2018 Agenda

FULL AGENDA


 

Tuesday, September 4th

 

1:00 pm – 5:30 pm (Pre-Conference – Optional – Register Separately)

AWWC Pre-Conference Leadership Forum: Work-Life Balance Across the Decades

Summary:

 

The AWWC will once again kick off the CWC & Risk Conference in Dana Point with a forum and networking event. We will hear from keynote speaker Michelle Brooke-Marciniak, Co-Founder and Co-CEO of SHEEX, followed by a panel highlighting leadership and the importance of prioritizing work-life balance across different decades in life. 

Panelists Include:


·        Marques Torbert, CEO, Ametros

·        Monica Lichtenstein, Vice President of Operations, EK Health

·        Josephine Copeland, Vice President of Operations, Broadspire

·        Ann Schnure, Vice President of Telemedicine Operations, Concentra

 Keynote Speaker:


·        Michelle Brooke-Marciniak, Co-Founder and Co-CEO, SHEEX

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3:00 pm – 9:00 pm

Attendee Registration & Exhibitor Set Up/Registration

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Wednesday, September 5th

 

6:00 am – 7:00 am

Sunrise Yoga Session on the Grand Lawn - Sponsored by: LegalNet, Inc.

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6:30 am – 11:00 am

Attendee Registration

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7:00 am – 8:00 am

Continental Breakfast in Monarch Foyer

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9:30 am – 4:30 pm  

Exhibit Hall Hours

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7:45 am – 8:00 am

Opening Remarks & Welcome

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8:00 am – 9:30 am

Employer & Stakeholder Panel: State of the Workers’ Compensation and the Influence of California on National Workers’ Compensation Programs

 

Summary:

Our national workers’ compensation system is constantly evolving with pressure from multiple stakeholders including the applicants bar, employer lobbyists, and many others who benefit from this arguably over complicated benefit delivery system. 

Because of this, managing a multi-state worker’s compensation program is a significant challenge for risk managers.  The dynamic nature of workers’ compensation and the fact that there is no national workers’ compensation program, can truly keep a claims team confused and, if improperly administered, will result in fines and penalties against the employer.

Although recent reform efforts in California have been successful in the eyes of most employers, it remains the highest cost state for worker’s compensation in the nation. This Panel will discuss the current state of workers’ compensation, potential headwinds with a new governor, and the impact that California WC has on national employers choosing California as a place to expand their business.

Topics:  

How is California different than other states where you operate? Unique challenges, costs, etc.??  Do you believe that companies hesitate to move their operations to California based upon our WC system in this State?

What is the best advice you can give to other employers who are faced with rising costs?  (Good opportunity for you to share success stories about your program)

How does worker’s compensation need to evolve in order to stay relevant in the future?

What concerns do you have with regard to the impact the political climate could have on workers’ compensation? (healthcare reform, state vs federal regulation)  How could a new governor disrupt the current environment?

What impact is/can technology have on workers’ compensation and Risk Management (your technology issues to watch)

What do you see as some of the biggest challenges the workers compensation and Risk Management Industry face

Speakers:

 

·        Tim East, Director of Risk Management, The Walt Disney Company

·        Fiona Williams, Sr. Risk Manager, Raley’s

·        Kurt Leisure, Vice President of Risk Services, The Cheesecake Factory, Inc.

·        Judie Tsanopoulos, Director, Injury Prevention & Ergonomics, Providence St. Joseph Health

·        Michael Sullivan, General Managing Partner, Michael Sullivan & Associates LLP

Moderator:


·        Bito Borovinsky, Managing Director, Marsh Risk & Insurance Services

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9:30 am – 10:15 am

Networking Refreshment Break in Expo Hall

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10:15 am – 11:15 am

Back, Shoulder, Ergo Injuries - Prevention Breakthroughs! Case Study - Sponsored by: FIT, Inc.

Summary:


CASE STUDY: Learn how Southern Glazer’s Wine & Spirits achieved a reduction in sprain/strain injury costs and lost workdays while evolving their safety culture. Helping employees to prevent pain and injuries while working and at home is a win/win.  SGW&S initiated programs with a holistic approach of preventing workers’ compensation claims before they happen. 

Speakers:


·        Michael Terranova, Corporate Director EHS and National Ergonomic COE Leader, Southern Glazer's Wine and Spirits

·        Dennis Downing, CEO, Future Industrial Technologies, Inc.

