Racing Risk

I love racing, particularly motorcycle racing.

I grew up on motorcycles. Though I didn't get my first motorized two wheels until age 10, my brother, friends and I would fantasize about having a motor, riding our bicycles and making vroom sounds or using playing cards to create the noise.

Riding bikes is thrilling, but racing takes the experience to a whole new level. Close riding proximity, the test of skills against another rider, competitive adrenaline - if you've raced anything on two wheels you know exactly what I'm talking about.

Zoom...

My last race was a motocross at Piru Race Track 10 years ago. I won my age class, and got third in the age 35-40 age group. I stopped because I realized my motor skills didn't keep up with my mental agility...

But spectating is just as thrilling. Perhaps it is because I can relate from my experience, or perhaps because motorcycle racers aren't hidden from view so you can see what the riders are actually doing; to me it's just much more up close and personal than automobile racing, or any other kind of racing really.

I try to go to a race every year. Usually it's the U.S. round of the World Superbike Championship held at Laguna Seca raceway near Monterey, CA. It's the proverbial child in a candy store adventure for me.

Of course, up on two wheels eventually means going down - as in crashing. Two wheels are inherently unstable. The gyroscopic effect keeps everything in proper order so long as the laws of physics are respected.

Racing always challenges those laws, though. Anyone and everyone that races eventually will get on the wrong side of Newton's laws. Momentum becomes an enemy. Injury and death result.

This past weekend three professional motorcycle racers died.

Luis Salom was only 24, and a rising star in the World Superbike support class, Moto 2.

Just a few days later the Isle of Man, known in racing circles as the most dangerous of courses, took two riders in one day.

Last year, at Laguna Seca, a horrible crash in the last MotoAmerica race of the day claimed two lives.

Of course there are the countless injuries on a daily basis too.

Bikes are dangerous. Risk management is taken beyond science to an art level in motorcycle racing.

Curiously, I know pretty much nothing about how workers' compensation works in professional racing, particularly international racing like World Superbikes, which goes to 13 different countries.

How are racers and crews covered? Who pays for what? What jurisdiction controls? How adequate are benefits (if any)? What is the scope of medical care, both preventive and responsive? How expensive is insurance and how is it rated?

I'm sure there are brokers who specialize in covering motor racing risks, and in particular international motorcycle racing - I hope you'll chime in and educate us domestics about racing risk management and insurance, and in particular occupational risk management...

Derby Lessons

I learned a lot at the 142nd running of the Kentucky Derby.

I learned that one can study and study and study the horses and still come out a loser.

I also learned that you could trust the experts, but they basically know about as much as you do, except in finer detail - and they can still be wrong.

I learned that 167,227 people can all get together and cheer a common cause, but still feel anxiety and angst for their own personal agendas.

I learned that the people of Kentucky (or at least Lexington and Louisville) are extraordinarily cheery and nice to outsiders.

I learned that there's some really good food in Kentucky, which just happens to go very well with mint juleps.

Which of course meant I learned that my wife doesn't like mint juleps.

I learned about bourbon, about distilleries, about exceptions to the law and prohibition.

I learned that Ohio (our table mates were from Ohio) has a huge concern with opioids and heroin addiction, perhaps more than most other states.

I learned that horse jockeys are in a very hazardous occupation and have their own rules, regulations and insurance programs that are workers' compensation, but take things a bit further.

I learned that there is an enormous amount of money in the horse racing business.

And I learned that all that money is because it takes a lot of people to make something like the Derby an event.

I learned that if I parlay my gambling smartly and stick with the statistics that there is a better chance of holding a winning ticket.

I also learned in that same lesson that you may not know until the very end if you made the right decision, because it can look very dire but someone, something, somehow, someplace, somewhere, could pull it off...

I learned that Dwight Johnson's shoes (and ties and hats) attract A LOT of attention and even more so when I explain that they are made by a double amputee, the result of two separate industrial injuries just 18 months apart.

I learned that the Shakers were probably some of the first to embrace equality among the genders.

I also learned that sometimes just a day or two off from the daily grind can be enormously refreshing.

Thanks to Cindy Whitehouse and her impressive team at Ascential Care in Lexington, KY for putting this all together for me.

Performance Perspective

"Will you decide to heal yourself and come back stronger? Or will you allow the injury to get the best of you? A great tool is to choose the best perspective and focus on what you want to happen," says Matt Belair, a sport psychologist in an interview in International Mountain Bike magazine. "I want to recover quickly and perform my best, I will continue to have total confidence in my abilities."

Athletes get hurt all the time. Particularly in the more "action" oriented sports more popular with the current generation, such as motocross, mountain bikes, parkour, etc.

Self belief is HUGE. The IMB article cited above is about accomplishing athletic feats at the very upper echelon of performance. There are lots of talented riders who are near equal in physical fitness and ability, for example, but only a very few have the mental horsepower to visualize and accomplish a world championship. or a double back flip with a twist over a 50 foot chasm...

That same mental horsepower is healing too.

Long time workers' compensation leader and expert, Robert Aurbach (now residing in Australia) has researched and written extensively on neuroplasticity - the ability of the brain to create new synaptic pathways in response to external stimuli, i.e. learned behavior.

This phenomenon works both ways - our brains can either learn to heal and overcome injury, or learn to be disabled.

Part of the external stimulus that affects neuroplastic response is system input - in our case how the laws, regulations and application of them to an injured worker's plight either stimulate, or depress, the healing forces.

It's sort of true that one can choose to be disabled, or not; but external stimulus plays a big part in that choice. And the starting point is the individual's own mental strength. If we are starting off with a person who's self picture is weak, then it is much more difficult to rewire his or her brain to overcome adversity than for someone who's mental picture of themselves is stronger to start with.

Founder of the all volunteer Work Injured Resources Connection (WIRC) in Adelaide, Australia, Rosemary McKenzie-Ferguson, sees the challenges on a daily basis. She deals with the people (not their cases) who are ejected from the workers' compensation system without the resources to find their new path in life.

She tells several stories in a recent publication of the Safety Institute of Australia about recovering injured workers, and she makes a very important distinction for those folks who are having a tough time finding normalcy in their lives: they need help understanding that they have an injury, and that they are not the injury.

This might be subtle, but it is an important distinction. One HAS an injury. When one BECOMES the injury, then they will not be able to overcome the injurious sequelae.

