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Greetings, dear reader, and welcome to the March edition of the Lex & Verum.
For your enjoyment, here is a selection of facts and events associated with this month:
Martius (later March) was originally the first month of the year in the 10-month Roman calendar believed to
have been invented by Romulus, the first king of Rome and, along with his twin brother Remus, the founder of
Rome. The month was named for Mars, the Roman god of war (and, evidently, Romulus and Remus’s father).
March 2 is the birthday of one of my favorite authors, Theodor Seuss Geisel (a.k.a., Dr. Seuss). 2017 would
have marked his 113th
birthday. National Read Across America Day is celebrated in his honor on that day.
March 2 also marks Texas Independence Day, the 181st anniversary of the adoption of the Texas Declaration of
Independence. The fall of the Alamo occurred four days later, after a 13-day siege.
March 4 used to be the day newly elected U.S. Presidents were sworn into office. The last president to be
inaugurated on that day was Franklin Delano Roosevelt in 1933. The 20th
Amendment to the U.S. Constitution
changed inauguration day to January 20.
On March 12, we all move our clocks forward an hour thanks to Daylight Savings Time (all of us, that is,
except for our colleagues in Arizona and Hawaii). That day’s not all bad, though – it’s Selection Sunday this
year for March Madness. Time to spring forward and get your brackets ready!
March 14 is Pi Day (get it, 3.14?). I’m not sure how this is actually celebrated, though I would presume that
pie and math are somehow involved.
Lex and Verum
The National Association of Workers’
Compensation Judiciary Number XCI
March 2017
NAWCJ President’s Page
By Hon. Jennifer Hopens
March 2017 NAWCJ - Lex and Verum Page 1
Continued, Page 2.
The President’s Page, from Page 1.
March 15 – beware the Ides of March! Many of you may remember
this date from having to read Shakespeare’s Julius Caesar in high
school (in my case, I think my class just watched the movie). The
soothsayer’s prescient warning to Rome’s dictator fell on deaf ears,
and, on March 15, 44 B.C., he went on to meet his end at the hands of
a knife-wielding mob of conspirators led by Cassius and Brutus in the
Roman Senate. On a lighter note, perhaps you remember the 1970s-
era band The Ides of March and their catchy hit “Vehicle”.
March 20 marks the official beginning of spring – the vernal
equinox for those of us in the Northern Hemisphere.
March 21 is the 146th
anniversary of a consequential event for our
field – on that day in 1871, Otto von Bismarck, later credited as the
father of modern workers’ compensation, was appointed chancellor of
the newly unified German Empire. Bismarck would go on to
introduce and implement workers’ compensation programs and other
forms of social insurance in Germany. Workers’ compensation laws
influenced by Germany’s spread across Europe and, eventually, to the
U.S.
There are even more items of interest for you to enjoy in this edition
of the Lex. Among the articles for this month is a thought-provoking
examination of causation of shoulder injuries by Joel Weddington,
M.D., Charles N. Brooks, M.D., Mark Melhorn, M.D., and
Christopher R. Brigham, M.D. In our continuing spotlight on
NAWCJ associate members, you will find profiles of attorneys from
the law firm of McConnaughhay, Coonrod, Pope, Weaver & Stern,
P.A.
I wish you all continuing good health, good fortune, and a safe and
happy spring. We hope to see you at the Judicial College in Orlando
in August.
.
In This Issue
Spotlight on Associate Members 3
Shoulder Pain at Work: Causation Analysis 5
Uncovering the True Cost of Physician Dispensing of Drugs 16
We’re Skipping the Simple Steps in Chronic Pain Management 21
Low Back Pain Treatment Guideline Steers Doctors Away from
Opioids 23
Common Sense Urged When Enforcing Treatment Guidelines 24
Ten Minutes with Hon. Jennifer Hopens 27
Judiciary College 2017 Program 32
Lex and Verum
Editorial Committee
Hon. LuAnn Haley, Chair Tucson, Arizona
Hon. Shannon Bishop Harahan, Louisiana
Hon. David Langham Pensacola, Florida
Hon. David Torrey Pittsburgh, Pennsylvania
March 2017 NAWCJ - Lex and Verum Page 2
2016-18
NAWCJ Officers
Hon. Jennifer Hopens
President Austin, Texas
Texas Department of Insurance,
Division of Workers’
Compensation
Hon. Jim Szablewicz
President Elect Richmond, Virginia
Virginia Workers’
Compensation Commission
Hon. Bruce Moore
Secretary Salina, Kansas
Kansas Department of Labor,
Division of Workers’
Compensation
Hon. Robert S. Cohen
Treasurer Tallahassee, Florida
Florida Division of
Administrative Hearings
Hon. Michael Alvey
Past-President 2012-14 Owensboro, Kentucky
Kentucky Workers’
Compensation Board
I am pleased to have the opportunity to write about four of our associate members who practice together in the area of workers’ compensation law with the firm McConnaughhay, Coonrod, Pope, Weaver, Stern, P.A. The firm began in 1979 with a single office in Tallahassee, focusing on the protection of business clients in civil claims and administrative actions. Over the years, and under the leadership of Jim McConnaughhay, the firm has experienced significant growth in the representation of employers and insurance carriers defending workers’ compensation claims across multiple industries. They have grown into a regional firm with offices across Florida and South Georgia. The firm is committed not only to providing high quality legal services, but thanks to Jim’s commitment to education and bringing all sectors of the workers’ compensation industry together, Jim and his partners have been instrumental in the creation of both the Florida Workers’ Compensation Institute (FWCI) and our organization, the National Association of Workers’ Compensation Judiciary (NAWCJ). For any of our readers unfamiliar with the FWCI, it is the annual educational gathering of thousands of individuals in Orlando from all sectors of the workers’ compensation industry, including judges, lawyers, regulators, adjusters, health care providers, and risk managers, to name but a few. What follows is a short tale of four of the principal members of the McConnaughhay firm who are associate members of NAWCJ. Jim McConnaughhay has practiced law in Florida since his admission in 1969. Jim is a proud graduate of The Florida State University College of Law. He is Florida Bar Board Certified in workers’ compensation law, and represents national insurers as well as employers of every size. In addition to workers’ compensation, Jim represents clients before the Florida Division of Workers’ Compensation, the Florida Office of Insurance Regulation, and the Division of Administrative Hearings, and Office of Judges of Compensation Claims, handling numerous issues relating to rules promulgation, excess profits determination, and insurance company regulatory activities. Jim’s interests in and unparalleled dedication to the workers’ compensation industry are legion. He has served on numerous task forces, research institutes, and advisory boards; held office in workers’ compensation in the Florida Bar, the College of Workers’ Compensation; and is regularly recognized at the state and national levels for all his contribution to the education of professionals engaged in every aspect of workers’ compensation. Our very organization would not have come into being without Jim’s brainstorm one day while driving down a particularly boring stretch of I-10 in North Florida. After his trip, he called to ask if we would be interested in creating a judicial organization to bring together not only the Florida judges of compensation claims, but adjudicators from around the country to participate in educational opportunities already in place at the FWCI. Thanks to the dedication of Jim, his colleagues, and other like-minded lawyers, we now are able to offer the best judicial college in the country for the education and training of workers’ compensation adjudicators.
Spotlight on Associate Members:
James N. McConnaughhay,
R. Stephen Coonrod, Patrick W.
Weaver, and E. Louis Stern
By: Hon. Bob Cohen, NAWCJ Treasurer*
James McConnaughhay
Steve Coonrod
March 2017 NAWCJ - Lex and Verum Page 3
Continued, Page 4.
Spotlight, from Page 3.
Steve Coonrod is certified by The Florida Bar Board of Legal Specialization and Education as a specialist in workers' compensation law and focuses on workers' compensation defense, presumption/heart and lung bill claims, and litigation management. Steve is the managing partner of the firm’s Tallahassee office. He is another proud graduate of the FSU College of Law. Steve is listed by The Best Lawyers in America for Workers' Compensation and serves as Litigation Manager for the Florida Workers' Compensation Joint Underwriting Association. Steve has been given the rating of "AV Preeminent," the highest rating possible by his peers through Martindale-Hubbell. Steve's clients include a broad range of private and governmental entities. He has or continues to serve with distinction in leadership positions on numerous Florida Bar committees, the FWCI, the Defense Research Institute, the Northwest Florida Manufacturers Council, and has annually been selected as a Florida Super Lawyer from the inception of that recognition. Steve is the father of three daughters, which he believes rules out any possibility of early retirement or long-term financial stability. He finds relaxation fishing on the Gulf of Mexico and attending FSU football games. Pat Weaver has defended businesses regarding their workers’ compensation claims for more than 20 years. Pat is a graduate of the University of Georgia and the South Texas College of Law. Working from and managing the firm’s Panama City office, which means he is never more than a stone’s throw from the beautiful white sand beaches of the Florida Panhandle and the famed Panama City Beach Spring Break, Pat conducts workers’ compensation and employment “audits” to assist employers in how to reduce such claims. His clients include businesses in a wide variety of industries, including insurance, healthcare, banking, employee leasing, construction, paper, grocery, and hotel/restaurant. Pat is a regular speaker on workers’ compensation and employment law topics at local and state seminars. Locally, he is involved with the Bay County Chamber of Commerce. Lou Stern devotes his legal practice to defending and advising employers, carriers, and their servicing agents in the area of workers’ compensation and employment law. He is another proud graduate of the FSU College of Law and followed me by a few years in law school which gives us the opportunity to reminisce about many of our favorite old professors. Lou’s clients include governmental bodies, construction and general contractor self-insureds, national insurance companies, statewide servicing agents, and large national to small local employers. Prior to joining the firm, Lou was an Assistant State Attorney for the 19th Judicial Circuit on Florida’s East Coast. He is approved by the Florida department of Financial Services as an instructor in the field of workers’ compensation and regularly speaks at local and state-wide seminars on workers’ compensation-related topics. Lou frequently appears in court and between his former years as a prosecutor and his workers’ compensation experience, his courtroom experience can be described as “prolific.” He has been rated by his peers as “AV Preeminent,” the highest rating in Martindale-Hubbell, and has been named a Top Lawyer in Sarasota and Manatee Counties by Sarasota Magazine. Lou is active in the Florida Defense Lawyers Association, the Sarasota County Bar Association, and the ABA’s Labor and Employment and Law Practice Management Sections. He has written several excellent articles in the area of workers’ compensation, including how to win your cases without going to trial. We are proud to have these distinguished members of the McConnaughhay firm support NAWCJ through their financial commitment, but, more importantly, through their commitment to the education of workers’ compensation adjudicators. I hope you will attend the 2017 edition of the NAWCJ Judicial College where you will have the opportunity to thank Jim, Steve, Pat, and Lou, as well as our other associate members, in person at our annual judicial reception.
__________
* Bob Cohen is the Director of the Florida Division of Administrative Hearings. His full bio is on page 44.
Pat Weaver
Lou Stern
March 2017 NAWCJ - Lex and Verum Page 4
A worker who claims to have shoulder pain from years of pulling on grapevines or sorting laundry on hangers
may have an occupational disease. On the other hand, if the job is limited to teaching or computer keyboarding,
shoulder pain is unlikely to be work related. However, most cases are not so clear-cut and require detailed,
thoughtful, and time-consuming causation analysis. Traditionally physicians have approached this in a cursory
manner, e.g., reporting, “In my opinion, the work activities caused (or did not cause) the patient’s shoulder
pain.” However, in the age of evidence-based medicine, with a progressively greater volume and better quality
of data available in the medical literature regarding causation of conditions, this is no longer appropriate.
An established method using 6 steps is outlined in the American College of Occupational and Environmental
Medicine Guidelines,1 and on page 116 in the AMA Guides to the Evaluation of Disease and Injury Causation
(2nd ed).2 These steps are as follows:
1. Evidence of disease: What is the disease? Is the diagnosis correct? Does the evidence support or
fail to support the diagnosis?
2. Epidemiological data: What is the epidemiological
evidence for the disease or condition? Does quality data
support a relationship with work? To what extent is the
condition idiopathic?
3. Evidence of exposure: What evidence, predominately
objective, is there that the level of occupational and
environmental exposure could cause the disease?
4. Other relevant factors: What other relevant factors are
present in this case? Are there individual risk factors
other than the occupational and environmental exposure
that could contribute to the development of the disease?
5. Validity of evidence: Are there confounding or con-
flicting data to suggest that information obtained in the
assessment is inaccurate? Are other opinions in the case
inaccurate?
6. Evaluation and conclusions: Do the data obtained in the
preceding assessment support the presence of work-
related disease?
Causation analysis must be based on science and other sources of
facts, rather than on unsubstantiated claims.3 Examinee history
may be unreliable, and therefore causation evaluations are
vulnerable to being influenced by the examinee’s self-reported
history.4 Studies have demonstrated that in addition to
exaggerating preexisting health status, claimants tend to minimize
their current health status, i.e., they tend to report they were better
than they were prior to an injury and then, after the injury, over-report symptoms and functional difficulties.
Shoulder Pain at Work:
Causation Analysis
By: Joel Weddington, MD, Charles N. Brooks, MD,
Mark Melhorn, MD, and Christopher R. Brigham, MD
March 2017 NAWCJ - Lex and Verum Page 5
Continued, Page 6.
Shoulder Pain, from Page 5.
Strength of evidence levels for causation are very strong, strong, some, low risk,
insufficient, conflicted, and no evidence. Risk factors for shoulder tendonopathy,
impingement, and rotator cuff tears, as presented in AMA Guides to the Evaluation
of Disease and Injury Causation (GEDIC; page 320) are provided in Table 1.
Thresholds for causation vary by state and are based on specific statutes or case
law. For example, California requires a physician’s opinion to be based on a
reasonable degree of medical probability in order for it to constitute substantial
evidence of medical causation in workers’ compensation cases.5 In that state there
are the following 2 types of legal causation: causation of injury that deals with
whether the injury arose out of employment and occurred in the course of
employment (AOE/COE), which triggers the right to medical treatment if the cause
is industrial, and causation of disability that deals with a determination of accurate
permanent disability and apportionment between industrial and nonindustrial factors.5 In some jurisdictions, an
injury is work related if employment was a contributing or precipitating factor, whereas in other states, it must
be a major contributing factor. Therefore, it is important to understand the standards of the specific jurisdiction.
The following 3 cases illustrate evidence-based causation analysis.
Case 1: Shoulder Pain While Keyboarding
A 58-year-old male systems analyst (a sedentary job that requires continuous computer use) had worked for
his present employer for 2 years and done similar work for 25 years. In 2015 he developed right worse than left
forearm and elbow pain that he attributed to keyboarding and use of a mouse at work. The patient was referred
for orthopedic evaluation when the pain persisted for longer than 3 months. Physical therapy to emphasize
strengthening was prescribed. On follow-up, his elbow and forearm pain was relieved. However, he then
reported evolving bilateral shoulder pain that he ascribed to keyboarding and working in a stressful environment
at a standard computer workstation that he perceived to be non-ergonomic. His shoulder pain was positional,
noted particularly with overhead activities, and worse at the end of the day. He denied
weakness or numbness. Past history was positive for pain in the shoulders, arms, and
wrists in 1998 and 2009, which he also attributed to use of a keyboard and mouse.
The medical records labeled his problem as “repetitive strain illness” (International
Classification of Diseases, Ninth Revision, Clinical Modification, 729.99, which
translates to International Classification of Diseases, Tenth Revision, Clinical
Modification, M79.89) without providing a specific diagnosis for his shoulders. He
was also diagnosed with forearm extensor tendonitis. The pain improved with non-
operative treatment, and there was no permanent disability. There was a history of
knee surgery but no history of any other injuries, medical illnesses, or metabolic
conditions.
Physical examination was normal apart from slightly protracted (slumped)
shoulders, positive impingement tests on right worse than left, and mild weakness of
shoulder flexion bilaterally.
Medical and physical therapy records since 2015 revealed complaints, findings, diagnoses, and treatment
regarding the elbows and forearms but no reference to the shoulders. No diagnostic tests were available or felt
to be necessary. The patient was diagnosed with bilateral forearm extensor tendonopathy, now improved, and
bilateral impingement syndrome of the shoulders. The extensor tendonopathy was deemed related to occupa-
tional activities, and the patient was discharged as cured. However, the impingement syndrome was determined
to be non-occupational.
Joel Weddington, MD
Charles Brooks, MD
March 2017 NAWCJ - Lex and Verum Page 6
Continued, Page 7.
Shoulder Pain, from Page 6.
