Tune into MEC Connect to hear MEC experts discuss the latest developments in workers' compensation. Drawing upon their extensive experience, they will share stories and practical tips that can help partners and employers discover innovative ways to create a better outcome in their program.
Post-Traumatic Stress Disorder (PTSD) has undergone significant evolution in both understanding and diagnosis over the past century. In our new MEC Connect Expert Insights episode, “PTSD Diagnosis Dilemma,” our Chief Medical Officer, Dr. Fernando Branco, provides a comprehensive overview of PTSD, its progression in medical understanding, and why it is becoming overdiagnosed in modern practice.
Dr. Branco challenges listeners to recognize the critical distinction between Acute Traumatic Stress Disorder – a standard, time-limited response to abnormal events – and true PTSD, which persists beyond six months and manifests through specific symptoms that are often misunderstood. He also urges healthcare providers to be more precise in their diagnosis and shares his perspective on:
Listen now to hear an essential conversation about how trauma affects the human mind and gain valuable insights about the vital importance of maintaining diagnostic integrity while still honoring the very real suffering of those affected by PTSD.
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Burns represent one of the most devastating workplace injuries, with treatment costs potentially reaching millions of dollars and recovery periods extending for months or even years. Diving deep into the world of severe burn injuries, this episode, “Understanding Burn Injuries in the Workplace,” MEC’s Senior National Catastrophic Medical Consultant Phyllis Ramondetta unveils the staggering reality behind workplace burns. The financial toll alone is eye-opening - from $207,000 for moderate burns to a jaw-dropping $10 million for severe cases with complications.
Understanding burn severity is crucial for appropriate treatment planning. With 63% of workplace burns involving thermal or scalding injuries, and manufacturing sectors reporting the highest incidents, the conversation explores:
For employers, healthcare providers, and safety professionals, understanding the complexity of burn injuries is crucial for both prevention and proper care management.
Listen now to gain essential insights that could save lives, reduce suffering, and mitigate the enormous financial impact of workplace burn injuries.
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Understanding brain injuries can be overwhelming for patients, families, and caregivers alike because every brain injury follows a different recovery path. In this episode, “Rancho Los Amigos Scale: Roadmap for Brain Injury Recovery,” Tracie Lemus, RN, CCM, National Medical Catastrophic Nurse Consultant at MEC, breaks down the vital tool that healthcare professionals use to track cognitive and behavioral rehabilitation after brain trauma.
Tracie shares her perspective about how the Rancho Los Amigos Scale helps monitor recovery progress, determine appropriate treatment plans and timing, and facilitate coordination among the various specialists involved in a patient's care journey. This knowledge empowers healthcare teams to create more targeted rehabilitation strategies tailored to each patient's current cognitive and behavioral functioning. It includes:
Listen now to gain key insights into the Rancho Los Amigos Scale assessments, which offer a roadmap through the complex journey of brain injury rehabilitation by breaking down recovery into distinct, observable stages in the realm of neurological healing.
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The Glasgow Coma Scale (GCS) is one of medicine's most critical assessment tools for traumatic brain injuries. In this episode, “The Glasgow Coma Scale: Setting the Bar for Brain Injury Evaluation," MEC’s Peggy Ford, a Senior National Medical Catastrophe Consultant with over 30 years of experience, provides essential knowledge about how the GCS measures brain injury severity.
Peggy offers valuable insights into this evaluation method, which has become the cornerstone of neurological tests worldwide in emergency settings. It includes a scoring system that allows medical professionals to quickly categorize the severity of brain injuries and make critical treatment decisions in time-sensitive situations where every moment matters. She explains:
Listen now to gain key insights on the importance of standardized assessment tools like the GCS in guiding initial treatment approaches and providing valuable prognostic information for healthcare providers, patients, and families during vital stages of care.
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Medicare Set-Asides (MSAs) represent a critical factor in the workers compensation settlement landscape, yet they remain widely misunderstood by many professionals in the industry. In this Expert Insights episode, "Demystifying Medicare Set-Asides in Workers Comp," MEC’s Medical Management Consultant, Tina D’Andrea, unpacks how a properly executed MSA ensures compliance with Medicare requirements and provides clarity and protection for all parties involved in the settlement process.