She writes about an injured factory worker who was earning $28,000 per annum and had to work endless hours of overtime to get up to $35,000 to support his family. His workplace injury meant he would never return to the factory floor.

WIRC first job was to get him to reimagine his life, reimagine his abilities, understand that HE was not the injury and that he had the power to change.

They got him started with a 12-week basic computer course and, according to Rosemary, "the last time I spoke with this injured worker he was based in Sydney, working between Sydney and New York, and earning many times the $28,000."

She writes about an enterprising engineering firm that turned a disused corner of the business into an area where their injured workers repaired wheelchairs and bikes for the community groups in a 50km radius of where they were based. This gave the injured workers something real to do, and it supported the injured workers as they regained medical capacity hours, but it also encouraged the rest of the workforce to get involved which improved the culture of the business.

Another injured worker came to WIRC with industrial emphysema from working in the coal industry. The message he got from the system was “just go away” (that is the polite version). He lost his ability to believe in himself. According to Rosemary, this man is now a mentor for others entering the construction industry, using decades of hands-on workplace knowhow.

There is a big push in the workers' compensation industry to reinvent itself. After 100 years we have learned quite a bit about ourselves, our mission, and how we impact people and lives.

For instance, at third party administrator, Gallagher Bassett, claims adjusters are "resolution managers," a title that denotes the important role the claims person has in resolving the ultimate conflict - that of self-belief.

This is a great start. We are in the people business. People have worth and that worth begins with the self. We can provide medical care, and a few dollars to help pay the bills, but the ultimate success is when belief in the self is restored - then the pathways to one's return to health, return to society, return to work, are opened.

It's a whole new paradigm, I believe. It's not one that is going to be filled by special interest vendors, though certainly there will be many entrepreneurial efforts towards this paradigm.

It's an entire cultural shift. I can see it happening all around us. It's part of the reason why we started Comp Laude - to recognize those that have been successful in helping, and actually achieving, the best perspective for resolving the work injury.

Restoring the confidence in one's abilities - that's a tough job, and a real goal. From there comes all other success.

Some folks will never be able to reach that goal for one reason or another, be it childhood psychology, drugs, whatever.

But most people have that power.

And I think a revolution in claims resolution is slowly taking place in our industry as we recognize that it's not all about bill review, guidelines, indemnity limits or any of the other artificial system contrivances in place.

There's always a passel of bad news about work comp. But I also know that there's big pride in most of us for doing a job well in restoring an injured worker's self-belief.

"Focus on what you want to happen." We don't have to provide psychological services to every injured worker - just help them focus on recovering quickly, performing their best, and having confidence in their abilities. It won't work for everyone, but it will work for most.

Stay On The Game

There's an immutable truth about two wheels - eventually you will go down.

Riding motorcycles involves a higher level of risk than other "ordinary" daily activities, so the level of risk management is also heightened.

After a risk event has occurred, then the task evolves from risk management to event assessment, then short term corrective activity, and eventually long term adjustment.

Hopefully, along these phases, we learn something to a) increase risk management skills and b) improve post event procedures.

Through my 46 years of motorcycling adventure, I've improved my risk management skills considerably, and have also increased my knowledge and understanding of post event procedures.

Alas, I tested those skills and knowledge on Saturday. Fortunately, all 46 years of learning paid off.

For instance, not long ago I recognized that my riding clothes were not suitable for the type of riding I most often engage in (canyon roads in Malibu), so I upgraded to an Alpinestar full leather two piece riding suit. I got a great deal on it, so it passed my wife's value test (sliding scale: the more safety provided the more I can spend, but if I get a "bargain" then it's like an 'Ebay instant buy' approval - no discussion needed!).

It was sunny and clear. In the canyons probably in the mid-90s. The roads weren't busy.

My favorite first run is up Deer Creek Canyon - the views at the ridge top, where it turns to Pacific View Drive, sweep from the Pacific Ocean on the right, to the beautiful red rock of Boney Mountain on the left.

After the ridge the road turns into Cotharin Road, and then intersects Yerba Buena.

Normally I would go north on Yerba Buena towards Boney Mountain. But I knew it would be over 100 at the top, so I decided to stay at the lower elevations and instead of left at Yerba Buena, I turned right to head down to Pacific Coast Highway.

I love Yerba Buena Road. It's tight, twisty, and relatively good pavement on that south-bound leg (going up to Boney Mountain the road is in dire need of repair).

So down Yerba Buena Road I went, pitching The Sewing Machine (2011 Honda CBR250R) left to right and right to left, diving into corners, scrubbing those tires, and having The Time of My Life.

Ah, but a moment of inattention resulted in a test of my risk management skills.

I wasn't riding particularly assertively as I entered a tight right hand drop away 180 degree corner about half way down Yerba Buena (40 miles into my ride) - ... my demise.

It was slow motion. I clearly felt the slide start, and I countered with my best corrective action - a little more counter-steering, a touch more throttle, no brakes - alas, too little too late.

TMS slid out at about 30 MPH - a low-side on the right. I held on, as I have learned over those 46 years, to maintain as much control over machine and man as possible. Clutch in, throttle still in hand - after we stopped sliding, I noted that we had swiveled nearly 120 degrees so the front of the bike was facing up hill.

Dang it!

Post event assessment ensued.

I quickly remounted, engine still running, and throttled out of the roadway, back up a few feet to identify what the heck happened and that's when I noticed that the right footpeg on TSM was missing.

The Alpinestar suit proved an excellent risk management system - no bruises, no cuts, no rash: no insult to my body whatsoever.

The only damage, other than the broken foot peg, was scraps on the tail pipe heat guard, scratches on the right mirror, a bent brake pedal and the scuff marks on the leathers.

Otherwise, very little damage, and if I didn't tell my wife she might not notice...

Inspection of the road didn't reveal anything abnormal. I didn't notice any loose dirt. The asphalt appeared normal. My conclusion was that I was just a hair off my game, and payment was extracted.

But clearly, the "temporary disability" of a missing footpeg meant the balance of my ride (Mulholland Highway, Latigo Canyon Road, Decker Canyon Road, among others) would be cancelled - time to limp home with my right foot using the rear, passenger, footrest for support.

Back home I straightened the brake lever with a wrench, cleaned up the hash marks on the mirror with a file, and ordered up a surplus footpeg on Ebay for $11.00, tax and shipping included.

The Alpinestar leathers are now officially broken in...