The patient became angry when told that his shoulder pain was nonindustrial; he pointed out that in previous
years, his shoulders had been treated as work related. He was informed that this is a difficult determination but,
based on recent and carefully weighed medical evidence that was not available in earlier years, working at a
computer is not hazardous for his shoulders. The patient was advised to seek further evaluation and treatment on
a nonindustrial basis.
Causation analyses for shoulder pain and computer use
Based on the 6 steps outlined earlier, the following are noted:
1. Evidence of disease: Impingement syndrome is diagnosed based on physical findings.
2. Epidemiological data: No epidemiological evidence indicates keyboarding causes or contributes
to shoulder problems.
3. Evidence of exposure: There is no objective evidence that the computer workstation in this case
caused shoulder injury or illness.
4. Other relevant factors: Age alone is a sufficient factor in this case to explain shoulder pain and
impingement. Posture may be contributory.6
5. Validity of evidence: The past history of shoulder pain at work is noted but insufficient to
establish that the current shoulder pain was caused by the job.
6. Evaluation and conclusions: Data in the preceding assessment do not support the presence of an
occupational disease. The age of 58 is sufficient to explain the shoulder pain and findings.
Working at a desk or computer does not rise to the threshold of causing or contributing to
shoulder injury.
Case 2: Aggravation of Rotator Cuff Tear at Work
A 61-year-old right-handed female who has worked as a neonatal intensive care unit nurse since 1981
reported “increasingly sore right shoulder, elbow, forearm and wrist, unable to move shoulder back to put coat
on or hold any heavy objects above shoulder height for long periods of time” in
August 2013. The pain began gradually in January 2013, progressively worsened,
and was reported when it began to interfere with her work. Ergonomic evaluation,
physical therapy, and acupuncture provided minimal relief. Further treatment was
denied by the workers’ compensation carrier. She was nevertheless able to continue
to work due to the low physical demands of her job, specifically the light weight of
neonates. She was referred to an orthopedic surgeon for an AOE/COE evaluation by
her occupational medicine provider, who noted that her upper extremity, primarily
shoulder pain, was nonindustrial.
At the orthopedic evaluation, she believed that a workstation was causing the
shoulder pain because an electronic medical record system implemented the previ-
ous year meant she had to alternately write into a medical record on a tray at chest
level, then reach down to type at a lower-level keyboard several times per hour
throughout her 12-hour shift. Asked to demonstrate, she elevated her arm to 75 degrees of flexion and 90
degrees of internal rotation to rest the forearm on the tray. This posture was sustained for several seconds while
writing.
Medical history was remarkable for hypertension and osteoporosis, plus surgeries for a right elbow fracture in
2012 and a left wrist fracture in 2013. However, she denied previous shoulder pain or injury. Physical
examination was normal apart from a body mass index (BMI) of 25.8; forward head posture; tenderness of right
anterior shoulder; left/right shoulder motions of abduction 155/110, flexion 165/155, internal rotation 90/70;
pain and restricted movement with impingement; apprehension tests that felt consistent with adhesive capsulitis;
and mild weakness of right shoulder flexion.
Mark Melhorn, MD
March 2017 NAWCJ - Lex and Verum Page 7
Continued, Page 8.
Shoulder Pain, from Page 7.
A June 2014 magnetic resonance imaging (MRI) scan of her right shoulder revealed probable full-thickness tears of anterior supraspinatus and infraspinatus, subscapularis tendonopathy, a near complete tear of the biceps tendon, superior labrum and biceps anchor torn off the glenoid (type II SLAP tear), and a severe lateral down-sloping type II (curved) acromion. Diagnoses were rotator cuff tears and tendonopathy, subacromial impingement, and frozen right shoulder. Based on the analysis described below, the shoulder symptoms and need for treatment were determined to be work related. Permanent modification of the workstation was recommended. As a result of this case, the employer removed all such raised writing platforms. Further treatment, including surgery, was covered by the workers’ compensation carrier. However, at maximum medical improvement (MMI), any residual impairment or disability will be apportioned to nonindustrial factors.
Causation analysis for aggravation of a rotator cuff tear The occupational medicine physician concluded that the shoulder pain was from non-occupational rotator cuff tears because, at age 61, the patient was in a high-risk age group for rotator cuff pathology and because working with neonates and at a computer workstation would not be expected to cause or contribute to shoulder problems.
Using the 6-step causation protocol described above, causation analysis requires consideration of both occu-pational and non-occupational risk factors. Regarding non-occupational risk factors for rotator cuff tears, there is very strong evidence for the age of 61, strong evidence for obesity (but the nurse is only marginally overweight with a BMI of 25.8), and low risk evidence for the down-sloping type II acromion. This is supported by multiple clinical studies reviewed and assigned strength-of-evidence levels in the GEDIC (Table 9-31, References and Comments for Shoulder Tendonopathy, Impingement, and Rotator Cuff Tears, pages 320–330). Of individuals aged >60 years, 28% had a full-thickness rotator tear and 26% a partial-thickness tear. In the 40- to 60-year-old age group, 24% had partial-thickness and 4% a full-thickness tears (page 323). One study reported that in asymptomatic people aged >60 years, more than 50% had at least partial-thickness tears and more than 25% had full-thickness tears.
7 Full and partial thickness tears are
more common with a type II or III (hooked) acromion (page 326). Adhesive capsulitis may coexist, but there is insufficient evidence that it causes or contributes to rotator cuff tendonopathy (page 326). Regarding occupational factors, the patient was not exposed to forceful or overhead work and lifting, and there was no history of shoulder trauma at work or elsewhere. However, the new electronic medical record system introduced an occupational risk factor that had been overlooked. While there is insufficient evidence to conclude the requirement to repetitively reach (in this case to write) at chest level causes shoulder pain, there is strong evidence that awkward and sustained shoulder postures with more than 60 degrees of flexion or abduction contribute to rotator cuff pathology (pages 320, 322). One study found that shoulder flexion, horizontal abduction, and internal rotation at 90 degrees showed higher vertical displacement and peak strain of the coracoacromial ligament, causing subacromial impingement, and recommended that patients with impingement syndrome or rotator cuff pathology avoid these shoulder motions.
8 Absent the
repetitive charting on an elevated tray and given studies that show a high incidence of asymptomatic rotator cuff tears in this age group, the patient might have remained asymptomatic indefinitely were it not for her occupational activities.
Comment on case examples In the above cases, the application of recent evidence-based medicine to determine causation in common shoulder conditions is straightforward. In the following example, causation was determined to be non-work related after the patient had undergone 2 shoulder surgeries under an accepted workers’ compensation claim. To illustrate the complexity of causation analysis in such a case, a lengthy summary of the evidence is included to demonstrate how the numerous occupational and non-occupational factors were assessed.
Christopher Brigham, MD
March 2017 NAWCJ - Lex and Verum Page 8
Continued, Page 9.
Shoulder Pain, from Page 8.
Case 3: Trivial Injury With Comorbidities and Previous
Trauma
Background: This was an orthopedic medicolegal evaluation to
address eligibility for disability retirement benefits under the
employer’s trust fund. At the time of the evaluation, the case had
been accepted by the state division of workers’ compensation,
and permanent disability benefits had been provided.
In October 2013, a 45-year-old female sheriff reportedly arrived
at work, reached across her chest to put on her bullet-proof vest,
and felt a tearing sensation in her right shoulder. She attached the
strap but was unable to tighten it because of pain, so used her left
hand to do so. The incident was reported in December, 2 months
later. The pain did not improve with non-operative treatment or
modified duty, and in January 2014 she underwent arthroscopic
subacromial decompression and reattachment of a torn rotator
cuff tendon. In May 2014, after a physical therapy session, she
attempted to blow-dry her hair and felt a tear in her right biceps.
A new MRI scan showed further partial thickness tears in the
supraspinatus and infraspinatus, and she underwent a second
shoulder surgery with tendon repairs in September 2014. She
improved somewhat but was still unable to return to work. The
patient was found to be permanent and stationary in February
2015 as a result of the vest incident and was receiving state
workers’ compensation benefits.
Her job as a sheriff, which began in 2006, required infrequent
use of force to apprehend suspects, routine handling of a firearm,
and carrying gear bags. She had not worked since her first
shoulder surgery in January 2014.
Regarding avocational limitations, she reported inability to push
a vacuum, dust in high places, hold a hair dryer for an extended
period of time, and sleep on the affected side. Pain Disability
Questionnaire scores were 16/90 for the functional status
component and 26/60 for the psychosocial component. Further
questioning revealed depression that was causing her to stay at
home during depression flare-ups and anger issues with her
children and husband. Her QuickDASH score was 30%,
indicating an overall slight impact on activities because of right
shoulder pain.
Physical examination was normal apart from a BMI of 32
(obese); multiple surgical scars on her right shoulder; shoulder
flexion of 140 degrees, abduction of 70 degrees, and internal
rotation of 40 degrees; a firm endpoint on passive shoulder
motions consistent with adhesive capsulitis; pain and guarding on
Hawkins’ impingement and apprehension tests; and mild
weakness of shoulder flexion. Grip strength averaged 99 pounds
on the right and 100 pounds on the left, approximately twice the
average for adult females. Her left shoulder exam was normal.
2016 NAWCJ Board of Directors
Hon. R. Karl Aumann, 2016-18 Maryland Workers’ Compensation
Commission
Hon. T. Scott Beck, 2016-18 South Carolina Workers’ Compensation
Commission
Hon. Melodie Belcher, 2016-18 Georgia State Board of Workers’
Compensation
Hon. LuAnn Haley, 2015-17 Industrial Commission of Arizona
Hon. Sheral Kellar, 2016-18 Louisiana Workforce Commission
Hon. David Langham, 2015-17 Florida Office of Judges of
Compensation Claims
Hon. John J. Lazzara, 2016-18
Past-President 2008-10 Florida Office of Judges of
Compensation Claims
Hon. Ellen Lorenzen, 2016-18
Past-President, 2010-12 Florida Office of Judges of
Compensation Claims
Hon. Deneise Turner Lott, 2015-17 Mississippi Workers’ Compensation
Commission
Hon. Frank McKay 2015-17 Georgia State Board of Workers’
Compensation
Hon. Kenneth Switzer 2015-17 Tennessee Court of Compensation
Claims
Hon. David Torrey 2015-17
Past-President 2012-14
Pennsylvania Department of Labor
and Industry
Hon. Jane Rice Williams, 2015-17 Kentucky Department of Workers’
Claims
March 2017 NAWCJ - Lex and Verum Page 9
Continued, Page 10.
Shoulder Pain, from Page 9.
Past medical history was remarkable, including a right shoulder dislocation and rotator cuff injury in 1988 that
resulted in surgery, with placement of a single titanium screw in the proximal humerus in 1989. Records from
the time of that injury were unavailable, making determination of what procedure was performed difficult. More
recent records described removal of a single titanium screw from the proximal humerus without more specific
detail.
In October 2009, her right wrist was injured while pushing and pulling a heavy suspect. A triangular
fibrocartilage complex (TFCC) tear was diagnosed followed by surgery in November 2009. Continued
symptoms prompted a second wrist surgery in November 2010.
Right shoulder symptoms were first noted in December 2009 and diagnosed as a “sprain,” while she was off
work recovering from the wrist injury and surgery, and were related to the wrist injury in October. Records
through 2010 described impingement, and a consultant reported that the October 2009 occupational injury
caused a flare-up of the “previously resolved” 1988 injury. Reports by 2 providers in 2010 reported flare-ups of
the shoulder associated with “awkward use of the wrist,” with pain and guarding on abduction. A corticosteroid
shot was helpful. After further rehabilitation, her wrist improved and she returned to full duty in June 2011.
The shoulder pain returned without any specific precipitant, and in February 2013 the primary treating
physician (PTP) reported that it was a consequence of the October 2009 occupational injury and therefore
compensable. Referring to the 1988 trauma, he stated that “there was no residual disability with respect to the
right shoulder.” An MRI scan showed severe tendonopathy and a partial-thickness tear of supraspinatus,
infraspinatus, and subscapularis tendinopathy; marginal osteophytes at the acromioclavicular joint; and a large
cyst in the greater tuberosity. In March 2013, he stated that “the patient injured her wrist and apparently injured
her right shoulder at that time” [2009].
An orthopedic consultant noted that images showed a hooked (type III) acromion. Repeat orthopedic consul-
tation in August 2013 documented increased pain that resulted in another injection and revealed that the patient
was strongly considering surgery. A November 2013 report by the PTP noted that the patient wished to proceed
with surgery. Soon after this report was file, an employer’s injury report and a workers’ compensation claim
form were filed describing “cumulative injury right extremity/shoulder.”
The October vest incident first appeared in a December 2013 PTP report and was described as follows:
“Putting on my vest, I reached across in front of me to tighten the Velcro strap and felt a tearing sensation.” A
few days later, an additional employer’s injury report was filed stating “tear to right shoulder rotator while
getting dressed for my shift.” She continued to work full duty after this event, including donning her vest daily.
The operative report in January 2014 described a rotator cuff tear with “a lot of unhealthy rotator cuff tissue”
and a “surprisingly arthritic [acromioclavicular joint] with complete cartilage loss and spur.” In her April 2014
disability retirement application, she claimed causation of her disability from the October 2009 injury and wrote
“ended up with a torn tendon in my right shoulder along with a second injury, which occurred on 10/1/13.” She
remained off work and under treatment, and the surgeon noted that she experienced increased pain while doing
some mild lifting in May 2014. The PTP noted that she felt a tear in her right shoulder after reaching to put
deodorant on. Another record noted that this occurred when she attempted to blow-dry her hair after a physical
therapy session. A new MRI scan showed s/p supraspinatus reattachment with a full-thickness tear in the mid
tendon without retraction or atrophy and additional areas of tendonopathy with partial-thickness tearing, along
with postoperative changes. A September 2014 operative report noted that the articular cartilage of the humeral
head had grade III/IV arthrosis (presumably chondromalacia) with several areas of exposed bone. Degenerative
tearing of the labrum was debrided, a tear in the supraspinatus tendon was repaired, and a biceps tenodesis was
performed. Subsequent reports by the PTP noted that pain continued, and the surgeon noted that the
reconstruction was tenuous and that the next step would be a shoulder replacement. The patient decided to put
off further workup or surgery. She was found to be at maximal medical recovery in March 2015 with permanent
restrictions from the PTP that precluded her usual job duties.
March 2017 NAWCJ - Lex and Verum Page 10
Continued, Page 11.
Shoulder Pain, from Page 10.
Diagnoses: Right wrist injury in 2009 and surgery ×2. Right shoulder
surgery ×2 in 2014. Frozen right shoulder (adhesive capsulitis v, pain
and guarding). Right shoulder dislocation 1988, and shoulder surgery
1989 (stabilization procedure v. rotator cuff repair).
Causation analysis for a trivial shoulder injury with multiple other
factors
This case addresses causation in a complex medicolegal scenario. Use
of the 6-step causation analysis methodology results in a conclusion
contrary to previous opinions on causation. The steps are as follows:
1. Evidence of disease: Rotator cuff tears, degenerative and/or
post-traumatic arthrosis, and additional shoulder pathology
are well documented.
2. Epidemiological data: No epidemiology was found to support
that her job duties in general caused or contributed to
shoulder problems.
3. Evidence of exposure: The mechanism of injury did not
involve force, resistance, weight, blunt trauma, fall, or other
mechanism to cause a violent contraction, tear, or injury to
the rotator cuff and did not result in the need for immediate
treatment or work disability. It is consistent with daily activi-
ties that might be performed while opening doors, cooking,
cleaning, bathing, shopping, or getting dressed. Some of these
activities would be expected to require more force than
putting on a vest (eg, preparing food) or more motion (eg,
putting on a seat belt). The fact that the vest incident was not
reported for 2 months supports that it was trivial. The
subsequent incident in May 2014 that resulted in another
surgery was also trivial and occurred while off work,
supporting that the shoulder pathology was vulnerable to
activities of daily living and the natural progression of long-
standing preexisting pathology. Medical reports that
retroactively claim the 2009 occupational injury involved
shoulder trauma fail temporality do not explain the 2-month
delay in symptom onset and overlook the pain-free period
between 2011 and 2013. Reports that describe compensatory
right shoulder injury from the right wrist trauma are
implausible because she was off work with reduced functional
demands following the ipsilateral TFCC tear.
4. Other relevant factors: Nonoccupational risk factors for the
shoulder tendonopathy and rotator cuff tears include age, with
very strong strength of evidence per GEDIC (page 323).