Tina shares insights about fundamental components of MSAs—from threshold requirements to submission procedures to review and appeal options— to help claims professionals better understand and navigate the complex process more effectively. This includes:
Listen now to get the guidance you need to successfully address the challenges of Medicare Set-Asides and approach your next workers compensation settlement with clear focus and confidence.
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Urine drug screens have become an essential component in the landscape of workers comp claims management. In this Expert Insights episode, "The Powerful Impact of Drug Screening on Claims Management," MEC’s Medical Management Consultant, Jeff Pack, RN, BSN, provides his unique perspective on how these tests serve multiple purposes throughout the lifecycle of a claim and can significantly impact treatment decisions, safety protocols, and claim outcomes.
Jeff breaks down the science behind drug testing methodologies and the way these approaches function as safety tools across various industries. This includes pre-employment screening, workplace accident investigations, and ongoing treatment monitoring. He shares compelling real-world examples of how drug screening is invaluable for:
Listen now to get essential insights into a tool that Pack describes as “the cornerstone of modern healthcare and safety practices” and why trained professional interpretation of drug testing is vitally important to avoid false positives.
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The medical field has long recognized the complex intersection of chronic pain and addiction, but a critical third component is often overlooked. In this MEC Connect Expert Insights episode, “Beyond Pain and Addiction: The Triple Diagnosis,” our Chief Medical Officer, Dr. Fernando Branco, shares his approach to treating patients beyond the traditional pain-addiction model.
Dr. Branco discusses the framework of "triple diagnosis" in pain medicine. His decades of experience revealed that addressing underlying psychiatric conditions alongside pain and substance use disorders is critical for successful treatment outcomes. He offers expert insights into:
Listen now to hear about Dr. Branco’s holistic approach to viewing patients as "global persons" and the paradigm shift that moves integrated patient care beyond the common dual focus of pain and addiction.
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In this MEC Connect Expert Insights episode, “Unsung Heroes: Spotlight on Nurse Case Managers,” MEC’s Medical Management Consultant Dana Dorsey explains how nurse case managers serve as the critical bridge between injured workers and successful recovery.
Based on two decades of experience in the field, Dana shares insights about how Nurse Case Managers play a vital role in facilitating collaboration between injured workers, employers, healthcare providers, and insurance carriers. This includes:
Listen now to gain a fresh perspective on the often underappreciated yet high-impact role Nurse Case Managers play in all aspects of effective workers compensation management.
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In this episode, MEC’s Senior National Medical Catastrophic Consultant Peggy Ford unpacks the complex world of the American Spinal Injury Association (ASIA) Impairment Scale. Peggy breaks down this essential clinical tool that standardizes how healthcare professionals evaluate and communicate about spinal cord injuries. This includes:
Listen now to understand the language that shapes spinal cord injury management and gain valuable knowledge applicable to workers' compensation and catastrophic claim oversight.
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Amputations are among the most challenging cases in workers' compensation. In this Expert Insights episode, MEC’s Senior National Catastrophic Medical Consultant Phyllis Ramondetta provides excellent insights into this complex topic that affects thousands of workers annually.
Phyllis shares expert commentary based on over 20 years of experience as a catastrophic nurse case manager. This includes:
Whether you are managing amputation claims, supporting an injured worker through recovery, or trying to understand prosthetic technology better, this episode provides essential insights to navigate these life-altering injuries.
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In this episode, Dr. Fernando Branco, MEC AVP of Claims and Chief Medical Officer, tackles the multifaceted world of Complex Regional Pain Syndrome (CRPS) by drawing on decades of specialized experience in physical medicine, rehabilitation, pain management, and addiction medicine.
Dr. Branco provides valuable insights about:
For claims professionals handling a claim with a CRPS diagnosis, this episode provides essential context that could change your approach to these challenging cases.
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In this episode, Tracie Lemus, RN, CCM, MSCC, National Catastrophic Nurse Consultant at Midwest Employers Casualty, highlights critical care strategies and rehabilitation insights for better recovery outcomes for spinal cord injuries. Tracie provides invaluable knowledge on injury types, common complications, and the importance of comprehensive treatment.
Topics covered include:
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Join us for a new MEC Connect season featuring our innovative series of Expert Insights podcasts. These episodes highlight the expertise of MEC colleagues who share insights and best practices for managing catastrophic claims and our outcome-based approach for excess workers’ compensation insurance coverage that benefits workers and employers alike. This includes breaking down complex cases, conditions, and terminology to give you a deeper understanding of how they impact injured employees and guidance on developing strategies for customized solutions to meet your unique needs.
