Post-Traumatic Stress Disorder (PTSD) has undergone significant evolution in both understanding and diagnosis over the past century. In our new MEC Connect Expert Insights episode, “PTSD Diagnosis Dilemma,” our Chief Medical Officer, Dr. Fernando Branco, provides a comprehensive overview of PTSD, its progression in medical understanding, and why it is becoming overdiagnosed in modern practice. 

Dr. Branco challenges listeners to recognize the critical distinction between Acute Traumatic Stress Disorder – a standard, time-limited response to abnormal events – and true PTSD, which persists beyond six months and manifests through specific symptoms that are often misunderstood. He also urges healthcare providers to be more precise in their diagnosis and shares his perspective on:

• How our understanding of PTSD shifted from purely military contexts to recognizing trauma in civilian populations.
• The fact that people living with genuine PTSD typically avoid discussing their trauma rather than repeatedly sharing it.
• The diagnostic criteria for PTSD evolving and becoming more inclusive.
• Promising treatment approaches, particularly the success of group therapy among first responders.

Listen now to hear an essential conversation about how trauma affects the human mind and gain valuable insights about the vital importance of maintaining diagnostic integrity while still honoring the very real suffering of those affected by PTSD.

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Burns represent one of the most devastating workplace injuries, with treatment costs potentially reaching millions of dollars and recovery periods extending for months or even years. Diving deep into the world of severe burn injuries, this episode, “Understanding Burn Injuries in the Workplace,” MEC’s Senior National Catastrophic Medical Consultant Phyllis Ramondetta unveils the staggering reality behind workplace burns. The financial toll alone is eye-opening - from $207,000 for moderate burns to a jaw-dropping $10 million for severe cases with complications. 

Understanding burn severity is crucial for appropriate treatment planning. With 63% of workplace burns involving thermal or scalding injuries, and manufacturing sectors reporting the highest incidents, the conversation explores: 

• Why these injuries occur and how they can be prevented through proper safety protocols and training.
• The four degrees of burn severity and treatment landscape for burn care and rehabilitation. 
• The recovery path after hospital discharge
• How modern medical advances transformed survival outcomes for patients.

For employers, healthcare providers, and safety professionals, understanding the complexity of burn injuries is crucial for both prevention and proper care management. 

Listen now to gain essential insights that could save lives, reduce suffering, and mitigate the enormous financial impact of workplace burn injuries.

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Understanding brain injuries can be overwhelming for patients, families, and caregivers alike because every brain injury follows a different recovery path. In this episode, “Rancho Los Amigos Scale: Roadmap for Brain Injury Recovery,” Tracie Lemus, RN, CCM, National Medical Catastrophic Nurse Consultant at MEC, breaks down the vital tool that healthcare professionals use to track cognitive and behavioral rehabilitation after brain trauma.

Tracie shares her perspective about how the Rancho Los Amigos Scale helps monitor recovery progress, determine appropriate treatment plans and timing, and facilitate coordination among the various specialists involved in a patient's care journey. This knowledge empowers healthcare teams to create more targeted rehabilitation strategies tailored to each patient's current cognitive and behavioral functioning. It includes:

• Tracking recovery progress through ten distinct levels, enabling better treatment planning and communication among medical team members.
• Valuable context for the often confusing and unpredictable nature of brain injury recovery.
• Factoring in both the patient’s state of consciousness and need for assistance with daily cognitive and physical functions.
• Projected timelines to help everyone involved understand where a patient currently stands and what challenges and progress might lie ahead.

Listen now to gain key insights into the Rancho Los Amigos Scale assessments, which offer a roadmap through the complex journey of brain injury rehabilitation by breaking down recovery into distinct, observable stages in the realm of neurological healing.

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The Glasgow Coma Scale (GCS) is one of medicine's most critical assessment tools for traumatic brain injuries. In this episode, “The Glasgow Coma Scale: Setting the Bar for Brain Injury Evaluation," MEC’s Peggy Ford, a Senior National Medical Catastrophe Consultant with over 30 years of experience, provides essential knowledge about how the GCS measures brain injury severity.

Peggy offers valuable insights into this evaluation method, which has become the cornerstone of neurological tests worldwide in emergency settings. It includes a scoring system that allows medical professionals to quickly categorize the severity of brain injuries and make critical treatment decisions in time-sensitive situations where every moment matters. She explains:

• How the scale rates three key aspects of traumatic brain injuries — eye opening, verbal response, and motor response — to generate scores ranging from 3 (completely unresponsive) to 15 (fully alert).
• Why understanding the nuances of each category is essential for accurate assessment.
• The science behind brain injury measurement. 
• Factors that can compromise proper evaluation. 

Listen now to gain key insights on the importance of standardized assessment tools like the GCS in guiding initial treatment approaches and providing valuable prognostic information for healthcare providers, patients, and families during vital stages of care.

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Medicare Set-Asides (MSAs) represent a critical factor in the workers compensation settlement landscape, yet they remain widely misunderstood by many professionals in the industry. In this Expert Insights episode, "Demystifying Medicare Set-Asides in Workers Comp," MEC’s Medical Management Consultant, Tina D’Andrea, unpacks how a properly executed MSA ensures compliance with Medicare requirements and provides clarity and protection for all parties involved in the settlement process.