The thing about risk management is that one never knows whether the techniques implemented work until a risk event occurs. And then it's too late to make adjustments - you can only learn from that risk event to make adjustments for future possibilities, which of course you won't know whether the adjustments are successful until the following risk event.

And the risks come from all sorts of different angles. In my case there's the risk of falling in the first place, but that is the major, precipitating event to other risk events.

But once a risk event happens, once an injury occurs, once a claim is made, managing the risk is no longer applicable. It's too late. The risk happened!

Risk management in the work place is about ensuring safe practices so a work injury or claim does not occur.

Risk management on the other hand is not about managing the work comp claim because, as I said above, the injury or claim occurred because of the failure in risk management in the first place.

What happens after a risk event, after the claim is made or injury incurred, now becomes claim management - or if we were following the lessons from Monday's teachings, people management.

Injured workers are not a risk anymore, they are real - risk management already failed because there was an injury or illness, or a claim of such. Using risk management techniques on injured workers fails them, fails the employer, fails the system.

The skills and techniques are different.

After the risk event it's time to manage the person, not the risk.

I think its noteworthy that the preeminent organization for risk managers includes in its title, insurance. For not only does the professional risk manager assess and remediate potential risks, but part of the equation is ensuring mitigation of a risk event with insurance coverage.

And once the risk event occurs the risk manager becomes the insurance manager to ensure the folks to whom the risk was transferred do their jobs in the post event setting. The top risk managers recognize that the next stage has occurred and people management becomes paramount.

Medical costs can go up, claim frequency can go down, indemnity severity might go up - at the end of the day, risk management first retards the probability of a risk event, but then moves into managing the claims response.

I said that after a risk event occurs the risk manager learns and makes adjustments.

After nearly 20 years of marriage, I have learned and have made adjustments, particularly in my post risk event people management techniques.

When I returned home I told my wife that I was really happy with my Alpinestar leather suit and that it "worked perfectly."

She was ecstatic at first, but frowned when I told her of my first person testing. She smiled again after I noted that there was no damage to body, or soul, and that TSM had only about $11 worth of damage.

Next weekend I'll be just a little more attentive to my riding, and stay on my game.

Get On Your Bike and Ride

Yesterday, after posting about mental health and its importance to the overall workers' compensation claims process I went for my morning bicycle ride.

Those of you who know me, or who have followed me for a while, know that I'm obsessed with cycling. I don't "follow" the sport like most sports aficionados because I can't sit long enough to "watch" anything, but I like to ride.

I have always been that way - I'm one of those "doers" - and I've been "doing" pretty much anything related to 2 wheels since I could ride without training wheels.

That also means that I have had more experience with the downside of two wheels than most people - aka crashing, or at least falling.

That's just a part of life on two wheels; eventually you WILL go down. Hopefully it is not that traumatic of an event, but it is a fall, and it does hurt.

I'm also fortunate (or maybe not) to have a very high tolerance for pain. Pain doesn't affect me as much as most people. Yep, things still hurt when I'm stupid and fall off my bicycle, but for the most part I just pick myself up, utter a few curse words, try to wipe up the blood as well as possible, and carry on.

Sometimes, like when I ended up in intensive care for a week due to a host of serious internal injuries after a particularly bad get-off, I endure a bit more pain than normal. In those situations it's just my body telling me that, yep, it really IS bad this time! I was thankful for the Demerol drip that time...

But for the  most part injuries are just part of my life. Which means pain is also just a part of my life.

Bowzer crashed into a wall, but dealt with the pain.

My wife can't tolerate any pain. She is a s frail a flower as I know. She complains of the slightest discomfort. Any minor bruise, burn or laceration causes her great irritation and misery.

The sight of blood terrifies my wife and she goes into shock - like the time I was riding "trials" on the rock jetty in front of my house on my mountain bike a few years back. I missed a step and got gored in the leg by a piece of rebar. Blood was spurting everywhere and of course I knew I needed stitches (and a tetanus shot), but my wife was so overwhelmed by the sight of blood that she couldn't drive me to the emergency room - she had to sit shot gun while I operated the throttle and brake with my left foot.

What is it that makes some people so resilient and able to deal with adversity, pain and suffering only to come back better, stronger and ready to take on more?

And others who can't tolerate nearly any pain or get set back by seemingly minor issues?

I was reminded of this yesterday after, serendipitously, posting about mental health. Took a little spill on my bicycle after only about seven or eight miles of what I had planned to be about a fifty mile ride.

The worst part is that I wasn't even going fast, which made me mad - there's nothing worse than an active person sustaining injuries in a relatively non-active way...

After picking myself up off the pavement I assessed my injuries: blood gushing from my right hand, blood all over my left calf and thigh, left shoulder abraded but thankfully no damage to the new cycling jersey I was wearing.

I hosed myself off with the water bottle, cursed a whole bunch for being stupid, saw that blood was spurting out everywhere ... and got on and rode to complete that fifty miles.

The injuries sort of hurt - I mean, lacerations, abrasions and contusions eventually induce some pain. But what I noticed most is that the cut on my right thumb wouldn't stop ejecting blood and that damned red stuff was getting all over everything.

To my compulsive way of thinking this was a huge inconvenience. I had a mission - complete my ride! But blood was getting in the way of that mission.

I was reminded of the time I went windsurfing in some big surf before work one day, ended up "biting" the sail boom on my first tack out through the waves and spit out my broken front tooth. Most rational people would call it a day, head back to shore and get an emergency dental appointment.

Not me! No sirree ... give up premium wave sailing just because of a broken tooth, cut lip, and enough blood to attract an entire school of sharks?!

And so it was with my thumb ... what do I have on me that I could tourniquet that thumb so I can complete my ride? Sunglass bag in my pocket! Wrapped it up, tied it up, thumb throbbed and wasn't much good for griping the handlebars, but I could still ride.

In the good old days when I was less tolerant of others I could not understand why some injured workers couldn't just wrap it up and still ride. I didn't have any compassion for those people who were unable to overcome a little pain and discomfort.

I've matured now, and understand that a lot of people can't tolerate pain like I can. And that's just part of the mental profile of being human - the variance in which we perceive and deal with pain is huge.

This is what makes the issue of "pain" in workers' compensation so controversial. Some people, like me, have something going on either psychiatrically, or psychologically, or both, that minimizes the perception of pain. To those of us, pain is an inconvenience but we adapt.

There are others, like my wife, who perceive pain in a much different way and for whom pain is a major concern, interferes with nearly all daily living activity, and which has no place in life.