There is strong evidence for obesity (page 324). Frozen
shoulder and immobility may adversely affect symptoms and
disability in rotator cuff tears and impingement (page 326).
Virginia Workers’
Compensation
Commission
Appoints
Linda Gillen as
Deputy
Commissioner
The Virginia Workers’
Compensation Commission
appointed Linda M. Gillen as
Deputy Commissioner. Deputy
Commissioner Gillen will serve as
an administrative law judge for
evidentiary and on-the record
hearings under the Virginia
Workers’ Compensation Act. She
will hold hearing dockets in
Richmond.
Ms. Gillen was appointed to
serve as Deputy Commissioner on
January 10, 2017. She is a graduate
of Marietta College and the
University of Pittsburgh School of
Law. Prior to joining the
Commission, Ms. Gillen spent over
23 years representing employers
and insurance carriers in Virginia,
Pennsylvania and Illinois, both in
private practice and as in-house
counsel. .
March 2017 NAWCJ - Lex and Verum Page 11
Continued, Page 12.
Shoulder Pain, from Page 11.
There is low risk evidence for the type III acromion (page 326). The previous traumatic dislocation
and rotator cuff repair in 1988–1989 are relevant factors in causation analysis. Following anterior
shoulder dislocation, a significant proportion of patients will require eventual surgery, and up to one
third of these patients will go on to develop long-term shoulder arthritis.9 Even patients who have
experienced a single episode of dislocation may go on to develop long-term sequelae. The multiple
areas of arthrosis/arthritis in the shoulder are far more likely due to the dislocation than work
exposure or trivial events such as the vest incident.
5. Validity of evidence: Several problems with the testimony are noted in the patient’s history and
medical records. Documents in November 2013, a month following the vest incident, describe cumu-
lative trauma to the right shoulder. The October vest incident is not noted until December. Multiple
work-related mechanisms were proposed for the right shoulder, but there was no attempt by provid-
ers to explain the severe degenerative changes seen on MRI scan and at surgery. Reports that
describe 3 versions of the incident in May 2014 bring into question the validity of reporting in
general. The patient did not recall, or provided a poor history of, events prior to the vest incident, but
records indicate significant preexisting pain.
6. Evaluation and conclusions: The extensive medical evidence available in this case indicates that the
2009 work injury, the October 2013 vest incident, and occupational activities as a sheriff between
2006 and 2014 were not contributory to or causative of the patient’s right shoulder pathology or the
disability resulting therefrom. More probable causes are residuals of the right shoulder dislocation
and rotator cuff injury in 1988 and, to a lesser extent, age, obesity, and the hooked acromion.
Other Shoulder Conditions and Work Relatedness
Rotator cuff tendonopathy and impingement syndrome are common and, as indicated, may or may be work
related. Less common conditions include adhesive capsulitis (frozen shoulder), labral tears, thoracic outlet
syndrome (brachial plexopathy), and arthritis and are generally not work related but need to be evaluated on a
case-by-case basis. Enigmatic conditions such as myofascial pain syndrome and fibromyalgia commonly
involve the shoulder girdle but not the shoulder joint per se and are usually nonoccupational. Psychosocial
factors are often present in shoulder pain and can strongly influence the outcome of shoulder injury or illness.
1. Adhesive capsulitis (GEDIC, page 684–685) is a condition of unknown cause characterized by
significant limitation of active and passive shoulder motions in the absence of a known shoulder disor-
der. Nevertheless, patients often try to remember an incident that caused it and may attribute it to
work. However, there is no epidemiological evidence that occupational activities cause adhesive
capsulitis. Immobilization following a shoulder injury or surgery, which may or may not be work
related, often cause shoulder stiffness, but this is not adhesive capsulitis.
2. Thoracic outlet syndrome (TOS), also known as brachial plexopathy (GEDIC, page 462), may be
caused by prolonged carrying of heavy shoulder loads, pulling the shoulder girdles back and down, or
repetitive reaching above shoulder level. However, most jobs do not involve such activities. Weak
shoulder muscles, sloped shoulders, and poor posture may also predispose to TOS.
3. Repetitive strain illness: Keyboard operators, drivers, line workers, and others may complain of pain in
the superior shoulder girdles including trapezii, perhaps due to muscular fatigue. Typically, the only
physical finding is muscular tenderness. This can be treated as an occupational muscle strain and
usually resolves with physical therapy, including strengthening exercises. Failure to improve suggests
nonindustrial psychosocial factors, perhaps anxiety manifested in tension myalgia, undiagnosed
cervical or shoulder pathology, or comorbidities such as endocrinopathies or obesity.
4. Labral tears and arthritis are usually due to age-related degeneration and incidental findings on an MRI
scan obtained for another reason. However, in some cases, occupational injuries or illnesses can aggra-
vate or even cause these conditions. Consequently, methodical causation analysis is still required.
March 2017 NAWCJ - Lex and Verum Page 12
Continued, Page 13.
Shoulder Pain, from Page 12.
Conclusion
Recent medical literature and the summaries and analysis
contained in AMA Guides to the Evaluation of Disease and
Injury Causation provide strong evidence-based medicinal
information that can be used to determine the multiple factors
that cause shoulder pain and the relative importance thereof.
This, in turn, makes it possible to form well-founded opinions on
whether a given condition is work related, non-occupational, or
some combination thereof. Causal conclusions should be
rational, consistent with facts of the individual case and medical
literature, and cite pertinent references therefrom. The opinion
should be stated to a reasonable degree of medical probability,
on a more-probable-than-not basis, with a reasonable degree of
medical certainty or using whatever phrase meets the legal
threshold in the applicable jurisdiction. When shoulder pain
truly is work related, identification of the occupational cause(s)
not only allows the injured or ill worker to receive appropriate
benefits but also makes it possible to modify the job to create a
safer work environment.
__________
References 1. Occupational Medicine Practice Guidelines: Evaluation and Management
of Common Health Problems and Functional Recovery in Workers, 2nd
ed., Chapter 4, “Work Relatedness.” OEM Press: Beverly, MA; 1997.
2. Melhorn, JM, Talmadge JB, Ackerman WE, Hyman, MH. AMA Guides to
the Evaluation of Disease and Injury Causation, 2nd ed. American
Medical Association: Chicago 2014.
3. Barth RJ. Determining injury-relatedness, work-relatedness, and claim-
relatedness. Guides Newsletter. May-June 2012, 1.
4. Barth RJ. Examinee-reported history is not a credible basis for clinical or
administrative decision making. Guides Newsletter. September-October
2009.
5. https://www.lexisnexis.com/legalnewsroom/workers-compensation/b/
causation-aoe-coe-issues/archive/2012/08/02/california-causation-of-
injury-v-causation-of-disability.aspx
6. Shoulder muscle imbalance and subacromial impingement syndrome in
overhead athletes. Int J Sports Phys Ther. 2011 Mar; 6(1):51–58.
7. Yamaguchi K, Ditsios K, Middleton W, Hildebolt C, Galatz, L. The
demographic and morphological features of rotator cuff disease: a com-
parison of asymptomatic and symptomatic shoulders. Bone Joint Surg Am.
2006;88(8):1699-1704.
8. Park I, Lee HJ, Kim SE, Bae SH, Byun CH, Kim YS. Which shoulder
motions cause subacromial impingement? Evaluating the vertical dis-
placement and peak strain of the coracoacromial ligament by ultrasound
speckle tracking imaging. J Shoulder Elbow Surg. 2105;24(11):1801-
1808.
9. Cutts S, Prempeh M, Drew S. Anterior shoulder dislocation. Ann R Coll
Surg Engl. 2009;91(1):2–7.
_________
The foregoing was originally published in the January/February 2017
AMA Guides Newsletter and is reprinted here with permission.
Thanks to our 2016
NAWCJ
Judiciary College
Sponsors:
Torrey-Greenberg Pennsylvania Workers’ Compensation treatise,
as published by Thomson-Reuters.
March 2017 NAWCJ - Lex and Verum Page 13
NAWCJ SCHOLARSHIP
OFFER 2017
The National Association of Workers’ Compensation Judiciary is offering scholarship opportunities to
adjudicators attending the 2017 Judicial College in Orlando, Florida, August 6-9, 2017!
First-time scholarships may be awarded to any currently presiding workers’ compensation adjudicator, who is
also a member of NAWCJ and may include a maximum of $300 for hotel accommodations, waiver of the
conference registration fee and a maximum of $500 for travel expenses. Second-time awards will be for a 50%
reduction in conference registration fee. No scholarship funds are available for meals but two lunches and two
receptions with heavy appetizers are included in the registration. The evaluation of scholarship applications will
include whether the applicant is eligible for funding from the employing agency and preference will be given to
first time college attendees who are interested in becoming more actively involved in NAWCJ.
The scholarship program is funded by a grant from the Workers’ Compensation Institute as well as annual
dues from associate members of NAWCJ (attorneys and other individuals/companies interested in supporting
the education of members of the workers’ compensation judiciary).
Each interested adjudicator must e-mail a completed scholarship application to
[email protected] by May 15, 2017. Scholarship awards will be announced by June 30, 2017 and
successful applicants will be asked to make travel arrangements soon after to help minimize airfares.
College attendees will have an opportunity to meet members of the workers’ compensation judiciary from
around the country, as well as practitioners and industry leaders. The judicial college is an excellent opportunity
to receive continuing education credit in a variety of areas including order writing, evidence, medical issues and
other matters that routinely come before workers’ compensation adjudicators.
I encourage you to apply for a scholarship to the 2017 judicial conference and look forward to meeting you
when the college convenes in August.
Sincerely,
The Honorable Jennifer Hopens, President
March 2017 NAWCJ - Lex and Verum Page 14
Application for Scholarship
NAWCJ College, August 6-9, 2017
Name:
_________________________________________________________________________________________ Address:
_________________________________________________________________________________________ E-mail:
_________________________________________________________________________________________
Phone #: ____________________________________ Fax#:_______________________________
Agency Name and Address:
___________________________________________________________________________________________________________
______________________________________________________________________________________________________
NAWCJ member since ____________ (year)
Have you ever attended a NAWCJ Judicial College or WCI Annual Meeting and Conference?
___YES ___NO
If so, what year(s)? _______________ Did you receive a scholarship? __________
Have you participated on a NAWCJ panel or committee in the past or would you be willing to do so in the future? ___YES ___NO
Explain how you would like to participate in the NAWCJ:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Will you receive any support from your employer to attend the college? (leave time, payment of expenses beyond registration waiver
and partial reimbursement of travel expenses): ___YES___NO If yes, explain support offered by employer:
_______________________________________________________________________________________________________
Please estimate your travel expenses for attending the college:
_______________________________________________________________________________________________________
Current adjudicatory position, dates held and description of duties:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Past experience in workers’ compensation law (may attach resume):
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
How will attending the 2017 NAWCJ Judicial College and FWCI Conference benefit you in the performance of your job:
_______________________________________________________________________________________________________
Would you be willing to write a brief article for the NAWCJ newsletter about the 2017 NAWCJ Judicial College and FWCI
Conference and its benefits? ___YES ___NO
March 2017 NAWCJ - Lex and Verum Page 15
Drugs prescribed and dispensed directly by physicians often cost substantially more to consumers, and by
extension any covering insurer, than drugs dispensed by pharmacies. Last April, I looked at a recent study (see
http://www.wcrinet.org/studies/public/books/pd_higher_priced_drugs_book.html) that examined the effect of
state legislative and regulatory attempts to control these cost discrepancies through reforms that limited the
amounts that can be charged by physicians for repackaged drugs to the original manufacturer’s average
wholesale prices (AWP). That study found that drug companies and physician-dispensers have been taking
advantage of those reform efforts tied to AWP prices by creating new drug formularies with new dosage
amounts and new AWPs that are not limited in price by the reforms, thus allowing physician dispensers to
continue to charge consumers more, sometimes substantially more, for certain prescription drugs than would be
charged by a pharmacy.
In “Does the Practice of Physician Dispensing Lead to Overprescribing of Drugs?,” a paper published by the
Sedgwick Institute (see http://www.sedgwickinstitute.com/studies/), author Richard Victor, Ph.D., formerly of
the Workers’ Compensation Research Institute, further examines this problem of physician dispensing of drugs,
focusing more on the incentives to prescribe more drugs created by the profitability of physician-dispensing
generally and examining policy changes that could be taken to control this behavior, specifically in the context
of workers’ compensation claims.
The Effect of Financial Incentives
Noting the unquestioned financial rewards that can be had from physician dispensing, fueled by secondary
industries that develop and provide the business frameworks and supplies necessary for the practice at little or
no financial risk to the physicians, Victor outlines some of the evidence showing the negative impact the
practice can have on prescribing patterns. One study showed that a ban in Florida of physician dispensing of
stronger opioids did not lead to a noticeably higher rate of pharmacy dispensing of these opioids as might be
expected, but rather to an increase instead of physician dispensing of weaker pain medications that were not
subject to the ban, creating questions about the need for the stronger opioids being prescribed before the ban.
However, this is not the only evidence of the negative effects created by the financial incentives of physician
dispensing. For example, in Georgia, Illinois, and Florida, some drugs that were overwhelmingly being
prescribed by physician dispensers, including Prilosec and Zantac, were generally being billed by the physicians
at twice the amount per pill as when they were dispensed by a pharmacy and at 10 times or more per pill as
over-the-counter equivalents.
In addition, as mentioned above, a study released last Spring suggested that physician dispensers in states that
had implemented reforms that limited prices based on AWP were, in conjunction with pharmaceutical
companies, finding a way around those reforms by prescribing newer formularies with different dosages and
AWPs. However, these newer formularies were much more expensive than the cost-controlled older
formularies, even though the newer formularies were often weaker strength than the older ones, and physicians
who did not dispense rarely prescribed the new, more expensive formularies.
Uncovering the True Costs of Physician
Dispensing of Drugs
Do the hidden, and not so hidden, costs of physician
dispensing of drugs outweigh the benefits?
By: Roger Rabb, J.D.
March 2017 NAWCJ - Lex and Verum Page 16
Continued, Page 17.
Physician Dispensing, from Page 16.
Victor also points to evidence from other countries
where bans on prescription dispensing have recently
been implemented, specifically Taiwan and Korea,
that showed that the bans resulted in fewer
prescriptions being written. In Switzerland, where
physician dispensing is permitted only in areas with
fewer pharmacies, a study showed that physician
dispensers were substantially more likely to prescribe
generic drugs with higher profit margins than were
non-dispensing physicians.
All of this would seem to suggest that prescription
patterns of physician dispensers are being driven at
least to some extent by the physician’s desire to profit
from the drug sale. When physicians are allowed to
dispense the drugs they prescribe, the financial
incentives result in more prescriptions being written,
more prescriptions for higher-priced drugs, or both.
Does Physician Dispensing Benefit Injured
Workers?
In contrast to these negative impacts of physician
dispensing, Victor also examines some of the
arguments that have been offered in support in the
practice, specifically in the context of injured
workers, and finds the evidence generally does not
support the justifications. To counter the argument
that physician dispensing is convenient and improves
access to drug dispensing for injured workers, studies
call into question whether worker access is actually a
problem. For example, a California study found that
80 percent of injured workers had a pharmacy within
2 miles of their homes and 95 percent had one within
4 miles. Other studies examining rural areas in other
states also found that the vast majority of rural
residents had access to pharmacies within 20 miles.
Moreover, surveys indicate that the vast majority of
patients are generally unwilling to pay an extra
premium for the convenience of having prescriptions
filled by the doctor, despite the fact that they often
unknowingly do so.
Victor also challenges claims about the efficacy of
physician dispensing on patient welfare. One
California study found that workers who did not get
physician-dispensed drugs returned to work about 8%
faster than workers who did.
THE NATIONAL ASSOCIATION OF
WORKERS’ COMPENSATION
JUDICIARY
APPLICATION FOR ASSOCIATE
MEMBERSHIP
THE NAWCJ ASSOCIATE MEMBERSHIP YEAR IS 12 MONTHS
FROM YOUR APPLICATION MONTH. ASSOCIATE MEMBERSHIP
DUES ARE $250 PER YEAR.
NAME:________________________________________
DATE: ____/____/____
FIRM OR BUSINESS:
______________________________________________
______________________________________________
PROFESSIONAL ADDRESS:
______________________________________________
______________________________________________
PROFESSIONAL E-MAIL:
______________________________________________
ALTERNATE E-MAIL: ___________________________
PROFESSIONAL TELEPHONE: ____________________
FAX: _________________________________________
HOW DID YOU LEARN ABOUT NAWCJ?
