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Robert D. Kirkpatrick, M.D. Medical Director Workers Compensation Division Tennessee Department of Labor Workforce Dev

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Robert D. Kirkpatrick, M.D. Medical Director Workers Compensation Division Tennessee Department of Labor Workforce Dev

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    1. Robert D. Kirkpatrick, M.D. Medical Director Workers’ Compensation Division Tennessee Department of Labor & Workforce Development March 26, 2010

    2. DISCLAIMER ANY AND ALL relationship or relationships between this presentation, its contents or comments by the presenter to any outcome, regulation or change in law or laws, either present or in the future, living or dead, should be presumed to be accidental. Although blind hogs are said to find acorns if they root around long enough, it should not be assumed that this hog would know an acorn if he found one. SEMPER UBI SUB UBI

    3. “Caveat Listenor” If it isn’t Tennessee Workers’ Compensation, please view all answers with reasonable disbelief. (i.e. “birthing babies..”) If it is Tennessee Workers’ Comp, the author might happen to stumble onto the right answer—i.e. the blind hog analogy !

    4. I HATE WORKERS’ COMP…

    5. WORKERS’ COMPENSATION What it is…. What it isn’t…. Why bother with it…. How to….

    6. WHAT IT IS… INSURANCE….. (a) for “work related” injuries/illness (b) required in most states (c) employer pays ALL the premium H.M.O. (a) “no fault” (b) state specific rules (c) Panels/free choice/10 day treatment/etc

    7. WHAT IT ISN’T….. Rocket Science Well understood--“80%” already done by F.P’s--- “Don’t put that in writing”..AAFP GUIDLINES Hard to do “Over Doctored” in primary care Likely to make you leave home at night TennCare/Cigna/Medicare

    8. The KEY to making Workers’ Comp work in your office…

    11. For the historians in the crowd: If someone is injured but not killed, the person at fault must “pay the injured man for the loss of his time(TTD) and see that he is completely healed (Open medical). ..Deut. 21:18 “Do not mistreat an alien or oppress him……” ..Deut.22:21

    13. Life of the pirate and their work-related hazards…..lots of them !!!

    14. “What do you mean you want to report an on-the-job-injury?”

    15. Piratesinfo.com : . Tennessee Law today: Eye-100 weeks Finger-15(small) to 60 weeks(thumb) Arm-200 weeks Leg-200 weeks Average weekly wages change by law.

    16. Where it all began…Bismarck Shrewd---maintained the loyalty of the common Prussian by co-opting opponents’ agenda of social insurance. Employers' Liability Law of 1871, limited social protection to workers in factories, quarries, railroads, mines. Workers' Accident Insurance 1884 first modern system of workers' compensation. Public Pension Insurance providing a stipend for workers incapacitated due to non-job related illnesses Public Aid providing a safety net for those who were never able to work due to disability.

    17. Bismarck’s enduring contribution: Established an important precedent: "exclusive remedy“---employers under the system could not be sued through the civil courts by employees. Tennessee Law..

    18. The English experience..

    19. Problems in the U.S.A…. the "unholy trinity of defenses CONTRIBUTORY NEGLIGENCE. If the worker was in any way responsible for his injury, the employer was not at fault. Regardless of how hazardous the workplace was…not entitled to any compensation… Martin v. the Wabash Railroad--a freight conductor fell off his train. Although due to a loose handrail, no compensation because his job included inspecting the train for faulty equipment

    20. The "assumption of risk." Employees know of the hazards of any particular job when they sign their contracts. By agreeing to work in a position they assume any inherent risk it carries. Employers were required to provide such safety measures as were considered appropriate in the industry as a whole.

    21. The "fellow servant" rule. Employers were not liable if the worker's injuries resulted in any part from the action or negligence of a fellow employee

    23. Upton Sinclair… “The Jungle” American influences-- given a stipend by a socialist newspaper The Jungle, a novel about horrors experienced by a Lithuanian immigrant working in Chicago slaughterhouses. -Spent seven weeks in disguise, working in meatpacking plants -founded a utopian colony -ran as a Socialist candidate for Congress “The Uncle Tom's Cabin of the Labor Movement!"

    24. “The Jungle”

    26. MISSISSIPPI 1948

    27. Why should I care?..Why do workers’ comp ?

    28. WHY BOTHER ? ? TennCare pays about 2/3 of Medicare (that’s 66%) Medicare pays Medicare Workers’ Comp in Tennessee pays 160% of Medicare. AND THAT’s JUST OFFICE VISITS…OTHER FEES HIGHER !

    32. $1,800,000,000 yearly cost

    33. How do we spend the Medical Dollars? 45% OF THE DOLLARS ARE FOR HOSPITAL CARE. 36% OF THE DOLLARS ARE FOR PHYSICIAN CHARGES.

    34. How do we spend the Medical Dollars? 45% OF THE DOLLARS ARE FOR HOSPITAL CARE. 36% OF THE DOLLARS ARE FOR PHYSICIAN CHARGES.

    35. Key Concepts…. General damages not paid for: ……..Pain and suffering ……..Punitive damages ..must be arising out of and in the course of employment…BUT, Basketball on break time, tornado when working at home…..

    36. Second Injury Funds

    37. Temporary Partial disability(TPD) Worker returns to work but due to a temporary disability, he/she can’t do their normal job and therefore make less money. Employer MUST pay at least 66 2/3 % of the difference between the two wages. An employer MAY pay the normal wage (Many do just to encourage return-to-work)

    38. Temporary Total Disability(TTD) Where the physician comes in Can this patient work? When? With/Without restrictions? Don’t give unnecessary restrictions—know what the job requires. Restrictions may make injuries “recordable” or generate “lost time”—even NOT needed ones LOST TIME/RECORDABLE = LOST COMPANY

    39. Permanent Partial Disability(PPD)

    40. Permanent Total Disability (PTD)

    41. How to do it….. Be FAIR & EFFECTIVE to both sides SEE PATIENTS PROMPTLY DO PAPERWORK PROMPTLY CALL COMPANY/ADJUSTER PROMPTLY Know state laws….i.e. Tennessee 160% of Medicare for office visits 200% of Medicare for office surgery BE NICE TO CASE MANAGERS!

    42. Don’t write “light duty” unless this is what you mean…

    43. The LAST slide…

    44. I LOVE CAN TOLERATE WORKERS’ COMP..

    45. QUESTIONS ?

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