Archive for January, 2008

Hi-tech wheelchairs improve life for the disabled

Monday, January 14th, 2008

If you haven’t seen some of the recent progress being made in wheelchair technology, you may be in for surprise. This feature from deputydog, a “cool and interesting things” weblog, features photos, video clips and links to various hi-tech wheelchairs. While some selections fall more under the category of “personal transport systems” than wheelchairs, most are designed to offer a better experience for disabled persons in various ways:

  • Better mobility – affording the user access to uneven terrain and non-paved surfaces, as well as the ability to maneuver curbs and stairs
  • Smaller footprint – reducing the size of wheelchairs to make them easier to navigate through normal doors and and fit better in public spaces
  • Better balance – improving stability and allowing users to be more agile in navigating turns
  • Better ergonomics – allowing a user to switch heights to experience the world at eye level, or to lower seat height to fit under standard tables and desks

One of the most exciting developments is the iBOT Mobility System based on the same technology as the Segway. Its development came about as a partnership between Dean Kamen’s research firm and Johnson and Johnson’s Independence Technology division. It is a four-wheeled chair, but it can convert to and operate on two-wheels. We’ve seen this chair being demonstrated at industry trade shows and an immediate sense of empowerment is conveyed when a user switches from normal use to two-wheeled eye-level use – it’s quite remarkable. The iBOT can also maneuver curbs and stairs. Sensors and gyroscopes give the chair stability and balance. If you haven’t see these in operation, you might enjoy some of the videos showing the iBOT in operation.
Medgadget (which, incidentally is a very cool weblog to visit every now and again for the latest in medical technology) recently reported on the NOA wheelchair from Tekniker-Ik4, which features ” …additional functions which go beyond the mere transport of users and aimed at facilitating the activities of their daily lives.” One of the goals was to design a chair that would function as a single purpose chair since many users have two chairs designed to meet the differing needs of internal and external use. The design also allows expanded vertical positioning, giving the user the ability to reach high or low objects, to converse at various heights, and to facilitate transfers at different heights.
There is even hope on the horizon that may revolutionize life for some of the profoundly disabled who have been largely immobile. Wired reports on the development of a wheelchair that reads your mind, a thought-controlled robotic wheelchair for disabled patients who suffer from disease or injury that leave them unable to move. This initiative is being developed in Spain and the first working prototype is expected in 2008 or early 2009. Here’s more information on how thought-controlled wheelchairs work.

With the number of disabled veterans returning from war, there is, unfortunately, a growing market for assistive technologies so we can expect to see advances in wheelchairs, prosthetics, and other device designed to help the disabled lead a more functional life.

The Job Accommodation Network has an accommodation and compliance guide for employers for Employees Who Use Wheelchairs (PDF), as well as an accomodation process flow chart (PDF). Also, the The Wheelchair User’s Work Environment has some practical tips for improving wheelchair access at work.

Health Wonk Review and news roundup

Thursday, January 10th, 2008

Bob Laszewski of Health Care Policy and Marketplace Review has posted the first Health Wonk Review of 2008, and it’s a good one because people had to save up their best posts over the last month since we had a short hiatus. Many entries focus on analysis of the presidential candidates’ positions on health care, which will be one of the hot-button issues for the coming election.
A deadly year for public servants – Celeste Monforton of The Pump Handle tells us that 2007 was a deadly year for law enforcement officers, with a 28 percent increase in on-the-job fatalities compared to 2006. Shooting deaths were up 33% and traffic fatalities up 10%. And Occupational Hazards reports that 115 on-duty firefighters died in 2007. Fire Administrator Greg Cade labels 2007 it “one of the most tragic years for firefighters in recent memory.”
High cost of chronic diseaseAn Unhealthy America – the economic burden of chronic disease – is a good reference site to bookmark. Find specific prevalence and costs by disease or by state.
From the courts – Peter Rousmaniere at Working Immigrants posts about a recent South Carolina Supreme Court ruling upholding the right for illegal immigrants to receive workers comp benefits. Courts continue to protect workers who are injured on the job, regardless of legal status. Justice James E. Moore stated that “…disallowing benefits would mean unscrupulous employers could hire undocumented workers without the burden of insuring them, a consequence that would encourage rather than discourage the hiring of illegal workers.” In making its decision, the court cited prior decisions by North Carolina, Florida, Georgia, Maryland, and Minnesota.
Laptop safety – By their very design, laptops force users into awkward positions so prolonged use can result in muscular fatigue in various body parts and may lead to repetitive stress injuries. Laptop Ergonomics discusses the particular safety hazards related to using laptops and offers recommendations to help help reduce the risk of developing injuries. Hat tip to Ergonomics in the News for the pointer.
Weighty mattersStudy links obesity to absenteeismOccupational Hazards reports on a recent study that links increased rates of absenteeism to morbid obesity, putting the cost at $4.3 billion per year in the United States.

