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Rethinking the Return-to-Work Handoff Shane Mangrum, MD Most return-to-work delays aren’t clinical. They live in the handoffs, like the work-status note that arrives late or is unclear or the back-and-forth over what a restriction actually means for a particular job. That observation is where RTW Hub began and why Axion Spine & Neurosurgery became the first place to put it to work. RTW Hub is a return-to-work platform built by clinicians who work inside Georgia’s Workers’ Compensation system every day. Rather than take it straight to market, we’ve been running it against Axion’s own caseload of real claims, real adjusters, and real employers. This ensures that the people writing the restrictions are also the ones refining the tool that carries them out. The underlying idea is deliberately unglamorous. Make the work-status update clear, structured, and quick to share, so an adjuster isn’t chasing a fax and an employer can line a restriction up against real available duty. When that handoff is clean, injured workers tend to get back to suitable work sooner, it’s better for recovery, and it’s easier on everyone carrying the claim. The piece that draws the most questions is the AI, where the approach is intentionally narrow. The platform surfaces guideline-referenced recovery data to support a physician’s decisions about restrictions and maximum medical improvement; it doesn’t make those decisions. The clinician stays in charge, the AI layer works only with de-identified information, and a built-in American Medical Association (AMA) Guide module handles impairment ratings once a patient reaches maximum medical improvement (MMI). We started with musculoskeletal injuries and public-sector employers, partly because that’s where the need is most visible: local-government workforces experience musculoskeletal injuries at roughly fifty-eight percent (58%) higher rates than private industry. It’s a population where a cleaner return-towork process does well. For now, the work is about getting it right in one practice. But as the platform matures, we’ve begun quietly talking with a handful of employers, third-party administrators, and publicsector risk pools curious to try the same approach in their own programs. If that’s a conversation worth having, we’d welcome it. Reach out to us at rtwhub.com or email@rtwhub.com.

Shane Mangrum, MD, is a physiatrist at Axion Spine & Neurosurgery in Atlanta and the cofounder of RTW Hub. He is double-boarded in physical medicine and rehabilitation, as well as sports medicine. He earned his undergraduate degree in organismic and evolutionary biology from Harvard College in Cambridge, Massachusetts, and medical school at the University of Utah in Salt Lake City. 1

MAGAZINE Your Trusted Resource for Workplace Wellness Human Resources, Risk, Safety and Workers' Comp

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Garlana H. Mathews President and CEO

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Michelle C. Wilds Please contact the Workplace Health team to advertise in our next issue. Call Workplace Health Magazine: 912-667-0441 or e-mail: garlana@selectonenetwork.com or visit us online at:

www.wphmag.com

Rethinking the Return-to-Work Handoff

Chronic Work-Related Low Back Pain

From the Publisher

The Power of Early Intervention

Upcoming Educational Events

Real Talk with Michelle: Roberta Mike

Engagement and Persistence

A Message from the Chairman

A Manager’s Guide to the 2026 Heat NEP

Thinking Outside the Box

What Occupational Therapy Brings

Physical Altercations in South Carolina Claims

The EEOC’s Proposed Strategic Plan

The 240 Process in Georgia

Age of Injury: Why MRI Timing Matters

Hire Smart, Reduce Risk

Rotator Cuff Injuries in the Workplace

Closing the Gap with Technology

Building Job Descriptions

Toxic Expectations: Yes, All of Them

2026 Upcoming Educational Events: Workplace Health Magazine gets around! Disclosure: Event dates could be postponed, cancelled, or virtual. Please use the following as a guide. If you would like your event added to the Workplace Health magazine calendar of events, please contact Michelle Wilds at michellewilds@selectonenetwork. com. Workplace Health magazine would love to come and cover your event.

AUGUST 2026 2–4 Alabama Self-Insured Association Conference — Sandestin, FL 3–5 Mississippi SHRM Conference — Biloxi, MS 14 SHRM Webinar — Nourishing Knowledge Series: Supporting Employees in High Stress Roles 18 SHRM Greater Orlando Annual Membership Networking Event — Orlando, FL 24–26 Workers’ Compensation Institute (WCI) — Orlando, FL 24–26 Alabama Governor’s Safety and Health Conference — Perdido Beach, AL 30–Sept 2 HR Florida Conference and Expo — Kissimmee, FL 31–Sept 2 Georgia State Board of Workers’ Compensation Annual Conference — Alpharetta, GA

SEPTEMBER 2026 1 SHRM Georgia Virtual Certification Prep Course — Zoom (6:30–8:30 p.m.) 2 SHRM Florida Inside HR — Virtual 8 Georgia Safety Conference Golf Tournament for Kids’ Chance — Savannah, GA 9–10 Alabama Department of Labor Workers’ Compensation Seminar — Gulf Shores, AL 9–11 Georgia Safety Conference — Savannah, GA 11 SHRM Webinar — AI Mindset & Strategy to Empower, Not Eliminate, presented by Jeff Wilser (12:00 noon) 13–16 Tennessee SHRM Conference — Knoxville, TN 15 SHRM Greater Orlando Dinner Meeting — Orlando, FL 15 SHRM SunCoast HR / Unite SHRM Florida District 7 Joint Networking Event — Tampa, FL 15 Defense Collaborative — Dallas, TX 16–18 South Carolina SHRM State Conference — Myrtle Beach, SC 17 Montgomery Claims Association Adjuster Appreciation Event — Montgomery, AL 22 SHRM Space Coast — Leadership Essentials Half-Day Workshop — Patrick Space Force Base, FL 23–25 North Carolina SHRM State Conference — Wilmington, NC 23–25 Mississippi Association of Self Insureds (MASI) — Gulf Shores, AL 25 SHRM Charlotte County — LEAD Smart 2026: Human AI — Port Charlotte, FL 29–30 National Workers’ Compensation and Disability Conference — Las Vegas, NV 30–Oct 2 Georgia State SHRM Conference — Savannah, GA

OCTOBER 2026 7 SHRM Florida Inside HR — Virtual 8 SHRM Greater Orlando 2026 Legal Summit — Orlando, FL 13 SHRM Mid Florida — Safety Nightmares — Lakeland, FL

14–15 National Retail and Restaurant Defense Association Lighthouse Seminar — Charlotte, NC 15–17 International Association of Rehabilitation Professionals (IARP) Fall Forum — New Orleans, LA 17 SHRM Florida Leadership Conference — West Palm Beach, FL 18–20 South Carolina Workers’ Compensation Employers Association Annual Conference — Myrtle Beach, SC 21 Kids’ Chance of Georgia Charity Golf Tournament — Jekyll Island, GA 22 SHRM Pinellas — HR Unscripted: Real Talk and Support — Clearwater, FL 22 Georgia Bar Association Workers’ Compensation Section Dinner and Auction — St. Simons Island, GA 22–23 Alabama Department of Labor Workers’ Compensation Seminar — Birmingham, AL

APRIL 2027 11–14 SHRM Talent — Denver, CO 11–14 SHRM Virginia — Virginia Beach, VA 18–21 RISKWORLD — New Orleans, LA 18–21 American Case Management Association (ACMA) 2027 National Conference — Las Vegas, NV 28–30 Georgia PRIMA — Grovetown, GA

MAY 2027 4 Alabama Workers’ Compensation Society (AWCS) — Birmingham, AL 10–12 NCCI Annual Insights Symposium — Orlando, FL 14 South Carolina Workers’ Compensation Educational Association Seminar — Columbia, SC 19–21 International Association of Rehabilitation Professionals (IARP) Life Care Planning Summit — Minneapolis, MN

NOVEMBER 2026

JUNE 2027

5–6 Alabama Workers’ Compensation Society (AWCS) — Birmingham, AL 5–7 SHRM Georgia In-Person Express Prep Certification Course — Macon, GA 11 Workplace Health Thank You / Veterans Luncheon — Maggiano’s Cumberland, Atlanta, GA 11–13 Louisiana Association of Self Insured Employers (LASIE) Annual Conference — Baton Rouge, LA 12 SHRM Mid Florida — Business Ethics for the HR Professional — Lakeland, FL 16–20 Southern Association of Workers’ Compensation Administrators (SAWCA) All Committee Conference — White Sulphur Springs, WV 18–20 Tennessee PRIMA Annual Conference — Franklin, TN

13–16 PRIMA National — New Orleans, LA 22–25 Case Management Society of America (CMSA) — Orlando, FL

JANUARY 2027 20 Georgia Workers’ Compensation Association (GWCA) Legislative Luncheon — Georgia Power Corporate Office, Atlanta, GA

FEBRUARY 2027 4 Workplace Health Symposium — Savannah Technical College, Savannah, GA 24–26 National Retail and Restaurant Defense Association Annual Conference — Tucson, AZ 26 Workplace Health Symposium — Columbia County Exhibition Center, Grovetown, GA TBA 49th Annual Medical Seminar on Workers’ Compensation — South Carolina

MARCH 2027 23–24 Alabama Department of Workforce — Perdido Beach, AL 31–Apr 2 NCASI — Wrightsville Beach, NC

JULY 2027 11–15 Southern Association of Workers’ Compensation Administrators (SAWCA) Annual Conference — Savannah, GA 15–16 SIGFA — Savannah, GA 19–23 National Association for Behavioral Intervention and Threat Assessment (NABITA) Case Management Summit — Milwaukee, WI

AUGUST 2027 2–4 RIMS Texas Regional Conference — San Antonio, TX 22–25 Workers’ Compensation Institute (WCI) — Orlando, FL 29–Sept 1 Georgia State Board of Workers’ Compensation Annual Conference — Alpharetta, GA

SEPTEMBER 2027 8–10 Georgia Safety Conference — Savannah, GA 21–23 Elevate WC Conference — San Diego, CA

OCTOBER 2027 11–13 Self-Insurance Institute of America (SIIA) National Conference — Phoenix, AZ

NOVEMBER 2027 4–5 Alabama Workers’ Compensation Society (AWCS) Winter Conference — Birmingham, AL