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10:15 am – 11:15 am

LEGAL ALERT: Legislation, Regulations and Case Law Update

 

Summary:

 

Take a fun rollercoaster ride as two attorneys on opposing forces interpret the newest trends and patterns in case law. Judge Pollack will try not to pick favorites while our employer representative Mr. Hampton will explain to us why we should all care. Case Law with us will be fun, entertaining and will not be boring.

 

In addition to case law this session will briefly cover the most recent legislation with regards to:

1.      The RX formulary

2.      The effects of SB1160 and AB1244 one year later

3.      The upcoming regulations on PQMEs

Speakers:

 

·        Negar Matian, Managing Partner, Matian Law Group

·        Adam Dombchik, Managing Partner, Gordan, Edelstein, Krepack, Grant, Felton & Goldstein, LLP

·        Honorable Robert G. Rassp, – WC Administrative Law Judge, WCAB Los Angeles

·        Derrick M. Au, Principal Deputy County Counsel, Metro Transit Authority

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11:20 am – 12:20 pm

 

Wage and Hour Violations: Understanding the Litigation Potential and Ways to Avoid Costly Lawsuits

 

Summary:

 

Wage and Hour Violations are costing employers millions and usually are not covered by insurance. When the Wage and Hour Violations become a certified class, and Private Attorney General Penalties are applied, the penalties are multiplied putting employers out of business. There are preventative measures to avoid wage and hour violations. There are remedies for resolution and settlement when there are Wage and Hour Violations. There are methods to prevent Class Certification. We also are on a legislative panel drafting legislation to minimize employer exposure and multiplicity of penalties.

Speakers:

·        Michael Simmons, Director, Risk Management, Riverside Community College District

·        Wayne W. Watten, Attorney, Prindle, Goetz, Barnes & Rrinholtz, LLP

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11:20 am – 12:20 pm

Handling the Catastrophic Loss--A Primer on Taming the Claim

 

Summary:

The specter of an evolving catastrophic loss claim is enough to send shivers down the spine of all but the heartiest of claims professionals. It is the Holy Grail among applicant attorneys. This session will explore the birth, evolution and resolution of catastrophic claims. Join us for a fascinating peak behind the "cat loss" curtain, while learning the motivations of the stakeholders and achieving a level of comfort in handling this most challenging of all claims.

Speakers:

 

·        Nathan Halprin, Managing Partner, Tobin Lucks LLP

·        Ted Grozen, Large Loss Analyst, ICW Group

       Diana Rich, Risk Management, Foundation Building Materials

Moderator:

·        Kurt Leisure, Vice President of Risk Services, The Cheesecake Factory, Inc.

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11:20 am – 12:20 pm

Employer Round Table: Risk & Business Continuity          

 

Summary:

Exclusively for risk managers, workers’ comp managers, claims managers, and HR managers. This session will consists of a round table format that will be highly interactive and will focus on best practices. Due to the format of this session, only the first 50 risk and claims managers will be invited to participate.

Speakers:

·        Heidi Bastien, Director of Risk Management, Rubio's Restaurants, Inc.

·        Jessica Cook, Manager, General Liability, The Cheesecake Factory, Inc.

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12:15 pm – 1:30 pm

Networking Lunch on the Pacific Lawn & Expo Hall Networking

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1:30 pm – 2:30 pm

Workers' Compensation Claim Closure Project - A Case Study

 

Summary:

 

This session serves as a crash course in claim closure projects, often referred to as CIWs (Claim Inventory Workouts), and provides a deep dive into the closure effort for California workers’ compensation claims.  

In the State of California, a properly thought-out workers’ compensation claim closure project can offer an enormous return on investment; but a successful effort requires pre-work, monitoring, and planning for the future to sustain the effort.  In this session a panel consisting of an actuary, claims manager, and risk manager will provide an overview of the California workers' compensation landscape and why it is fertile ground for a claim closure project.  They will explain the investment of resources required to launch and maintain the effort, provide some examples of how to build a business case for investing in a claim closure project, demonstrate how results early on in the project are manifested in actuarial data (not good), provide some parameters around how long one should expect to wait before seeing favorable actuarial results emerge, and offer ways to sustain a CIW culture in your claims shop well beyond the project end date.  

Learning Objective

1.      Have the foundation needed to understand the complexities of a claim closure project and support/champion the effort.

2.      Identify the characteristics of an open claim inventory that make it a good candidate for a claim closure project.

3.      Have some techniques in your tool kit that can be used to build a business case for investing in a claim closure project.