Tina shares insights about fundamental components of MSAs—from threshold requirements to submission procedures to review and appeal options— to help claims professionals better understand and navigate the complex process more effectively. This includes:

• Centers for Medicare and Medicaid Services thresholds that determine when an MSA should be submitted for their review.
• Why the MSA submission process requires meticulous documentation and attention to detail.
• Remediation pathways that can save thousands of dollars and countless headaches. 
• Re-review options for mathematical errors, missing documentation, or significant pricing changes
• The vital importance of working with experienced MSA vendors for best results.

Listen now to get the guidance you need to successfully address the challenges of Medicare Set-Asides and approach your next workers compensation settlement with clear focus and confidence. 

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Urine drug screens have become an essential component in the landscape of workers comp claims management. In this Expert Insights episode, "The Powerful Impact of Drug Screening on Claims Management," MEC’s Medical Management Consultant, Jeff Pack, RN, BSN, provides his unique perspective on how these tests serve multiple purposes throughout the lifecycle of a claim and can significantly impact treatment decisions, safety protocols, and claim outcomes. 

Jeff breaks down the science behind drug testing methodologies and the way these approaches function as safety tools across various industries. This includes pre-employment screening, workplace accident investigations, and ongoing treatment monitoring. He shares compelling real-world examples of how drug screening is invaluable for: 

• Use in safety-sensitive industries to enhance workplace protection
• Determining if substances contributed to workplace accidents
• Monitoring injured workers' compliance with prescribed treatments
• Revealing dangerous behaviors such as exceeding the prescribed dosage 
• Helping to prevent risks of overdose from medication interactions

Listen now to get essential insights into a tool that Pack describes as “the cornerstone of modern healthcare and safety practices” and why trained professional interpretation of drug testing is vitally important to avoid false positives. 

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The medical field has long recognized the complex intersection of chronic pain and addiction, but a critical third component is often overlooked. In this MEC Connect Expert Insights episode, “Beyond Pain and Addiction: The Triple Diagnosis,” our Chief Medical Officer, Dr. Fernando Branco, shares his approach to treating patients beyond the traditional pain-addiction model.

Dr. Branco discusses the framework of "triple diagnosis" in pain medicine. His decades of experience revealed that addressing underlying psychiatric conditions alongside pain and substance use disorders is critical for successful treatment outcomes. He offers expert insights into:

• The interconnected nature of physical pain, substance use, and mental health.
• Why a triple diagnosis framework could enhance treatment approaches for some of medicine's most challenging cases.
• The importance of considering psychosocial factors, such as family dynamics, environmental stressors, and social support systems, that can either facilitate recovery or create additional barriers. 
• How underlying psychiatric conditions consistently influence treatment outcomes. 
• Why pre-existing conditions create a complex treatment landscape that demands a more comprehensive approach.

Listen now to hear about Dr. Branco’s holistic approach to viewing patients as "global persons" and the paradigm shift that moves integrated patient care beyond the common dual focus of pain and addiction.

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In this MEC Connect Expert Insights episode, “Unsung Heroes: Spotlight on Nurse Case Managers,” MEC’s Medical Management Consultant Dana Dorsey explains how nurse case managers serve as the critical bridge between injured workers and successful recovery.

Based on two decades of experience in the field, Dana shares insights about how Nurse Case Managers play a vital role in facilitating collaboration between injured workers, employers, healthcare providers, and insurance carriers. This includes:

• Conducting comprehensive evaluations to identify recovery barriers
• Formulating action plans to overcome them and develop return-to-work strategies.
• Mitigating attorney involvement through consistent communication with injured workers.
• Interpreting medical information, educating injured workers, and ensuring necessary treatments.
• Assistance with claims involving wage loss, multiple injuries, catastrophic conditions, non-compliant workers, and surgical recommendations.      

Listen now to gain a fresh perspective on the often underappreciated yet high-impact role Nurse Case Managers play in all aspects of effective workers compensation management.

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In this episode, MEC’s Senior National Medical Catastrophic Consultant Peggy Ford unpacks the complex world of the American Spinal Injury Association (ASIA) Impairment Scale. Peggy breaks down this essential clinical tool that standardizes how healthcare professionals evaluate and communicate about spinal cord injuries. This includes:

• The three crucial components of the ASIA scale 
• The scoring system for sensation 
• Categories for measuring muscle strength 
• Insights into how clinicians map injury severity  
• The five grade classifications for the assessment tool 
• How classifications drive treatment decisions, rehabilitation strategies, and recovery expectations. 

Listen now to understand the language that shapes spinal cord injury management and gain valuable knowledge applicable to workers' compensation and catastrophic claim oversight.

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Amputations are among the most challenging cases in workers' compensation. In this Expert Insights episode, MEC’s Senior National Catastrophic Medical Consultant Phyllis Ramondetta provides excellent insights into this complex topic that affects thousands of workers annually.
Phyllis shares expert commentary based on over 20 years of experience as a catastrophic nurse case manager. This includes:

• How trauma accounts for 44% of all work-related amputations, typically in high-risk environments.
• How prosthetists collaborate with medical teams to find the right solution. 
• The multi-faceted recovery process following an amputation.
• The psychological impact of an amputation. 

Whether you are managing amputation claims, supporting an injured worker through recovery, or trying to understand prosthetic technology better, this episode provides essential insights to navigate these life-altering injuries. 

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