New Hampshire Backpedals on Contractors

Tuesday, January 8th, 2008

Back in December we blogged a legislative remedy that backfired in New Hampshire: House Bill 471 eliminated the exemption for corporate officers and directors from workers comp coverage. Given the state’s extremely high costs for comp, this created an immediate outcry. We compared it to the weather on top of Mount Washington, which at the time was minus 13 degrees with the wind howling at 93 miles per hour.
Well, today things look a lot milder. Mount Washington is enjoying relatively mild weather (38 degrees, with a modest wind of 42 mph). And the newly reconvened legislature has already amended House Bill 471 by restoring the exemption for corporate officers and directors.
Governor Lynch jumped on the bandwagon: “I will sign this law as soon as possible and I applaud the bipartisan leadership of the House and Senate for listening to the concerns of small business…”
Lasting Solutions
As we mentioned in our previous blog, New Hampshire still has a very big problem, driven by its disproportionately high rates for comp coverage in the construction trades. The legislature would do well to figure out why these rates are among the highest in the country. It’s fine to exempt business owners from coverage, but that does not address the burdensome costs faced by contractors with employees. These folks are being hammered by costs that are twice as high as their competitors in neighboring states. By allowing business owners to opt out of the system, New Hampshire has bought itself a little time. But just as the mild conditions on Mt. Washington are soon to end, they had best start focusing on long-term solutions that bring rates into alignment with other states. Anything less would be like climbing Mt. Washington in January with nothing more than a backpack and an extra layer of clothes. A very bad idea indeed!

Surgical Implant/Ethical Bypass: The Story of Dr. Chan

Monday, January 7th, 2008

The Insider has often speculated about the thought process of medical providers, so we are very interested in case of Dr. Patrick Chan, a neurosurgeon working out of Searcy, Arkansas. The Canadian trained doctor has pleaded guilty to charges of demanding and accepting kickbacks from surgical implant maker Blackstone Medical of Springfield MA, a subsidiary of Orthofix International. Dr. Chan used the (expensive) devices in back surgeries. He was a very busy fellow, billing about $200,000 a month. He has amassed a $10 million nest egg (minus the court-assessed penalty of $1.5 million plus substantial legal fees).
The kickback scheme initiated by the doctor raises two compelling issues: one involves how a doctor determines which medical device to use. Dr. Chan reduced that decision tree to its barest branches. “I use the device that pays me the most money.”
The second dimension of Dr. Chan’s thought process involves utilization: when should a specific device be used? Apparently, Dr. Chan went out of his way to find opportunities to use his preferred surgical implants. His work is being reviewed to determine whether the surgical procedures were in fact needed. One suit, filed in Arizona, alleges that in 2005 Dr. Chan told his patient, a young trucker, that if he did not agree to implantation of a spinal device, he was at risk of becoming a quadriplegic. After the surgery, a worker’s compensation evaluation of the MRI done prior to the procedure showed that it was medically unnecessary. [NOTE to insurer: Speed up the utilization review process!]
Breakthroughs, Innovations…and Scams
Blackstone Medical touts itself as the home of “Breakthrough Thinking.” Parent company Orthofix is “always innovating.” Unfortunately, high level thinking and innovation, along with overly ambitious marketing goals, have led the companies into an ethical morass.
Dr. Chan is currently under house arrest and awaiting sentencing. He faces up to five years in prison. We can assume that he is under considerable pressure to testify against his former suppliers. It’s ironic, of course, that Dr. Chan and the people at Blackstone began with the same goal in mind: helping people in pain. They intended no harm, but, alas, much harm has apparently been done.
Thanks to fellow blogger Joe Paduda at Managed Care Matters for the heads up on this interesting story.