4.      Understand the impact of a claim closure project on actuarial data.

5.      Know what permanent changes can be made to the claims administration process to sustain the claim closure effort beyond the project end date.

Speakers:

·        Martin King, Director, Corporate Risk Management,  Kaiser Permanente

·        Beth Dupre, Managing Director, National Claim Consulting Practice Leader, Marsh USA, Inc.

·        Esther Becker, Principal, Actuarial Consulting, Oliver Wyman Actuarial Consulting

·        Debbie Ehsan, Sr. Workers’ Compensation Manager, Kaiser Permanente

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1:30 pm – 2:30 pm

Historic Shift in Medicare Recovery Policy Looms Large in 2018

 

Summary:

For the first time in history, Medicare intends to implement a review process as early as July 1, 2018 for Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSAs).  Further, Medicare has taken steps in 2017 with medical providers to verify LMSA information, prior to billing Medicare. How this Medicare review process will work is completely unknown.  Additionally, there are many questions about the inclusion of an allocation for future medical care in settlements with Medicare beneficiaries.  The panel of experts will equip attendees with Best Practices for protecting Medicare’s interests with regard to future medical in liability and no-fault cases.  In addition to discussing LMSAs, the presenters will dive into recent aggressive Medicare Advantage Plan litigation aimed against attorneys and insurance carriers alike.  It is critically important that all settling parties be able to protect against such actions. 

This well-rounded insight comes from decades of experience in the field, and is offered from the perspectives of a third-party administrator (TPA), self-insured organization and Medicare compliance expert.  Their knowledge and understanding of real-world applications will prove to be indispensable in preparing attendees for the realities of compliance in 2018. 

Takeaways:

Best practices for dealing with the emerging changes to Medicare compliance, including, but not limited to;

o   Liability Medicare Set-Asides

o   No-Fault Medicare Set-Asides

o   Medicare Advantage Plans

Speakers:

·        Barry Dillard, Director, Risk Strategies, Insurance and Compliance, Walt Disney World Resort

·        Cliff Connor, Vice President of Medicare Compliance, Gallagher Bassett

·        Heather Sanderson, Chief Legal Officer, Franco Signor LLC

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1:30 pm – 2:30 pm

Employer Round Table: General Liability 101

 

Summary:

 

Exclusively for risk managers, workers’ comp managers, claims managers, and HR managers. This session will consists of a round table format that will be highly interactive and will focus on best practices. Due to the format of this session, only the first 50 risk and claims managers will be invited to participate.

Moderators:


·        Eric Spalsbury, Director of Risk Management, Stanley Steemer

 

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2:35 pm – 3:35 pm

Application of Telemedicine for Occupational Health

 

Summary:

 

In this session you will learn how telehealth solution works for occupational injuries. What injuries are appropriate, what you need to know about privacy and HIPAA, and what a good telehealth solution looks like.

Speakers:

·        Carrie Powers, Global Claims Specialist:  NC & PN Regions, Whole Foods Market

·        Ann Schnure, VP of Telemedicine Operations, Concentra

·        Lisa M. Figueroa, MD, FACEP, Vice President, Medical Operations, Concentra

Moderator:

·        Kurt Leisure, Vice President of Risk Services, The Cheesecake Factory, Inc.

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2:35 pm – 3:35 pm

Cannabis & Comp: The Intersection of Weed and Workers’ Compensation

 

Summary:

This panel is comprised of an attorney experienced in dealing with cannabis law issues, the liaison for cannabis related issues for the California Department of Insurance, and an executive from the leading insurance carrier in the cannabis space.  Their discussion will outline the current state of legalization for cannabis, review the key legal developments in cannabis law impacting the worker’s compensation industry and explore the current marketplace and opportunities for worker’s compensation within the cannabis industry.

Speakers:

·        Camille Dixon, Director of Cannabis Insurance Policy Initiative, California Department of Insurance

·        Michael Aberle, Sr. VP/Program Administrator, Next Wave Insurance Services, LLC

·        Dean A. Rocco, Partner, Wilson Elser Moskowitz Edelman & Dicker LLP

Moderator:


·        Scott Ritto, VP, Risk Management, Kilroy Realty Corporation

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2:35 pm – 3:35 pm

Class Half Full:  PAGA Claims, Plaintiff’s Preferred Alternative to Class Action Wage and Hour Claims

 

Summary:

Class Half Full: PAGA Claims, Plaintiff’s Preferred Alternative to Class Action Wage & Hour Claims

The Private Attorney General’s Act allows employees to recover civil penalties for certain Labor Code/Wage Order violations. Join Amber Solano, partner with Atkinson, Andelson, Loya, Ruud & Romo to discuss and understand the implications of a PAGA claim and best practices for mitigating risk.