______________________________________________
______________________________________________
______________________________________________
Mail your application and check to:
Kathy Shelton, P.O. Box 200, Tallahassee, FL 32302 850.425.8156; Email: [email protected]
March 2017 NAWCJ - Lex and Verum Page 17
Continued, Page 18.
Physician Dispensing, from Page 17.
An Illinois study found a similar result, with the period away
from work in workers’ compensation claims being greater for
workers who received physician-dispensed drugs within 90 days
of injury than for workers who did not receive physician-
dispensed drugs. Victor also notes that another argument, that
patients are more likely to comply with prescribed medications
when dispensed by the physician, is of little value in the injured
worker context where pain medications constitute the
overwhelming majority of prescriptions, as noncompliance with
pain medication prescriptions generally means that the pain is
manageable without the drugs.
In addition to the already-mentioned drawback that physician-
dispensed drugs usually cost more to the consumer, Victor also
notes one other benefit to pharmacy dispensing over physician
dispensing: pharmacists are much more likely to run software
checks for drug interactions that could be potentially harmful to
the patient and can also check pharmacy records to see if the
patient is receiving drugs from multiple physicians.
Policy Options
Given the way that financial incentives can negatively affect
prescription patterns and the lack of any real benefit for injured
workers of physician dispensing, what might be done to improve
the situation given the problems that have been found with
previous reform efforts based on AWP-linked price controls?
Victor identifies three potential options:
Banning physician dispensing altogether.
Restricting physician dispensing to a short period after
the first office visit.
Giving payers such as workers’ compensation insurers
the ability to direct patients to specific dispensaries,
whether that be a local pharmacy, a mail order pharmacy,
or a physician’s office.
However, he questions how effective the first two options
would be, noting that when bans were implemented in other
countries, physicians often responded by opening onsite
pharmacies in order to work around the ban. Moreover, he points
out that “not all physician dispensers prescribe unnecessary
medications or charge unnecessarily high prices,” although the
banning options would still negatively impact these practitioners
as well.
Virginia General
Assembly Appoints
Robert Rapaport
Commissioner of the
Virginia Workers’
Compensation
Commission
On January 18, 2017, the Virginia
General Assembly appointed Robert
Rapaport as Commissioner of the Virginia
Workers’ Compensation Commission
(VWC).
Commissioner Rapaport will join
Commissioners Wesley G. Marshall and
R. Ferrell Newman. The Commissioners
serve as appellate judges at the agency
and direct its operations and staff.
Commissioner Rapaport will begin his
judgeship at the VWC on February 16,
2017. He is a 1976 graduate of the
Virginia Polytechnic Institute and State
University and earned his Juris Doctor
degree in 1979 from the Marshall Wythe
School of Law at the College of William
and Mary.
His appointment as Commissioner
follows a 35-year practice of law with a
heavy concentration in workers’
compensation. He currently serves as
President of the Virginia Workers'
Compensation American Inns of Court
and was nominated as a Fellow of the
College of Workers’ Compensation
Lawyers in 2016.
March 2017 NAWCJ - Lex and Verum Page 18
Continued, Page 19.
Physician Dispensing, from Page 18.
As Victor notes, the final option permitting payer selection
of the dispenser might avoid these issues. Allowing the payer
to specify the dispenser would not eliminate physician
dispensing, but could effectively punish those physician
dispensers who overprescribe or prescribe at higher prices.
Payers are better positioned than patients to detect over time
which physicians might be engaging in this behavior and
would have the financial incentive and ability to direct patients
to other dispensaries, while at the same time allowing
physicians who do not abuse the system to continue
dispensing.
Implementing this option would require some effort in some
jurisdictions, however, as Victor counts 19 states that
currently prohibit payer direction to a specific pharmacy.
Conversely, both California and New York specifically
authorize the practice, and the practice could potentially be
implemented in other states as well. The benefits to injured
workers and payers could be worth it.
__________
* Born a Navy brat in Washington state, Roger also lived in
Florida and California before his family settled in Texas. After a
stint in the Marines after high school, Roger attended the
University of California at Berkeley, earning both a B.A. and
J.D. Roger currently resides in Eugene, OR, where he does legal
research and writing.
© Copyright 2017 LexisNexis. All rights reserved. This article
originally appeared in the LexisNexis Workers’ Compensation
eNewsletter, www.lexisnexis.com/wcnews.
Interesting
Workers’
Compensation
Blogs Law Professor’s Blog http://www.lawprofessorblogs.com/
Managed Care Matters http://www.joepaduda.com/
Tennessee Court of
Compensation Claims https://tncourtofwcclaims.wordpress.com/
Workers’ Compensation http://workers-compensation.blogspot.com/
From Bob’s Cluttered Desk http://www.workerscompensation.com/compnewsne
twork/from-bobs-cluttered-desk/
Workers’ Comp Insider http://www.workerscompinsider.com/
Maryland Workers’
Compensation Blog http://www.coseklaw.com/blog/
Wisconsin Workers’
Compensation Experts http://wisworkcompexperts.com/
Workers’ compensation http://workers-compensation.blogspot.com/
March 2017 NAWCJ - Lex and Verum Page 19
THE NATIONAL ASSOCIATION
OF WORKERS’ COMPENSATION JUDICIARY
APPLICATION FOR MEMBERSHIP
THE NAWCJ MEMBERSHIP YEAR IS 12 MONTHS FROM YOUR APPLICATION MONTH. MEMBERSHIP DUES ARE $75 PER YEAR OR
$195 FOR 3 YEARS. IF 5 OR MORE APPLICANTS FROM THE SAME ORGANIZATION, AGENCY OR TRIBUNAL JOIN AT THE SAME TIME, ANNUAL DUES ARE REDUCED TO $60 PER YEAR PER APPLICANT.
NAME: ____________________________________________________________________ DATE: ____/____/____
OFFICIAL TITLE: _________________________________________________________________________________
ORGANIZATION: _________________________________________________________________________________
PROFESSIONAL ADDRESS: ______________________________________________________________________
______________________________________________________________________
PROFESSIONAL E-MAIL: ______________________________________________________________________
ALTERNATE E-MAIL: ______________________________________________________________________
PROFESSIONAL TELEPHONE: ________________________________FAX:__________________________________
YEAR FIRST APPOINTED OR ELECTED: ______________________________________________________________
CURRENT TERM EXPIRES: _____________________________________________________________________
HOW DID YOU LEARN ABOUT NAWCJ: _____________________________________________________________
________________________________________________________________________________________________
DESCRIPTION OF JOB DUTIES / QUALIFICATIONS FOR MEMBERSHIP:
________________________________________________________________________________________________
________________________________________________________________________________________________
IN WHAT WAY WOULD YOU BE MOST INTERESTED IN SERVING THE NAWCJ:
________________________________________________________________________________________________
________________________________________________________________________________________________
Mail your application and check to: Kathy Shelton, P.O. Box 200, Tallahassee, FL 32302
850.425.8156; Email: [email protected]
March 2017 NAWCJ - Lex and Verum Page 20
Take deep breaths. Drink lots of water. Get some extra sleep.
This is the prescription I tend to apply, at least initially, to all complaints of illness
emanating from my three children. I find it's effective approximately 90% of the time.
For the 10% of the time it's not effective, we escalate to Mom, and occasionally from
there, we head to the doctor. Nothing special here, just basic triage for childhood
illness.
The problem I see is that adults often skip a step or two (or three) in this process.
And there's a lot of scientific data to support the reliance on these initial steps in the
management of chronic pain.
Take deep breaths
There's ample evidence to suggest that relaxation techniques and mindfulness
exercises can significantly influence chronic pain management. One study, among
dozens of high quality studies available (and hundreds more of lower quality), showed
a roughly 50% decrease in total pain rating index for half of the patients involved in
the study.
Granted, small sample — but really compelling results. Why did I pick this study to
highlight? It was published in April 1982. This isn't new, folks.
Drink lots of water
The link between dehydration and chronic pain is a little more recent, but still
compelling. A recent study from the journal Psychophysiology linked hypohydration
(not as severe as dehydration, but still not healthy — essentially, most of us are
walking around hypohydrated) with lower pain sensitivity thresholds. We also know
that the discs in the lower back require proper hydration for optimal functionality.
Getting enough water also effects our immune system response. We've been told
since we were kids to drink lots of water, it's just that none of us actually do that.
Get some sleep
Sleep hygiene is among the most overlooked elements of chronic pain management.
This topic is admittedly made complicated by the chicken and egg nature of problem -
to manage chronic pain, one needs to get more sleep, but sleep is often inhibited by
chronic pain symptoms.
This nasty cycle is often addressed by sleep aid medications that are not indicated
for long-term use (and, as we well know, that doesn't stop them from being used long
term). One way off of this hamster wheel is ensuring that relaxation and hydration are
incorporated into daily habits.
We're Skipping the Simple
Steps in Chronic Pain
Management By Michael Gavin*
March 2017 NAWCJ - Lex and Verum Page 21
Continued, Page 22.
Chronic Pain Management, from Page 21.
Along with mindfulness techniques, one must also incorporate a simple set of
sleep management tips that are hard for people to come to grips with: going to
bed and waking up at the same time every day, no television or other electronic
devices in the bedroom, no alcohol or caffeine assumption.
How many Americans, in chronic pain or not, can pull of that bedtime routine?
No, not all chronic pain can be managed by taking deep breaths, drinking lots
of water and getting plenty of sleep. Some chronic pain has to be escalated to the
care of medical professionals, and these patients deserve the best, evidence-
based care available.
But far too often, chronic pain is diagnosed and immediately treated with
surgery and/or medications without an attempt at patient self-regulation based on
simple principles of mindfulness, proper diet and good sleep hygiene — all three
of which, when missing, significantly contribute, even exacerbate, chronic pain.
Take deep breaths. Drinks lots of water. Get some sleep.
_________
* Michael is responsible for the strategic direction and management of PRIUM. He
leads PRIUM with deep experience in several major sectors of the health care
industry. Most recently, Michael was a consultant with Kurt Salmon Associates, a
leading provider of strategic advisory services to the healthcare provider sector. Prior
to KSA, he served as the Vice President of Operations for MDdatacor, Inc., a health
services start-up that provides innovative information technology solutions to support
pay-for-performance programs in the ambulatory care environment. Before joining
MDdatacor, Michael was a consultant with The Monitor Group in Cambridge, MA.
He holds an M.B.A. from Emory University's Goizueta Business School, as well as a
BSBA degree in Finance from Georgetown University's McDonough School of
Business.
NA
WC
J
Nati
on
al
Ass
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tion
of
Work
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Com
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sati
on
Ju
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March 2017 NAWCJ - Lex and Verum Page 22
Kentucky Labor Cabinet
Department of Workers' Claims
Announcement
Per 803 KAR 25:010 § 3(1)(b), effective July 1, 2017, the department of
workers’ claims will no longer accept paper filings.
To file a claim, registration with the Litigation Management System is
required. (LMS) https://kyworkersclaims.lms.ky.gov. Additional information
is available at http://labor.kentucky.gov/workersclaims. Department of
Workers' Claims is located at 657 Chamberlin Ave, Frankfort, KY 40601;
(502) 564-5550.l
Low-Back Pain Treatment Guideline
Steers Doctors Away From Opioids
By Elaine Goodman
February 15, 2017
A new low-back pain treatment guideline from the American College of Physicians is the latest medical
guideline to discourage the use of opioids, instead encouraging the use of such treatments as exercise,
acupuncture or biofeedback.
Low-back pain is a common complaint among injured workers as well as in the population at large. About one
quarter of U.S. adults reported having low-back pain lasting at one day or more in the past three months,
according to ACP, an organization whose members include 148,000 internal medicine physicians, related
subspecialists and medical students. For new cases of low-back pain, doctors should reassure patients that the
pain usually subsides over time regardless of treatment, according to ACP President Dr. Nitin Damle.
“Physicians should avoid prescribing unnecessary tests and costly and potentially harmful drugs, especially
narcotics, for these patients,” Damle said in a news release.
When low-back pain becomes chronic, defined as lasting longer than 12 weeks, ACP recommends that
patients start with non-drug therapy, which might include exercise, acupuncture, biofeedback, cognitive
behavioral therapy or spinal manipulation. “Physicians should select therapies that have the fewest harms and
costs, since there were no clear comparative advantages for most treatments compared to one another,” Damle
said. ACP developed its treatment guideline based on a systematic review of published research on low-back
pain treatments. The guideline applies to cases of non-radicular low-back pain, where pain is not radiating into
the patient’s leg.
The ACP guideline joins others that discourage opioid use for treatment of low-back pain. The Official
Disability Guidelines published by Work Loss Data Institute say that opioids are not recommended for cases of
low-back pain, except for short-term use of two weeks or less in severe cases. ODG is used as a workers’ comp
medical treatment guideline in several states, including Texas and Ohio.
Conservative treatments that get a thumbs-up from ODG for low-back pain include a short course of
acupuncture — up to 12 visits over six weeks, when functional improvement is seen. As little as 20 minutes of
aerobic exercise twice a week can be effective in managing low-back pain, according to ODG, which also
recommends treating low-back pain with yoga “for select, highly motivated patients.”
Colorado’s workers’ comp medical treatment guideline for low-back pain says opioids should be reserved for
the treatment of severe acute low-back pain. But the guideline says there may be situations where prolonged use
of opioids is justified, depending on the diagnosis and severity, in which case the reasons for using opioids
should be documented.
March 2017 NAWCJ - Lex and Verum Page 23
Continued, Page 24.
Low-Back Pain, from Page 23.
Although workers’ comp medical treatment guidelines urge caution on opioids,
most doctors treating injured workers also see patients who are covered by other
payers. The new ACP guideline will help get the message across about opioids, said
Mark Pew, senior vice president of Prium, a workers’ comp medical managed care
provider.
Pew agreed with the ACP guidelines’ strategy of first trying non-drug therapies for
treating chronic low-back pain, followed by non-opioid drugs if necessary — and
only then trying opioids if other options have failed. “In other words, opioids should
almost never be considered because one of the foregoing options will likely work,”
Pew said. And workers’ comp payers have become more open to approving the
alternative treatments, Pew said, such as yoga or cognitive behavioral therapy.
As physicians are increasingly discouraged from prescribing opioids, a concern is
that they’ll shift to using more procedures, invasive interventions and surgeries for
treating low-back pain, said Dr. Steven Feinberg of Feinberg Medical Group in Palo
Alto, California. The clinic provides evaluation and treatment of injured workers.
“We are a long way from doctors recognizing the importance of the
biopsychosocial model” for treating pain, Feinberg said.
The American Chronic Pain Association’s Resource Guide to Chronic Pain
Management, which Feinberg helped write, notes that there are many other methods
for pain relief besides drugs. Self-care techniques, which are taught by ACPA and
other organizations, are one option to help patients gain relief from chronic pain.
“Mastering them may allow the person with pain to find relief and minimize the
things that often make pain worse, such as stress, inactivity, uncertainty, feeling
powerless, being out of shape, lack of sleep, boredom, fear and anger, which are all
normal human reactions to pain and life disruption,” the ACPA Resource Guide says.
Common Sense Urged When
Enforcing Treatment
Guidelines By Elaine Goodman
February 15, 2017
Medical treatment guidelines are an important tool for improving the care of injured
workers, but their use must be coupled with common sense, speakers said during a
webinar on Thursday.
For example, it might be better to take a more holistic approach to a claim if denial
of a particular treatment is going to cause the claim to grind to a prolonged halt, said
Darrell Brown, executive vice president and chief claims officer for Sedgwick. He
gave as an example the case of SCIF v. Sandhagen in California, where denial of an
applicant's request for an MRI went all the way to the Supreme Court.
March 2017 NAWCJ - Lex and Verum Page 24
Continued, Page 25.
Common Sense, from Page 24.
“Sometimes you have a situation where the guideline says ‘nope, this is not relevant,’” Brown said. “But
you’re going to pay three more years, or four more years of indemnity benefits, you’re going to pay other
medical treatment to fight that one issue, so I think it all needs to be looked at in context. And sometimes we
should take a step back and say okay, what makes sense for this particular case?”
The webinar, titled “Obstacles and Opportunities of Treatment Guidelines,” was part of the Outfront Ideas
series, hosted by Kimberly George of Sedgwick and Mark Walls of Safety National.