In workers' compensation schemes we try to account for pain. There are pain scales. Some doctors specialize in treating pain. Impairment tries to adjust for pain.

For some people accounting for pain is over-compensation. For many others there isn't any adequate compensation.

In the civil world a jury awards money based on "pain and suffering." It's up to a dozen people of the community, with their collective experience, judgement and knowledge, to determine if someone is really experiencing pain and what that pain is "worth."

In workers' compensation we have disability guidelines and statutory schedules that tell us what an impairment is worth, and sometimes there is a factor to adjust for pain perception.

We know now that prescribing certain medications, e.g. opioids, is more risky and has worse effects on the pain patient than the pain itself.

And there will always be injured workers for whom the remedy is inadequate. There is no adequate answer for them, unfortunately, other than perhaps providing as much emotional and psychological support as possible to assist those persons in dealing with pain.

Mental health treatment is as much a part of workers' compensation as physical health treatment.

As for me, I'm going on my bike ride now.

Cheerleaders Are Employees

Professional sports, and in particular, the NFL have brazenly scoffed at employment laws for years and years.

Then the players unionized and started pressing for greater remuneration for the profits they were delivering to team and league owners.

Still, when backed into a corner (head injury suits by players) not only did the NFL escape any real financial consequences with a questionable settlement after years of denial in spite of their own research, but the league has sponsored workers' compensation and other employment laws that deny players any real protection for their futures - when these injuries finally manifest to significantly disabling degrees.

And the league knows it can get away with it - all one need do is read the public comments by the ignorant fan base when stories are told about players who seek compensation for their injuries.

"They knew what they were getting into," "they are paid gobs of money," - all the same old tired excuses that employers used for years to defeat attempts at fair labor laws.

Right - of course the tone changes when one knows what they are getting into when going to work on an oil platform, or working as a roofer, a firefighter or police officer.

The glorification of sports entertainment and the people employed to provide that entertainment on a large scale is no different than, facetiously of course, glorifying coal mining, or truck driving, or any other hazardous occupation...

The extent to which professional sports exploits its labor is highlighted by the recent spat of NFL cheerleaders suing their teams for wage and other employment violations.

The bottom line allegations to these law suits is that the teams didn't pay these cheerleaders for all of the time they were required to work. They allege that when all of the time is tallied up working under the direction and control of the team they were making a couple of dollars an hour.

The teams have responded, basically, that these women were independent contractors and were "volunteering" for the job.

Well, in most states as measured by workers' compensation laws (and other employment laws) the argument that the cheerleaders signed a piece of paper stating that they were independent contractors doesn't hold up very well.

An independent contractor has her own tools, shows up when she wants to, and delivers a final product or service generally not subject to the direction and control of the employer.

By contrast professional cheerleaders must wear uniforms, had to show up for practices hours at a time or make public appearances at the direction and control of the team cheerleader "coach" and undergo "jiggle tests" among other conditions of their employment.

Forget that a professional cheerleader may be injured on the job - NFL teams calling cheerleaders independent contractors are engaged in what is often decried as fraud: misclassification of workers.

We know that employer misclassification of their work force, whether intentional or not, is a major issue because it puts more pressure on the rest of the work force through employer premium to make up for the shortfall.

Not to mention states that collect premium taxes on work comp policies, assuming correct classification of workers, getting cheated out of revenue.

The trend of professional cheerleader lawsuits has more implications than just back pay.

The way the NFL has purchased legislation I would not be surprised to start seeing proposed laws to redefine what a cheerleader is and limit the availability of employment law protections to them too.

These women are hired to provide entertainment and are a critical component to the entire NFL show (and other sports entertainment), and should be compensated and provided fair employment protections accordingly.

And teams should be paying for workers' compensation coverage for them.

The fact that these positions are glorified with public appearances, fleeting fame and television time is poor remuneration without legally justifiable correlation to labor law.

These cheerleaders provide uncompensated marketing for the teams (and this spans many sports - just look at all the beer company sponsored posters for various soccer clubs in America and other nations). You can bet they signed away any rights to the use of their individual likenesses as part of their "contracts."

It is amazing to me that even in 2014 in America we have such disparity in how workers are treated, and how much we tolerate such treatment (as long as it isn't "us").

What's even more amazing to me is that such chicanery occurs in an industry where, when one really gets down to it, there is very, very little competition.

It's about time professional sports are made to play by the same rules the rest of employing America plays by.

AB 1309 - Told You So

There's no surprise that California Governor Jerry Brown signed the National Football League's bill largely terminating workers' compensation benefits for nearly every football player that could ever make a claim, what with its draconian eligibility requirements and jurisdictional restrictions. I had predicted this bill would pass.

And it's no surprise that nobody cares.

Except Michael Hiltzik of the Los Angeles Times, who said yesterday that the NFL, “unabashedly misrepresented its effect to the soft-headed state legislators who sponsored and passed it.”

The NFL is incredibly powerful because it is the biggest, most profitable sports franchise in the world. The NFL means jobs, means taxes, means entertainment.

But most of all, the NFL means money - lots of money. Last season's estimated revenues were reported to be $9.5 billion, about 25% more than Major League Baseball. Forbes values the average NFL franchise at $1.17 billion.

I don't know what the residual economy is swirling around the NFL - sports betting, patronization of bars, travel, workers' compensation insurance premiums, etc. - but I'm sure it's billions more.

Dr. Bennett Omalu, who was the first physician to identify accurately the incredible increase in Chronic Traumatic Encephalopathy in professional football players says in the Public Broadcasting System's documentary, "League of Denial: The NFL's Concussion Crisis":

"I wish I never met Mike Webster [Webster was a former Steelers center and was the first player where the NFL, through its retirement board, acknowledge any link between football and brain trauma]. CTE has driven me into the politics of science, the politics of the NFL. You can't go against the NFL. They will squash you."

And that is really what this new law is all about - it is the culmination of a long drive to the goal by the NFL using the hefty might of its offensive line to bully, lie, intimidate and if there's too much resistance, just plow over whoever gets in the way.

Because the NFL knows that mostly everybody doesn't care about the athletes, so why should they?

For instance, a research group from Boston University published an independent report linking CTE to football and presented their research at the 2009 Super Bowl. No one showed up.