Takeaways:

1. Understand the effectiveness and exposure that a PAGA claim brings to the organization.

2. Review specific case law of notice and standing.

3. Practices to implement to comply with various wage & hours laws that most often cause exposure.

Speakers:

·        Amber Solano, Partner, Atkinson, Andelson, Loya, Ruud & Romo

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3:35 pm – 4:20 pm

Networking Refreshment Break in Expo Hall

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4:20 pm – 5:20 pm

 

The Power of Words in Claims

 

Summary:

 

The presentation will discuss the Power of Words as positively or negatively influencing the direction of claims.

We will initially discuss the concept of the power of words with supportive evidence that demonstrates how and why words directly influence desired direction and outcomes. Next we will review the opportunities to influence the direction and outcome of a claim at the employer level, claims level, and during litigation. We will highlight the critical opportunities of each to illustrate the direction our words can take and the costs or savings in each.

The key takeaways from this presentation include:

1.      Words can and do influence direction and outcomes

2.      There are readily identifiable opportunities for an employer to use words to positively or negatively influence direction and outcomes

3.      There are readily identifiable opportunities for a claims professional to positively or negatively influence direction and outcomes

4.      There are readily identifiable opportunities for the litigation defense team to positively or negatively influence direction and outcomes

5.      The content of interactions with our employees have real cost implications and the active use of our power of words can create savings

We believe our industry is just scratching the surface of this topic. Education leads to training, training leads to action, and action leads to savings. We hope through this presentation to raise awareness and inspire training in our industry on the Power of Words.

Speakers:

·        Ronny Arevalo, Safety Risk Manager, Gothic Landscaping

·        Danny Thorn, Regional Claims Manager, Benchmark Administrators

·        Chad Coleman, Partner/Owner, Coleman, Chavez & Associates, LLP

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4:20 pm – 5:20 pm

 

Early Intervention in Delayed Recovery of Injured Workers – Sponsored By: IMCS Group Inc.

 

Summary:

This presentation will outline an early intervention screening and biopsychosocial treatment intervention in workers’ compensation claims management by one of the largest food and drug retailers in the United States, with 265,000 employees at 2,200 locations across 33 states and the District of Columbia. This presentation will outline the intervention within the workers’ compensation environment to:

1. screen for risk of delayed recovery using a brief questionnaire

2. provide a cognitive behavioral therapy intervention

3. demonstrate outcomes on disability durations and medical claims costs

The employer risk\claims management and medical leadership identified the problem that a percentage of injured workers do not recover within expected disability durations and these injured workers account for a disproportionate amount of the claims costs.  They then identified from the literature and claims reviews that psychosocial factors are predictive of this population.  The employer then designed and piloted a brief biopsychosocial intervention, measured the outcomes and subsequently deployed the intervention across a full region and then nationally.  The opportunities and challenges of moving from pilot to full nationwide implementation will be presented.

The employer Director of Managed Care and Disability will outline the employer workflows implemented including the role of the risk management and HR return to work coordinators, the claims organization adjusters and case managers and the outcomes demonstrated.  The Psychologist Network Medical Director will discuss the workflow for managing the integrated care by the workers’ compensation treating providers, the biopsychosocial assessment and treatment protocols utilized and how the biopsychosocial model of care does not create unwarranted ‘psych’ claims.  

Outcomes will be presented that demonstrate a statistically significant predictive outcome on  claimant PSQ Score to claims costs: (Low PSQ Risk - average total paid (TP) was $2,059, Moderate PSQ Risk - average TP was $21,783, High PSQ Risk - average TP was $26,212, Very High PSQ Risk average TP was $39,967).  Further outcomes will be presented on a matched group design of participants who engaged in the CBT program compared to those that did not attend: (Attended average TP = $36,629 versus a ‘Not Referred’ matched group design of those average TP = $73,488)

1. Identify cases that have high risk of psychosocial factors associated with chronic pain and delayed recovery

2. Facilitate functional recovery by providing brief biopsychosocial interventions that work effectively within the workers compensation benefit system

3. Design a plan to measure outcomes

 

Speakers:

·        Denise Zoe Gillen-Algire, Director, Risk Initiatives/National Medical Director, Albertsons Companies

·        Michael Coupland, Network Medical Director, IMCS Group Inc.