Amy Lee, special advisor to the Texas Department of Insurance, Division of Workers’ Compensation, said a
challenge in implementing medical treatment guidelines in Texas was initial confusion about how to handle
situations where treatment fell outside of the guidelines. That might occur with an injured worker who has
comorbidities and an extensive history of past medical treatments, she said.
Lee said that DWC worked with Work Loss Data Institute, the company that publishes the Official Disability
Guidelines that are used in Texas and other states, to write an Appendix B to ODG that explains to providers
how to document treatment exceptions. That eased providers’ concerns that any treatment outside the guidelines
would receive an automatic “no,” she said.
Lee also noted the importance of getting everyone involved in the comp system to use the same guidelines,
including providers, payers and medical evaluators. Providers won’t use a particular set of treatment guidelines
if they know the payer isn’t using them, she said.
But not everyone in the system needs the guidelines in the same format. Lee said DWC worked with Work
Loss Data Institute to obtain a simple list of “N” drugs, which are those that are not recommended and need
preapproval, to provide to pharmacies. Pharmacists don’t want to spend time poring over treatment guidelines
just to find out if a drug prescribed to an injured worker is labeled “N.”
On the topic of documenting treatment requests, Dr. Doug Benner, chief medical officer at EK Health, said
providers often aren’t thorough enough. For example, providers should detail conservative treatments that
they’ve tried but have failed for the injured worker. Another problem is that when payers ask for more
information, providers often don’t respond, he said.
Although not discussed during the webinar, the issue of information sharing is one that the Western
Occupational & Environmental Medical Association, or WOEMA, addressed in a white paper last year on the
utilization review process. The group proposed giving the provider who is requesting authorization the option to
designate times that he or she will be available, “which the reviewing provider must honor.” Peer-to-peer
conversations may help smooth the utilization-review process, WOEMA noted.
Mark Pew, senior vice president at Prium and one of the webinar speakers said that workers’ comp
prescription drug formularies are rapidly catching on across the nation. States that already have formularies
include Delaware, North Dakota, Nevada, Ohio, Oklahoma, Texas, Washington, Tennessee and Arizona.
In California, the Division of Workers’ Compensation expects to begin formal rule-making for a formulary
this month, after earlier saying it would be do so in January. Assembly Bill 1124 mandated the establishment of
a formulary by July 1 of this year.
“That probably will change, given it’s taken so long to actually publish and document the rules,” Pew said.
In addition, Arkansas, Florida, Georgia, Illinois, Louisiana, Mississippi, Montana, Nebraska, New York and
North Carolina are considering formularies, Pew said. Six of those states -- Arkansas, Florida, Georgia, Illinois,
North Carolina and Nebraska -- don’t have medical treatment guidelines, he added. “That’s a fundamental
guiding principle, having that evidence-based medicine,” Pew said.
__________ The articles on pages 23-25, Low-Back Pain Treatment Guideline Steers Doctors Away From Opioids and Common Sense
Urged When Enforcing Treatment Guidelines were originally published on WorkCompCentral.com and are reprinted here
with permission. The NAWCJ gratefully acknowledges the contributions of WorkCompCentral to the success of this
publication and the NAWCJ.
March 2017 NAWCJ - Lex and Verum Page 25
2017 ZEHMER
MOOT COURT
SAVE THE DATES!!!!
The E. Earle Zehmer National Moot Court
Competition will be held at the Orlando
World Center Marriott from August 5th – 7th,
2017 in Orlando, Florida.
This competition affords students the
opportunity to argue in the preliminary and
quarterfinal rounds before sitting workers’
compensation judiciary from across the
country. The semi-final rounds are judged by
retired Judges of Compensation Claims with
the final round argued before presiding Judges from the First District Court of Appeals of the State of Florida.
Most competition expenses are generously covered by the Workers’ Compensation Institute, including travel
to/from the competition (mileage or reasonable coach airfare for out of state competitors); hotel
accommodations for two nights; a meal per diem for two days, and copying costs. Please encourage all law
schools in your state to consider participation and pass along this information to the law school deans and/or
Moot Court Boards. Should you have any questions about the competition, please direct those to one of the
following:
Judge Jennifer Hopens
Jacqueline Steele
Judge David Langham
Judge Michael Alvey
Judge James Szablewicz
March 2017 NAWCJ - Lex and Verum Page 26
L&V: What is your formal title?
JH: I am the director of hearings for the Northern and Western Regions of the Texas Department of Insurance-
Division of Workers’ Compensation (TDI-DWC).
L&V: How long have you been at your current position?
JH: I started as director on January 1, 2016, so a little over a year. Prior to
that, I had served as a hearing officer and hearings coordinator for DWC.
L&V: Where is your office?
JH: I work out of the DWC central office in Austin, Texas (7551 Metro
Center Drive, Suite 100, Austin, Texas 78744). We are located a few miles
from Austin-Bergstrom International Airport.
L&V: How many judges are in your office?
JH: We have three traveling hearing officers who work in the central office
here in Austin. When they are not conducting contested case hearings
(CCHs) in the Austin central office, they often travel to cover dockets at
DWC field offices in other parts of the state. I supervise these officers. We
also have a hearing officer who works out of the DWC field office in Austin, but she is supervised by my co-
director, Allen Craddock, who is the director of hearings for the Southern and Coastal Regions.
L&V: How many workers’ compensation judges are there in your state?
JH: Currently, we have 32 hearing officers in the entire state. I supervise 16, while Dr. Craddock manages the
remaining half. We also have 30 benefit review officers throughout the state. The benefit review officers preside
over benefit review conferences (BRCs), which are mediations that take place in the dispute resolution process
before the CCH stage. I supervise 13 benefit review officers, while Dr. Craddock supervises 17.
L&V: What is your caseload like?
JH: I no longer have a caseload, but DWC hearing officers are typically scheduled for three CCHs per day, four
days a week. Pursuant to 28 Texas Administrative Code (TAC) Section 142.16, the hearing officer is required to
file his or her Decision & Order (D&O) with Hearings by the 10th
day after the close of the hearing record.
Benefit review officers are generally scheduled for up to eight BRCs per day, four days a week. In accordance
with 28 TAC Section 141.7, benefit review officers are required to issue their BRC reports, which document all
resolved and unresolved issues for dispute resolution and which contain a description of the parties’ positions
on the issues, within five days after the BRC is closed.
Ten Minutes with
Hon. Jennifer Hopens
March 2017 NAWCJ - Lex and Verum Page 27
Continued, Page 28.
Ten Minutes, from Page 28.
L&V: Are you required to apply the Rules of Evidence in your
hearings and decisions?
JH: No, pursuant to Texas Labor Code Section 410.165 (titled
“Evidence”), the hearing officer is the sole judge of the relevance
and materiality of the evidence offered and of the weight and
credibility to be given to the evidence, and conformity to the legal
rules of evidence is not necessary.
L&V: Do you rule from the bench?
JH: Generally, no. A hearing officer may make a ruling from the
bench on an objection or a party request, such as a request for
continuance, but the hearing officer’s rulings on the disputed issues
in a case are found in a written D&O, which is generated by the
hearing officer following the CCH.
L&V: What did you do before you became a judge?
JH: I’ve been a hearing officer in some capacity since I graduated
from law school at the University of Texas at Austin in 2002. My
first job was as a hearing officer for a little more than four years
with the Texas Workforce Commission, where I presided over
disputes in unemployment insurance cases. That job entailed seven
to eight scheduled telephonic hearings per day and a three-day
deadline for issuing decisions. I feel like I gained a lot of valuable
experience in that position, particularly in dealing with a high
volume of cases and tight deadlines, which served me well when I
joined DWC as a traveling hearing officer in 2007.
L&V: What do you like the most about judging?
JH: Making a positive difference in the lives of those who appear
before you. There was nothing more rewarding or meaningful to
me than that when I was a hearing officer.
L&V: What do you do to relieve the stress of judging?
JH: Throughout my life, I’ve found listening to music to be one of
the most effective ways of relieving stress and decompressing. One
of my favorite pieces to listen to when I need to relax is The
Aquarium from Carnival of the Animals by French composer
Camille Saint-Saens. Other good ones are Symphony No. 9 in E
Minor (From the New World) by Czech composer Antonin Dvorak
and The Lark Ascending by British composer Ralph Vaughan
Williams. I’ve also found music to be motivating and empowering
(for example, the Rocky theme or any of John Williams’s Star Wars
or Olympics themes), and helps me refocus on the here and now
and the task at hand.
Governor
Appoints
Magistrate,
Reappoints Five
Michigan Governor Rick Snyder
recently announced the appointment of
John Housefield, as well as the
reappointments of Keith Castora, Jane
Colombo, Lisa Woons, Robert
Timmons, and David Williams. Each of
the reappointed magistrates, except
Judge Timmons, has served since 2013.
Housefield has been practicing law for
37 years in workers’ compensation. He
holds a B.S. from Western Michigan
University and a J.D from Thomas M.
Cooley Law School.
Castora has over 25 years of
experience in workers’ compensation.
He holds a B.S. from State University of
New York and a J.D. from the Michigan
State University Detroit College of Law.
Woons has over 20 years of experience
as a workers’ compensation lawyer. She
holds a B.S. and a J.D. from Valparaiso
University.
Colombo formerly served on the
Workers’ Compensation Appeal Board.
She holds a B.S. from Eastern Michigan
University and a J.D. from the
University of Detroit School of Law.
Timmons has been a magistrate since
2011. He holds a B.S. from Western
Michigan University and a law degree
from the University of Miami School of
Law.
Williams has more than 34 years of
experience in workers’ compensation
law. He holds a B.S. from Wayne State
University and a J.D. from Wayne State
University Law School.
March 2017 NAWCJ - Lex and Verum Page 28
Continued, Page 29.
Ten Minutes, from Page 28.
L&V: Are you active in the legal community?
JH: Yes, but primarily on a national basis. I’ve been involved with NAWCJ as a member of the Board of
Directors going back to 2011. From 2013 to 2015, I served as secretary and, from 2015 to 2016, as president-
elect. I succeeded Michael Alvey of Kentucky as president in August of 2016. It has been my great honor to
serve this organization and work with so many amazing and dedicated members of the judiciary from around
the country.
Here in Texas, I am a member of the Workers’ Compensation section of the State Bar of Texas, and I’ve served
on the planning committee for the State Bar’s Advanced Workers’ Compensation course for several years.
L&V: Are you active in your community?
JH: I am passionate about philanthropy, but I’ve definitely found it challenging to contribute time to charitable
causes outside of work hours. I hope to do more volunteer work in the community this year.
L&V: Tell us about your family?
JH: A common bumper sticker around here definitely applies to me: “I wasn’t born in Texas, but I got here as
soon as I could.” I was born in Rochester, New York, and my mom’s side of the family has hailed from Western
New York/Northwestern Pennsylvania since the late 18th
Century (see my hobbies, below). My mom is from
Jamestown, New York (best known as the hometown of legendary entertainer Lucille Ball and Supreme Court
Justice and Nuremberg prosecutor Robert H. Jackson). My dad (né Hopensztadt) was born in Poland and spent
his early years after World War II broke out in Kazakhstan. After the war ended, he and his mother settled in
France, but they immigrated to the U.S. when he was a teenager. He eventually met my mom at the State
University of New York at Buffalo, and they married in 1966. To escape the harsh lake-effect snow, they later
moved to San Antonio, Texas, when I was two years old. I grew up primarily in Temple, Texas, where my
parents still live. I have one sibling, an older brother, who lives in Dallas.
My extended family is pretty small (my dad is an only child, my mom has one brother, and I have two first
cousins total). Because my parents live within an hour of me, I am fortunate to be able to visit them frequently.
We also enjoy spending time with the rest of our extended family, and we have been able to meet up with them
in different parts of the country at least once a year for the past several years. I typically travel with my family
to Western New York once a year. Last year, we had a party to celebrate my parents’ 50th
anniversary in Bemus
Point, New York, on Chautauqua Lake.
I treasure the time I get to spend with my family, and I try not to take it for granted.
L&V: What are your hobbies?
JH: As you could probably tell from the previous answer, I’m interested in genealogy.
I also enjoy reading (mainly memoirs and biographies), photography, trivia, travel, and, of course (see above),
listening to music.
March 2017 NAWCJ - Lex and Verum Page 29
Continued, Page 30.
Ten Minutes,, from Page 29.
L&V: What do you see as the value in your association with NAWCJ?
JH: Being a part of such a wonderful organization as NAWCJ has definitely enriched
my knowledge of workers’ compensation law and has also broadened my awareness
and perspective of important issues affecting our unique area of the law. I look
forward to receiving and reading the Lex & Verum each month, and I’ve found the
articles to be enjoyable, informative, and relevant. I first attended the NAWCJ Judicial
College in Orlando back in 2009, and I’ve been lucky to have come back each year
since. I’ve gotten to know adjudicators and regulators from around the country
through the College. I’ve had wonderful mentors in the organization, including all of
my predecessors as President of NAWCJ (Judges Lazzara, Lorenzen, Torrey, and
Alvey), as well as Judges Cohen and Langham. I’ve also learned so much from
attending dozens of presentations at the College over the years, which I’ve been able
to apply to my work at the Division. I also had an amazing opportunity in May of
2016, to attend, along with Judges Alvey, Langham, and Torrey, the Workers’
Compensation Summit in Dallas, which was the start of a “national conversation” on
the future of workers’ compensation.
L&V: Do you have any words of wisdom you would like to share?
JH: For judges, the certainty of reversal is up there with death and taxes.
On that note, I did a presentation on “Learning from Reversals” at our annual Hearings
Conference in Austin in August of 2016. I went through each of my own reversals as a
hearing officer to illustrate what I learned from each reversal and how I incorporated
what I learned into my work going forward.
I will leave you with the same parting thought and quotes I left them in my
presentation, with the hope that you may find them instructive:
Reversals create opportunities to learn and improve your skills as a hearing officer.
“By seeking and blundering we learn.” German writer and philosopher Johann
Wolfgang van Goethe
“Failure is instructive. The person who really thinks learns quite as much from his
failures as from his successes.” American philosopher and educational reformer John
Dewey.
March 2017 NAWCJ - Lex and Verum Page 30
Mark your calendar! Judiciary
College 2017
August 6-9, 2017
Before School –
Bring the Kids!
NAWCJ 2017
Associate Members
James M. Anderson*
Anderson, Crawley & Burke
Robert Barrett* Rissman, Barrett, Hurt, Donahue & McLain
Douglass Bennett* Swift, Currie, McGhee & Hiers
Sharkey Burke* Anderson, Crawley & Burke
Regan Cobb* McAngus, Goudelock & Courie
R. Stephen Coonrod* McConnaughhay, Duffy, Coonrod, Pope & Weaver
Mark Davis* McAngus, Goudelock & Courie
Charlie Domer Domer Law
Robert Donahue* Rissman, Barrett, Hurt, Donahue & McLain
Terry Germany* Anderson, Crawley & Burke
J. Russell Goudelock* McAngus, Goudelock & Courie
Molly Lawyer Latham, Wagner, Steele & Lehman
Laurence Leavy* Laurence Leavy & Associates, P.A.
Hugh McAngus* McAngus, Goudelock & Courie
James McConnaughhay* McConnaughhay, Duffy, Coonrod, Pope & Weaver
John E. McLain* Rissman, Barrett, Hurt, Donahue & McLain
R. Briggs Peery* Swift, Currie, McGhee & Hiers
William E. Pipkin Austill, Lewis & Pipkin
John F. Power Power & Cronin
Steven A. Rissman* Rissman, Barrett, Hurt, Donahue & McLain
Gerald A. Rosenthal* Rosenthal, Levy, Simon & Ryles
Michael Ryder* Swift, Currie, McGhee & Hiers
E. Louis Stern* McConnaughhay, Duffy, Coonrod, Pope & Weaver
Richard A. Watts* Swift, Currie, McGhee & Hiers
Patrick E. Weaver* McConnaughhay, Duffy, Coonrod, Pope & Weaver
Glen D. Wieland* Wieland, Hilado & Delaitre, P.A.
*Denotes Charter Associate Member.
March 2017 NAWCJ - Lex and Verum Page 31
Ninth Annual NAWCJ
Judiciary College Orlando, Florida August 6-9, 2017
Sunday, August 6, 2017
12:00 - 1:30 MOOT COURT JUDGES’ LUNCHEON
1:40 – 5:00 E. EARLE ZEHMER MOOT COURT PRELIMINARY ROUNDS Celebrating 30 years in 2017, the E. Earle Zehmer Competition will include twenty-two teams. The competition is co-sponsored by the NAWCJ and the preliminary rounds are judged by members of the NAWCJ. The final rounds on Monday are judged by a panel of the Florida First District Court of Appeal. The competition is outstanding, the participants are exceptional, and this opportunity to contribute to the law students’ development is both exciting and gratifying.
