Everyone who labors in the vineyards of workers' comp knows that successful RTW falls off rapidly once a claim gets to be five or six months old. Why? In a paper developed for the Institute of Actuaries of Australia, Robert Aurback takes a look at the mechanisms of neuroplasticity. Brain science has come a long way in the last generation or so. Once neurologists thought that the brain was pretty much finished by age 20 and could no longer adapt to life changes or physical damage.
Now we know that the normal, healthy brain does an amazing job of adapting through a mechanism generally known as neuroplasticity. New circuits get wired up, new brain cells get made and the brain wraps itself around the new circumstances of its owner. This is all well and good, except when the brain adapts itself too well to being off work and on the couch. To squeeze several elegant gallons of careful thought and research into an awkward pint of summary, Aurbach shows how over time the brain of the off work claimant changes to become well adapted to the couch potato lifestyle. Conventional claims processes are based on principles of biomechanics and behavioral economics, but not modern neuroscience. One of the iron laws of neuroscience is use it or lose it. When the injured workers' brain becomes inured to loss of work identity, loss of economic control and all the psychosocial pressures of being on benefit, it changes in ways that make this new status acceptable and frustrate later RTW efforts.
In practical terms, this reminds us that time really is of the essence and that conventional claims administration processes, which often fossilized around the use of first class mail and electric typewriters, can burn time that could be put to better uses before mental changes set in. Time is not the friend of risk managers, adjusters, or of the claimant. Comp program managers often worry about spending money unnecessarily on claims. Perhaps a more important concern is spending time unwisely.
(Many thanks to Tom Lynch of Lynch/Ryan for bringing this paper to our attention.)
We have noted before in these pages that some curious things are happening with the US highway safety stats. Since 2004, the death rate on American roads has been going down. New research from the University of North Carolina at Chapel Hill provides some useful insight. There appear to be two major factors involved.
First, the overall number of miles driven annually by the average US driver has gone down by 600 miles or 9.2 minutes per average day of wheel time. Second, the drivers logging the most notable declines in driving have been young males, the most accident prone part of the driving population. Millennials generally do not drive (or even travel by other means) as much as earlier generations of Americans. While cars continue to become safer with more driver assistive technology, the UNC researchers attributed the bulk of the decline in deaths to simple reduced exposure.
Some of the associated factors cited in the study, such as high gasoline prices and the international economic crises which dominated the study's base period, are now changing. Noreen McDonald, Ph.D., chair and associate professor in the Department of City and Regional Planning at the University of North Carolina at Chapel Hill and author of the study, said in part in a press release, "the challenge that we must all now work towards is how to maintain the safety record on American roads as population growth, low gas prices, and an improving economy lead to more travel."
US fleet managers have had the benefit of a very favorable environment for containing auto liability claims for the last decade, but Dr. McDonald makes it clear that new challenges are just around the curve of the highway.
A Note on Notes: The Very Best Fakes
About a year ago, ABC News in Charleston, SC, reported on the sale and use of fake doctor's notes for various purposes. Dr. Jennifer Christian updated us recently in her Webility blog on the current state of phony provider certs. As she noted, we have no statistics on the use of such materials in OCC med, but anecdotes abound. If you want to see what we are all contending with, check out a couple of the more notorious websites. You might want to keep an eye out for these imposters in other contexts as well such as Monday morning flu or hunting season head colds.
Would one of these "very best fakes" get past the practiced eye of an experienced claims adjuster? Probably not, but this example of fraud on the hoof illustrates why handling your claims may involve checking and cross checking and the investigation process might sometimes take a touch longer than you expect. A laptop, a printer, and a ballpoint pen are all you need to set up your very own medical cert mill.
The GB Journal tries to keep up with the burgeoning combinations of obesity and risk. We've looked at the association of growing waistlines on workers' comp risks but here's a look at what happens when flab meets auto liability.
The International Center for Automotive Medicine at the University of Michigan (where else?) recently announced that it has commissioned new, heavier crash test dummies. Heavier people suffer different and more extreme injuries from crashes than their thinner counterparts and the Center needs new dummies to accurately reflect the greater injury potential as more older and heavier drivers and passengers are involved in highway accidents.
An article from the Sacramento Bee via Health News summarizes the situation neatly: "In frontal crashes, for instance, obese drivers tend to 'submarine', or slide under the lap belt, the University of Michigan research found. An obese person's lower body tends to be loosely restrained because his or her lap belt has far more slack. As a result, obese drivers suffer a much higher rate of more severe lower-extremity injuries."
If you are a risk or fleet manager, you might want to take this into consideration when evaluating new vehicle related workers' comp or bodily injury claims. Body mass and age both increase the severity of what might at first appear to be routine collisions. In this case, trust the dummies.