There is no rational reason for the discrimination reflected in AB 1309 other than the well planned "settlement" the league entered into with the player's union to pay for, over time, concussive brain disorders - something the league for many, many years completely disputed, even after their own study linked player's dramatic probability of brain injury. And I argue that settlement is inadequate.

Angie Wei, legislative director of the California Labor Federation and more famous to us in the work comp industry as the person who negotiated SB 863 on the Labor side of the table, told the Los Angeles Times, "This is a terrible precedent for players and a more dangerous precedent for all workers."

I was confronted at the California Workers' Compensation and Risk Conference last week by a high level insurance executive, who did not wish to be quoted, with claims administration oversight authority of his company's professional sports exposure about my stance against AB 1309. His essential argument was that the applicant's bar had taken the liberality of California work comp too far with professional players and that carriers were paying for claims decades old made by players with little connection to California.

I can sympathize with that argument, and likely wouldn't have a problem IF a) other states took care of their own players (and in my opinion they don't) AND b) AB 1309 didn't discriminate against the entertainers - the people for whom audiences actually pay to see - and who for the most part have very little earnings from their professional careers. After all, the bill covers ALL professionals in football, baseball, hockey, basketball and hockey.

For instance, minor league professional baseball players starts their first year at a MAXIMUM salary of $850 per month. If you get up to triple-A ball, then you can get $2,150 per month. In hockey a minor league player might make up to $39,000 per year, but it is pro-rated daily over the regular season. These aren't highly paid athletes, and now they are largely left with no remedy for the injuries incurred doing their jobs.

As noted in the Times article, the average professional life of a football player is only 4 years. During those 4 years one needs to make enough money to pay for his own medical insurance since the NFL doesn't provide such coverage post retirement.

The bill would cover Arena Football players who make a whopping $500 per game, or maybe $12,000 per year if they play all 18 games with bonuses and incentives.

Athletes in the National Basketball Association's D-league, or Development league, averaged between $12,000 and $24,000 per year.

One way to get the NFL to pay for the medical care needed by its employees who are the ones responsible for the $9.5 billion/year juggernaut we see on television is through workers' compensation.

But NO - instead now the rest of the nation gets to pay, even more, for its entertainment through social security, Medicare and other social programs.

Just another way for Big Business to stick it to the Little Guy, and the Little Guys just bends over - just read the comments to the LA Times article; there's no comprehension of workers' compensation, of athlete pay, or of league profits. People just want their football.

The NFL knows that America is populated mostly by the ignorant and that it has the most powerful marketing machine known to corporate America. The league's marketers are true professionals, turning a negative (unwanted attention to head trauma) and spinning it with the Head Health Initiative suckering GE into sponsoring it with a $60 million deal.

Dr. Omalu is right. You can't go against the NFL. Even Jerry Brown, probably one of the most independent politicians to run California in a long time, is a sucker for football.

The question in my mind is how far will this go? How many other special interest industries will see what the NFL accomplished and seek the demise of certain provisions of California workers' compensation law that cover and assist the working people of this state?

Time will tell of course. The door is opened however and I don't see it getting shut any time soon. Until some really smart plaintiff's lawyer figures out how to sue a team civilly ...

Sports Fans - Don't Stipulate in California

In many workers' compensation litigated disputes, much of the factual issues are stipulated because the legal issues are so limited.

But sometimes a stipulation will work against a party when the existing law is shifting in scope and context.

One of the noted trends sweeping the workers' compensation world is the constriction on professional athletes taking their cumulative trauma claims to California for adjudication despite minimal physical contacts to the state.

The National Football League has been aggressively seeking legislation in key states to impose jurisdictional limitations and the California Workers' Compensation Appeals Board (WCAB) this year issued two en banc decisions turning away football players who sought to bring cumulative trauma claims in California.

In fact just two weeks ago, the WCAB issued an en banc decision in which it found it did not have jurisdiction over a cumulative trauma claim by Wesley Carroll, a wide receiver who had played for the New Orleans Saints and Cincinnati Bengals, even though Carroll was time-barred from bringing a claim in Ohio.

The WCAB in that decision ruled that California's workers' compensation laws could not govern a claim by an employee who was hired outside of the state and who was only temporarily within the state to perform work for an employer.

But the WCAB ruled against the New York Knicks in asserting jurisdiction over a claim brought by power forward Jerome Williams to adjudicate his claim in California. The Knicks filed an appeal with the 4th District Court of Appeal, Division 3, on Monday.

There was debate about the Williams case in the applicant attorney circles - some stating that the WCAB was sending a mixed message.

But there isn't any mixed message - the WCAB was simply following the facts of the case as stipulated by the parties.

And one of those facts that the Knicks, rightly or wrongly, stipulated to was a continuing trauma injury in California:

"Defendant Federal Insurance Company, the insurer for the New York Knickerbockers, petitions for reconsideration of the September 17, 2012 Findings and Orders. In that decision, the workers' compensation administrative law judge (WCJ) found that the Workers' Compensation Appeals Board (WCAB) has jurisdiction over applicant's claim and that applicant was a professional athlete, occupational group 590, for purposes of compensation. The parties had stipulated that applicant sustained an industrial injury to his back, neck, shoulders, knees, right elbow and right foot from 1996 through April 20, 2005." [Emphasis added.]

In fact, the WCAB simply adopted the WCJ's report and recommendations on reconsideration because there was no dispute on the salient facts. The WCJ's report states:

"The relevant facts are not in dispute. Applicant Jerome Williams was a professional basketball player who played for four NBA teams from 1996 through April 20, 2005, most recently the New York Knickerbockers (Knicks) from November 8, 2004 through April 20, 2005. Applicant filed an Application for Adjudication alleging multiple injuries as a result of cumulative trauma throughout his career. Applicant was never hired in California and played his entire career with Eastern Conference teams. He currently lives in Nevada and has never resided in California. His agent was based in Washington, D.C. Applicant's only contacts with California, and his sole basis for asserting California jurisdiction, were 24 games played in California during his nine-year career, including three games in California during his final season with the Knicks. (Report, p. 2.)"

It is emphasized again in the WCAB's opinion that the "parties stipulated that applicant sustained a cumulative industrial injury to his back, neck, shoulders, knees, right elbow, and right foot from 1996 through April 20, 2005 at various locations in California."

There was dispute about some other body parts.

"At trial, defendant stipulated to industrial injury in California. (Citation.) Although defendant argues incorrectly that the de minimis standard precludes jurisdiction, it concedes that applicant sustained 'mictrotraumas' in California which contributed to his cumulative injury. (Citation.) The WCJ therefore properly exercised jurisdiction over applicant's claim." [Emphasis original.]