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5:30 pm – 7:00 pm

Opening Night Networking Cocktail Reception located at the Grand Lawn - Cocktails & Music

Employer Prize Giveaway

Sponsored by: Medcor, Inc.

Music by: Natalie Clark (NBC’s The Voice)

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7:00 pm – 12:00 am

Musical Entertainment in Hotel Lobby Bar

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Thursday, September 6th

 

6:00 am – 7:00 am

Sunrise Yoga Session on the Grand Lawn - Sponsored by: LegalNet, Inc.

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7:00 am – 8:00 am

Continental Breakfast in Monarch Foyer  

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9:30 am – 4:30 pm

Exhibit Hall Hours

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8:00 am – 9:00 am

Self-Insurance Update & Trends for 2018

 

Summary:

This session will provide a recap of issues and developments impacting self-insurance and self-insured employers for 2018. Additionally, participants will be provided an overview and important insights into expected developments for 2019 - including a recap of national trends and regulatory developments impacting self-insured employers.

Speakers:

 

·        Lyn Asio Booz, Chief, California Office of Self Insurance Plans

·        Steve Tolan, Workers’ Compensation Director, Nordstrom

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8:00 am – 9:00 am

Defense Strategies for Post Termination Claims

 

Summary:

A substantive review of the post-termination defense through the eyes of an employer, insurance broker and attorney. Session will review Labor Code 3600 (a) (10), key cases that support this defense and recommendations for mitigating the employer's and insurance carrier's exposure.

Speakers:

·        Marjorie Davidson, WC Manager, Bimbo Bakeries USA, Inc.

·        Josh Diggs, Director of Workers’ Compensation, Orion Risk Management

·        Jesse Bernal, Attorney, Bernal & Robbins, APLC

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8:00 am – 9:00 am

 

Employer Round Table: Public Entities

 

Summary:

 

Exclusively for risk managers, workers’ comp managers, claims managers, and HR managers. This session will consists of a round table format that will be highly interactive and will focus on best practices. Due to the format of this session, only the first 50 risk and claims managers will be invited to participate.

Moderators:

 

·        Jamelle W. Peck, Claims Manager, City of Long Beach

·        Tyrone Spears, Workers’ Compensation Administrator, City of Los Angeles

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9:05 am – 10:05 am

 

The latest developments from California Labor Secretary, David Lanier (DWC/DIR Update)


Speakers:

 

·        David Lanier, Secretary, California Labor and Workforce Development Agency

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9:05 am – 10:05 am

Subrogation Claims Arising From Catastrophic Loss (Lessons Learned Post Hurricane)

 

Summary:

Subrogation refers to circumstances where an insurance company or other party attempts to recoup expenses for a claim when another party is potentially responsible or liable for causing it.

We will look at:

Investigating acts and/or omissions that were the initiating causes or contributed to the loss

Example loss scenarios

What to look for BEFORE the loss occurs

Speakers:


·        Scott Ritto, Vice President, Risk Management, Kilroy Realty Corporation

·        John Shaw, ARM, Sr. Vice President, Claims Management, Marsh

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10:00 am – 10:45 am

Networking Refreshment Break in Expo Hall

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10:45 am – 11:45 am

 

When Good Shoulders Go Bad: A step by step guide to better outcomes - Sponsored by: MedRisk, Inc.

 

Summary:

Shoulder pain is one of the most common musculoskeletal disorders in workers’ compensation, second only to low back pain. The management of rotator cuff tears should be considered in the context of the risks and benefits of operative versus non-operative treatment. Tear size and acuity, the presence of irreparable changes to the rotator cuff or glenohumeral joint, and patient age should all be taken into account.  Clear communication among the referring physician, the interpreting radiologist, the orthopedic surgeon, and the physical therapist is critical in order to walk the fine line between unnecessary surgery and the irreversible, adverse changes associated with prolonged nonsurgical care.

This presentation discusses the diagnosis and treatment of rotator cuff tears (RCTs) and reviews recent research and evidence-based treatment guidelines along with the risks and benefits of surgery and conservative care.

Key Takeaways:

·        The top 3 pitfalls in radiologic interpretation for RCTs that can lead to unnecessary surgery.

·        The danger signs that physical therapists and claims professionals need to catch and communicate in order to facilitate recovery.

·        The best timing for physical therapy services

·        What the latest research and evidence-based guidelines say about conservative care versus surgery so you can authorize the right care and the right time.

Speakers:

·        Mary O’Donoghue, RN – Moderator, Chief Clinical and Product Officer, MedRisk, Inc.

