Risk Insider: Joe Cellura

Keep Head Trauma in Mind

By: | February 1, 2016 • 3 min read
Joe Cellura is President, North American Casualty, at Allied World, responsible for for the production and profitability of Primary Casualty, Excess Casualty, Environmental, Surety, Primary Construction and Programs. He can be reached at [email protected]

This is part one of a two-part Risk Insider post by Allied World’s president of North America Casualty Joe Cellura on the dangers of scholastic athletic head injuries.

He runs the plays from yesterday’s practice in his head.

Flashing back to last week’s game, he remembers the sharp crack of the helmets as he and the other team’s wide receiver collided. He vaguely remembers everything going black as teammates and coaches gathered around him in a circle of concern.

He needs to push aside fear and get pumped up. What are the chances he gets hit again anyway?

Pretty high, actually.

Concussions among high school and middle school athletes are becoming increasingly common. While high school football accounts for 47 percent of all reported sports concussions, it is estimated that one in five high school athletes will sustain a sports concussion during any given season.

The rising prevalence of concussions in sports at the high school and middle school levels pose a difficult dilemma for risk managers and insurers.

Today, the risks of injury from high impact sports at these levels have serious implications for the risk management landscape and for municipalities more broadly.

While football is a key driver of concussion related injuries at the high school level, and the focus of much attention at a college and professional level, ice hockey and soccer pose significant head health risks as well.

Across all sports, four to five million concussions occur annually, with the numbers rising among middle school athletes. When signing their children up for team sports, most parents do not expect that their child will sustain injuries to this level of severity at such a young age.

In fact, many would think that concussions are more likely to occur in a professional setting, where the stakes of winning or losing are higher, and players are more willing to take risks.

But here are the stark facts. Concussion rates among students age 8-19 have more than doubled in sports such as basketball, soccer and football between 1997 and 2007, even though participation in these sports overall has declined.

Research shows the number of concussions across all high school sports to demonstrate the amount of risk associated with each sport. The chart below indicates the average amount of sports concussions taking place per 100,000 athletic exposures.

An athletic exposure is defined as one athlete participating in one organized high school athletic practice or competition, regardless of the amount of time played.

While the numbers vary, the trend is alarming as concussions occurring in both male and female athletes continue to grow. Fully 33 percent of high school athletes who have a sports concussion report two or more in the same year.

Cellura_chart_700

High school athletes who have been concussed are three times more likely to suffer another concussion in the same season. While the first hit can prove problematic, the second or third head impact can cause permanent long-term brain damage.

Ninety percent of most diagnosed concussions do not involve a loss of consciousness, so it’s not always glaringly obvious when a student should step off the field. Perhaps even more troubling, 15.8 percent of football players who sustain a concussion severe enough to cause loss of consciousness still return to play the same day.

Fifty percent of “second impact syndrome” incidents – brain injury caused from a premature return to activity after suffering initial injury (concussion) – result in death.

Cumulative sports concussions are shown to increase the likelihood of catastrophic head injury leading to permanent neurologic disability by 39 percent. The most prominent place where the effects of this kind of head trauma are evident is in the NFL.

NFL athletes have historically experienced concussions and head traumas as part of the sport, and for many years, the full extent of neurological damage was not appropriately discussed or acknowledged.

Rumors of retired players becoming disabled and whispers of players dying young from head injuries began to build, until a bright light was cast on the reality of the situation in a court of law.

In April the organization was ruled to be responsible for baseline medical exams for retired NFL players, monetary awards for diagnoses of ALS, Alzheimer’s, Parkinson’s, Dementia and certain cases of CTE, as well as education programs and initiatives related to football safety.

This settlement is costing the NFL an enormous amount of money, with some estimating the cost at $1 billion over 65 years. The NFL itself expects that 6,000 of the nearly 20,000 retired players will someday suffer from debilitating diseases caused by traumatic brain injuries.

It stands to reason that other organizations in the world of sports could face similar financial consequences. In my post next week I’ll discuss how broad the risk could spread and what carriers and risk managers should be thinking about.

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]