The WCAB also noted that there was no forum selection clause governing industrial injury claims.

The WCAB did its job correctly in the Williams case. If the defendant didn't feel that there was an injury in California, microtrauma or not, it should have not stipulated to such.

But it did and as a consequence, based on long standing, well established California law, jurisdiction was asserted.

I doubt the Court of Appeals will find differently.

How A Federal Take Over Could Occur

Last week I wrote about the expanding influence, and perhaps, jurisdiction of the federal government over our lives, and in particular (of course) workers' compensation.

Yesterday I argued that California Assembly Bill 1309 was bad law and should not get to the governor's desk.

The two may come together - when we look at the various legal and legislative/ regulatory actions going on regarding professional athlete injuries and the politics across the nation concerning the limitation of jurisdiction - we see argument why workers' compensation may need uniformity and consolidation; ergo, federal control.

I'm not saying I'm in favor of a federal take over of workers' compensation, but look at these facts and tell me whether or not, if you were a federal legislator, you would be inclined to mandate a federal system of workers' compensation, at least for professional sports that cross state lines whether via live participation or virtually via television or other media, and other migratory industries.

After arbitrator Michael H. Beck on Dec. 12 issued a decision saying football players signed contracts agreeing to file work comp claims in the state where the team was located, rejecting the player's arguments that the order violated a federal court ruling stating that there needs to be an opportunity to demonstrate where the injuries occurred, a federal judge has granted a hearing on a proposed order that would overturn Beck's decision.

In July, a federal judge in Philadelphia is expected to rule on whether former players can sue the National Football League about concussion-related injuries. An estimated 4,300 former players have filed lawsuits that have been consolidated in the U.S. District Court for Eastern Pennsylvania but the NFL seeks dismissal on the argument that the suits are preempted by the collective-bargaining agreement between the league and the NFL Players Association.

In April, Arizona Gov. Jan Brewer signed a bill similar to California's AB 1309 that prohibits people working for employers in the state from filing work comp claims for injuries sustained while working temporarily in another state.

Other states have also passed laws limiting the ability of professional sports athletes to seek redress in states other than that of the players' contractual domicile, most recently Florida and Tennessee.

Then on Thursday a district court judge in Washington, D.C., allowed Bryan Namoff, a former soccer player to proceed with a $12 million civil suit against his former team for medical negligence alleging his former team, D.C. United, allowed him to play too soon after a head injury.

Judge Natalia M. Combs Greene said D.C. United didn’t have insurance and wasn’t exempt from suit as a consequence.

“The liability of D.C. Soccer is clearly outside the coverage of the WCA,” she wrote. “D.C. Soccer failed to secure workmen’s compensation insurance coverage for Namoff and the WCA grants an employee the right to bring a case at law against an employer who fails to secure such coverage.”

Don't forget the disparity between state jurisdictions on how to handle the ongoing issue of opioids and other prescription drugs.

Some states have drug monitoring programs, others don't. Some states restrict drug repackaging, most others don't.

The migration of drugs across state lines occurs as soon as a neighboring state implements restrictions that impede the prescription, procurement, delivery or ingestion of drugs.

Where's the Food and Drug Administration in all of this?

And don't forget the financial impact of big insurance across state lines, in particular when an insurance company is "too big to fail" and the federal government is inclined to bail that company out, all while evidence mounts that there was surreptitious use of questionable financial instruments to avoid premium taxes and other state obligations.

Still to this day, there are fights between states regarding failed workers' compensation carriers - New York's Liquidation Bureau has filed a petition in New York Supreme Court seeking to be appointed ancillary receiver of Ullico Casualty Co. while in Illinois the Circuit Court of Cook County has refused to stay proceedings involving Ullico despite a Delaware court order to the contrary.

Fights between jurisdictions, big money on the line, worker rights over safety and benefits, inconsistency in awards or order enforcement, migratory claims and drugs - the list can go on why some federal lawmakers may want to carve out certain jobs and industries and make them subject solely to federal jurisdiction.

Combine the above with a federal agency examining workers' compensation across the nation, a federal insurance oversight office, and overall expansion of the federal government and it's not hard to see how a federal take over of at least a portion of state workers' compensation systems could occur.

I'm not saying this is inevitable, desirable or reprehensible. I'm just saying ...

AZ Did It, CA's Next; Why Stop There?

Arizona Gov. Jan Brewer signed SB 1148 on April 3.

This new law prohibits people working for employers in the state from filing workers’ compensation claims for injuries suffered while temporarily working in other states.

SB 1148 defines temporary work as fewer than 90 continuous days out of the 365 days immediately preceding the date of injury. In addition to prohibiting an Arizona worker from claiming benefits in another state, the bill also prohibits an out-of-state worker from seeking benefits in Arizona provided:

• The employer has a policy that covers his workers while they are in Arizona.
• The laws of the state covering the workers temporarily assigned to Arizona are the sole remedy against an employer for a workplace injury.
• An Arizona employer with workers temporarily in another state is subject to Arizona workers’ compensation laws, not the laws of the other state.

Arizona is mad at California and apparently isn't going to take it anymore.

Jim Stabler, chief counsel for SCF Arizona, testified in support of the bill during a House Commerce Committee hearing in March. Stabler said SCF has to maintain a full-time third-party claims office in California because of the state’s “nebulous cumulative trauma doctrine.”

"Nebulous" is defined as "hazy, vague, indistinct, or confused."

From Sullivan on Comp, section 5.5:

A cumulative injury is commonly referred to as a cumulative trauma (CT) injury or a continuous trauma injury. Per LC 3208.1, a cumulative injury occurs as a result of "repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or the need for medical treatment." The California Supreme Court has also stated that a cumulative injury occurs "as the result of a number of minor strains over a period of time" and are "traumas which are minor in themselves but eventually result in disability." The Court of Appeal has added, "A cumulative injury is one which results from repetitive events, occurring during each day's work, which in combination cause any disability or need for medical treatment."

I don't find this doctrine "nebulous" at all - it may be disconcerting to someone not from California, or an insurance executive with uncomfortable with California law, or a professional sports team seeking to escape long term liability for traumatic brain injury medical claims - but I would not characterize it as nebulous.

Yesterday the California Applicants Attorneys Association (CAAA) issued a press release statement officially condemning AB 1309 (Perea, D-Fresno), a measure similar to the one just signed into law in Arizona.