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Engagement and Persistence David Langham, Judge There is great change coming. The oldest Baby Boomers were born in 1946 and are well past retirement age; the youngest, born in 1964, are approaching retirement. The torch has been passed; Generation X (1965-1980; 46-61) is largely managing, but the millennials (1981-1996; 30-45) are a driving force. Generation Z (1997-2012; 14-29) is entering and challenging the workplace. Oh, “these kids today.” This is not new. You’ve seen it all before. Each year brings the retirement of some and the entry of new trailblazers. Generations come and go and the world changes. If you have never listened carefully to The Sunscreen Song, that’s your loss. It helps me grasp that change is inevitable, and it is full of sound advice. One essential clarity is: “… advice is a form of nostalgia, dispensing it is a way of fishing the past from the disposal, wiping it off, painting over the ugly parts and recycling it for more than its worth.” Nonetheless, be careful whose advice you buy. There is wisdom in that tune from last century. Imagine that 20thcentury advice still resonates. Today, this Boomer pauses to reflect, and this is my advice as I hobble toward the stairs off the stage. The world changes. This will be persistent and pernicious. Technology, economy, and people cannot remain static despite your predispositions, expectations, or hopes. The latest existential threat is artificial intelligence. We old folks have lived through various such revolutions and somehow survived. I have witnessed the advent of the word processor, personal computer, cellular phone, the internet, social media, text messaging, algorithmic research, electronic documents, and artificial intelligence. And each of these is comfortable and even ubiquitous to some generation(s). Be comforted by your familiarity, but buckle up for the as yet unpredicted changes you will see. I have similarly witnessed the end or diminishment of the typing pool, professional organizations, sticks and bricks retailers, newspapers, facsimile machines, answering machines, landlines, receptionists, video cassette players, and more. Roles and tools will come, conquer, prevail, and fade. The only constant will be change. But “this one is really scary.” Granted; I accept your premise. But they were all scary in real time. We tend to view past changes as less pervasive or threatening simply because they are past. The effects and impacts of the old changes are known, accounted for, habituated, and not a present threat. They seem less important, but only because they are fading in your rearview mirror instead of rushing at your windshield. Change will persist. Heraclitus said in about 500 BC, “panta rhei,” or “everything flows.” He explained, “you cannot step into the same river twice.” Modernists have adapted this to “the only constant is change.” That is a truth you can waste your life denying or face up to with resolve to adapt, adjust, and overcome, nonetheless. Is some generation better at accepting these challenges than others? That implies groups of people are homogenous or appropriately categorized. In truth, some people are inherently more accepting of change. Some are more philosophical and intrigued by change. But this is individual, not generational. The generational difference is in how immediate and personal change may be perceived. The young will face AI, while many of us old folks will flee it. In all, we face four realizations. We must accept that change is inevitable and that our control is only over our personal reaction. Know you cannot control the reactions, fears, and exuberance of others. We must know that as we “keep on truckin’” some will forge past us as we likewise pass others. There will be obstacles, impatience, and surprises. Despite it all, there will be opportunity. The world is no more ending today than it ever was. The immediacy of today’s threats magnifies them to us. Their velocity scares us. But they are merely opportunities if we choose to accept them as such. “Damn the torpedoes, full speed ahead!” These threats will likewise diminish in our rear views, personal and collective. No, AI did not write this; I did.

David Langham has been Florida’s Deputy Chief Judge of Compensation Claims since 2006. He has delivered more than 1,900 professional lectures, published over 40 articles, and 1,800-plus blog posts regarding the law, technology, and professionalism. He authored Florida Workers’ Compensation: Its History, Evolution, and Function (2023) and The Mock Trial Performance (2023). He lives in Pensacola, Florida with his wife Pamela Langham, Esq. 6

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A Manager’s Guide to the 2026 Heat National Emphasis Program Logan Martin Summer is no longer just a season; in many parts of the country, it feels like an occupational hazard. As temperatures climb and heat waves become longer and more intense, heat-related illness remains one of the most persistent—and preventable—risks in the American workplace. It’s not just an outdoor problem, either. For every roofer baking in the midday sun, there’s a warehouse worker dealing with stifling radiant heat inside a metal building. Recognizing that environmental heat is the leading cause of weather-related deaths in the U.S., the Occupational Safety and Health Administration (OSHA) hasn’t been sitting idle. While the agency’s highly anticipated Heat Injury and Illness Prevention in Outdoor and Indoor Work Settings federal standard is still working its way through posthearing evaluation in 2026, OSHA isn’t waiting around to enforce safety. Enter the revised National Emphasis Program (NEP) for Outdoor and Indoor Heat-Related Hazards, which took effect in April 2026. If you run a job site or manage a fixed facility, this NEP is your current playbook. Let’s break down what the NEP actually is, how OSHA is enforcing it across different industries, and the exact steps you need to take to keep your people safe and your operations compliant. What’s New and Why It Matters The original Heat NEP launched in 2022, but the April 2026 revision sharpened its teeth and refined its focus. Built on fresh Bureau of Labor Statistics (BLS) data, the updated directive targets 55 high-risk industries that show elevated rates of heat-related days away, restricted, or transferred (DART) cases. Here is the most significant shift: OSHA eliminated its previous numerical quota system for heat inspections. Instead of trying to hit an arbitrary number of site visits, they are prioritizing when and where they show up. Under the revised NEP, OSHA relies heavily on the General Duty Clause to issue citations. They are targeting complaints, severe injury reports, and conducting random, unannounced inspections on “heat priority days.” These priority days are triggered the moment the National Weather Service (NWS) issues a heat advisory or warning for your local area. Additionally, the 2026 update formalized a structured framework for evaluating employer heat programs (Appendix I of the directive), which essentially serves as a compliance checklist that OSHA inspectors use when evaluating your site. How Enforcement Looks Across Industries OSHA’s enforcement branch applies the NEP differently based on the work environment, but their core philosophy remains the same: heat stress is a recognized hazard, and ignoring it is an actionable violation. For road crews, framers, and agricultural workers, OSHA inspectors are pulling up on high-heat days looking for immediate, frictionless access to shade and water. They are heavily scrutinizing acclimatization logs. If a new hire suffers heat exhaustion on day two because they were thrown into a 10-hour shift without a break-in period, OSHA will cite you for failing to protect a vulnerable worker. Package delivery and unconditioned warehouses are massive targets. Inspectors know that a metal warehouse without proper ventilation can exceed outdoor temperatures by ten to fifteen degrees. OSHA has actively cited major logistics companies for failing to provide adequate work-rest cycles and for pushing production metrics that inherently discourage workers from taking necessary hydration breaks. In environments with heavy machinery, commercial ovens, or molten materials, OSHA inspectors focus heavily on radiant heat. They expect safety managers to use the Wet Bulb Globe Temperature (WBGT)—which accounts for temperature, humidity, wind speed, and radiant heat—to accurately measure the heat load on workers, rather than just relying on a standard wall thermometer. Tips for Outdoor Job Sites When your workplace is under the open sky, you can’t control the thermostat. But you can control how your crew navigates the environment. • Upgrade your hydration station. “We have a hose” doesn’t cut it. OSHA expects readily accessible, cool drinking water. Provide electrolyte-replenishing drinks alongside water, especially when workers are sweating profusely. A standard rule of thumb is one quart of water per employee, per hour. • Redefine shade. Shade means a designated area that blocks direct sunlight and allows the body to cool down. Sitting inside a hot truck cab with the windows rolled down or hiding behind a backhoe isn’t shade. Erect pop-up canopies with open sides to allow for maximum airflow, and make sure they are positioned as close to the work area as safely possible. 8

• Master acclimatization. This is where most outdoor sites fail. New workers or veterans returning from a week-long vacation haven’t adapted their cardiovascular systems to the heat. Follow the 20% rule: limit new workers to 20% of their normal workload or duration on day one, and gradually increase it by 20% each subsequent day. Tips for Fixed Facilities Just because your team is under a roof doesn’t mean they are safe from heat illness. Stagnant air, heavy PPE, and radiant machinery create a perfect storm for heat stress. • Map your microclimates. A 500,000-square-foot facility doesn’t have one single temperature. The shipping dock might be 85°F, while the mezzanine level near the metal roof could be 105°F. Identify the hottest zones in your facility and implement targeted cooling strategies like industrial HVLS (High Volume, Low Speed) fans, spot coolers, or local exhaust ventilation. • Rethink work-rest cycles. In high-heat indoor zones, continuous heavy labor is dangerous. Implement mandatory cooling breaks in climate-controlled areas, like an air-conditioned break room. When temperatures spike, increase the frequency of these breaks, even if it temporarily slows production. • Audit your PPE. Are your workers wearing heavy, non-breathable protective gear in a hot facility? Look into lighter, moisture-wicking alternatives that still meet safety ratings. For workers stationed directly next to high-heat machinery, consider providing cooling vests. Building a Compliant Program To meet OSHA’s expectations under the 2026 NEP—and to successfully defend yourself if an inspector knocks on your door—you need more than good intentions. You need a documented, site-specific strategy. • A written Heat Illness Prevention Plan. A verbal agreement to “take it easy when it’s hot” is a guaranteed citation. You must have a written plan that identifies heat hazards and outlines exactly how your company mitigates them. The plan should assign a designated Heat Safety Coordinator on-site whose job is to monitor weather conditions using tools like the OSHA-NIOSH Heat Safety Tool app and trigger safety protocols accordingly. • Actionable heat triggers. Your plan must outline what happens at specific temperature thresholds. At 80°F, water and shade must be universally accessible, and supervisors must begin monitoring workers for signs of heat stress. At 90°F, mandatory scheduled rest breaks kick in, and the buddy system should be heavily enforced, ensuring no one is working alone in a high-risk area where they could collapse unnoticed. • Comprehensive training. Training must happen before the hot weather hits, and supervisors and workers need to be trained on the exact same curriculum. They must know the critical physiological differences between heat exhaustion (heavy sweating, weakness, dizziness) and heat stroke (hot/dry skin, confusion, loss of consciousness). Make sure your team knows that if someone stops sweating and becomes confused, it is a medical emergency, not a time to “walk it off. • An aggressive emergency response plan. “Call 911” is not a complete emergency response plan. If a worker goes into heat stroke, irreversible brain damage or death can occur in the time it takes for an ambulance to arrive. Your site procedures must include immediate, aggressive cooling measures. Do you have a plan to move the worker to a cool area immediately? Do you have ice packs, cold water, or a cooling tub to rapidly lower their core body temperature while EMS is en route? OSHA inspectors will evaluate whether your team is actually equipped to intervene. The Bottom Line OSHA’s 2026 Heat NEP sends a clear message: heat illness is no longer being treated as an unavoidable, unfortunate hazard of the summer months. It is an operational risk that requires proactive, documented management. Whether you’re pouring concrete on a highway or managing inventory in a distribution center, a robust heat illness prevention program isn’t just about passing an OSHA inspection—it’s about making sure your people go home safely when the shift is over. Don’t wait for a historic heat wave to test the temperature of your safety culture. Plan now, train today, and keep your crew cool.