·        Kathryn Mueller, MD, Professor, University of Colorado Schools of Medicine and Health

·        Angela DeBortoli, Program Manager, Workers’ Compensation, University of California

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10:45 am – 11:45 am

Exploring the Impact of New CA WC Formulary and SB 1160

 

Summary:

SB 1160 will implement major reforms to the California workers’ compensation system. The primary goal of the bill is to reduce the fraudulent billing claims handled by the system every year that result in billions of dollars of unnecessary payouts. Not only will this help to balance the state’s budget, but it should also reduce the amount of time necessary to provide injured workers the treatments and benefits they need. Explore the impact of SB 1160 with some of the workers' compensation industry's most qualified and experienced clinical experts. This session will:

1.      Summarize the intent of SB 1160

2.      Identify the qualitative and quantitative impact of SB 1160 on California workers' compensation

3.      Strategize the most effective means of optimizing SB 1160's enactment.

Speakers:


·        Raymond Meister, Executive Director, CA DWC

·        Dr. Rajiv Das, MD, MPH, Medical Director, Risk Management, Albertsons

·        Rena David, Sr. VP Research and Operations, California Workers’ Compensation Institute

·        Dr. Douglas Benner, MD, FACOEM, Medical Director, Marriott International

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10:45 am – 11:45 am

Round Table: Risk & Liability Trends including Cyber Security

Summary:

Exclusively for risk managers, workers’ comp managers, claims managers, and HR managers. This session will consists of a round table format that will be highly interactive and will focus on best practices. Due to the format of this session, only the first 50 risk and claims managers will be invited to participate.

 

Moderators:

 

·        Monica M. Lichtenstein, VP of Operations, EK Health

·        Shaun Jackson, Executive Director of Risk & Insurance, Panda Restaurant Group

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11:50 am – 12:35 pm

 

How to Engage Your Employees through the Claims Process

Summary:

Disengaged employees at times can be a result of the lack of impactful engagement by leaders. As leaders in the workplace, our ability to engage our employees especially our injured employees, is critical to mission success. In today's working environment, where we can spend more time working than at home, engagement is directly linked to bottom line and worker's safety. This motivation and informational keynote by Dr. Lee, former USAF flight surgeon and occupational medicine physician, will leave the audiences energized and with a higher level of commitment to better engagement and excitement in the workplace and throughout the claims process.

Key Takeaways

1.      Engaging employees throughout the claims process lowers cost

2.      Engaging providers (site visits, meet & greets) leads to greater rapport during claims process

3.      Enthusiasm about your company's vision goes a long way and a listening ear can help avoid lawsuits

4.      Rewarding safe behavior can help promote a company culture of safety first

Speaker:

·        Clarence Lee, Jr. MD, MBA, CEO, CMLEEJR Companies, LLC

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11:50 am – 12:35 pm

 

Successful Safety Initiatives

Summary:

Safety, security, loss prevention and workplace violence.

 

Speakers:

·        Louis Burke, Sr. Manager of Safety & Loss Prevention, El Pollo Loco

·        Michael Simmons, Director, Risk Management, Riverside Community College District

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12:30 pm – 1:45 pm

Networking Lunch on the Pacific Lawn

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1:45 pm – 2:30 pm

 

Motivational Keynote – Mark Sanchez

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2:30 pm – 3:30 pm

 

Meet & Greet with Mark Sanchez

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3:45 pm – 4:45 pm

Top Five Work Comp Cases You Need to Know

 

Summary:

 

1.            Escobedo v. Marshalls (2005),

“how and why” standard.  Keys to proving apportionment. 

 

2.            Benson v. Workers’ Comp. Appeals Bd.

“inextricably intertwined”  Multiple claims, successive injuries – apportionment. Every physician must try and parcel out apportionment between successive industrial injuries.

 

3.            Hikida (Maureen) v. W.C.A.B.,

“seismic change”  An employer is entirely responsible for both medical treatment and permanent disability arising “directly” from unsuccessful medical intervention without apportionment even in situations where the need for the surgery or medical treatment was necessitated by both preexisting industrial and nonindustrial factors or conditions.

 

4.            Almaraz/Guzman

Almaraz vs. Environmental Recovery Services (SCIF); Guzman vs. Milpitas Unified School District (Keenan)

“rebutting the AMA guides” The PDRS rating is prima facie evidence and therefore rebuttable.  Rebut a PD rating by successfully challenging one of its components.