March 2017 NAWCJ - Lex and Verum Page 32
The NAWCJ Board meets annually at the
Judiciary College. Every two years we have
a momentous passing of the torch. This year
Judge Alvey became “past-President” and
Judge Hopens took over!
Judges (left to right) Switzer (TN), Moore
(KS), and Knott (TN) preside over oral
arguments in the preliminary round.
Monday, August 7, 2017
8:00 – 8:30 REGISTRATION AND INFORMATION
8:30 – 9:00 WELCOME Honorable Jennifer Hopens, NAWCJ President
Texas Department of Insurance, Division of Workers’ Compensation Austin, Texas
9:00 – 10:50 EVIDENCE FOR ADJUDICATORS Honorable T. Scott Beck, Introduction of Speaker South Carolina Workers’ Compensation Commission Columbia, South Carolina
Professor Charles W. Ehrhardt
Florida State University School of Law
Tallahassee, Florida
This will be an interactive program in which various scenarios will be addressed. These will
include: the role of workers’ compensation adjudicators in weighing evidence, distinctions
between competent and substantial evidence versus clear and convincing evidence, the
concept of “presumption” standards in first responder injuries, and the admissibility of social
media evidence. Professor Ehrhardt will also address perceptions of differences between
legal causation and medical causation, between medical probability or possibility, and
between medical certainty, and the evidentiary gaps between standards like “more probable
than not” and “major contributing cause.”
10:50 – 11:00 BREAK
11:00- 11:50 STRESS AND JUDGING Honorable LuAnn Haley, Introduction of Speaker
Industrial Commission of Arizona
Tucson, Arizona
Debi Galler, Esq.
Berger Singerman
Tallahassee, Florida
Case load, fatigue, multitasking and burnout are daily conditions many workers’
compensation judges face as they deal with case management and decision-making.
Mindfulness is the practice of focusing attention to one’s thoughts, feelings and bodily
sensations in an effort for judges to give sufficient attention to each case in order to arrive at
fair and just decisions and avoid reliance on stereotypes about class, gender and race.
12:00 – 12:30 LUNCH (PROVIDED)
March 2017 NAWCJ - Lex and Verum Page 33
Monday, August 7, 2017, Continued
12:30 – 1:50 COMPARATIVE WORKERS’ COMPENSATION LAW PANEL This panel discussion will bring perspective on how our statutes are different, and how they
are similar. Dealing with statutory interpretation is part of our daily routine. Despite the
diversity of our particular statutes, we share a multitude of concordant issues and challenges,
which this program illuminates. Each year brings different states to the panel, and therefore
differing viewpoints to the conversation. This program is consistently among the highest
rated of the judiciary college.
Honorable Jim Szablewicz, Introduction of Moderator and Panel
Virginia Workers’ Compensation Commission
Richmond, Virginia
Honorable Suzette Carlisle, Moderator
State of Missouri, Office of Administration
St. Louis, Missouri
Panel
1:50 – 2:00 BREAK
2:00 – 5:00 THE AFTERNOON IS DIVIDED INTO TWO TRACKS, ONE FOR THE NEWER
ADJUDICATOR AND ONE FOR THE MORE SEASONED ADJUDICATOR
Track One - The NAWCJ NEW JUDGE PROGRAM Back by popular demand, the NAWCJ presents education specifically for the new
adjudicator. Transitioning to the bench from private practice can involve various challenges.
Much of the three hour program Monday afternoon is intended to foster frank discussions in
small groups. This series of discussions is focused on those who have been on the bench for
two years or less, but all adjudicators are encouraged to attend.
2:00-2:10 ANNOUNCEMENTS AND BUSINESS Honorable Jennifer Hopens, NAWCJ President
Texas Department of Insurance, Division of Workers’ Compensation Austin, Texas
Honorable Neal Pitts
Office of Judges of Compensation Claims
Orlando, Florida
Honorable Michael J. Feeney
Rhode Island Department of Labor and
Training
Cranston, Rhode Island
Honorable LuAnn Haley Industrial Commission of Arizona Tucson, Arizona
Honorable Jennifer Hopens
Texas Department of Insurance, Division
of Workers’ Compensation
Austin, Texas
March 2017 NAWCJ - Lex and Verum Page 34
Monday, August 7, 2017, Continued
2:10 – 3:00 TRANSITIONING TO THE BENCH AND WRITING THE ORDER Honorable Robert Cohen, Introduction of Panelists
Florida Division of Administrative Hearings
Tallahassee, Florida
Honorable Michael Alvey
Kentucky Workers’ Compensation Board
Owensboro, Kentucky
Honorable David Imahara Honorable Wesley Marshall
Georgia State Board of Workers’ Compensation Virginia Workers’ Compensation
Atlanta, Georgia Commission
Richmond, Virginia
The journey to the bench is long and hard. Having achieved it, the new judge faces a variety
of new challenges, questions and trials. This panel will work through some common issues
for those new to the bench, and with the help of the Judiciary College audience, provide
wisdom and suggestions.
3:00 – 3:10 BREAK
3:10 – 4:00 DEALING WITH DIFFICULT LITIGANTS
Honorable John Lazzara, Introduction of Panelists
Florida Office of Judges of Compensation Claims
Tampa, Florida
The challenges for adjudicators are many, even when everything goes well. When difficulties
complicate the process and our proceedings, the adjudicator must be prepared to manage
situations and personalities, to keep the proceedings on track and efficient, and to afford
everyone due process and consideration. The challenges of the difficult litigant will be
explored in-depth by this all-star panel of seasoned experts.
4:00 – 4:10 BREAK
March 2017 NAWCJ - Lex and Verum Page 35
Honorable Jane Rice Williams
Kentucky Department of Workers’ Claims
London, Kentucky
Honorable Robert Swisher
Kentucky Department of Workers’ Claims
Frankfort, Kentucky
Honorable William Culbreth,
Virginia Workers’ Compensation
Commission
Richmond, Virginia
Honorable Sylvia Medina-Shore
Office of Judges of Compensation Claims
Miami, Florida
Monday, August 7, 2017, Continued
4:10 - 5:00 JUDICIAL ETHICS CONUNDRUMS AND HUMDRUMS? Honorable Jane Rice Williams, Introduction of Speakers
Kentucky Department of Workers’ Claims
Frankfort, Kentucky
T
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The new judge takes the bench with a volume of experience and knowledge. As good as that
foundation may be, there are new rules and processes that must now be mastered. The Code
of Judicial Conduct, state policies, and executive orders confront the new workers’
compensation adjudicator. Moderator Jane Williams and a panel of seasoned judges,
commissioners, and deputies will guide a discussion of some of the common ethical concerns
of new judges. Attendees will gain knowledge and confidence in the interpretation of judicial
ethical requirements.
Track Two
2:00 – 5:00 SAWCA REGULATOR ROUNDTABLETM
For the more seasoned adjudicators, Monday afternoon offers the opportunity for a doctorate-
level exposure to comparative law in workers’ compensation. The Southern Association of
Workers’ Compensation Administrators (SAWCA) will present its 6th Annual Regulator
Roundtable. Regulators and Administrators from across the country will discuss hot topics
challenging workers’ compensation systems. Attendees will hear perspectives, initiatives,
problems and solutions.
Monday Evening:
5:00 – 6:00 NAWCJ and SAWCA RECEPTION
The perfect closure for the first day of our NAWCJ program is the official welcoming
reception for adjudicator attendees, regulators and associate members. Following a full day
of edification and instruction, this is the chance to mingle and unwind with old friends and
new acquaintances from across the continent.
7:00 – 11:00 WCI® Reception and Entertainment Casual attire, drinks and heavy hors d’oeuvres. This is a rocking closure to the first day of the
WCI conference. All registered NAWCJ Judiciary College attendees are invited to the
reception and entertainment. There will be live entertainment, lighthearted conversation, and
more opportunity to renew and form friendships.
March 2017 NAWCJ - Lex and Verum Page 36
Honorable Michael Alvey
Kentucky Workers’ Compensation Board
Owensboro, Kentucky
Honorable Shannon Bruno-Bishop
Office of Workers’ Compensation
New Orleans, Louisiana
Honorable Bruce Moore
Kansas Department of Labor, Division of
Workers’ Compensation
Salina, Kansas
Honorable Jane Rice Williams
Kentucky Department of Workers’ Claims
London, Kentucky
Tuesday, August 8, 2017
8:45 – 9:45 LIVE SURGERY (IN THE ADJUSTER BREAKOUT)
9:55-10:00 ANNOUNCEMENTS AND UPDATES Honorable Ellen Lorenzen, NAWCJ Past-President
Florida Office of Judges of Compensation Claims
Tampa, Florida
10:00 – 10:50 MEDIATION CHALLENGES AND SUCCESSES
Honorable Bruce Moore, Introduction of Moderator and Speakers
Kansas Department of Labor, Division of Workers’ Compensation
Salina, Kansas
Deborah Blevins, Moderator
Virginia Workers’ Compensation
Commission
Richmond, Virginia
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States vary in their utilization of mediation as a mechanism for resolving conflicts in workers
compensation claims. This panel will discuss various approaches to mediation, its strengths,
weaknesses, efficacy, and those situations or circumstances where it has the greatest potential
impact.
10:50 – 11:00 BREAK
11:00- 11:50 HEAD INJURIES AND CONCUSSIONS Honorable Deneise Turner Lott, Introduction of Speakers
Mississippi Workers’ Compensation Commission
Jackson, Mississippi
Pritesh Parbhoo, Psy.D. Tammy Boyd
NeuroInternational NeuroInternational
Sarasota, Florida Sarasota, Florida
There are various settings for a head injury and concussion. Anytime there is head trauma,
concussion is a potential. Often, however, other injuries may be perceived with greater
urgency and treatment following a trauma may focus on lacerations, broken bones or
otherwise. The symptoms of head trauma may become of concern later, and litigation may
ensue. How do the experts scientifically diagnose head injury, and what post-injury
complaints are potentially suggestive of developing problems?
March 2017 NAWCJ - Lex and Verum Page 37
John Brooks
Office of Judges of Compensation Claims
Daytona, Florida
Allen Craddock
Texas Department of Insurance, Division
of Workers’ Compensation
Austin, Texas
Honorable Neal Pitts
Office of Judges of Compensation Claims
Orlando, Florida
Honorable Dave Torrey
Pennsylvania Department of Labor and
Industry
Pittsburgh, Pennsylvania
Tuesday, August 8, 2017, Continued.
12:00 – 12:30 LUNCH (PROVIDED) NAWCJ ANNUAL BUSINESS MEETING Honorable Jennifer Hopens, NAWCJ President
Texas Department of Insurance, Division of Workers’ Compensation Austin, Texas
12:30 – 1:00 KIDS’ CHANCE
Honorable Jennifer Hopens, Introduction of Speaker Texas Department of Insurance, Division of Workers’ Compensation Austin, Texas
Ann Bishop, Esq. Sponsler, Bishop, Koren & Hammer, P.A. Board Member, Past-President, Kids’ Chance of America Kids’ Chance of Georgia Atlanta, Georgia
Ms. Bishop will discuss the workers’ compensation judges’ role in supporting the legal community’s involvement in “Kids’ Chance,” a national charitable organization devoted to providing financial assistance towards the education of children of injured workers.
1:00 – 1:10 BREAK
1:10 – 4:00 ADVANCED JUDICIAL WRITING Honorable Melodie Belcher, Introduction of Speaker
Georgia State Board of Workers’ Compensation
Atlanta, Georgia
Professor Wayne C. Schiess University of Texas School of Law Director - The David J. Beck Center for Legal Research, Writing, and Appellate Advocacy Austin, Texas
Judicial writing is a skill, and challenges exist in writing effective orders. Professor Schiess will provide an advanced perspective on how judges can and should write more efficiently and effectively. This program will be informative and sometimes humorous. Attendees will emerge with perspective and tools to enhance their writing.
(There will be a ten minute break each hour, 2:00-2:10 and 3:00-3:10).
March 2017 NAWCJ - Lex and Verum Page 38
Tuesday, August 8, 2017, Continued.
4:00 – 4:10 BREAK
4:10 – 5:00 UNNECESSARY SURGERY, COMPOUND MEDICATIONS, PAIN MANAGEMENT
Honorable Sheral Kellar, Introduction of Speakers Louisiana Workforce Commission
Baton Rouge, Louisiana
Rosalee Farris, RN Dr. Robert Snyder, M.D.
Occupational Managed Care Alliance, Inc. Tennessee Medical Director
Louisville, Kentucky Nashville, Tennessee
Dr. Robert Murrah, M.D.
Murrah Orthopedics
Orlando, Florida
Judges are frequently asked to approve, or disapprove, recommended medical treatment. Sometimes, the efficacy of the recommended treatment, its “experimental” nature, or its approval by the FDA may be in question. This panel will address judges’ common concerns and provide objective medical information about medical decision-making and when or whether a particular procedure, treatment regimen or compounded drug is medically appropriate.
Wednesday, August 9, 2017
8:50 – 9:00 ANNOUNCEMENTS AND UPDATES
Honorable David Torrey, NAWCJ Immediate Past-President
Pennsylvania Department of Labor and Industry
Pittsburgh, Pennsylvania
9:00 – 10:15 SECURITY ISSUES: INSIDE AND OUTSIDE THE COURTROOM Honorable Karl Aumann, Introduction of Speaker
Maryland Workers’ Compensation Commission
Baltimore, Maryland
Timothy Hughes
United States Marshall Service
Arlington, Virginia
Security is a concern, professionally and personally. Proceedings before a workers’
compensation adjudicator are likely to be unfamiliar to many litigants, and the process itself
may bring stress, frustration and even anger. Adverse decisions and resulting financial effects
may exacerbate feelings and heighten emotions. Adjudicators, staff, and parties must be
conscious of their safety and surroundings.
10:15 – 10:30 BREAK
March 2017 NAWCJ - Lex and Verum Page 39
Wednesday, August 9, 2016, Continued
10:30 - 11:45 COMPROMISE SETTLEMENTS
Hon. Frank McKay, Introduction of Speaker
Georgia State Board of Workers’ Compensation
Atlanta, Georgia
Honorable Ken Switzer
Tennessee Court of Compensation Claims
Nashville, Tennessee
The Court of Workers’ Compensation Claims will approve between 8,000-10,000 settlement
this fiscal year. All settlements must be court approved in person, with minor exceptions. The
statute requires that the judge “examine the proposed settlement to determine whether the
employee is receiving, substantially, the benefits provided under the statute.” In so doing, the
judge shall “thoroughly” inform the employee of the scope of benefits available. Or, in the
case of disputes as to compensability or the amount actually due, the judge must find that the
settlement is in the best interest of the employee. Add to these factors the ability to settle a
case with the closure of medical benefits and you have a process ripe for abuse. Judge Switzer
will discuss the process by which these varying scenarios are handled.”
March 2017 NAWCJ - Lex and Verum Page 40
Judiciary College 2017 August 6-9, 2017
Marriott World Center, Orlando, Florida
NAWCJ Judiciary College Hotel - The Caribe Royale
$110.00 per night
One block away from Marriott World Center (convention site)
Continuous shuttle service to/from Marriott World Center.
To reserve, email arrival and departure dates to [email protected]
NAWCJ Judiciary College 2017 Faculty
Honorable Michael Alvey
Chairman Michael W. Alvey received his Bachelor’s degree from Western Kentucky
University, and his J.D. from the University of Kentucky College of Law. Admitted to
the Kentucky Bar in 1988, Chairman Alvey practiced primarily defending workers’
compensation, federal black lung and personal injury claims. On November 13, 2009
Chairman Alvey was appointed to serve as Chairman of the Kentucky Workers’
Compensation Board effective January 5, 2010. Chair Alvey has served on the board of
directors of the National Association of Workers’ Compensation Judiciary, Inc., and is
the President. Chairman Alvey retired from the Kentucky Army National Guard in
2000 where he served nearly 21 years as an armor officer and is a graduate of the
Armor Officer Basic Course and Armor Office Advanced Course. Chairman Alvey
resides in Owensboro, Kentucky where he has been involved in various church and civic activities as well as
working with youth sports including both coaching and officiating.
Honorable R. Karl Aumann
Appointed Commissioner of the Workers’ Compensation Commission in March 2005, R.