Logan F. Martin, PhD, CIH, CSP, CHMM, is a Certified Industrial Hygienist, Certified Safety Professional, and Certified Hazardous Materials Manager with almost forty years of experience in occupational exposure assessment and reconstruction and in safety program auditing. She serves as a consulting and testifying expert in OSHA enforcement matters, workplace accident litigation, and occupational injury and disease claim. She can be reached at lfmartinphd@gmail. com. 9

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What Occupational Therapy Brings to Return-to-Work Pinnacle’s Workers’ Comp Team Hand and upper extremity injuries rarely look serious on the first report. A finger fracture, a wrist tendonitis, a laceration repaired in the emergency department. Then the claim stays open, and nobody can quite explain why. The reason is that hands are unforgiving. A knee can tolerate a few degrees of lost motion. A hand cannot. Ten degrees of missing flexion at the index finger is the difference between a machinist who can grip a tool for eight hours and one who cannot. Scar tissue forms fast, stiffness sets in faster, and the window for a good outcome is measured in weeks. That is where occupational therapy (OT) differs from physical therapy (PT) in ways that matter to anyone managing a claim. Physical therapy restores the body part. Occupational therapy restores the job. We start with activity analysis: breaking a worker’s actual duties into their component steps, the grips and postures each one demands, the tools involved, the surfaces, the repetitions per hour, the environment. A warehouse selector and a dental hygienist may present with identical carpal tunnel findings and need entirely different rehabilitation, because the demands they return to have almost nothing in common. That analysis then drives treatment. Custom orthotic fabrication, scar and edema management, sensory reeducation after nerve repair, graded strengthening built around the specific motions the job requires. It also drives the discharge decision, which is where the value shows up on the claim. Consider a musician treated after a fall and surgical repair of the arm and elbow. Range of motion and strength both returned to normal well before discharge. But normal measurements do not tell you whether someone can carry an instrument case to a car, load it, unload it, and set up on the other end. So the final treatment session was exactly that task, start to finish. She passed and went back to work. The same logic applies to a lineman, a welder, or a line cook. Grip dynamometry tells you a number. Simulating the actual task tells you whether the worker can do the job on Monday. When therapy ends at the number instead of the task, workers get released, fail, and return with a new complaint six weeks later. Complex cases benefit from a Certified Hand Therapist (CHT), whose credential requires at least three (3) years of clinical practice, a minimum of 4,000 hours in direct hand and upper extremity therapy, and a comprehensive examination, with recertification every five (5) years. For tendon repairs, replantation, nerve injuries, and complex regional pain syndrome, that depth changes outcomes. Finally, communication is not a courtesy in these claims; it affects the outcome. When the surgeon, therapist, adjuster, case manager, and employer share the same understanding of protocol and restrictions, therapy progresses on schedule. When they do not, the worker sits idle waiting for authorization while the tissue stiffens. Refer early. Refer specifically. Ask what the worker will be doing when they go back, and make sure the therapist is asking, too. If you are managing a hand or upper extremity claim and aren’t sure what level of therapy it needs, call a Certified Hand Therapist and ask. At Pinnacle Orthopaedics, we take those calls, and we see acute injuries the same day. Pinnacle’s dedicated Workers’ Compensation Team coordinates care across five locations, sixteen physicians, and an outpatient surgery center, with same-day appointments for acute injuries. Here are some team members hard at work… Jamey Abbott, OTR/L, CHT, Occupational Therapy Manager, Rhonda Abbott, OTR/L, Bri Mazzei, OTD, OTR/L, and Amanda Odegaard, OTR/L 13

What the EEOC’s Proposed Strategic Plan Means for Employers Graham Newsome The Equal Employment Opportunity Commission (EEOC) recently released its proposed Strategic Plan for Fiscal Years 2026–2030, offering employers an early look at how the agency intends to carry out its mission over the next four years. Although the plan does not create new legal requirements or change employers’ obligations under federal anti-discrimination laws, it provides valuable insight into where the EEOC is headed and how businesses can prepare for the agency’s evolving approach to enforcement. Unlike the EEOC’s National Enforcement Plan, which identifies the types of cases the agency intends to prioritize, the Strategic Plan focuses on the agency itself. It establishes goals for improving efficiency, reducing case backlogs, increasing the use of mediation, expanding employer outreach, and measuring the agency’s overall performance. The proposed plan outlines three broad objectives: enforcing federal equal employment opportunity laws effectively, preventing discrimination through education and outreach, and strengthening the agency’s internal operations. One of the clearest takeaways is the EEOC’s commitment to resolving charges more efficiently. As the agency continues to streamline its operations and improve case management, employers should expect investigations to move quicker than they have in recent years. Requests for position statements, personnel records, and witness information may come sooner and with shorter response deadlines. Employers that already have procedures in place for responding to EEOC charges will be better positioned to meet those deadlines and avoid unnecessary delays. The Strategic Plan also reinforces the EEOC’s continued reliance on mediation and other forms of alternative dispute resolution. Early resolution has long been a priority for the agency, and the proposed plan suggests mediation will remain an important tool for resolving workplace disputes before they develop into costly litigation. Employers should evaluate each charge individually and consider whether an early settlement may be more cost-effective than prolonged administrative proceedings or litigation. Another area that deserves attention is the EEOC’s emphasis on education and technical assistance. The agency plans to continue expanding its outreach efforts by offering guidance, training materials, and educational programs for employers and employees alike. Employers should view these resources as more than informational—they provide insight into how the EEOC interprets federal employment laws and what the agency expects to see during an investigation. Incorporating updated guidance into supervisor training and workplace policies can help reduce the risk of discrimination claims before they arise. Perhaps the most notable aspect of the proposed Strategic Plan is what it says about the EEOC’s broader direction. The proposal places greater emphasis on operational accountability, measurable performance, and evenhanded enforcement of federal anti-discrimination laws. While the Strategic Plan itself does not establish enforcement priorities, it should be read alongside the EEOC’s recently adopted National Enforcement Plan, which outlines the substantive issues the agency intends to pursue. For employers, the best action is not to wait for enforcement activity to increase. Instead, this is an appropriate time to review employment practices and confirm that policies are being applied consistently throughout the organization. Hiring, promotion, discipline, and termination decisions should continue to be based on legitimate, well-documented business reasons. Supervisors should receive regular training on equal employment opportunity obligations, and employee complaints should be investigated promptly and thoroughly. Maintaining accurate documentation remains one of the most effective ways to defend employment decisions if they are later challenged. While the proposed Strategic Plan is primarily an internal management document, it serves as a useful reminder that the EEOC is focused on becoming a more efficient and effective enforcement agency. Employers that prioritize compliance, respond promptly to agency inquiries, and maintain sound employment practices will be in the strongest position as the EEOC implements its priorities over the next several years. Graham Newsome defends corporations in employment litigation, including claims under Title VII, ADEA, FMLA, ADA, and comparable state laws. His clients include religious institutions, private schools, hospitals, and companies in retail, restaurant, and hospitality. He also advises employers of all sizes on human resources matters, including handbook drafting and review. Reach him at Chartwell Law: https://www.chartwelllaw.com/attorney/gnewsome

Timing Matters: How Age of Injury Is Changing Workers’ Compensation Jonathan Luchs, MD In musculoskeletal imaging, timing matters. The same MRI performed weeks apart can tell very different stories. In workers’ compensation, understanding not only what is injured, but when the injury occurred, can influence treatment decisions, claim management, return-to-work planning, and, ultimately, outcomes for the injured worker. This is where Age of Injury (AOI) analysis adds value by providing independent insight into the injury timing and helping with next steps in care. Traditional clinical MRI reports do an excellent job identifying injuries such as ligament tears, meniscal injuries, or tendon damage. However, they do not traditionally discuss the timing of each finding or the age of the positive finding demonstrated on the MRI images. For years, workers’ compensation followed a “wait and see” approach designed to reduce the upfront cost of advanced imaging. Injured employees often completed weeks or months of conservative treatment before an MRI was approved. While this may have saved money initially, it frequently resulted in delayed diagnoses, unnecessary treatment, prolonged time away from work, and higher overall claim costs. In many cases, obtaining an earlier MRI would have identified the appropriate treatment path from the start. The timing of the MRI is critical. The ability to determine whether an injury is acute is greatest when imaging is performed soon after the injury occurs. As the body heals, it becomes increasingly difficult to distinguish a recent injury from chronic or pre-existing findings. Obtaining an MRI earlier—instead of after months of conservative treatment—provides the most meaningful information for both the clinical team and the claims process. At Premier Radiology Services, fellowship-trained musculoskeletal radiologists perform independent Age of Injury reviews by evaluating the MRI imaging studies and the positive findings documented in the original MRI report. Rather than re-reading the entire examination, we determine whether those reported findings are most consistent with an acute, subacute, chronic, or indeterminate process and, just as importantly, explain why. Our goal isn’t simply to answer a medical question; it’s to provide adjusters, case managers, physicians, employers, and attorneys with objective information that helps guide the injured worker to the right treatment pathway as early as possible. PepsiCo incorporated AOI analysis into its workers’ compensation program to better understand whether MRI findings represented acute workplace injuries or pre-existing conditions. By obtaining imaging earlier and using independent radiologic analysis to help guide care, the company reported faster diagnoses, earlier return-towork, more successful transitional duty placements, reduced employee frustration, and a less adversarial claims process. The experience demonstrated that earlier diagnostic clarity not only improved the worker’s experience but also strengthened overall claim outcomes and saved the company a substantial amount of money. When you have the right information early, you make better decisions. Some workers may need prompt orthopedic consultation or surgical evaluation, while others can confidently continue with conservative treatment. Rather than spending months trying to determine the next step, clinicians and claims professionals can use AOI to have objective information early in the process to support evidence-based care. Perhaps the greatest benefit is one that can’t always be measured. When injured workers see that their injury is being thoroughly evaluated from the beginning, they are more likely to feel heard and stay engaged in their recovery. That confidence strengthens the relationship between employee and employer while supporting better outcomes. Workers’ compensation continues to evolve, and so should the way we evaluate the injured worker. By providing earlier answers, AOI helps guide appropriate treatment, supports better decision-making, and improves outcomes for injured workers, employers, carriers, and the clinicians responsible for their care.