 

5.            Coldiron v. Compuware Corp

“know your client”  A third-party administrator must inform the Board and its counsel, if any, no later than at least the commencement of any litigation in the case, who the third-party administrator's client is, whether a self-insured employer or an insurance carrier.

Speakers:

·        Celestial Scott, Sr. Claims Analyst, Risk Management, LiveNation

·        Demetra G. Johal, Esq., Managing Attorney, Laughlin, Falbo, Levy & Moresi

·        Anthony Santos, Attorney, Laughlin, Falbo, Levy & Moresi

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3:45 pm – 4:45 pm

 

Excess: The Forgotten Layer

 

Summary:

This is a presentation for WC Claims professions with or for a self-insured entity who need more information regarding claims management in matters involving an excess carrier and SIR.  Learn about the nature of an Excess Policy, its purpose, who needs them, and who's required to have them, common pitfalls with claims handling involving an excess carrier, and excess dispute resolution.

 

Speakers:

·        Scott Ritto, VP, Risk Management, Kilroy Realty Corporation

·        Medy F. Beauchane, Attorney at Law, Mullen & Filippi, LLP

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3:45 pm – 4:45 pm

 

Employer Round Table: Workers’ Compensation

 

Summary:

 

Exclusively for risk managers, workers’ comp managers, claims managers, and HR managers. This session will consists of a round table format that will be highly interactive and will focus on best practices. Due to the format of this session, only the first 50 risk and claims managers will be invited to participate.

 

Topics for discussion at Round Table:

·        Early Intervention 

·        Return To Work Programs

·        Employer Pitfalls

·        CT Claims

·        Cost Drivers

·        WC Hot Topics 2018

·        WC Program Tips

 

Moderators:


·        Dawn Watkins, Director, Los Angeles Unified School District

·        Denise Evans, Director of Work Comp Claims, Staffmark

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5:30 pm – 8:30 pm

“Red Carpet” Oscars Themed Casino Night on the Grand Lawn 

Food, Drinks, Music, Casino Games and Prizes

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8:30 pm – 12:30 am

Dancing with the Risk Professionals

Sponsored by: Medata, Inc.

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Friday, September 7th

 

7:30 am – 10:00 am

Networking Breakfast in Expo Hall

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7:30 am – 10:00 am

Exhibit Hall Hours

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10:00 am – 12:30 pm

Exhibitor Breakdown

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9:00 am – 10:00 am

 

Comprehensive Settlement Strategies:  Protecting Against Liabilities not Covered by Exclusive Workers' Compensation Jurisdiction

Summary:

This session will discuss and explain developing theories of liability not covered by exclusive WCAB jurisdiction, and will include the following takeaways:

1.  Understand why the common practice of employment resignation in conjunction with a C&R settlement could give rise to a cause of action for disability discrimination and/or wrongful termination in violation of California public policy.

2.  Learn how to structure a Workers' Compensation settlement so that employment is terminated without a violation of either California law or public policy.

3.  Understand why CMS Submission Compliance Criteria alone will not constitute a safe harbor against Medicare Secondary Payer Act (MSP) liability.

4.  In addition to Medicare Set Aside submission and compliance issues, learn how a C&R can be drafted to protect against double damages liability for both a cause of action by the United States for reimbursement of conditional payments and a private cause of action under the MSP.

Speakers:

 

·        Joseph Gayed, Strategic Claims Manager, Modern HR

·        Douglas Farmer, Shareholder, Ogletree Deakins – San Francisco

·        Kevin Bland, Shareholder, Ogletree Deakins - OC

·        Bill Morrow, Workers' Compensation Defense Attorney and Partner, Morrow & Morrow

__________________________________________________________________________________________________

 

9:00 am – 10:00 am

 

Opioid Task Force: Building a 360-Degree Line of Defense against the Epidemic   

Summary:

The roots of the opioid epidemic have gone deep and broad into societal norms. The result: more than 100 overdose deaths a day. To effectively combat this issue in workers’ compensation, we need a comprehensive approach that confronts the problem head-on and from multiple fronts. In this session, a medication safety expert and San Diego County in the role of an employer and law enforcement present a task force approach to assess the problem and develop targeted strategies to fight it. 

 

San Diego County is building a task force to assess and address unique aspects of the problem in their community. The speakers suggest a similar task force approach, so communities and workers’ comp programs can pool resources and look at what’s worked for other regions and payers in order to adopt similar solutions for problem areas. Aspects of this multi-faceted approach would include legislative lobbying to further shore up harmful prescribing patterns; law enforcement to prosecute fraudulent practices; drug testing and zero tolerance policies to defend against impairment at the employer front, and a more patient-centric approach that aims to alleviate pain with proper medication management and alternative therapies, as well as tapering and rehab, when needed.