Cavalcade of Risk’s first edition of 2008

Thursday, January 3rd, 2008

Jonathon Pletzke of Consumer’s Health Insurance Book Blog does a fine job hosting this week’s back-to-work edition of Cavalcade of Risk – the first edition of the New Year. We’ll be hosting the January 16 edition here at Workers’ Comp Insider. Also, Health Wonk Review had a brief holiday hiatus but will be returning to its regular schedule a week from today with a stop at Bob Laszewski’s great blog, Health Care Policy and Marketplace Review.

2007 insurance year in review

Wednesday, January 2nd, 2008

Here at Workers Comp Insider, we’re digging out after a holiday hiatus, and getting back into the swing of things with recaps of top insurance news from 2007 as presented by some of the leading insurance publications. While few of the major insurance stories in 2007 were specific to workers compensation, nothing in the insurance world lives in a vacuum. Anything that affects major property casualty insurers can be expected to have a spillover effect on workers comp.
Business Insurance’s Year in Review offers top 10 lists for news related to risk managers and benefits managers in 2007. While most offer links to more detail, here’s a summary of BI’s picks for the top 10 risk management stories for 2007:

  1. Rates for property/casualty insurance begin to decline
  2. Congressional lawmakers launch efforts to extend the federal terrorism insurance backstop.
  3. Some brokers and insurers float new compensation plans.
  4. Marsh management woes
  5. Private equity expands buyouts of publicly held brokers
  6. AIG sues former executives, including Maurice Greenberg, to recover settlement payouts
  7. IRS moves to limit tax breaks for captives
  8. Supreme Court limits punitive damage awards
  9. A real estate developer and insurers settle on World Trade Center coverage
  10. New York proposes easing reinsurer collateral rules

Insurance Journal offers a rundown of the top insurance stories for 2007. More commentary about each item can be found in the article, but here’s a summary:

  1. Climate Change
  2. Hurricanes Hardly Happen
  3. Soft Market … Everywhere
  4. Subprime Mortgage Credit Crunch
  5. Terrorism Coverage
  6. ‘Made in China’ Loses Its Luster
  7. Agency Compensation
  8. Fires and Floods
  9. Regulation Rumbles
  10. Marsh Meltdown Hits MMC

Sam Friedman of National Underwriter offers his top 10 story picks on his blog A View From the Press Box. More detailed stories can be accessed via links – here’s the summary:

  1. Prices Plummet, With No Letup In Sight
  2. Critics Fry Insurers Over Katrina Claims
  3. TRIA Extension Goes To The Wire
  4. Floridians On The Hook For Billions
  5. A New Sheriff Cleans Up New York
  6. Bermuda Sitting Pretty, But For How Long?
  7. ‘Sicko’ Exposes Health Insurance Ills
  8. Real Time: It’s Now Or Never!
  9. IRS Attack Blindsides Captives
  10. California Fires Burn Insurer Reputations

Terrorism update – One of the stories that appears on all three lists was the pending renewal of a terrorism insurance bill. In an eleventh hour move before its expiration, on Dec. 26, Bush extended the terrorism insurance backstop with his signing of the Terrorism Risk Insurance Program Reauthorization Act of 2007 (TRIPRA). This will extend protection for seven years under similar terms as the current program.