IMPAIRMENT IS THE OBJECTIVE MEASUREMENT OF THE INJURY

DISABILITY INVOLVES A COMPLEX BLEND OF IMPAIRMENT AND PSYCHOSOCIAL FACTORS

IMPAIRMENT AND DISABILITY ARE NOT THE SAME THING!

American College of Occupational and Environmental Medicine (ACOEM) – ‘Preventing Needless Work Disability by Helping People Stay Employed’ www.acoem.org

AMA Guides to the Evaluation of Work Ability and Return to Work www.ama-assn.org

THE BEGINNINGSRecognizing the inconsistencies in occupational and specialty practices that resulted in lengthy periods of disability, Brian Konowalchuk, MD from Essentia Health (then St Mary’s Hospital System) partnered with Minnesota Power, a large employer in Duluth, MN to host a multi-stakeholder conference in 2006. A member of the faculty for that first meeting was Jennifer, Christian, MD.

About the same time Mayo Clinic disability management staff began talks with the Occupational Medicine Practice to discuss strategies for improving communications and collaboration to reduce disability durations.

Having attended a 2007 conference in Duluth, MN, Mayo staff approached Dr. Konowalchuk for advice from his conference experiences. Dr. Konowalchuk suggested the two organizations partner in the effort and IWD was born.

Facilitated by Jennifer Christian, MD a multi-stakeholder summit in Minnesota was held to review and evaluate the recommendations from ACOEM’s guideline. One of the major recommendations was the need for continued education for all parties.

PRACTICE GAP REINFORCED THROUGH NEEDS ASSESSMENT

• Physicians in Psychiatry, Family Medicine, Physical Medicine and Rehabilitation, Orthopedics, Neurology and Occupational Medicine were surveyed.

• Through the course of their practice, health care providers identified inconsistencies in prescribing return to work recommendations , and a lack of knowledge regarding:– the consequences of prolonged

disability– the importance of their –or others’ –

roles in managing disability– disability duration guidelines– resources and education

CONFERENCE LEARNING OBJECTIVES

• Explain the impact the physician has on preventing needless work disability

• Establish how improved communications between health care provider, employer and employee (patient) contributes to optimal management of injured/ill employees

• Assess negative impact on patient and economy that results from poor RTW management

• Demonstrate best practices and new ideas that improve RTW outcomes

• Explain the physician’s role in defining appropriate disability management

TOPICS

• Managing chronic illness• Rational imaging of spine pain• Effective management of

behavioral health disabilities• Physician role in the workers

compensation system• Physician imposed activity

restrictions• Addiction and disability• Health promotion and wellness• When disability exceeds

impairment• FMLA medical certification• Canada’s mental health

standards

• Motivational Interviewing• Concussion• Opiate epidemic• Psycho social aspects • Accommodations for

effective SAW/RTW• Evidence based disability

guidelines• Rehabilitation of chronic low

back pain • Social Security Disability• Return to work programs

and management• Minimizing psychological

impairment

TOPICS

• Major depression and depression as co-morbidity

• Workers compensation reforms in Washington state

• Resilience• Neuropsychological

examinations • ADA interactive process• Chronic pain• Communication strategies

for productive interactions• Living abled

• Navigating and understanding workers compensation, FMLA and Americans with Disabilities Act (ADA)

• Post traumatic stress disorder• New concepts in managing pain• Personal, social and policy • ramifications of low back pain• A course in power and what • works in managing injury and• illness• Obesity, diabetes and the ADA• The crippling of America

FACULTY

• International thought leaders

• Subject matter practitioners

• Individuals who overcame impairments

• Academics• Attorneys• Researchers

AUDIENCE

• Health Care Practitioners• Occupational Health

Nurses• Employers• Insurers• Rehabilitation

Professionals• Attorneys

FEATURED KEYNOTES

• Billy McLaughlin-Billboard Top Ten guitarist and star of an award winning documentary about living with dystonia

• Gary Karp-motivational speaker and author of Life on Wheels who suffered a spinal cord injury at 18

• Darryl Strawberry-major league baseball slugger who battled substance abuse and founder of addiction rehabilitation centers in Florida and Texas

• Ken Barlow-Emmy award winning meteorologist whose bipolar disorder was misdiagnosed into his forties

• Jim Abbott- Former major league baseball pitcher who played despite having been born without a right hand

• Kevin Kling- American commentator for National Public Radio and acclaimed storyteller who acquired significant impairments following a near fatal motorcycle accident

• Josh Blue –the comedian who put the ‘cerebral’ in Cerebral Palsy, voted the Last Comic Standing on NBC's reality show, star of Comedy Central and several TV programs

• Lori Schneider-adventurer and author who climbed the world’s seven summits after a diagnosis of multiple sclerosis

APPLYING NEW KNOWLEDGE TO PRACTICE• Incorporate more psychosocial approaches into my practice• Turn to new learned resources for boosting knowledge base • Recognize and address of signs psycho social issues • Use proper language/words to describe employee's medical status to focus on

function, not pathology• Learned different and important perspectives of others involved with an impaired

person• Know the difference between impairment and disability• I have significant tools to use in my practice• Paradigm changing concepts for me• I will share these concepts with colleagues in my practice• Incorporate discussion of return to work planning in every appointment• More empathy-not sympathy-and humanistic approach to clients• Be aware of both physical and psychosocial elements in practice• JAN is an excellent accommodation resource I will use• Use better interviewing skills when recovery is delayed• Provide appropriate referrals when co-morbidities are issues• New knowledge about MRI spine interpretations • Will establish a more comprehensive program to assist employees with delayed

recovery• Create more partnerships with others in the process-be more collaborative• Use better interviewing to really engage the employee in their own recovery• I will focus on abilities, not what someone can’t do• I have a better understanding of compliance and legal issues• I will use the ACOEM guidelines to improve my practice• I will use in mentoring medical grads-these concepts in caring for and evaluating

patients are vital for them to learn now • Over medication is an issue-will continue to minimize prescriptions and opiate and

consider alternatives presented• Change is perception will cause me to seek even more knowledge to change

aspects of my clinical practice

Mayo School of Continuous Professional DevelopmentMayo Clinic in collaboration with Essentia Health offers

Impairment Without DisabilitySeventh Annual Conference

October 2-3, 2014Duluth, MN

www.impairmentwithoutdisability.com/

THANK YOU

Jane RyanRyan.jane@mayo.edu