The same injury can lead to different review decisions depending on the facts around the claim. That can look inconsistent, but often it reflects a careful review process. The medical evidence may stay the same, while the claim context changes how that evidence is applied. This matters in workers’ compensation, auto injury, and commercial health […] Read More

Navigating the new technology landscape is challenging, even for seasoned casualty leaders. There is a new AI tool just about everywhere you look. But which ones can be relied upon? I frequently hear the question: “How do you successfully use technology to lighten workloads while simultaneously reducing the risk of poor-quality outcomes?” Claim’s culture often […] Read More

In today’s fast-paced professional landscape, the intersection of mental health and workplace productivity has become increasingly significant. The impact of mental health comorbidities—conditions where an individual experiences a mental health disorder simultaneously with a chronic medical condition—can have profound effects on employees, influencing both the duration of workplace disability and overall health outcomes. These comorbidities […] Read More

Despite the end of the public health emergency last spring, the impact of COVID-19 on how healthcare was provided, in broader society as well as in worker’s compensation, still resonates today. When governments mandated shelter-in-place and hospitals faced unprecedented patient volumes, the delivery mechanism for much of non-COVID healthcare switched almost overnight to virtual settings. […] Read More

Hippocrates said of the practice of medicine, “There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.” This quote could be interpreted to mean clinical opinions should not be considered. We know in modern medical practice that this should not be the case, though his statement on knowledge is […] Read More

A recent study published by the Texas Department of Insurance’s Workers’ Compensation Research & Evaluation Group (REG) shows that pharmaceutical costs and utilization among injured workers continue to trend down in Texas, more than a decade after the state adopted ODG by MCG’s evidence-based closed drug formulary.1 The ODG Drug Formulary lists more than 350 […] Read More