2016 NWCDC

Rehab Rx: Return to Work

Return to work should be an active part of the recovery process, not just the end goal.
By: | November 30, 2016 • 2 min read

“Injured workers are a rewarding group to take care of, but a challenging group,” said Robert Hall, corporate medical director, Helios.

He and Dr. Marcos Iglesias, vice president and medical director, The Hartford, outlined the barriers to returning injured workers to full functionality and how to overcome them at a Wednesday morning session at the National Workers’ Compensation and Disability Conference, titled “Medical Director’s Perspective: Restoring Function and Returning to Work.”

Comorbid conditions – both physical and psychosocial – present the greatest obstacle.

They not only set people up for injury but also delay recovery. If an injured worker has a physical condition like obesity, diabetes or older age, recovery time usually doubles, Iglesias said.

If that condition is coupled with a psychosocial factor like catastrophic thinking or perceived injustice, the recovery time quadruples. Add in a mental health issue like depression or anxiety, and that time increases by a factor of eight.

Psychosocial risk factors are increasingly gaining awareness from the workers’ comp provider and payer community.

“Self-predictions about return to work are often self-fulfilling prophecies,” Iglesias said. He said that claims managers can identify patients as high or low risk by asking them when they believe they can return to work.

“Any answer beyond 10 to 14 days means they are at high risk for delayed recovery,” he said.

The best way to manage comorbid conditions and speed up return to work is through open and frequent communication between patient, provider, payer and employer, Hall said.

Physicians should use simple language to address patients’ fears and provide reassurance, and payers should follow up with doctors to verify that their treatment plan follows evidence-based guidelines.

Non-pharmacological treatments like exercise and socialization should also pay a big role. As Hall said, “Opioids alone don’t bring about recovery.”

Because time away from work only increases the likelihood of developing depression and exacerbating existing comorbids, returning to work should also be considered part of the rehab process, Iglesias said, and not just the end goal.

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

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

Wawa’s Director of Risk Management knows that harnessing data and analytics will be key to surviving the rapid pace of change that heralds new risk exposures.
By: | July 27, 2017 • 5 min read

R&I: What was your first job?

My first job was at the age of 15 as a cashier at a bakery. My first professional job was at Amtrak in the finance department. I worked there while I was in college.

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

A position opened up in risk management at Wawa and I saw it as an opportunity to broaden my skills and have the ability to work across many departments at Wawa to better learn about the business.

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

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The advancements in analytics are a success for the industry and offer opportunities for the future. I also find value in the industry focus on emerging and specialty risks. There is more alignment with experts in different industries related to emerging and specialty risks to provide support and services to the insurance industry. As a result, the insurance industry can now look at risk mitigation more holistically and not just related to traditional risk transfer.

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

Developing the talent to grow with the industry in specialization and analytics, but to also carry on the personal connections and relationship building that is a large part of this industry.

Nancy Wilson, director, quality assurance, risk management and safety, Wawa Inc.

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

I have had successes at all of the RIMS events I have attended. It is a great opportunity to spend time with our broker, carriers and other colleagues.

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

I think the biggest challenge facing most companies today is related to brand or reputational risk. With the ever-changing landscape of technology, globalization and social media, the risk exposure to an organization’s brand or reputation continues to grow.

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

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The changing consumer demands and new entrants into an industry are concerning. This is not necessarily something new but the frequency and speed to which it happens today does seem to be different. I think that is only going to continue. Companies need to be prepared to evolve with the times, and for me that means new risk exposures that we need to be prepared to mitigate.

R&I: Are you optimistic about the U.S. economy or pessimistic and why?

I try to be optimistic about most things. I think the economy ebbs and flows for many reasons and it is important to always keep an eye out for signs of change.

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

I am fortunate to have opportunities professionally that make me proud, but I have to answer this one personally. I have two children ages 12 and 9 and I am so proud of the people that they are today. They both are hardworking, fun and kind. Nothing gives me a better feeling than seeing them be successful. I look forward to more of that.

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

This is really hard as there are too many favorites. I do prefer books to movies, especially if there is a movie based on a book. I find the movie is never as good. I have multiple books going at once and usually bounce back and forth between fiction and non-fiction.

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

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I have eaten at a lot of different restaurants in many major cities but I would have to pick Horn O’ Plenty in Bedford, PA. It is a farm to table restaurant in the middle of the state. The food is always fresh and tastes amazing and they make me feel like I am at home when I am there. My family and I eat there often during our trips out that way.

R&I: What is your favorite drink?

I do love a good cup of coffee (working at Wawa helps that). I also enjoy a good glass of wine (red preferably) on occasion.

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

Vacations aside, I do get an opportunity to travel for work and visit our food suppliers. The opportunities I have had to visit back to the farm level have been a very interesting learning experience. If it wasn’t for my role, I would have never been able to experience that.

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

My husband, kids and I recently did a boot-camp-type obstacle course up in the trees 24 feet in the air. Although I had a harness and helmet on, I really put my fear of heights to the test. At the end of the two hours, I did get the hang of it but am not sure I would do it again.

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

The first people that come to mind are those who are serving our country and willing to sacrifice their own lives for our freedom.

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

Every day is different and I have the opportunity to be involved in a lot of different work across the company.

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

My husband and children have a pretty good sense of what I do, but the rest of my family has no idea. They just know I work for Wawa and sometimes travel.




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