view a captive as an essential tool for a successful risk management program.

R&I: Who is your mentor and why?

I can’t point to just one. I have and continue to be lucky to work for really good managers throughout my career. Each one has taken the time and interest to develop me as a professional. I certainly haven’t arrived yet and welcome feedback to continue to try to be the best I can be every day.

R&I: What have you accomplished that you are proudest of?

I would like to think I have and continue to bring meaningful value to my company. However, I would have to say my family is my proudest accomplishment.

R&I: What is your favorite book or movie?

Favorite movie is definitely “Good Will Hunting.”

R&I: What’s the best restaurant you’ve ever eaten at?

Tough question to narrow down. If my wife ran a restaurant, it would be hers. We try to have dinner as a family as much as possible. If I had to pick one restaurant though, I would say Fire Food & Drink in Cleveland, Ohio. Chef Katz is a culinary genius.

R&I: What is the most unusual/interesting place you have ever visited?

The Grand Canyon. It is just so vast. A close second is Stonehenge.

R&I: What is the riskiest activity you ever engaged in?

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A few, actually. Up until a few years ago, I owned a sport bike (motorcycle). Of course, I wore the proper gear, took a safety course and read a motorcycle safety book. Also, I have taken a few laps in a NASCAR [race car] around Daytona International Speedway at 180 mph. Most recently, trying to ride my daughter’s skateboard.

R&I: If the world has a modern hero, who is it and why?

The Dalai Lama. A world full of compassion, tolerance and patience and free of discrimination, racism and violence, while perhaps idealistic, sounds like a wonderful place to me.

R&I: What about this work do you find the most fulfilling or rewarding?

I really enjoy the company I work for and my role, because I get the opportunity to work with various functions. For example, while mostly finance, I get to interact with legal, human resources, employee health and safety, to name a few.

R&I: What do your friends and family think you do?

I asked my son. He said, “Risk management and insurance.” (He’s had the benefit of bring-your-kid-to-work day.)

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]