Send us a text and let us know what you think!
Hosts Matt Yehling and Patty Reinecke welcome back Dan Dalton, Chief Claims and Regulatory Counsel at MEC, to discuss the resolution process for complex and high-exposure workers compensation claims. Dan provides insights into when to begin settlement discussions, the steps involved in resolving these claims, and the role of mediation in reaching a compromise.
Discussion Points:
Timing and Steps for Resolution: Dan explains when to consider settlement and outlines the steps involved in resolving excess claims, from identifying issues to determining exposure and engaging the other party.
Involving Defense Attorneys: MEC strongly recommends involving a defense attorney, especially on large dollar claims, to protect the employer's interests, handle paperwork, and navigate the administrative system. Dan highlights the importance of having legal representation for both the claimant and the employer in complex cases.
Mediation as a Resolution Tool: Dan discusses how mediation serves as an alternative dispute resolution process that brings parties together to reach a compromise. He explains that mediation is particularly effective for claims with disputed issues and high exposure, where a neutral mediator helps the claimant, their attorney, and the employer's representatives find middle ground.
Hosts Matt Yehling and Patty Reinecke sit down with Vicki Barker, Senior Claims Analyst for at MEC, to discuss success stories and the positive impact MEC has made on injured workers’ lives through their handling of complex workers compensation claims. Vicki shares her perspective on measuring success, collaborating with partners, and achieving positive outcomes for all parties involved.
Discussion Points:
Defining Success: Vicki explains that success in excess workers compensation claims is measured by making a difference, regardless of the size of the impact, through new perspectives, ideas, information, and resolution strategies.
Collaboration and Addressing the Opioid Epidemic: Vicki emphasizes the importance of collaborating with all parties involved in a claim and discusses how MEC assists partners in identifying and mitigating opioid usage while prioritizing the well-being of the injured worker.
Impact Story: Vicki shares the inspiring story of a police officer who, despite being shot and rendered semi-quadriplegic, received comprehensive support from MEC and went on to become a consultant for his department and a hometown hero.
Hosts Matt Yehling and Patty—Reinecke are joined by Gina Holt, former Client Consultant Manager and current ISI Underwriter at MEC, to discuss how MEC collaborates with clients and TPAs to mitigate costs on complex, potentially excess-level workers compensation claims. Gina shares insights on MEC's hybrid role, early intervention strategies, and leveraging internal resources to improve claim outcomes.
Discussion Points:
osts Matt Yehling and Patty Reinecke are joined by Marianne Reed, Senior Claims Analyst at MEC, to discuss strategies for containing and mitigating costs in complex workers compensation claims. Marianne shares her expertise on identifying cost drivers, collaborating with stakeholders, and implementing targeted interventions to improve outcomes and reduce expenses.
Discussion Points:
Hosts Matt Yehling and Patty Reinecke sit down with Dr. Fernando Branco, MEC's Chief Medical Officer, to discuss Complex Regional Pain Syndrome (CRPS) and Reflex Sympathetic Dystrophy (RSD). Dr. Branco shares his expertise on these challenging diagnoses, explaining how they can develop from seemingly minor injuries and the difficulties in accurately diagnosing and treating these conditions.
Discussion Points:
This episode features guest Tina D'Andrea discussing the critical topic of post-traumatic stress disorder (PTSD) in the workplace. With over 25 years of experience in workers compensation, Tina offers deep insights into the symptoms, diagnosis, and effective treatment of PTSD, particularly among professions with high public interaction like first responders, medical personnel, and teachers.
Discussion Points:
Hosts Matt Yehling and Patty Reinecke are joined by Jeff Pack, a Medical Management Consultant at MEC, to discuss failed back syndrome. Jeff shares his experience dealing with complex back injury claims that often start as sprains or strains but can lead to multiple surgeries and the diagnosis of failed back syndrome. The episode explores common trends in these cases, potential interventions, and advice for managing claims involving failed back syndrome.
Discussion Points:
Hosts Matt Yehling and Patty Reinecke welcome Dana Dorsey from MEC's Medical Management Unit to discuss sprains and strains. Dana, with her extensive background in field case management, dives into the definitions, treatments, and prevention of these injuries, highlighting how they can lead to complex claims if not managed properly from the outset. The episode focuses on practical advice for both employers and employees to handle and prevent these injuries effectively.