Karl Aumann was subsequently named as Chairman in October 2005. Immediately prior
to this appointment, he served as Maryland’s Secretary of State. He earned a Bachelor of
Arts from Loyola University in Maryland in 1982. Chairman Aumann received his J.D. in
1985 from the University of Baltimore, School of Law and was admitted to the Maryland
Bar in 1986. He was an associate with the Towson firm of Power & Mosner and later with
the Baltimore office of Miles & Stockbridge. In 1991, President George H.W. Bush
appointed him Counsel and Senior Policy Advisor to the Appalachian Regional
Commission. From 1994 until 2003, Chairman Aumann served as Chief Administrator
and District Director for Congressman Robert Ehrlich. Chairman Aumann served as president of the Southern
Association of Workers’ Compensation Administrators and is co-chair of the Adjudication Committee of the
International Association of Industrial Accident Boards and Commissions. He has served since 2010 as a board
member of the National Association of Workers’ Compensation Judiciary, and since 2006 as a board member of
the Maryland Workers’ Compensation Educational Association.
Honorable Scott Beck
Commissioner Beck was appointed to the South Carolina Workers’ Compensation
Commission on June 30, 2008 by Governor Mark Sanford. In 2010, he was elected by
the Commission as Interim Chairman and subsequently nominated by Governor Haley
for reappointment in 2012, 2014, and 2016 as Chairman. He graduated with a BS
Degree from Penn State University in 1981 and from the University of South Carolina
School of Law in 1999. Prior to joining the Commission, he served in various positions
in law enforcement from 1979-1996 and most recently as an Assistant Attorney
General from 2000-2008 prosecuting healthcare fraud cases. Commissioner Beck
served as a City Councilman in North Augusta, South Carolina from 1993-1996, and
was elected to the South Carolina House of Representatives, serving from 1996-2000.
Commissioner Beck currently serves on the Board of Directors of the National
Association of Workers’ Compensation Judiciary and the Southern Association of Workers’ Compensation
Administrators.
March 2017 NAWCJ - Lex and Verum Page 41
Honorable Melodie Belcher
Melodie Belcher attended Georgia State University College of Law where she was an
editor on the law review, graduating cum laude in 1992. She then worked as an associate
for Swift Currie McGhee & Hiers, representing employers and insurers in workers’
compensation claims. In 1999, she joined the State Board of Workers’ Compensation as a
mediator in the Columbus office. She was appointed Administrative Law Judge in 2002,
and served as the Chief Judge from 2009 to 2012. Melodie is an active participant with
the Southern Association of Workers’ Compensation Administrators and served as the
President of the organization from July of 2013 to July of 2014. She currently serves as a
Co-chair of the Administration and Procedures Committee for that organization. Melodie
is a Board Member of the National Association of Workers’ Compensation Judiciary. She was inducted as a
Fellow of the College of Workers’ Compensation Lawyers in 2014. Melodie speaks regularly on a variety of
workers’ compensation issues and has moderated SAWCA’s Regulator Roundtable at WCI in Orlando. She
looks forward to again moderating this event in 2017. Melodie has two grown children (both lawyers), two
dogs, and lives in LaGrange, Georgia with her husband, Bill (who is not a lawyer).
Ann Bishop .
Since 1981, Ann has practiced almost exclusively in the area of workers’ compensation
representing employers and insurers. Ann began practicing in the area of workers’
compensation at Swift, Currie, McGhee and Hiers before leaving with 21 other lawyers
to form Drew, Eckl and Farnham where Ann was selected as the first female partner. Ann
was the founding member of A. B. Bishop & Associates where she represented self-
insured employers and insurance companies in the area of workers’ compensation.
Currently, Ann is a partner with Sponsler, Bishop, Koren & Hammer. She graduated with
a Bachelor of Arts from Vanderbilt University in 1973 and from Mercer University
School of Law with a Juris Doctor in 1976. Ann served on the Executive Committee of
the Workers’ Compensation Section of the State Bar of Georgia, was Section Chairman
for 2007-2008, has served on the Rules and Mediation Committee of the Chairman’s
Advisory Council of the State Board of Workers’ Compensation for more than 20 years. Ann is on the Board of
Directors of Kids’ Chance of Georgia, Inc., and for which she served a two year term as President. Ann was
appointed to the Board of Directors of Kids’ Chance of America in 2010 and was elected to serve as President
of the national Kids’ Chance organization for 2014 to 2016. Ann is a Fellow in The College of Workers’
Compensation Lawyers, on which she serves on the Board of Governors, and is a Fellow in the Georgia
Lawyer’s Foundation. Ann serves on the Board of Visitors of Mercer University School of Law and will serve
as Chair of the Board of Visitors 2017 – 2019.
Tammy Boyd
Tammy Boyd is Vice President of Business Development for NeuroInternational in Sarasota,
Florida. NeuroInternational works with the unique needs of brain and spinal cord injury
survivors. A multidisciplinary Team of staff and consortium providers offer services in a
variety of settings (facility, apartments, houses, host homes). The primary goal is to facilitate
neurorecovery and promote independence and quality living. The Team establishes outcome-
driven goals and objectives for each survivor, and involves the survivor, family, payor and
other stakeholders in the treatment planning process to ensure targeting desired outcomes.
March 2017 NAWCJ - Lex and Verum Page 42
John Brooks
John Brooks is a state mediator with the Florida Office of Judges of Compensation Claims.
He works in the Daytona Beach District. John has practiced in the field of workers’
compensation for almost 49 years, primarily in Central Florida.
Honorable Shannon Bruno-Bishop
Shannon Bruno Bishop is the Office of Workers’ Compensation (OWC) District Judge in
Harahan, Louisiana. As District Judge of the OWC, Shannon conducts judicial hearings
in the district office by presiding over workers’ compensation claims in a judicial
capacity rendering final appealable judgments in the claims. She has full administrative
responsibility in the district office. Judge Bishop is a native of New Orleans and
graduated from Tulane University with a B.A. in Sociology and The University of
Mississippi School of Law with a J.D. She is admitted in Mississippi and Louisiana.
Prior to becoming District Judge, Judge Bishop served as mediator, in Harahan and New
Orleans, where she mediated hundreds of workers’ compensation cases each year. Judge
Bishop is married to State Senator Wesley T. Bishop and they have two sons, ages 7 and
3. Judge Bishop’s past and/or current professional and community involvements include: Louisiana State Bar
Association, The Mississippi Bar, American Bar Association, National Bar Association, American Diabetes
Association, Young Leadership Council, Martin Luther King Charter School, Greater New Orleans Louis A.
Martinet Legal Society, Mississippi Mock Trial Competition, Boy Scouts of America, and Alpha Kappa Alpha
Sorority, Incorporated. Judge Bishop is also a member of the Editorial Committee of the Lex and Verum
newsletter for the National Association of Workers’ Compensation Judiciary.
Honorable Suzette Carlisle
Judge Suzette Carlisle earned a B.S. degree and J.D. degrees from St. Louis University, an
MBA from Lindenwood College, and a Masters’ degree in Judicial Studies from the
University of Nevada-Reno (“UNR”). Currently, she is a candidate for a Ph.D. in judicial
studies from UNR. Since 2005, Judge Carlisle has served as an administrative law judge
(“ALJ”) with the Missouri Division of Workers’ Compensation. She served as a legal
advisor in the same office for 8 years before becoming an ALJ. For a brief time Judge
Carlisle served as a criminal defense attorney, and later as an Assistant Circuit Attorney in
St. Louis City.
March 2017 NAWCJ - Lex and Verum Page 43
Honorable Robert Cohen
A native of Orlando, Florida, Bob Cohen graduated from Brandeis University in 1979 with
a B.A. degree in American Studies. He graduated in 1981 from the Florida State
University College of Law, where he served on the Law Review. After more than 20 years
in private practice, concentrating in administrative and civil law representing large
companies, professional licensees and consumer associations, Bob was appointed by the
Governor and Cabinet in October, 2003, as the Director and Chief Administrative Law
Judge of the Florida Division of Administrative Hearings which includes under its
umbrella, the Office of Judges of Compensation Claims. Bob currently serves as President
of the National Association of Administrative Law Judiciary, as a Board Member of the
National Association of Workers’ Compensation Judiciary, on the Second Judicial Circuit
Bench/Bar Committee, as an alumni member of the William Stafford Inn of Court, as a
Board Member of the Legal Aid Foundation of the Tallahassee Bar Association, and has served as a consumer
organization representative on the Federal Alliance for Safe Homes Steering Committee, The Residential
Community Mitigation Program Advisory Committee, and the Department of Revenue Property Tax
Administration Task Force. He is active in the community, currently serving as Leadership Giving Co-Chair in
the Florida State Employees Charitable Campaign, having previously served as President of the Tallahassee Bar
Association, the Legal Aid Foundation (twice), and numerous community organizations. He is a Fellow of the
Florida Bar Foundation and a Charter Life Mentor of the National Administrative Law Judiciary Foundation.
He is also a past recipient of the Florida Bar’s Pro Bono Service Award for the Second Judicial Circuit. Bob is a
frequent speaker on topics related to administrative law at Bar events, regional and state organizations, and in
the classroom. He is Board Certified by the Florida Bar in State and Federal Government and Administrative
Practice.
Allen Craddock
Allen is a frequently requested speaker and serves as an adjunct professor of law at St.
Mary’s University – School of Law. Allen teaches Mediation, Negotiation, and Arbitration.
Allen is board certified in Workers’ Compensation by the Texas Board of Legal
Specialization. In 2005, Allen was recognized as a “Super Lawyer” by Texas Monthly, a
distinction held by only two percent of the practicing attorneys in Texas.
Honorable William Culbreth
William R. Culbreth is the resident Deputy Commissioner in the Harrisonburg Regional
Office of the Virginia Workers’ Compensation Commission which serves the Harrisonburg to
Lexington corridor. Deputy Commissioner Culbreth received his B.A. from Wake Forest
University in 1984 and his J.D. from the T.C. Williams School of Law of the University of
Richmond in 1990. Prior to moving to the Valley and joining the Commission in 1996, he
practiced law in Richmond specializing in workers’ compensation and medical malpractice
defense. He currently serves as an adjunct faculty member at Eastern Mennonite University
where he has taught business law and political science.
March 2017 NAWCJ - Lex and Verum Page 44
Rosalie Farris, RN
In addition to being a Registered Nurse, Rosalie Faris is a Certified Case Manager and a
Certified Occupational Health Nurse-Specialist. She has 20 years hospital experience,
having developed and managed an out-patient surgery center, a hospital-based occupational
medicine program, and broad experience in ADA consulting. She designed, implemented
and managed multi-state case management systems for workers’ compensation and group
health applications. Additionally she consults with hospitals and physician practices on a
variety of clinical and administrative issues.
Professor Charles W. Ehrhardt
Author of Florida Evidence (West 2011), the leading treatise on the topic, and Florida Trial
Objections (West 4th ed. 2007), Professor Ehrhardt has been cited as an authority by
appellate courts more than 500 times. He taught Torts, Evidence, Trial Practice and Trial
Evidence Seminar, and was named Outstanding Professor seven times. After serving as the
Ladd Professor of Evidence for 35 years, he earned emeritus status in 2007. He continues to
teach Evidence at the law school. Professor Ehrhardt served as a commissioner to the
National Conference of Commissioners on Uniform State Laws from 1996-2005. He was a
member of the faculties of both the National Judicial College in Reno, Nevada, and the
Federal Judicial Center in Washington, D.C. He has been a visiting professor at University
of Georgia and Wake Forest. Professor Ehrhardt received the Selig I. Goldin Award from
the Criminal Law Section of The Florida Bar and the President's Award from the Florida Board of Trial
Advocates. He clerked for the Honorable M.D. Oosterhout of the U.S. Court of Appeals for the Eighth Circuit
and joined Florida State University College of Law's faculty in 1967. For almost 20 years, he served as the
university's representative to the NCAA and the ACC. In 2007, he was inducted into the Florida State Sports
Hall of Fame. Education: J.D., University of Iowa, 1964; B.S., Iowa State University, 1962.
Honorable Michael Feeney
Judge Feeney was appointed in May 2016, joining a bench comprised of a Chief Judge and
nine Associate Judges. He previously practiced with Jeffrey and Feeney in Warwick, Rhode
Island, focusing on workers’ compensation, appellate practice and municipal law. Previously,
he served as assistant town solicitor in East Greenwich. He earned his bachelor of science
from Suffolk University and his juris doctor from New England School of Law in 1988.
Debi Galler, Esq
Debi Galler has an extensive background in real estate, transactional, and corporate
bankruptcy matters. She focuses her practice in business transactions, including
commercial real estate projects, acquisition and disposition of businesses, asset-based
lending, and leasing and financing arrangements, as well as in bankruptcy, receiverships,
insolvency, and assignments for the benefit of creditors which are state court liquidation
proceedings pursuant to Florida Statutes. Debi is Chair of Berger Singerman's pro
bono legal services.
March 2017 NAWCJ - Lex and Verum Page 45
Honorable LuAnn Haley
After earning her JD in 1981, Ms. Haley worked in the field of Workers’ Compensation
as a defense lawyer in Pennsylvania. After passing the bar in Arizona in 1999, she was
appointed an Administrative Law Judge for the Industrial Commission of Arizona. Ms.
Haley lectures for state bar CLE programs and also serves as a reviewer for AMA
publications. She is a member of the Board of Directors of the National Association of
Workers’ Compensation Judiciary and the Editor of the Lex and Verum newsletter.
Honorable Jennifer Hopens
Jennifer Hopens received a bachelor’s degree from the University of Texas at Austin
and a law degree from the University of Texas School of Law. She joined the Texas
Department of Insurance, Division of Workers’ Compensation as a hearing officer in
2007, and traveled across the state presiding over numerous contested case hearings
involving a variety of workers’ compensation matters. She is currently the Director of
Hearings for the Northern & Western regions of the Division and is Board Certified in
Workers’ Compensation law by the Texas Board of Legal Specialization. She also
serves as president of the National Association of Workers’ Compensation Judiciary.
Timothy Hughes
Timothy Hughes is a fourteen-year veteran of the United States Marshals Service (USMS),
where he serves as Assistant Chief Inspector responsible for security for the National Center
of Judicial Security. In this role, he teaches federal, state, and local judges, and law
enforcement officers security and protection best-practices. Chief Hughes has lead over 100
protection details that includes dozens of United States Supreme Court Justice details, and
served as the Inspector in Charge of detail for District Judge Timothy Corrigan who was
shot at in his home. He also served as the USMS congressional affairs fellow during which
time he was instrumental in securing funding for the Adam Walsh Act and the
Florida/Caribbean Regional Fugitive Task Force. Chief Hughes is a founding members of
the Lone Star Fugitive Task Force, and has been the lead investigator in over 150 federal
fugitive cases closed by arrest, with many of those cases involving sex offenders. Previously, Chief Hughes
served in the United States Navy. He received his M.A. in Strategic Communication and Leadership from Seton
Hall University, completed a Georgetown University fellowship in government affairs, and has his B.A. in
Creative Writing from Eckerd College.
Honorable David Imahara
Judge David Imahara is the Chief Administrative Law Judge for the Georgia Board of
Workers’ Compensation. He previously served as Administrative Law Judge, Deputy Chief
Judge, and director of the Alternative Dispute Resolution unit of the State Board. He has
served on the Board of the National Association of Workers’ Compensation Judiciary.
March 2017 NAWCJ - Lex and Verum Page 46
Honorable Sheral Kellar Sheral C. Kellar was appointed Director, Office of Workers’ Compensation Administration in January, 2016 by Governor John Bel Edwards and Louisiana Workforce Commission (formerly the Louisiana Department of Labor) Executive Director, Ava Dejoie. Kellar has served at the Louisiana Workforce Commission as a Workers’ Compensation Judge since 1991 and as Workers’ Compensation Chief Judge since May 1999. In July 2015, she was appointed to the new Louisiana State Bar Association’s Access to Justice Commission, co-chaired by the Chief Justice of the Louisiana Supreme Court. In March 2014, she was inducted as a fellow of the College of Workers’ Compensation Lawyers. Since 2007 she has been a member of the National Association of Workers’ Compensation Judiciary and serves on its Board of Directors and its Curriculum Committee. She is also a member of Baton Rouge Bar Association and the Louisiana State Bar Association. In June 2007 Kellar received the Louisiana State Bar Association President’s Award for her many contributions to the Bar Association and her exceptional service as Co-Chair of the Access to Justice Committee. She is a former member of the American Bar Association, the National Legal Aid & Defender Association, board member of the Louisiana Bar Foundation and at-large member of the Louisiana State Bar Association Board of Governors having been appointed in 2002 to a three year term. She is a former Court Appointed Special Advocate (CASA volunteer). Kellar speaks frequently on issues of workers’ compensation and professionalism. She received her Bachelor of Science and Juris Doctor degrees from Louisiana State University.