Jonathan Luchs, MD, FACR, is a board-certified, fellowship-trained musculoskeletal radiologist and Chief Medical Officer of Premier Radiology Services. A nationally recognized expert, he has authored numerous peer-reviewed publications, served in leadership roles with the American College of Radiology and the Society of Skeletal Radiology, and is dedicated to advancing imaging technologies that improve diagnostic accuracy and patient care.

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Rotator Cuff Injuries in the Workplace: Prevention, Treatment, and Return to Work Lindsay Barrera, MD Rotator cuff disorders are among the most common work-related musculoskeletal disorders, particularly in occupations requiring repetitive overhead activity, forceful exertion, or heavy lifting. Workers performing frequent overhead work or heavy lifting have a 1.5- to 4-fold increased risk of developing rotator cuff disease compared with workers without these exposures. Occupations with the highest risk: • Construction workers • Carpenters • Electricians • Painters

• Plumbers • Mechanics • Warehouse and material handlers • Manufacturing workers

Ways of Prevention 1. Optimize workplace ergonomics — minimize work above shoulder height; position tools between waist and chest level; avoid heavy lifting away from the body; use mechanical lifts for heavy loads. 2. Limit repetitive overhead activity — rotate job tasks, incorporate breaks, and alternate overhead work with other activities. 3. Reduce heavy lifting — lift with two people, keep loads close to the body, and use carts, hoists, or forklifts. 4. Recognize symptoms early — shoulder pain with overhead activity, night pain, weakness, loss of endurance. 5. Educate workers — early warning signs, proper ergonomics, safe lifting, the importance of strengthening and flexibility, and when to seek medical evaluation. Treatment Rotator cuff injuries can range from rotator cuff tendinitis (inflammation) to partial tearing, to full-thickness rotator cuff tears. Treatment typically starts with conservative management, as many rotator cuff disorders can improve without surgery. • Activity modification — temporary lifting restrictions, avoiding repetitive overhead work, and a gradual return to activity as symptoms improve. • Physical therapy — restoring range of motion, rotator cuff strengthening, scapular stabilization, and work-specific conditioning. • Medications — acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and topical antiinflammatories. • Corticosteroid injections — to relieve pain and decrease inflammation, making rehabilitation possible. If symptoms do not improve with conservative management, surgery may be recommended to repair the rotator cuff. Return to Work Structured rehabilitation is critical after both nonoperative and operative management of rotator cuff disease. Graduated return to work with temporary restrictions helps optimize recovery and reduce the risk of reinjury. Collaboration between the patient, employer, therapist, and physician is essential to achieving safe and durable return to the workplace. Lindsay Barrera is an orthopedic surgeon at OrthoGeorgia, fellowship-trained in sports medicine. Her interests include hip, knee, and shoulder arthroscopy; ACL reconstruction; and total knee and shoulder reconstruction. She earned a B.S. in Biobehavioral Health from Pennsylvania State University, where she competed on the Division I women’s gymnastics team. She treats Workers’ Compensation injuries. 19

Building Job Descriptions Steve Heinen Job descriptions have a huge impact on workers’ compensation results, and the document you write before the injury decides what happens after it. Let’s look at how the job description impacts employers in the Pre-Hire, PostOffer, Prevention, and Post-Claim phases. In risk terms, a job description is the medical and legal definition of the job. It does three (3) things at once. 1. Essential functions. The observable, action-based tasks the role exists to perform, written in ADAcompliant language. 2. Physical and environmental demands. Lifting, posture, movement, sensory requirements, and exposures — each rated by how often it occurs. 3. A shared reference document. Hiring managers, physicians, claims adjusters, and attorneys all rely on this one document to make decisions. That third point is the one most employers underweight. Everyone downstream is reading the job you defined. The quality of that single document quietly sets the ceiling on every decision made after it. One Job Description, Four Points of Leverage The same job description does real work at four (4) distinct points in a workers’ compensation program, treated as P1 through P4. 1. P1 Pre-Hire — define the job before you fill it. The standard you write down is the standard every candidate is measured against, and the one you will defend later. Setting it once means every hiring manager applies the same physical requirements—reducing disparate-impact exposure—and documenting the demands up front, before any candidate is in the picture, removes any argument that the requirements were built around a specific person. This is the foundation for everything that happens at the post-offer stage. 2. P2 Post-Offer — match the person to the demands. Once a conditional offer is made, a post-offer health questionnaire (POHQ) and a physician fit-for-duty review tie the documented demands to the individual. Post-offer employment testing criteria flow directly from the physical demands table, and the result is a capability baseline on file from day one — invaluable if a claim arises later. If something is flagged on the POHQ, you can only screen against demands you have in a detailed job description; a vague job description cannot be tested. Read the EEOC Guidance Letter on this topic for more detailed information. 3. P3 Prevention — clarity is the first control. You cannot reduce a hazard you have not identified. While it is not an Occupational Safety and Health Administration (OSHA) standard, OSHA strongly encourages job hazard analysis. Task-level demand detail in your job description is the raw material for a job hazard analysis: it tells you which roles carry which exposures, where personal protective equipment (PPE) and ergonomics spending is justified, and what training should target. 4. P4 Post-Claim — your documentation defines the job in a dispute. If an employee goes to the doctor for a work-related injury without a job description, who do you think makes up the job description? The employee. Do you think they ever exaggerate their requirements? And if the employer or insurer impeaches what the employee said, that creates friction that will likely lead to attorney involvement. How about simply having the job description on file with your treating providers—or sending a copy with the injured employee to the doctor’s appointment? The best chance you have of getting a claim started in the right direction is to make sure the treating physician has two things: the mechanism of injury and the job description. Employers with frequent claims typically keep a bank of light-duty jobs on file with the treating physician. And if you get really granular on your physical demands, the physician may release the employee back to the regular job with a slight modification. Good, Better, Best — Granularity Is the Dial On Your Loss Numbers Years ago, I hired an ergonomist to create granular job descriptions, broken down by task. If one task involves heavy lifting but is only performed a couple of minutes an hour, the granular job description lets the physician return the employee to their regular job, simply eliminating that one task. A closed-claim study showed this process reduced lost-time days by twenty-five percent (25%). Not every job description carries the same protective weight. Think of granularity as a dial with three (3) settings. 1. Good is the defensible baseline every role should reach—an AI-generated description with essential functions, qualifications, and clean ADA and EEO language, achievable in under a minute.

2. Better adds verified demand frequencies and weight specifications, making the description physician-ready. 3. Best adds a task-based physical demands analysis and per-task frequency mapping—the tier that matters most for safety-sensitive roles. We offer a tool in our Compass RMS platform that helps employers jumpstart their efforts to build meaningful job descriptions. The tool uses AI to provide an outline for the employer to finetune. The strategy is not to make everything Best. Get every role to Good today, then invest the deeper task-level work into your highest-risk, safety-sensitive jobs. That is where the loss reduction concentrates. The Payoff: Why Task-Level Detail Moves the Numbers In a Compass RMS closed-claim study, safety-sensitive roles documented at the task level (Best tier) were associated with roughly a twenty-five percent (25%) reduction in lost-time days. The treating physician has to approve the job description. When a doctor can see exactly which tasks drive which physical demands, they are more likely to return an employee to their regular job with targeted restrictions— instead of defaulting to full disability or an unrelated modified-duty assignment. That precision eliminates extended lost time, prevents modified-duty mismatches, and keeps reserves from escalating. A vague job description forces the physician to guess, and they guess conservatively, which costs the employer. (Source: Compass RMS closed-claim study.) State-Specific Considerations Most of what makes a job description defensible is federal and universal—ADA-compliant essential functions, EEOC-aligned language, and proper post-offer timing do not change from state to state. The real pocket of variation is post-claim. Workers’ compensation is a state system, so return-to-work and light-duty obligations, causation and apportionment standards, and the handful of state fair-employment laws that reach broader than the ADA all differ. It is critical to understand state-specific guidelines and rules. Georgia, for example, has very specific rules regarding return to work and has a form that outlines the physical demands of the job. Under Board Rule 240 and O.C.G.A. § 34-9-240, to offer suitable employment and—if the worker refuses—the employer/insurer can unilaterally suspend benefits. To do this, the employer/insurer must attach to Form WC-240a or a description of the job and its physical requirements, approved by the authorized treating physician. The State Board’s WC-240a “Job Analysis” form is the recommended vehicle for that description: a granular physical demands analysis that rates lifting, carrying, push/pull, and postures by Never / Occasional (up to 1/3) / Frequent (1/3–2/3) / Constant (over 2/3)—the same frequency bands used to build the job description in the first place. In the case of most claims in Georgia, the employer creates the job description (the 240a) after the injury. Why wait to have a claim to create a 240a? It makes sense to have the job descriptions available from pre-hire. The practical consequence: an employer already maintaining Best-tier, task-level job descriptions can populate a WC-240a in minutes and move quickly on a defensible light-duty offer. An employer without one is building a granular physical demands analysis (PDA) from scratch in the middle of an open claim — often while indemnity benefits are already running. And, they have lost the impact the job description makes in the P1 through P3 stages. Job descriptions have a significant impact on your organization from pre-hire all the way through to post-claim. Our Compass RMS platform has a tool that can generate a solid draft for your team to build out your questionnaires. However, it is a guidance document. You should always run all of your internal policies, procedures, and forms by your attorney to make sure they are legally compliant. Steve Heinen is a partner at Sterling Seacrest Pritchard and is the President of Risk Management Inc. He has led the Georgia Workers’ Compensation Adjuster Certification (CWCP) Program since its inception in 1999. He is also the author of the Work Comp Playbook for Employers and the new Risk Management Playbook for Employees. 21