Discussion Points:
They explore key differences from catastrophic claims, focusing on disputed issues, medical care management, and disability assessment. Dan shares insights on the use of Independent Medical Examinations (IMEs) and emphasizes the value of involving opposing counsel. The episode highlights the need for a collaborative approach to improve outcomes for injured employees.
Discussion Points:
In this episode of MEC Connect, hosts Matt Yehling and Patty Reinecke sit down with MEC Senior Claims Analyst Kam Garrett to delve into the complex world of migratory claims. Kam shares a real-life example of a migratory claim that spanned over a decade and the challenges involved in handling such cases. They also discuss recurring trends, resources, and strategies for managing migratory claims effectively.
Discussion Points:
Hosts Matt Yehling and Patty Reinecke interview MEC’s Sherrie Murray about the challenges of "migratory claims"—claims involving injuries that start simple but spiral into complex cases involving endless treatments and prescriptions. In this episode, we explain MEC’s approach to these thorny claims, focusing on appropriateness of care, prescription issues, and ultimately settling cases.
Discussion Points:
Nature of Migratory Claims: Common types of injuries in migratory claims, particularly involving the spine.
Challenges of Migratory Claims: The medical, psychological, and employment-related challenges faced in these claims.
MEC's Approach to Migratory Claims:
In our final episode of Season 1, Matt Yehling and Patty Reinecke speak with Geoff Jones, Senior Claims Attorney at Midwest Employers Casualty (MEC) about resolution of catastrophic claims.
Topics covered include:
In episode 8, Kelly Loos, Senior National Catastrophic Claims Analyst at Midwest Employers Casualty (MEC), teams up with Matt Yehling and Patty Reinecke for a conversation about claim management once an injured employee has achieved medical stability.
Topics covered include:
In episode 7, Matt Yehling and Patty Reinecke welcome back Phyllis Ramondetta, Senior National Catastrophic Medical Consultant at Midwest Employers Casualty (MEC). They will discuss the factors involved for an injured employee to achieve the goal of returning home after a catastrophic injury.
Topics covered include:
In episode 6, Matt Yehling and Patty Reinecke welcome Phyllis Ramondetta, Senior National Catastrophic Medical Consultant at Midwest Employers Casualty (MEC), for a discussion on what to expect after the acute phase of a catastrophic injury.
Topics covered include:
In episode 5, Matt Yehling and Patty Reinecke welcome back Midwest Employers Casualty’s (MEC) Chief Medical Officer, Dr. Fernando Branco. The three discuss the significant role Centers of Excellence (COE) play in the rehabilitation of catastrophically injured employees.
Topics covered include:
In this installment of MEC Connect, Matt Yehling and Patty Reinecke chat with Midwest Employers Casualty’s (MEC) Chief Medical Officer, Dr. Fernando Branco. Dr. Branco addresses the importance of proper medical treatment to achieve the best outcome for the injured employee. Topics discussed include:
Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.
For inquiries about MEC Connect, email MECConnect@mecasualty.com.
In Episode 3, Matt Yehling and Patty Reinecke welcome Dan Dalton Chief Claims and Regulatory Counsel at Midwest Employers Casualty (MEC). Dan addresses the benefits of having a lawyer involved in catastrophic (CAT) claim investigations.
Topics covered include:
Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.
For inquiries about MEC Connect, email MECConnect@mecasualty.com
Matt Yehling and Patty Reinecke welcome back Courtney Waltz, Senior National Catastrophic Claim Analyst at Midwest Employers Casualty (MEC), to continue their discussion about MEC’s unique approach to CAT claims management.
Topics covered include:
Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.
For inquiries about MEC Connect, email MECConnect@mecasualty.com.
Welcome to the first episode of MEC Connect! Special guest Courtney Waltz, Senior National Catastrophic Claim Analyst at Midwest Employers Casualty (MEC), joins cohosts Matt Yehling and Patty Reinecke for the first in a series of discussions about catastrophic (CAT) workers’ compensation claims.
Topics covered include:
· How the MEC dedicated CAT Claims team defines CAT claims
· Who makes up the CAT Claims team
· The initial reporting process for these types of claims
· Why immediate action for CAT claims is critical to helping achieve better results
Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.
For inquiries about MEC Connect, email MECConnect@mecasualty.com.
Matt Yehling and Patty Reinecke explain why you should listen to the MEC Connect podcast!