Column: Workers' Comp

The Case for Exoskeletons

By: | October 15, 2016 • 2 min read

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

I hope more workers’ compensation insurers seriously evaluate paying for exoskeletons that allow patients with certain spinal cord injuries to rise from their wheelchairs and walk.

Exoskeletons are assistive devices often described as “wearable robots” or “Segways with legs.” Since 2014, the Food and Drug Administration has approved two models for personal use, including one earlier this year.

Some workers’ comp insurers have already approved a few claims for the motorized devices and the cost of training. Other underwriters have declined to fund them.

The battery-powered devices cost at least $80,000 plus additional training. Safety questions remain and some doctors who agree on the medical benefits they provide are still wary of certifying them as “medically necessary.”

But the products are among technological advancements in patient care — like increasingly sophisticated prosthesis — that payers should learn about to adequately weigh the exoskeleton’s price tag against potential medical care and medication expense reductions resulting from their benefits.

“Psychological benefits also result from standing, walking and looking others eye to eye. Well-being impacts claims expense.” – Clare Hartigan, physical therapist, exoskeleton clinical trail leader at Shepherd Center

Attendees at the National Workers’ Compensation and Disability Conference® & Expo in New Orleans can watch an injured worker’s exoskeleton demonstration during a session titled “The Bionic Claimant: Emerging Medical Technology’s Impact on Care and Cost.”

Clare Hartigan, a physical therapist who will speak during the session, has led clinical trials on exoskeletons at the Shepherd Center, a rehab hospital in Atlanta. She will be joined by Mark Sidney, VP of claims at Midwest Employers Casualty Co.

Advertisement




Exoskeletons’ well-documented medical benefits for spinal injury patients include improved bowel and bladder function, weight loss and better glucose test results, Hartigan said.

“Psychological benefits also result from standing, walking and looking others eye to eye,” Hartigan said. “Well-being impacts claims expense.”

Apart from clinical uses and workers’ comp, other exoskeleton applications are emerging. The military is testing robotic-like suits that could help soldiers carry more weight and reach the battleground less fatigued.

The National Institute for Occupational Safety and Health expects rapid growth in industrial wearable exoskeleton suits that can help workers lift greater loads or hold up heavier tools for longer periods.

But it would also be great to see more workers who have lost their mobility in workplace accidents benefit from the health and quality-of-life improvements exoskeletons offer. Perhaps that will come as more insurers learn about exoskeletons and begin evaluating their unit costs against their impact on medical expenses.

We can also hope for decreases in exoskeletons’ cost as commonly occurs with most technology products. But the companies offering them will need to recoup their R&D expenses. &

More from Risk & Insurance

More from Risk & Insurance

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.

Advertisement




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.

Advertisement




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]