 

Speakers:

 

·        Terri Perez, District Attorney, San Diego County

·        Dr. Marcos Iglesias, Chief Medical Officer, Broadspire

·        Mark Pew, Senior VP, Product Development & Marketing, Preferred Medical

__________________________________________________________________________________________________

 

10:05 am – 11:05 am

 

Top 10 Employment Practices Every Employer Should Adopt

 

Summary:

This session will discuss top 10 non-litigation tips every employer should know and this includes the following:

 

Job discrimination

Overtime/minimum wage

Family leave

Age discrimination

Disability discrimination

Gender-pay differences

Workplace safety

Pregnancy discrimination

Sexual Harassment

Workplace Harassment & Bullying

 

Speakers:

 

·        Robert Yonowitz, Partner, Fisher Phillips

__________________________________________________________________________________________________

 

10:05 am – 11:05 am

 

Malingering & Symptom Exaggeration: I Saw the Sign

Summary:

Malingering and symptom exaggeration are among the most common types of workers compensation fraud. These types of cases can spiral into dangerous territory for injured workers with a risk of addiction to painkillers and complications from unnecessary treatment. This can become costly and lead to an elevated impairment rating that results in long-term and lifetime payouts. In this session, we will outline how certain tests, tools and practices are at a risk manager’s disposal to assess the true severity of an injury to identify whether malingering or symptom exaggeration may be occurring. A risk management professional will outline experience with the phenomena and share real-life cases. A clinical expert will outline how certain tests, tools, and practices are at a risk manager’s disposal to assess the true severity of an injury, and whether malingering or symptom exaggeration may be occurring.

 Key Takeaways:

1. Understand the scope of claims with malingering and symptom exaggeration in terms of occurrence and costs, and learn how to identify warning signs early in a case.

2. Recognize the common profile of injured workers who malinger or exaggerate injuries, including both occupational and demographic factors.

3. Learn from real-life cases how to apply proactive strategies that mitigate, address and prevent malingering and symptom exaggeration.

Speakers:

 

·        Dawn Watkins, Director, Los Angeles Unified School District

·        Edward Canavan, VP, Workers Compensation Practice and Compliance, Sedgwick Claims Management Services, Inc.

·        Michelle Despres, PT, CEAS II, VP, National Product Leader, One Call Care Management

__________________________________________________________________________________________________

 

10:05 am – 11:05 am

 

Employer Round Table: Risk & Liability

 

Summary:

 

Exclusively for risk managers, workers’ comp managers, claims managers, and HR managers. This session will consists of a round table format that will be highly interactive and will focus on best practices. Due to the format of this session, only the first 50 risk and claims managers will be invited to participate.

 

Moderator:

 

·        Scott Ritto, VP, Risk Management, Kilroy Realty Corporation

·        Dan Holden, Risk Manager, BBSI

__________________________________________________________________________________________________

 

11:15 am – 12:30 pm

 

QME Crisis in California

 

Summary:

 

Session walking through the new and old rules of the QME Billings. The attendees who would be interested, would be carriers, defense attorneys and applicant attorneys, all of whom use, rely on and cross examine QMEs. This topic involves significant issues regarding “billing practices” acceptable or otherwise.

 

Speakers:

·        Nicholas P. Roxborough, Esq., Partner, Roxborough, Pomerance, Nye & Adreani, LLP

·        Gabor Vari, MD, CEO, California Medical Evaluators

·        Suzanne Honor-Vangerov, Esq., Author of QME Regulations

·        TBD Defense Attorney

·        TBD Applicant Attorney         

_________________________________________________________________________________________________

 

11:15 am – 12:30 pm

 

2018 Insurance Market Trends

 

Summary:

 

 

Speakers:

 

·        TBD

__________________________________________________________________________________________________

 

11:15 am – 12:30 pm

 

Women Success Stories in Risk Management

 

Summary:

 

Topics of Discussion:

        Statistics

        Perception and Labels

        Barriers

        How to transition into Risk and Safety careers

 

Speakers:

 

·        Angel Guerra-Chagolla, Sr. Risk Manager, Aryzta LLC

·        Jennifer Lund, Sr. Vice President, Claims and Risk Control, Global Risk LLC

__________________________________________________________________________________________________

 

12:30 pm

Conference Concludes

 

 

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