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Toxic Expectations: Yes, All of Them Kermit Jones, Jr., DMin Fifteen years ago, as a Navy Chaplain assigned to a ship, I had a front-row seat to a commanding officer who was fired for “cruelty and maltreatment” of the crew. People told me what they could say nowhere else. I watched the light go out in sailors’ eyes, and a command lose what keeps a ship safe: people telling the truth early. They were impossible to please. Perfection was expected. Mind-reading was expected. Pretty much the impossible was expected, routinely, and when it did not arrive, which was most of the time, the whole ship heard about it. Junior officers were taken apart in front of their peers (senior officers, too). Inevitably, good people started making dangerous mistakes; that’s what happens when fear is the loudest thing in the room. Here is the part to sit with: that officer did what leadership books often recommend. They made their expectations clear. And, by the standard most of us were handed, they were doing it right. It sounded extreme the first time I said it out loud… Every expectation is toxic. Not just the unreasonable ones. Not just the unspoken ones. All of them. Only Two Things Can Happen When you hold an expectation of another person, there are two emotional outcomes, and neither is good for you: 1. If they miss it, you feel disappointment, frustration, and something close to betrayal, because in your mind there was a deal and they broke it. An expectation often schedules disappointment in advance. 2. If they meet it, you get… nothing. Walk into a Walmart bathroom and flip the light switch. The lights come on. What do you feel? Mostly nothing, because you expected light and got light. Nor do expectations pay out when met with people. At best, you offer limp applause for somebody doing their job. Those are the two default emotional outputs: nothing or negativity, emptiness or anger. Is that how you want to lead? Is that how you want to be led? Every unmet expectation lands like a small betrayal, and small betrayals accumulate. That is one source of being soul-tired, and why people who genuinely care about the work sometimes stop caring on purpose. Yes, We Still Need Standards Some of you are already arguing with me (and you’re right to). We need standards. We need accountability. In workers’ compensation, we need statutes, filing deadlines, medical criteria, and policies that hold whether anybody personally agrees with them or not. I am not asking you to lower a single bar, and anybody who tells you that compassion means letting the work slide is selling you something. Releasing expectations does not excuse cruelty, abuse, discrimination, or independent harm. Those remain real and require protection and accountability. A standard has force on its own. Your expectation adds only a private debt the other party never knew they owed. It’s a contract they never signed. That is the distinction the whole thing turns on. Belief is what you hold about somebody’s potential. A standard is the bar. Support is what you provide so they can clear it. Those are three real things, and not one of them is an expectation. An expectation is the fourth thing we quietly substitute for all three, and then we get frustrated when it doesn’t work. We Would Never Operate Without Consent Here the leadership argument becomes an ethical one. Outside an emergency or another lawful exception, no physician reading this magazine would take a patient into an operating room without informed consent. Not because the paperwork requires it. Because doing otherwise violates the patient’s autonomy. The procedure might even be the right one, medically speaking, and it would still be a violation, because the person on the table never agreed to it. 2

Now look at what we do to each other every day. We decide how a colleague should respond, an employer should prioritize, or an injured worker should approach recovery without saying it aloud. Then, when people fail to follow our private plan, we punish them with frustration, silence, and tone. That is why I say treating a private expectation as though it were an agreement is ethically suspect rather than merely unhelpful. It assumes consent instead of requesting it. And that is also why leading by making your expectations clear is, if we are being honest with each other, a little cowardly. Clarity is emotionally safer for the leader. Clarity is one-way. It lets us blame people for breaking agreements they never made, and it protects us from the genuinely vulnerable act of sitting across from another human being and negotiating. The Cure Is a Conversation Agreement does not replace lawful authority. When a standard comes from law, policy, safety, or role, name it honestly. Sometimes you’re not negotiating whether; you are agreeing on how. For simple commitments, that can take sixty seconds. Clarify the specific need and exact date without assuming they already know why. Listen for their constraints. Ask what might make this difficult, and then actually value the answer. Explore the path together, so the question becomes “What would help make this work?” rather than “Do it my way.” Agree on who will do what, by when, including what you will provide. A yes that assigns work to only one person is still a one-signature contract with better manners. Revisit by setting a review point, because conditions change and a good agreement is designed to be revisited. If the conversation surfaces complexity, safety risk, coercion, or a power gap that makes an honest no impossible, stop the frame and begin a longer process or use lawful authority honestly. CLEAR: Clarify, Listen, Explore, Agree, Revisit. In the next twenty-four hours, catch yourself imposing a one-sided expectation on a colleague, claimant, spouse, or kid. Before expressing disappointment, ask whether a real agreement existed or whether you assumed they had signed. Then go make one. Out loud. With one person. Expectation is extraction. Agreement is creation. Fifteen years later, I still think about (and talk to) those sailors. Not one of them failed to understand what was expected. Every one of them understood perfectly. That was never the problem.

Kermit Jones, Jr. is an author, speaker, and executive coach. His forthcoming book, Toxic Expectations, examines why clear expectations still fail and how agreements repair the relationships that carry the work. He can be found online at ToxicExpectations.com.

Chronic Work-Related Low Back Pain: Beyond Traditional Treatments Anthony Massoll, MD Low back pain remains one of the leading causes of missed work, lost productivity, and workers’ compensation claims across the United States. While many workplace back injuries improve with time, physical therapy, medications, and activity modifications, some individuals continue to experience persistent pain long after the initial injury has healed. One of the biggest challenges in treating chronic low back pain is identifying its true source. Not all back pain originates from the muscles, discs, or joints of the spine. In some patients, the pain comes from the vertebral endplates, the area where the spinal discs connect to the vertebrae. This condition is known as vertebrogenic low back pain and is associated with irritation of the basivertebral nerve, which carries pain signals from these damaged endplates. For years, treatment options for these patients have focused primarily on managing symptoms. Today, advances in spine care allow us to better identify vertebrogenic pain and, for appropriately selected patients, treat the source of that pain. One of these newer treatment options is the Intracept® Procedure, a minimally invasive outpatient procedure designed specifically for chronic vertebrogenic low back pain. Rather than treating surrounding muscles or joints, the procedure targets the basivertebral nerve inside the vertebra using radiofrequency energy to interrupt the transmission of chronic pain signals. No hardware is implanted, and the procedure is typically completed in a single outpatient visit. For injured workers, the goal is not simply pain relief. The ultimate objective is restoring function and helping patients safely return to work and the activities that matter most to them. Chronic low back pain can significantly affect mobility, concentration, sleep, and overall quality of life. It often prevents employees from returning to their previous job duties, even after completing months of conservative treatment. Clinical studies have demonstrated that appropriately selected patients undergoing the Intracept Procedure experience meaningful improvements in both pain and function, with results shown to be durable for more than five years. These outcomes highlight the importance of identifying the correct pain generator before determining the most appropriate treatment plan. Most importantly, the Intracept Procedure is not intended for every patient with chronic low back pain. A comprehensive evaluation is necessary to determine whether vertebrogenic pain is the underlying cause. This includes a detailed medical history, physical examination, and MRI imaging to identify characteristic vertebral endplate changes known as Modic changes. Most candidates have experienced chronic low back pain for at least six months and have not achieved adequate improvement despite conservative care, such as physical therapy, medications, or spinal injections. As an interventional spine physician, my approach is to begin with an accurate diagnosis and develop an individualized treatment plan based on each patient’s condition and goals. Many patients improve without surgery through conservative management, while others may benefit from newer minimally invasive technologies that directly address the source of their pain. Workers’ compensation care is ultimately about helping people regain their function, independence, and ability to return to productive lives. As our understanding of chronic low back pain continues to evolve, so do the treatment options available to patients. For individuals with chronic vertebrogenic low back pain who have exhausted traditional therapies, the Intracept Procedure represents an important advancement that may offer meaningful, long-term improvement and a pathway back to work and everyday life.

Anthony Massoll, MD, is a fellowship-trained Interventional Spine and Pain Medicine physician at TOC. He specializes in the comprehensive evaluation and treatment of neck, back, and spinerelated pain using the latest evidence-based, minimally invasive techniques. His areas of expertise include spine interventions, image-guided procedures, and advanced treatments for chronic pain, including vertebrogenic low back pain.

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A Surgeon’s Perspective: The Power of Early Intervention in Musculoskeletal Injuries Thomas Alexander, MD As an orthopedic sports medicine surgeon who treats athletes and active working professionals, I have seen firsthand how musculoskeletal injuries can disrupt careers, productivity, and quality of life. Whether it is an athlete straining a rotator cuff or a warehouse employee developing a repetitive stress injury, optimal outcomes often depend on early intervention. Prompt subspecialist evaluation, accurate diagnostics, and injury-specific treatment can turn a potentially longterm condition into a manageable recovery. This approach is especially important in occupational health, where delayed care affects not only the injured employee but also workplace productivity, medical costs, and workers’ compensation outcomes. Effective treatment begins with an early, accurate diagnosis by a subspecialist of that body part or injury type. When a patient presents with pain, swelling, weakness, or limited mobility, delaying evaluation can allow a relatively manageable injury to become more complex. Early assessment by a musculoskeletal subspecialist helps distinguish between conditions such as a sprain, ligament tear, stress fracture, or tendon injury. Imaging studies, including X-rays, MRI, CT, and ultrasound, may also play an essential role. For example, a construction worker who injures a shoulder while lifting may have an acute rotator cuff tear that is identified through an early MRI. A timely diagnosis allows the treatment plan to address the actual injury before it progresses or tasks are improperly approached, leading to further injury. Without that clarity, general recommendations such as rest, anti-inflammatory medications, or unrestricted activity may temporarily mask symptoms without correcting the underlying problem. Early subspecialist involvement ensures that the evaluation and treatment plan reflect the injury’s mechanism, whether it resulted from a single traumatic event or repetitive workplace activity. Early intervention also helps prevent acute injuries from becoming chronic. Diagnosis-specific physical therapy, modified activity, functional bracing, medications, and targeted injections can often reduce symptoms while restoring strength and function. In my practice, patients who receive appropriate treatment soon after ligament sprains, muscle strains, and tendon injuries frequently recover in weeks rather than months. For occupational injuries, early ergonomic adjustments and targeted rehabilitation can also prevent employees from compensating with other parts of the body. This reduces the risk of secondary pain and allows for a safer, more efficient return to work and daily activity. The financial benefits can be equally significant. Delayed treatment may lead to additional office visits, prolonged therapy, advanced procedures, surgery, extended work restrictions, and lost wages. Research shows that prompt subspecialist evaluation can cut overall treatment costs by thirty percent (30%). For employers and workers’ compensation administrators, expedited referral to a trusted musculoskeletal subspecialist can reduce unnecessary treatment and help prevent temporary injuries from becoming long-term disability claims. Timely care can also strengthen the workplace environment. Employees are more likely to feel supported when their concerns are taken seriously and they receive access to qualified care. This can improve trust, morale, job satisfaction, and confidence in the return-to-work process while reducing turnover, absenteeism, and potential litigation. The long-term health benefits and indemnity should not be overlooked. Early diagnosis and treatment can limit degenerative progression, preserve mobility, reduce recurrent symptoms, and protect an employee’s functional baseline. Patients that I’ve treated early report fewer recurrences, faster recovery, and better quality of life. For active professionals and athletes, As an orthopedic sports medicine surgeon, I advocate for a proactive approach to musculoskeletal injuries. By prioritizing early subspecialist evaluation, appropriate imaging, and targeted treatment, we can improve patient outcomes, increase workers’ compensation efficiency, reduce costs, and help employees return to work safely and confidently. Thomas Alexander, MD, is a fellowship-trained orthopedic surgeon (sports medicine). He treats full-spectrum conditions for active-lifestyle injuries, including the shoulder, elbow, and knee, from rotator cuffs and arthritis to tendon repairs.