Honorable John Lazzara
Judge Lazzara is Judge of Compensation Claims (JCC) for the Tallahassee District, Florida,
having received his initial gubernatorial appointment in 1990 and reappointed several times
since. Judge Lazzara was twice nominated for appointment to the First District Court of
Appeal, the Court which has exclusive statewide jurisdiction over workers’ compensation
appeals. He served as Interim Deputy Chief Judge of Compensation Claims from 2005-06.
The judge was elected the Inaugural President of the National Association of Workers’
Compensation Judiciary in 2008 and currently serves on its Board. In 2009, he was
inducted a Fellow of the ABA-founded College of Workers’ Compensation Lawyers and
currently sits on its Board of Governors. He was selected a Charter Member of the 2012 Florida Workers'
Compensation Institute's Hall of Fame, and was recently inducted by Florida Blue Key of the University of
Florida in its 2015 Honorary Tapping Spring Class. Judge Lazzara has been an Adjunct Professor of Workers’
Compensation Law at Florida State University, College of Law, and is a frequent national and state speaker on
workers’ compensation topics. He received his B.A. (’65) and J.D. (’67) degrees from the University of Florida.
Honorable Ellen Lorenzen
Ellen Lorenzen was originally from Los Angeles, CA. but grew up in Baton Rouge, LA. She received her B.A.
from Emory University, Atlanta, GA in 1971 and moved to Florida. She began working as an all-lines adjuster
until she attended Stetson College of Law where she graduated in 1978. After admission to the Bar, she became
employed as staff counsel for Continental Insurance in Tampa, practicing primarily in the area of personal
injury defense with some workers’ compensation cases. In 1985 Ms. Lorenzen became employed with the firm
of Morris & Rosen where she represented injured employees. In 1986 she was hired by Travelers Insurance as a
staff attorney where she was responsible for a mix of workers’ compensation and personal injury cases until
1990. At that time she became the managing attorney for the Tampa staff counsel office of Travelers and
restricted her practice solely to workers’ compensation defense. In 1994 Ms. Lorenzen became associated with
the firm of Barr, Murman, Tonelli in Tampa and became a partner there in 1997. In 1998 Ms. Lorenzen and
John Dixon, Esq. formed a firm handling workers’ compensation defense statewide on behalf of several self-
insured employers. Ms. Lorenzen resigned her membership in that firm in 2004 when she was appointed a
Judge of Compensation Claims by Governor Bush. She has been Board Certified in Workers’ Compensation
since 1988.
March 2017 NAWCJ - Lex and Verum Page 47
Honorable Deneise Turner Lott
Judge Lott received her undergraduate and law degrees from the University of
Mississippi and is a past president of SAWCA, the Southern Association of Workers’
Compensation Administrators. She has also chaired SAWCA’s Adjudication Committee
since 2006. Judge Lott has twice served as president of the Administrative Law and
Workers’ Compensation Section of the Mississippi Bar, and she is a Fellow of the
Mississippi Bar Foundation and of the American College of Workers’ Compensation
Lawyers. She is a member and currently serves on the board of the National Association
of Workers’ Compensation Judiciary. She is also a former adjunct professor of workers’
compensation law with Mississippi College School of Law. Between 2008 and 2016, she
served on a twelve-member Advisory Committee on Disability Compensation chartered
by the United States Congress to recommend improvements to the disability compensation system
administered by the Compensation Service of the United States Department of Veteran’s affairs.
Honorable Wesley Marshall
Commissioner Marshall was appointed to the Virginia Workers’ Compensation
Commission in May 2012. He serves on the Southern Association of Workers’
Compensation Administrators’ Executive Committee and the IAIABC’s Dispute
Resolution Committee. He is a member National Association of Workers’ Compensation
Judiciary, the Lewis F. Powell, Jr. and Virginia Workers’ Compensation American Inns of
Court, and other bench and bar organizations. In 2015 he was inducted as a fellow of the
College of Workers Compensation Lawyers.
Honorable Frank McKay
Frank R. McKay is the Chairman and Chief Appellate Court Judge of the State Board of
Workers’ Compensation. He came to the Board in 2013 from private practice where he was
a partner in the Stewart, Melvin and Frost law firm in Gainesville, Georgia. His practice
was concentrated in workers’ compensation, and he tried and presented many cases before
the Administrative Law Judges and the Appellate Division of the State Board, and appeals
to the Superior Courts and the Georgia Court of Appeals. He is a former Special Assistant
Attorney General handling workers’ compensation claims for the State of Georgia. He was
on the State Board’s Advisory Council prior to being appointed the Chairman. He is on the
Board of Directors for the National Association of Workers’ Compensation Judiciary and
the current President-Elect of the Southern Association of Workers’ Compensation
Administrators. He is on the Board of Directors for the International Association of Industrial Accident Boards
and Commissions (IAIABC). He serves on the Board of Directors of Kids’ Chance of Georgia and he is a Fellow
in the College of Workers’ Compensation Lawyers. He obtained his law degree (J.D.) from Walter F. George
School of Law, Mercer University, and his undergraduate degree (B.A. Economics) from Clemson University.
March 2017 NAWCJ - Lex and Verum Page 48
Honorable Sylvia Medina-Shore
Sylvia Medina-Shore has been a Judge of Compensation Claims in the State of Florida
since March of 2000. Since her initial appointment as a judge, she has been reappointed
by three different Governors of the State of Florida. Judge Medina-Shore adjudicates
workers compensation cases in Miami-Dade County. Previously, she was in private
practice for approximately ten years specializing in workers' compensation cases,
representing injured workers and employer/carriers. In addition to undertaking her judicial
functions, Judge Medina-Shore was appointed Administrative Judge of the Miami Office
of Judges of Compensation Claims in March of 2006. Judge Medina-Shore has lectured at
continuing legal education seminars for Dade County Bar Association, American Bar
Association and Florida Bar Workers Compensation Section. She has also guest lectured at Florida International
University and Florida Atlantic University. She was a volunteer judge for the Miami Dade County Silver Night
Award general scholarship and participated in the UM Summer Scholar Program. She continues to attend
"Career Day" at Miami Dade County middle and high schools. In her spare time, Judge Medina-Shore enjoys
reading, traveling and spending time with her family.
Honorable Bruce Moore
Judge Bruce Moore has served as an administrative law judge for the Kansas
Department of Labor, Division of Workers’ Compensation, since 1995 where he
presides over workers’ compensation cases. He also serves as a municipal court judge
pro tempore for the City of Salina, Kansas. Before joining the Department of Labor,
Judge Moore served as municipal court judge pro tempore for the City of Prairie
Village, Kansas, and as a district judge pro tempore for Kansas’ 10th Judicial District.
He practiced law in Kansas for 15 years, concentrating his practice on criminal
prosecution and defense and the prosecution and defense of personal injury and workers’
compensation claims. Judge Moore received his bachelor’s degree from Kansas State
University and Juris Doctor from Kansas University. He is the author of “Litigating a
Defense of Alcohol or Drug Impairment Under the Workers’ Compensation Act,”
published by the Journal of Kansas Trial Lawyers Association, and Chapter 25,
“Causation: A Judge’s Perspective,” for the American Medical Association’s Guides to the Evaluation of
Disease and Injury Causation,” Second Edition (2013). He has served as President of two Rotary Clubs, and as
an Assistant District Governor of Rotary International; he served two terms as President of the Board of
Directors of the Salina Community Theatre, and as a Disaster Response team member for the American Red
Cross. Judge Moore was awarded a Professional Certificate of Judicial Development in Administrative Law
Adjudication Skills in 2008 and a Professional Certificate of Judicial Development in Dispute Resolution Skills
in 2009 by the National Judicial College. Judge Moore is an alumnus of The National Judicial College and
joined its faculty in 2009. In 2015 he was inducted as a fellow of the College of Workers Compensation
Lawyers.
Dr. Robert Murrah
Dr. Murrah is a Board Certified Ortopedic Surgeon practicing in Orlando, Florida. He
received his Bachelor of Science in biochemistry and his medical degree from Duke
University, and performed his surgical residency at Johns Hopkins Hospital. He is a
member of the American Academy of Othropedic Surgeons, the Florida Orthopedic
Society, and is certified by the states of Florida, Georgia and North Cariolina. He is a
certified Expert Medical Advisor in Florida.
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Dr. Pritesh Parbhoo
Dr. Parbhoo is the Clinical Director of Psychology/Neuropsychology and administrative
Program Consultant at NeuroInternational in Sarasota, Florida. NeuroInternational works
with the unique needs of brain and spinal cord injury survivors. A multidisciplinary Team
of staff and consortium providers offer services in a variety of settings (facility,
apartments, houses, host homes). The primary goal is to facilitate neurorecovery and
promote independence and quality living. The Team establishes outcome-driven goals and
objectives for each survivor, and involves the survivor, family, payer and other
stakeholders in the treatment planning process to ensure targeting desired outcomes.
Honorable Neal Pitts
Neal Pitts was appointed a Judge of Compensation Claims on November 1, 2009 to serve
in the Jacksonville, Florida district office. Effective December 1, 2010, he transferred to
the Orlando, Florida district office. He holds a BA degree from Rhodes College (1975); a
JD degree from Ohio Northern University in 1978, where he was a member of the Law
Review Phi Kappa Phi and Willis Society honor societies and listed in Who’s Who in
American Colleges and Universities and the National Dean’s List; and a Master of Laws
(in taxation) from the University Of Florida Levin College of Law in 1982. In law school,
he served on the Law Review where two of his articles were published in the Ohio
Northern University Law Review in 1978 and 1982. He also received a Certificate of Merit
for outstanding contribution to the field of legal journalism from the Ohio Northern University Law Review in
1982 for his article regarding federal taxation of natural resources. Prior to his appointment as a JCC, he
practiced law in Orlando, Florida. He has been a member of the Florida Bar since May 31, 1979. He holds an
AV rating from Martindale Hubbell and is listed in The Bar Registry of Preeminent Lawyers in both the Peer
Review and the Judicial Editions. He recently received recognition for his 15th
year listing in The Bar Registry
of Preeminent Lawyers. He is a member of The Florida Bar, Orange County Bar Association, an honorary
member of the E. Robert Williams American Inn Of Court, and the Judge William Wieland American Inn of
Court. He is the immediate past president of the Judge William Wieland American Inn Of Court and the
recipient of the David Hammond Professionalism Award. He serves as the current president of the Conference
of the Judges of Compensation Claim. He also serves as a member of the Advisory Board for the University of
Florida College Of Public Health and Health Professions.
Professor Wayne C. Schiess
Professor Schiess joined the faculty at The University of Texas School of Law in 1992,
after three years of law practice in the Dallas office of Baker Botts, LLP. Professor
Schiess is the director of the legal-writing program and teaches legal writing, legal
drafting, and plain English. He is also a frequent seminar speaker on those subjects. He
has published more than a dozen articles on practical legal-writing skills, plus two books:
Writing for the Legal Audience and Better Legal Writing. He expects his third and fourth
books on legal writing to be published soon. He received his Juris Doctor from Cornell
Law School. In 2012 and 2015, he was chosen as the Law School’s legal-writing teacher
of the year. In 2011, the Texas Pattern Jury Charges Plain Language Project, for which
he was the drafting consultant, was named a finalist for a ClearMark Award by the
Center for Plain Language. He blogs on legal writing at LEGIBLE.
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Dr. Robert Snyder
Dr. Robert B. Snyder, M.D. is a Board Certified orthopaedic surgeon from Nashville,
Tennessee and is licensed to practice in Kentucky and Tennessee. Retiring in 2013 after 37
years in private practice, he was President of the Medical Staff at St. Thomas Hospital in
Nashville and had additional privileges at Tristar Centennial Hospital and Williamson
Medical Center. He is an Adjunct Clinical Professor at Vanderbilt University Medical
School. Presently, he serves as Medical Director for the Tennessee Bureau of Workers’
Compensation under Administrator Abbie Hudgens.
Honorable Robert Swisher
Robert Swisher is the Chief Judge of the Kentucky Department of Workers’ Claims.
Appointed to the bench in 2009 by Governor Beshear, Judge Swisher became the Chief
Judge in 2014. Prior to his appointment, Judge Swisher was a partner with the Northern
Kentucky based workers’ compensation defense firm of Jones, Dietz & Swisher. He is a
graduate of the University of Notre Dame and the University of Kentucky College of
Law. He has been licensed to practice law since 1979.
Honorable Kenneth Switzer
Kenneth M. Switzer was appointed to the Tennessee Court of Workers’ Compensation
Claims in spring 2014 to serve as the Court’s first chief judge. In that role, he has led rolling
out the new court, which officially opened its doors on July 1, 2014. Chief Judge Switzer
oversees all court operations, in addition to handling a full docket of cases. In the past he
spoke frequently on the subject of civil trial practice and Tennessee worker's compensation
law at continuing education seminars and before business and community groups. At present
he speaks exclusively on workers’ compensation and the new system. Chief Judge Switzer is
a retired “on the field” Ohio Valley Conference Football official, having worked as a Referee
for 13 years. In 2014, he transitioned into an assistant replay official in C-USA. He now
works in replay for the National Football League. He is an avid runner and has completed 30 marathons. His
other hobbies include biking and spoiling his two grandsons and one granddaughter.
Honorable James Szablewicz
Jim Szablewicz is the Chief Deputy Commissioner of the Virginia Workers’
Compensation Commission and is responsible for the Judicial Division of the
Commission, including the functions of the Commission’s Clerk’s Office, six Regional
Offices and all of the Deputy Commissioners state-wide. Jim received his B.A. in Political
Science from Yale University in 1984 and his J.D. from the University of Virginia School
of Law in 1987. He is the President-elect of the National Association of Workers’
Compensation Judiciary and an active participant in the Southern Association of Workers’
Compensation Administrators and the International Association of Industrial Accident
Boards and Commissions. Jim was inducted as a Fellow of the College of Workers’
Compensation Lawyers in 2014.
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Honorable David Torrey
David B. Torrey, a native of Alexandria, VA, has been a Workers’ Compensation Judge
with the Pennsylvania Department of Labor & Industry since 1993. He is Adjunct
Professor of Law, University of Pittsburgh School of Law (1996-present). He is also the
Editor of the Pennsylvania Bar Association Workers’ Compensation Newsletter (1988-
present). He received his A.B., 1982, from West Virginia University; and his J.D., 1985,
from Duquesne University School of Law. While in law school, he was Editor-in-Chief
of the Duquesne Law Review (Volume 23, 1984-85). In 2010 he was elected to
membership in the National Academy of Social Insurance. He a Past President of the
National Association of Workers’ Compensation Judiciary; and a Fellow and Secretary
of the College of Workers’ Compensation Lawyers. In 2008, he published the Third
Edition of his treatise, Torrey & Greenberg, Pennsylvania Workers’ Compensation: Law
& Practice (4 Volumes: Thomson-Reuters 3rd ed. 2008 & Supp. 2016). He also served in the U.S. Army (1976-
1979), and in the West Virginia Army National Guard (1979-1982).
Honorable Jane Williams
Jane Rice Williams is an Administrative Law Judge with the Kentucky Department of
Workers Claims. She received her Bachelor of Arts from the University of Kentucky and
Juris Doctorate from Salmon P. Chase College of Law. She was admitted to the practice
of law in the Commonwealth of Kentucky in October of 1995 and is a member of the
Kentucky and Laurel County Bar Associations. She serves on the Board of Directors of
the National Association of Workers’ Compensation Judiciary and served as part of the
Kentucky delegation to the “New Judges College” for the new Tennessee Court of
Workers’ Compensation Claims. In 2017, she was inducted as a Fellow of the College of
Workers’ Compensation Lawyers. She presents annually for various workers’
compensation seminars including NAWCJ, Comp Ed, KWCEA and the Kentucky
Chamber of Commerce. Judge Williams is a native of Harlan, Kentucky. She was in
private practice in Lexington and then London from 1995 until July 2012 handling a variety of civil matters with
a concentration on workers’ compensation law representing both plaintiffs and defendants. Judge Williams was
appointed as an Administrative Law Judge and has served in that position since July 15, 2012.
March 2017 NAWCJ - Lex and Verum Page 52