Assemblyman Perea said in a statement after his bill was introduced that “there’s no rationale for burdening our system with thousands of claims for millions of dollars for non-specific injuries from athletes with little connection to our state.” Athletes are entitled to workers’ compensation benefits, “but they should file where they work and live, like anyone else,” he added.

Right.

So are traveling salespeople, truck drivers, flight attendants, migrant farm workers, executives with multi-state jurisdictions, etc.

Oh, and don't forget the coaches, cheerleaders, attendants and all of the other people that travel with the athletes.

Why are athletes singled out?

What is different about professional football, baseball, hockey and basketball players?

That's rhetorical - the difference is long term medical issues - like traumatic brain injury, encephalitis, hip and other joint replacements - medical issues that have root in long term abuse and over use, but otherwise would not be covered by a state's workers' compensation system (other than California's) because they are maladies that build up over time. THAT's what's different.

California recognizes that some injury modalities may not be properly recognized in the context of a single "injury".

Like it or revile it - California grew to the nation's biggest state in part because the government made a promise to the people that moved here that there was a safety net. Some of that safety net is in state disability coverage, some of it is in state unemployment benefits, and some of it is in California's workers' compensation laws.

Is it perfect?

Heck no - far from it. And we have seen the response from business groups since the early 1990s trying to rectify what they see as an impediment to their thinking of how business should be done.

The real danger with AB 1309, as CAAA rightly points out, is that it is the first step towards the entire elimination of the cumulative trauma doctrine.

As much as I dislike the multitude of presumptions that favor certain classes of workers making injury claims, I also dislike the discrimination against certain classes of workers.

And more importantly, I disfavor the disintegration of laws that seek to provide redress and remedy where an injury, as real as any other injury, doesn't fit neatly within the context of a specific event.

Arizona can have their SB 1148 (thought I think the people of that state will live to regret it). But California doesn't need AB 1309.

Supporters of AB 1309 should be truthful and admit that they'd just rather get rid of workers' compensation ... if only they could also avoid civil liability for using up the working class.

NFL CTE Cases Uniquely American

As the various lawsuits concerning allegations of misrepresentation and violation of safety protocol against the National Football League (NFL) progress, one element that is going to provide some very interesting legal fodder is whether the teams themselves, and their carriers, will be able to subrogate for workers' compensation benefits against the NFL suits.

The cases are maturing. In May, 558 players filed 13 complaints in federal courts in Georgia, Louisiana, Pennsylvania and Texas and in district courts in Los Angeles and Fulton, Ga. More than 2,200 former players have filed 80 lawsuits against the league since Aug. 17, 2011.

The basic allegations in the lawsuits say the NFL withheld from players evidence linking multiple concussions to chronic traumatic encephalopathy (CTE), a progressive and degenerative disease that causes headaches, dizziness, dementia, depression and possibly Alzheimer’s disease.

Certainly many of those players filed for and received workers' compensation benefits against their teams. The past several years have seen quite a bit of legal, legislative and public relations maneuvering by the NFL and the player's union concerning jurisdictional issues since many players preferred to use the loose jurisdictional rules of certain states, most notably California, to take advantage of more liberal laws - primarily concerning recognition of continuous trauma injuries.

Player's head injuries fall within that category.

The civil cases appear headed for consolidation and/or class certification status. On April 26, Anita Brody, a U.S. District judge in Philadelphia, ruled that plaintiffs must submit a master administrative complaint by June 8 compiling common statements in the growing number of lawsuits filed at the federal and state level against the NFL.

The timeline for managing this litigation in Philadelphia will take the master case through the balance of the year to get to the first ruling regarding consolidation and class status:

• Plaintiffs must submit the master complaint by June 8.
• NFL and Riddell can file briefs on the master complaint by June 19.
• Motions to dismiss filed in response to the master complaint are due Aug. 9.
• Plaintiffs’ response to the motions to dismiss are due Oct. 10.
• Replies to plaintiffs’ motions are due Nov. 26.

According to experts, if the Philadelphia case rules favorably towards players, the courts where the complaints were originally filed will determine damages.

Someone with more expertise on NFL team workers' compensation policies will have to educate me here, but my guess is that most of these policies are high deductible policies meaning that the teams have quite a bit of subrogation potential in these cases and whether or not to join the suits is going to be more of a political decision between the owners rather than a legal decision.

But certainly the carriers for the teams have no obligation to the NFL, and the decision of whether or not to join in these suits to recover payments made in related workers' compensation claims is a more pure business decision.

Whether or not the teams can exert influence on their carriers presents an interesting ethical dilemma due to the inherent conflict of interest.

The NFL concussion cases are nothing dramatic in my opinion, and reach newsworthy status only because this country loves its football. If this were some other industry there would be hardly any notice at all.

Indeed some of the sports commentators have ridiculed the lawsuits and the publicity they are drawing, stating that the players knew they were getting into a dangerous, violent game and that they are paid well to do so - basically assumption of the risk.

For legal wonks though, this is a very interesting situation because the NFL is owned by its member teams setting up a closed network that can five rise to conflicts of interest such as this potential subrogation issue.

It will be a couple of years before this all gets sorted out. I suspect eventually the game of football is going to undergo some "reform" in both equipment and rules. 

In the meantime the uniquely American appeal of football extends to the legal playing field too.

The NFL, Apportionment and Substantial Evidence

It's playoff season in the National Football League so it is only fitting that we get workers' compensation news concerning professional football claims.

In a fact pattern that I have personally defended against (unsuccessfully by the way) when I was practicing law, the Oakland Raiders may be stuck paying for the entirety of a claim that has an 11 year cumulative trauma history because of a failure of medical opinion on the issue of apportionment.

The Oakland Raiders have asked the California 4th District Court of Appeal, Division 3, to review a panel decision holding the team and its insurer, Ace USA, liable for former defensive tackle Sean Gilbert's permanent total disability claim for cumulative injuries. Gilbert played for the Raiders for only the final season in his career.

The Workers' Compensation Appeals Board (WCAB) in its panel opinion said that the Raider's Qualified Medical Examiner's (QME) opinion was not substantial evidence on the issue of apportioning Gilbert's injuries to the other teams he played for.