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Real Talk with Michelle: A Conversation with Roberta Mike Welcome to Real Talk with Michelle, a new column where we sit down with the people doing the work in our industry and ask them the questions that aren’t asked. There’s a lot of talk in this industry about outcomes, metrics, and closing files. There’s less talk about what actually happens between a phone call and a resolution, like the trust that gets built or broken, the conversations that go sideways, the difference between an adjuster who manages a claim and one who changes how it ends. I’m starting with Roberta Mike. Roberta is the founder of the Workers’ Compensation Mentoring Group and a 2026 Deconstructing Comp Changemaker Award finalist. She has spent her career on the claims side, and she has strong opinions about what this work requires — most of them about slowing down and treating people like people. Here’s our conversation. How do you build trust and maintain transparency with injured workers, employers, attorneys, and medical providers throughout the life of a case? Building trust starts with consistent, honest communication from day one. I make it a priority to set clear expectations with everyone involved — injured workers, employers, attorneys, and medical providers — about the claims process, what information is needed, timelines, and next steps. I keep a checklist of what I plan to cover, and at the end of every conversation I ask whether there are any questions. Another component people overlook is the speed of your speech. A rushed conversation loses trust. I also make sure injured workers understand their rights as employees. Throughout the life of a claim, I maintain constant communication, address concerns as they come up, and hold conference calls with the employer. With attorneys, I present the plan of action and clear expectations, then follow up in writing. With medical providers, I ask for clarity on every diagnosis and care plan, and collaborate to obtain accurate medical information that supports it. Trust comes from constant, prompt follow-up — from the beginning of the case through to conclusion. When parties know I will communicate honestly, respond promptly, and make decisions based on the facts and applicable regulations, it creates confidence in both the process and the outcome. How do field adjusters contribute to claim outcomes? Field adjusters are usually the primary contact after a claim is filed. They go on site, interview the involved parties, secure photographs and video, and conduct accident simulations. They help ensure claim decisions are based on facts rather than assumptions. They also reduce anxiety when meeting with the injured worker and their family. They meet with medical providers, secure information, and sometimes approve treatment on the spot. Being there in person builds trust and creates space for real conversation about what happens next after a work injury. Settlement outcomes tend to be better as well, because you have already gone over everything in person. What steps should be taken to ensure accurate investigations and positive customer experiences? Educate your customers on the importance of promptly reporting serious injuries or concerns. If the employee is available, obtain a statement as soon as possible. Secure photographs of the accident scene and contact information for all involved parties and witnesses. Interview everyone with knowledge of the accident and clarify the sequence of events. Preserve everything, including video footage from the day before the accident along with all reports. Document the facts clearly and seek legal counsel as needed. Explain the process to both parties and why their cooperation matters, including during the investigation. And explain why you are asking about prior medical conditions: it ensures those conditions are not aggravated and allows medical providers to build informed treatment plans. Injured workers come from diverse backgrounds and cultures. How do you adapt your communication style to better understand a claimant’s circumstances? Reach out to the employer’s manager and human resources first. They should have an accurate understanding of their employee. Use excellent translators. Take the time to listen to a person’s story — their life, their family — and the rest follows. Be mindful of your speech and your speed during that conversation, and walk them through the claim process alongside their employer.

How do you build meaningful relationships with all parties involved? Through consistent communication with everyone, including people outside the workers’ compensation industry. I enjoy open communication, I am an active listener, and I treat everyone with respect. Trust gets built through transparency in those conversations. I also stay engaged and active in the workers’ compensation community. Workers’ compensation laws and medical treatment guidelines are constantly evolving. How do you stay current on state-specific regulations, medical advancements, and treatment protocols? Staying on top of the changes can be overwhelming, but knowing them is what prepares you for good outcomes. Each state has its own statutes and its own changes, and learning them matters for strategy in claims handling. I rely on defense counsel, and on a lot of conference calls and Teams meetings to talk things out and get feedback. On the medical side, it is important to learn about upcoming technologies in care and services, because those affect the cost of care. Reviewing evidence-based treatment guidelines is essential. Knowledge paired with critical thinking is what matters. Every case is unique, and the outcomes are always different. Sound decisions come from investigation and facts, medical information, and statements from all parties. Social media and outside opinions can influence perceptions of a claim. How do you balance information obtained through social media investigations with objective claim handling and a fair evaluation of the facts? Social media is part of a claim investigation, but it should never be the sole basis for a claim decision or for a profile of the injured worker. It is one piece, and the information should be verified through the carrier’s own resources, such as a special investigation division. It is critical to obtain written statements, video, and photographs early in the case to preserve as many facts as possible. Ethical claim handling matters in this industry, and we need to adhere to what can lawfully be used and shared with all parties. Be fair. Get clear facts before making accusations. Stay unbiased throughout the investigation. Build trust, and verify. What separates a good workers’ compensation adjuster from an exceptional one? Exceptional adjusters do what is right, not what is easy. They show empathy in everything they do throughout the entire case. They stay educated on regulatory changes, attend conferences, and keep up with industry updates and best practices — from their own company and from outside state insurance agencies. Balancing compassion against objective issues is a real talent. So is treating injured workers as human beings rather than claim numbers. A good adjuster manages the claim to conclusion. An exceptional adjuster looks for a successful outcome, not just a closed file. What do you wish new adjusters would do that you aren’t seeing enough of right now? Slow down, and learn from seasoned adjusters whenever the opportunity comes up. This profession requires continuous education and a commitment to developing expertise across an entire career. Approach this work with passion rather than for the paycheck. Every case represents a person and their family’s experience. Never lose sight of the human side of what we do. Build relationships with medical providers, attorneys, your manager, medical case managers, and other industry professionals. The best adjusters are lifelong learners who invest in their own development and strive for the best outcome. Michelle C. Wilds is Director of Client Relations and an HR and safety consultant with SelectOne and Workplace Health Magazine. Know someone who should be featured in Real Talk? Reach her at 478.232.0660 or through www.wphmag.com. 33

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A Message from the Chairman Ben Vinson, Chairman and Chief Appellate Judge Hello from the State Board of Workers’ Compensation. Hope everyone is staying busy and having a successful year so far. Well, it is most certainly summertime in Georgia, which means the SBWC Annual Educational Conference just happened. Our 2026 Annual Educational Conference, A Day at the Beach: Surfing the Waves of Change in Workers’ Compensation, happened August 31 to September 2 at the beautiful Hotel at Avalon in Alpharetta. As part of this year’s conference theme, exhibitors will bring the excitement, nostalgia, and energy of a classic beach setting to life. We will feature interactive experiences, photo booth opportunities, games, themed decor, and plenty of beachside fun for attendees. The 2026 education agenda is comprised of a variety of timely and thought-provoking sessions on Insurance, Medical, Legal, and Case Management topics. Our special awards presentations on Monday are where we will recognize outstanding contributions in our industry through the presentation of the State Board’s Spirit Award, the Dr. Tom S. Howell Memorial Award, and the Kids’ Chance of Georgia Scholarship. On Wednesday, we will present the new “ACE” Award honoring the Adjuster of the Year. These important recognitions provide an opportunity to celebrate inspiring real-life stories and highlight the meaningful impact and hard work that our Georgia workers’ compensation sector has on the lives of individuals, families, and communities. This year, we will kick off the State Board’s 4th Annual Insurance Adjuster Training Program on Monday with an informative “Nuts and Bolts” session covering the organization and functionality of the Georgia Workers’ Compensation System. Then we will showcase the always popular Live Oral Arguments before the Appellate Division on Monday afternoon. Finally, on Wednesday the conference will conclude with a robust Ethics session, including keynote speaker Dr. Kien Vuu, a triple board-certified physician and an expert in performance and longevity. You won’t want to miss this impactful presentation on ethics, resilience, purpose, and achieving peak personal and professional performance. I am also pleased to announce several exciting upcoming changes. First, we are relocating our main office at 270 Peachtree Street in downtown Atlanta to the Perimeter area in Fall of 2027. We are excited about our future move and look forward to continuing to serve the workers’ compensation community from our new location. Also, we will be opening a new Macon office this summer. The new office will be centrally located in downtown Macon and will feature a state-of-the-art courtroom. Due to the expansion of the Macon office, the Columbus office will close at the end of this year. On a related note and after many years of state service, several of the State Board’s administrative law judges will be retiring at the end of 2026. We are deeply grateful for their wisdom and leadership. While they will be profoundly missed, we wish them a wonderful and well-deserved retirement. The State Board has also been busy implementing several technological upgrades this year including an upgraded Enforcement Division Information System (EDIS) which includes a new automated penalty process. The Drug-Free Workplace Program (DFWP) is undergoing a complete overhaul in 2026. The updated DFWP website and registration database will be launched this Fall, with a streamlined registration and payment process. The State Board also has a new online payment process for WC-12 record requests, and we continue to add functionality to the Integrated Claims Management System (ICMS) for both internal and external users. Another exciting change at SBWC is the addition of our new Conference and Meetings Coordinator, Charles Thigpen, who was recently promoted and joined our conference team full-time. He looks forward to working with everyone and assisting with the State Board’s mission of providing high-quality educational programs, conferences, and events that support Georgia’s workers’ compensation stakeholders. I look forward to seeing everyone at our Annual Educational Conference. Please visit our website for new features and updates on important developments. Feel free to contact me anytime with questions or comments about the State Board or any other matter.

Ben Vinson is the Chairman and Chief Appellate Judge of the State Board of Workers’ Compensation, appointed by Governor Brian Kemp in May 2021. He handles policy and regulatory issues for the state agency in addition to hearing workers’ compensation cases on appeal. He graduated from Furman University and the University of Georgia School of Law. He resides in Greensboro, Georgia with his wife and two children.

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Workplace Health Influencers WPH is super excited about our influencers! They are all over the country sharing our magazine at industry events! When you are out and see one of them- snap a picture and post on social media with our hashtag

#wphrocks!

Michael Anderson A National Industry Leader with ties to every state, we are looking forward to having WPH in all the places Michael goes.

Jackie Woods I’m Jackie Arbelaez-Woods, proud to be part of the ProCare team, covering Alabama, Arkansas, Kentucky, North Carolina, South Carolina, Louisiana, and Georgia. With over 15 years in the workers’ compensation industry, I’m grateful for the relationships I’ve built and excited to make many more. If you see me, please stop and say hello! And if you read my bio in WPH, be sure to mention it—I’m honored to support and be an influencer alongside such an amazing group of professionals. James Swinton James Swinton is a former standout athlete. Swinton played college football at Auburn University. After his collegiate career, Swinton signed briefly with the Atlanta Falcons. Currently, Swinton is an accomplished Sales & Business Development Professional with Wright Rehabilitation Services.

Kristi Miller Kristi joined Vona Case Management as Regional Sales Director in 2024. She has provided regional and national continuing education presentations for workers’ compensation professionals on catastrophic rehabilitation of neurological injuries, the psychological impact of disability on recovery, and a variety of other topics impacting claims since 2005.

Claudia Birthisel Claudia is in her junior year at the University of Alabama, majoring in marketing and minoring in real estate. She is a Workplace Health intern in Alabama. With a special interest in helping those with injuries, she hopes to secure a position in the workers’ compensation industry after graduation.

Kristin Green Kristin Green is an influential voice in the workers’ compensation industry, owner and founder of the newly launched Thrive to Rise Consulting Company. Known for blending strategy with heart, she founded Bag of Happies and Soleful Socks to bring comfort and give back. Kristin’s mission is simple yet powerful: create a culture of kindness where every injured worker feels seen, heard, and valued.

Changes in Workers’ Comp: Try Thinking Outside the Box Kristin Carnovale Green With workers’ compensation being over 110 years old, how often are we thinking outside of the box? The processes have changed with technology, but we are still seeing and feeling a lack of change. One hundred and ten years...wow! Over a century of taking care of injured employees and their families. What is our industry doing differently now compared to how things have always been done? We have over a century of individuals with a role in our industry because human beings are getting injured at work. Yet, the injured employees and their families still have the same feelings of being lost, unseen, and unheard. How have we continued to miss the mark on this, and what are we doing differently within our organizations to demand to think outside the box? In past experiences where I have been fortunate enough to sit in homes of injured employees and their families, the common theme is that no one hears them and the lack of communication – yes, with so many people involved in a claim at one point in time (roughly sixteen companies during an active claim), the injured employee and their family are often lost and confused. Listening to the family’s plea to get a better understanding of what’s really going on is a true test of your heart versus your mind. Additionally, sitting in on calls with TPAs/Carriers and hearing that the “family is being difficult” proves the theory of being boxed in our thinking. Why? Because things can be handled much differently. We have insurance carriers, TPAs, nurse case management companies, an array of strategic vendor partners, and more than can be listed, and some of these have been in existence since the birth of work comp. We have countless individuals in our industry waving a flag, pounding the pavement, putting in the work - to create the demand for change in so many ways. However, when it comes to truly putting anything into action, how often are we thinking outside the box with work comp? Not as much as you think. Inside the Box Thinking Our thinking is inside the box when it comes to workers’ compensation. Every day we have approximately 12,000 new claims reported across the United States. If you do the math, our adjusters are inundated with weeding through it all every single day. The average caseload for workers’ compensation adjusters is between 125 and 150. There has been little change in all these years; in fact, over the past decade, the caseload for workers’ compensation adjusters has significantly increased, impacting their efficiency and the quality of service provided. This diminishes the quality of work, as well as the type of customer care service that is being delivered to injured employees. Turnover rates for workers’ compensation adjusters are notably high, averaging twenty percent (20%) annually. It’s increased over the past ten years, and it’s getting worse. There are rules and regulations unique to each state. Some employers dictate customized service instructions on their programs. Some carriers don’t allow employers to make decisions on their accounts - account managers and unbundling services. We need to have a creative mind and the courage to change things. Not only have things progressively changed for the worse, but the lack of improving such an antiquated system means we have failed to think outside the box to make a change. Think about what’s truly changed and what you could do to break the monotony of being stuck inside a box, and then not doing anything about it at all. How can you be part of that change? Think outside the box. One of the most admired leaders in our industry, Shari Starkey at Corvel, ensures her team is seen and heard, but first has the understanding that she needs to be a good leader for herself to be good for her team. She also organizes a yearly summit where they share new ideas; the employees have the opportunity to share what they do each day for their employees, bring in speakers, and do team-building events – all of which impacts how they go back to their adjusting teams – the communication strengthens the bond of the teams and directly impacts

how they take care of their clients and injured employees. Being involved in the summit last year, one takeaway was how each team leader made it a point to say thank you to their team on any given day. Implementing a tool like this is a great way to think outside the box. Changing how you lead a team will directly impact how they treat your clients. Doing good things for your clients, such as sending a card to say thank you, picking up the phone to actually call someone, goes a long way. But what if you did more? Why, if the simple things make such a difference, do we have a hard time doing them? This type of behavior yields results: client and employee retention, and outcomes that you aren’t expecting. It’s okay to think with empathy and creativity. These actions and intentions directly impact their employees, who directly impact the people they take care of - clients and injured employees. Sure, following the rules is necessary, but what can be done within the rules, thinking outside the box for your team that would directly impact the clients and injured employees they are taking care of? As leaders, how do we help them manage this along with work-life balance? Be open to being creative to create an environment where changes are possible. Helpful tips to Think Outside the Box • Find your courage and speak up – It’s not always easy to ignite a change in the way an organization does things, but it only takes one voice. • Be willing to unleash and unbox the creative side. This will spark new ideas. • Connect with mentors and leaders in our industry to elevate best practices. • Work with your teams and collaborate for new ideas and ways to implement these ideas internally so it filters out to the clients and injured employees. Remember that lack of good communication seems to be the root cause of every problem, yet we continue to push it aside and brush it off. It could solve so many things. There is no connection without good communication. This is about change. Changing the way you do things in comp… in your own way, where you can make a difference where it counts. It’s time to shake us out of a system that holds us in a box. Be willing to see it and do something about it.

Kristin Carnovale Green is a health and wellness professional, executive coach, and public speaker, and the owner of Thrive to Rise Consulting. With more than ten years of workers’ compensation experience, she partners with leaders and organizations on culture, engagement, and employee wellbeing, helping them build workplaces that attract, retain, and develop talent.

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Break It Up: Physical Altercations in South Carolina Claims Andrew T. Smith Workers’ compensation defense attorneys in South Carolina see a number of claims each year involving physical altercations between a claimant and a co-worker. These fights or attacks arise in a wide variety of circumstances, and they often come with competing versions of the story. The threshold question is whether the injured worker’s injuries are compensable. Contrary to popular belief, injuries resulting from fights often are compensable in South Carolina. Generally speaking, injuries resulting from a physical altercation—regardless of who started the fight—are compensable as long as the fight was spontaneous and not purely personal in nature. This general rule is sometimes confused with the “aggressor defense” in the context of claims involving horseplay. Under Section 42-9-60 of the South Carolina Workers’ Compensation Act, no compensation is payable where an injury is the result of an employee’s “willful intention to injure or kill himself or another.” What is often referred to as the “willful or intentional” defense is an affirmative defense to compensability. In its 1967 decision in Zeigler, the South Carolina Supreme Court noted that this defense is an exception to the general principle that workers’ compensation in South Carolina is a no-fault law. Zeigler is the seminal case in South Carolina for compensability of physical altercations. In short, two law enforcement agents were involved in an initial verbal argument at work. There was then a cooling-off period, after which both men left the building and a scuffle erupted, with both agents firing their pistols at each other. One agent was wounded, and the other—the claimant—was killed. The claimant’s act of going outside and engaging in an altercation after the initial verbal dispute was found to be a voluntary acquiescence to settle the dispute by violence. The Court found that the claimant’s conduct was of such a grave and serious nature as to evidence willful intent to injure, and it denied benefits. Conversely, in a 1977 case called Kinsey, the Court awarded benefits in a case involving a fight between two employees. The employer took the position that an aggressor, or a person who struck the first blow, is barred from compensation. The employees even had a history of personal disagreements. However, the fight began suddenly during an argument regarding work-related issues. The Court noted that the willful and intentional defense is not based upon who struck the first blow. Instead, the defense is based upon conduct that is so serious and aggravated that it shows a willful intent to injure. From a defense perspective, any physical altercation initiated by a first blow would seem to qualify as evidence of willful intent to injure, but the Court does not agree. In Kinsey, the Court held that “the ultimate altercation was spontaneous and impulsive,” rendering the defense inapplicable. When evaluating compensability of injuries resulting from a fight, it is critical to understand that South Carolina law currently treats compensability very liberally in these situations. Ultimately, when questions arise about compensability in a physical altercation claim, adjusters and employers should contact local defense counsel before making a compensability determination, so that the claim is handled appropriately from the outset. Andrew T. Smith is a workers’ compensation defense attorney in the Charleston, South Carolina office of Willson Jones Carter & Baxley, P.A. Andrew handles a wide variety of workers’ compensation claims. Andrew is also a member of the South Carolina Workers’ Compensation Educational Association. He can be reached at atsmith@wjcblaw.com.