The Los Angeles Rams drafted Gilbert in the first round of the 1992 NFL draft, and he spent the next four seasons playing for the franchise. Gilbert joined the Washington Redskins for one season in 1996, did not play at all in 1997, and subsequently signed with the Carolina Panthers for the next five seasons. The Oakland Raiders employed Gilbert for the last season of his career in 2003, when he played six games for the Northern California franchise as a backup.

The Raiders' QME apportioned liability for Gilbert's claim based upon the percentage of time he spent playing for each team.

But two of the WCAB commissioners agreed with Gilbert's QME who said that apportionment could not be done with any reasonable medical probability because there wasn't any evidence of limitations or injury during the 11 years Gilbert was in the NFL.

The majority said that the defense could have cross-examined Gilbert's QME but didn't - no substantial evidence means you lose! And the dissenting commissioner simply said that he didn't think Gilbert's QME adequately addressed the issue either, but it sounds like he was leaning towards the majority outcome anyhow:

"Escobedo v. Marshalls (2005) requires a physician to determine what percentage of applicant's permanent disability was caused by his industrial injury and what percentage was caused by other factors," Commissioner Moresi wrote. "However, in Benson v. Permanente Medical Group (2007), the Appeals Board noted that under some circumstances it may be impossible for a physician to parcel out between successive injuries the causative factors of a current level of disability. This may have been [Gilbert's QME's] intent, but he does not adequately address this issue."

Here's my take-aways from this case:

1. The "good old days" of "expert opinion" are gone - medical opinion must be supported by both fact and science. Just saying it is, because one is an expert, doesn't make it so. If the Raider's QME was apportioning to other exposure then there needs to be supporting evidence upon which to base that opinion and in this case just dividing up the liability without some evidence in the record that indicates an exposure is not substantial evidence. We see this all the time.
2. When you don't have substantial evidence to support your case, and the other side has better evidence (remember that substantial evidence is evidence that is "good enough"), then there should be an attempt to challenge that evidence. In this case, either get a change in opinion that supports apportionment or disqualifies the opinion completely so you can start over.
3. Professional football is brutal and the players come out of their careers with significant injuries and disabilities. workers compensation, work comp, injured worker 

Professional Sports and the Relevancy of Comp

Professional sports represents an odd situation for workers' compensation schemes. There is a high degree of risk of injury or even death, especially for the more violent sports such as football, or sports involving speed and/or endurance such as cycling.

Work in professional sports really comes down to being all about performance on play day. Enhancements to performance are encouraged except to the extent that enhancements may be outlawed either by the sports governing body or by law (and even then enhancements are encouraged, just more quietly, as we have seen throughout the history of cycling).

Like most jobs the worker in professional sports has a "shelf life" but this is typically much, much shorter than the average nine-to-fiver. Consequently for the short life of a professional athlete the pay grade must be much higher on a per unit basis than the nine-to-fiver; and since work comp is based on payroll this inflates the premium (which of course is absorbed by the various income streams).

In professional sports there is tremendous peer pressure to perform despite the athlete's health, or lack there of. And the support crew around the professional athlete encourages and provides assistance to assure top performance at and during show time.

This is because professional sports is big business. Television rights, stadium tickets, food and beverage concessions - all of this adds up to billions of dollars per year in economic activity related to the entertainment of enthusiasts.

Primarily involving football, but applicable to other sports, we are seeing an increase in litigation claiming the practices of sports leagues, which are not a part of the workers' compensation system because the leagues are not the employer - the teams are - seeking redress for what athletes are now claiming to be essentially intentionally inflicted injuries, or in the least a negligent ignorance of the safety for athletes.

This morning WorkCompCentral News reported a new lawsuit filed by eleven National Football League (NFL) players against the league over the use of the drug Toradol, contending that the league ignored the drug's blood-thinning side effects, which enhanced their concussions and other injuries.

"The Toradol label states that 'Toradol inhibits platelet function and is therefore, contraindicated in patients . . . at high risk of bleeding,'" the complaint states. "Toradol is not to be used if the recipient has a closed head injury or bleeding in the brain. 'The bleeding risk of Toradol is an utmost concern in collision sports such as football. Even a small increase in bleeding risk can exacerbate high-risk injuries, such as concussions, spinal cord, spleen, and kidney trauma.'"

Marc S. Albert, one of the plaintiffs' attorneys on the case, told our reporter that the exclusive remedy of workers' compensation should not be an issue in the case, because the players have opted to sue the NFL, as opposed to their individual teams. Many players are opting to file civil suits, because teams' workers' compensation carriers are denying claims for concussion-related injuries, Albert said.

"This is an epidemic, it happened in every locker room, it is something the NFL certainly knew about," Albert said of the Toradol use. "It is league practice, so to speak, by every team doctor in every locker room. It is being given in wholesale format, so to speak. It is why the league is the defendant in this case."

The complaint that Albert and his fellow attorneys filed mentions "cattle calls," where groups of players were called to receive Toradol injections shortly before game time, regardless of the type of injuries they had.

The other brain injury suits against the NFL also name as defendants helmet manufacturers and others, and allege negligence about infliction of chronic traumatic encephalopathy (CTE). CTE is a progressive and degenerative disease seen in people who have suffered multiple concussions or other forms of head trauma.

Just yesterday WorkCompCentral reported on the case of National Hockey League star, Derek Boogaard, who died of a drug overdose. According to the story, Boogaard CTE and his doctors said that even if Boogaard had survived his drug overdose he would have probably suffered from dementia-like symptoms.

To complicate matters relative to risk (for both the athlete and the employer/team), there is a trend to limit forums to seek benefits. Florida earlier this year passed a law restricting professional athletes from seeking benefits in states other than where their team is based, the 12th state in the nation to recognize "extraterritorial reciprocity" regarding workers' compensation claims. Michigan yesterday moved a bill through the state senate purporting to do the same thing.

Perhaps what this recent acrimony between athletes and their employers is telling us is that workers' compensation is inadequate to deal with the modern issues of professional sports. I wonder if this is just a small representation of a larger social issue - that work comp is archaic relative to the modern economy and that the risks have changed dramatically.

We know that Texas style non-subscription fans are seeking to change the status quo in neighboring Oklahoma to provide for voluntary protection systems. Is this the new trend to bring health and indemnity programs in line with the new economy ("new" relative to the age of the workers' compensation scheme)? I think it is.

I see all of this as evidence that things are changing, and that the pace of change is quickening. Obviously such things don't change overnight, but I would wager that the work comp world is going to be a much different landscape in 20 years, or even 10.