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240 Process in Georgia Scott Andrews Consider the following situation: an injured employee receiving temporary total disability (TTD) benefits is released to light-duty work with restrictions that the employer can accommodate, but the injured worker refuses to voluntarily return to work. The claim stalls out while the injured worker continues receiving TTD benefits. What can the employer/insurer do? What legal processes are in place in Georgia to address this situation? In Georgia, the employer/insurer can utilize the “240 Process” to compel the injured worker to return to work. Generally, the 240 Process allows employers/insurers to suspend TTD benefits if they refuse to return to work, as long as the specific procedural requirements of O.C.G.A. § 34-9-240 and Board Rule 240 are followed. First, the employer must complete a WC-240a Job Analysis describing the light duty job available. Once completed, the authorized treating physician (ATP) must review the WC-240a and approve of the job described. When the Job Analysis is sent to the ATP, it must also be sent to the injured worker and the injured worker’s attorney (if represented). This is called “perfecting service.” Practice pointer: ensure the ATP executes Box 1 on the WC-240a, which states that the injured worker is capable of working while taking medications as prescribed. Otherwise, the injured worker’s attorney could argue the WC-240a was not properly executed. Once the job described on the WC-240a is approved by the ATP, the light duty job can be formally offered to the injured worker on a form WC-240 Notice to Employee of Offer of Suitable Employment. The injured worker must receive ten (10) days’ notice before the return to work date listed on the WC-240, and service of the WC-240 must also be perfected on the injured worker and the injured worker’s attorney. The WC-240a approved by the ATP must also be included with the WC-240 when service is perfected. Practice pointer: confirm all supervisors/ managers with the employer are aware that the injured worker plans to return to work on the date provided to perform the light duty job. There is nothing worse than complying with the procedural requirements of 240 only to have a supervisor unwind it all by sending an injured worker home because they were not aware of the plan for return to work. If the injured worker refuses to return to work on the date listed on the WC-240, the employer/insurer can suspend TTD benefits. If the injured worker returns to work and attempts the job for eight (8) cumulative hours or one scheduled workday, whichever is greater, but is unable to perform the job for fifteen (15) working days, TTD benefits must be re-commenced. The employer/insurer would then file a hearing request seeking an Order from a judge authorizing suspension of TTD benefits based on the unjustifiable refusal to continue performing the job. Personally, these are my favorite claims to litigate because injured workers commonly manufacture quite the nonsensical narrative to support their position that they were unable to continue working. The 240 Process is an excellent way to push a stubborn claim toward settlement or closure because an injured worker will either want to avoid litigation or receive some sort of payment after TTD benefits are suspended if they did not attempt the job. I recommend keeping this legal process in your toolkit as a way to move a stalled claim forward.

Scott Andrews is a senior attorney with Speed, Seta, Martin, Trivett, Stubley, and Fickling, LLC, and focuses his practice on defending employers and insurers in Georgia workers’ compensation claims. In his off time, he enjoys traveling and hiking with his wife, fishing, golfing, and watching Braves baseball.

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Hire Smart, Reduce Risk: Prevent Claims Before Day One Rushe Hudzinski, MBA, GPHR, SHRM-SCP Rushed or inconsistent hiring decisions can lead to more than employee turnover. They may also contribute to workplace injuries, workers’ compensation claims, legal exposure, and higher operating costs. A widely cited Leadership IQ study found forty-six percent (46%) of new hires failed within eighteen (18) months. More recent BambooHR research found seventy percent (70%) of employees decided whether a new job is right for them within the first month and twenty-nine percent (29%) decided within the first week. The message is clear: employers cannot afford to cut corners when recruiting, screening, and onboarding employees. Hiring practices can directly affect workers’ compensation risk. When candidates are not carefully evaluated, employees may be placed in jobs that do not match their qualifications, abilities, or expectations. This mismatch can increase the chance of poor performance, unsafe behavior, injuries, and claims. Inconsistent hiring practices may also expose employers to discrimination complaints, negligent-hiring claims, employment-practices lawsuits, and other legal disputes. For these reasons, screening procedures should be job-related, consistently applied, properly documented, and compliant with employment laws. A structured hiring process does not have to be complicated. Candidate scorecards and standardized interview guides help managers evaluate applicants using the same criteria and make more objective comparisons. Managers should be trained in lawful interviewing, documentation, risk assessment, and recognizing behaviors that may affect job performance or workplace safety. Reference checks, résumé and education verification, job-related background investigations, and legally compliant drug testing can provide valuable information. When appropriate, properly validated preemployment integrity assessments may also help identify behaviors associated with dishonesty, violence, substance misuse, theft, bullying, disregard for rules, or unsafe conduct. The process should not stop once an employee is hired. During onboarding, employers should clearly explain job duties, performance expectations, safety requirements, and workplace policies. Supervisors should confirm that employees complete required safety training, follow established procedures, and properly use personal protective equipment. Performance or safety concerns should be addressed promptly and consistently, and then documented. Research shows stronger screening can make a measurable difference. A peer-reviewed study published in the Journal of Business and Psychology examined 33,418 employees across four (4) industries. Employees who had not completed a preemployment integrity assessment were 2.5 to 4.8 times more likely to file a workers’ compensation claim than screened employees. Screened employees also generated significantly lower claim costs per worker. Although no assessment can eliminate every risk, the findings show how lawful, job-related, and validated screening can strengthen the overall hiring process. Fraud involving multiple identities or aliases is another recognized concern, although national data do not show where it occurs most frequently. Employers should consistently verify identities through lawful employment procedures. After a claim is filed, authorized insurers, claims administrators, and investigators should review relevant information for duplication or inconsistencies. Better hiring decisions can reduce turnover, misconduct, injuries, claims, costs, and legal exposure while improving productivity, morale, and safety. Ultimately, the strongest claim-prevention strategy begins before day one by hiring the right person for the right job through the right process.

Rushe Hudzinski is a professor of Management and Human Resources at Savannah Technical College and serves as the Business Strategy Educational partner for Workplace Health/ SelectOne Network. She is a graduate of Elmira College and Syracuse University.

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Closing the Recovery Gap: How Technology Is Improving Patient Engagement and Accelerating Return-to-Work Outcomes Steven Kiak, PT, DPT, and Carrie Manges, Carrie Manges, PTA, CIR, CFCE In workers’ compensation, recovery occurs far beyond scheduled therapy appointments. It happens in combination with the hours and decisions between them; when an injured worker completes a home exercise program, experiences changes in symptoms, chooses to follow their therapy program, or begins to disengage from it. For years, that space between appointments has been one of the industry’s biggest blind spots. Today, digital health solutions are helping close it. Remote Therapeutic Monitoring (RTM) gives clinical teams greater visibility into patient progress and participation while helping injured workers stay connected, accountable, and confident throughout recovery. Traditional claim management depends heavily on information gathered during in-person visits, but this can be a limited report relying on memory and summary. Outside of the therapy appointments, patients are independently managing their pain, completing prescribed exercises, and making activity decisions largely on their own. When communication is limited, small issues can become larger barriers: adherence drops, progress slows, frustrations grow, and claim durations can increase. Closing this reporting gap will rely on more than just episodic care. It will require timely insight, proactive communication, and a superior approach to keep the injured worker engaged. Clinical expertise remains essential, but engagement is emerging as a strong indicator of recovery momentum. Less engagement can lead to missed appointments and delayed symptom reporting.. The workers’ compensation process can also be confusing and isolating. For the injured worker, RTM can make recovery feel less fragmented. Direct communication with their clinical team can help patients ask questions sooner, maintain compliance with their home program, and understand how daily efforts impact their recovery timeline. RTM brings this strategy to life by extending care beyond the clinic via ongoing monitoring of program adherence, symptom response, and activity levels. Instead of waiting for the next visit to discover a plateau, their clinical care team can adjust exercises, reinforce education, and keep the patient moving toward measurable goals. The growing research on RTM demonstrates the critical role patient engagement plays in recovery outcomes. Studies have shown a fifty-seven percent (57%) reduction in patient drop-off rates, with patients completing their home exercise programs 3.3x more often than those receiving traditional care alone. RTM has also been associated with a thirty percent (30%) increase in patient compliance, a thirty-four percent (34%) improvement in physical function outcome scores, and thirty-three percent (33%) more patients reporting reduction in pain interference measures. Workers’ compensation populations experienced approximately thirty percent (30%) fewer temporary total disability (TTD) days; all while boasting a thirty-two percent (32%) improvement in patient satisfaction. Together, these outcomes highlight how technology-enabled engagement can help close the recovery gap, improve clinical results, and accelerate return-to-work success. Recovery time becomes more productive when injured workers are supported consistently between visits. Datadriven recovery with RTM represents a shift from episodic care to continuous Steven Kiak, PT, DPT, Director of Digital Health, intervention. The goal is not simply more and Carrie Manges, PTA, CIR, CFCE, Executive care; it is smarter, more connected care that moves each patient closer to Director of Workers’ Compensation, are leaders function and safe return to work. at CORA Physical Therapy. Their crossEmployers, risk managers, payers, and department collaboration unites digital health providers should adopt recovery models innovation with workers’ compensation expertise that combine technology with human to improve patient engagement, support connection, use data to identify risk consistent recovery, and drive better functional earlier, and keep injured workers actively outcomes. Together, they share a vision for engaged. making recovery more connected, measurable, and meaningful for injured workers and the stakeholders who support them.

Closing the recovery gap is not a future opportunity, rather a practical strategy for

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SELECTONE PREFERRED PROVIDERS Axion Spine and Neurosurgery

Georgia Bone and Joint

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Workers’ Compensation Director Linda Lee: Direct Line: 470-357-0196 Ph: 470-579-3962 Email: workerscomp@axionspine.com Workers’ Compensation Coordinator Ashley Jones Ph: 470-579-3962 ext. 187 Email: workerscomp@axionspine.com Web address: www.axionspine.com Physicians: Raymond Walkup, MD • Shane Mangrum, MD

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Optim Orthopedics Director of Workers’ Compensation Laura Ross, MSW, CCM Ph: 912-629-6076 | Fax: 912-644-6190 Mobile: 912-373-4367 Email: lross@optimorthopedics.com Web address: www.optimorthopedics.com Physicians: Don G. Aaron, MD • Thomas Alexander, MD • Johnathan Christy, MD • Travis Farmer, MD • Delan Gaines, MD • Jeffrey Goldberg, MD • Mark Kamaleson, MD • Gregory Kolovich, MD • Thomas Lawhorne, MD • John McCormick, II, MD • Thomas Niemeier, MD • Christopher Nicholson, MD • David Palmer, MD • Justin Lancaster, MD • David M. Sedory, MD • George Sutherland, MD • James Wilson, Jr, MD • Amir Shahien, MD • Robert Shelley, MD • Jordan Paynter, MD • Wesley Stroud, MD • Jay Cook, MD • Kevin Brooks, MD • John Burke, MD • Michael Dunn, MD • Edward Fakhre, MD • Charles Powell, MD • William “Cole” Skinner, MD

Performance Orthopaedics & Sports Medicine With locations in: Atlanta and Duluth

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OlympusMD

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