Shows
MEC ConnectThe Glasgow Coma Scale: Setting the Bar for Brain Injury EvaluationThe 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...2025-06-3007 minMEC ConnectDemystifying Medicare Set-Asides in Workers CompMedicare 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...2025-06-1608 minMEC ConnectThe Powerful Impact of Drug Screening on Claims ManagementUrine 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 acc...2025-06-0208 minMEC ConnectBeyond Pain and Addiction: The Triple DiagnosisThe 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...2025-05-1906 minMEC ConnectUnsung Heroes: Spotlight on Nurse Case ManagersIn 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 barriersFormulating action plans to overcome them and develop return-to-work strategies.Mitigating attorney involvement through consis...2025-05-0506 minMEC ConnectCategorizing Spinal Cord Injuries with Peggy FordIn 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 c...2025-04-2108 minMEC ConnectNavigating the Journey of Amputation CasesAmputations 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 clai...2025-04-0708 minMEC ConnectDecoding Complex Regional Pain SyndromeIn this episode, Dr. Fernando Branco, MEC AVP of Claims and Chief Medical Officer, tackles the multifaceted world of Complex Regional Pain Syndrome (CRPS) by drawing on decades of specialized experience in physical medicine, rehabilitation, pain management, and addiction medicine.Dr. Branco provides valuable insights about: How this complex diagnosis can create significant physical and emotional stress for patients.Why a proper CRPS diagnosis requires careful assessment of specific symptoms across three key categories: sensory system, vasomotor activity (blood flow) and sudomotor function (sweat glands). Diagnostic criteria to help distinguish true CRPS from other pain conditions.The...2025-03-2407 minMEC ConnectManaging Spinal Cord Injuries with Tracie LemusIn this episode, Tracie Lemus, RN, CCM, MSCC, National Catastrophic Nurse Consultant at Midwest Employers Casualty, highlights critical care strategies and rehabilitation insights for better recovery outcomes for spinal cord injuries. Tracie provides invaluable knowledge on injury types, common complications, and the importance of comprehensive treatment. Topics covered include:Understanding spinal cord injury demographics and causes The importance of immediate care and specialized centers Complications and their management The role of rehabilitation in recovery Transitioning home and ongoing support needs Impact of vocational rehabilitation on independence Send us a text and let us know what you thi2025-03-1008 minMEC ConnectResolving Complex Workers Compensation ClaimsHosts Matt Yehling and Patty Reinecke welcome back Dan Dalton, Chief Claims and Regulatory Counsel at MEC, to discuss the resolution process for complex and high-exposure workers compensation claims. Dan provides insights into when to begin settlement discussions, the steps involved in resolving these claims, and the role of mediation in reaching a compromise.Discussion Points:1. Timing and Steps for Resolution: Dan explains when to consider settlement and outlines the steps involved in resolving excess claims, from identifying issues to determining exposure and engaging the other party.2. Involving Defense...2024-06-1024 minMEC ConnectMeasures of Success in Complex Workers Compensation ClaimsHosts Matt Yehling and Patty Reinecke sit down with Vicki Barker, Senior Claims Analyst for at MEC, to discuss success stories and the positive impact MEC has made on injured workers’ lives through their handling of complex workers compensation claims. Vicki shares her perspective on measuring success, collaborating with partners, and achieving positive outcomes for all parties involved.Discussion Points:1. Defining Success: Vicki explains that success in excess workers compensation claims is measured by making a difference, regardless of the size of the impact, through new perspectives, ideas, information, and resolution strate...2024-05-2711 minMEC ConnectCollaborating to Mitigate Costs on Complex Workers Compensation ClaimsHosts Matt Yehling and Patty—Reinecke are joined by Gina Holt, former Client Consultant Manager and current ISI Underwriter at MEC, to discuss how MEC collaborates with clients and TPAs to mitigate costs on complex, potentially excess-level workers compensation claims. Gina shares insights on MEC's hybrid role, early intervention strategies, and leveraging internal resources to improve claim outcomes. Discussion Points:Early Intervention and Collaboration: Gina emphasizes the importance of early intervention and collaboration among MEC, clients, and TPAs to prevent medical costs from compounding. MEC's team reviews claims to identify red flags and...2024-05-1310 minMEC ConnectCost Containment and MitigationHosts Matt Yehling and Patty Reinecke are joined by Marianne Reed, Senior Claims Analyst at MEC, to discuss strategies for containing and mitigating costs in complex workers compensation claims. Marianne shares her expertise on identifying cost drivers, collaborating with stakeholders, and implementing targeted interventions to improve outcomes and reduce expenses.Discussion Points:Cost Drivers in Complex Claims: Marianne outlines the medical treatments that tend to be the biggest cost drivers in complex claims, such as injections, brand name medications, spinal cord stimulators, and failed surgeries. She also describes the typical features of...2024-04-2915 minMEC ConnectComplex Regional Pain Syndrome (CRPS) and Reflex Sympathetic Dystrophy (RSD) with Dr. Fernando BrancoHosts Matt Yehling and Patty Reinecke sit down with Dr. Fernando Branco, MEC's Chief Medical Officer, to discuss Complex Regional Pain Syndrome (CRPS) and Reflex Sympathetic Dystrophy (RSD). Dr. Branco shares his expertise on these challenging diagnoses, explaining how they can develop from seemingly minor injuries and the difficulties in accurately diagnosing and treating these conditions.Discussion Points:Sprains and Strains Progressing to CRPS/RSD: Dr. Branco explains that it's common for minor injuries like sprains and strains to progress into CRPS or RSD, especially in the excess claims world. He notes...2024-04-1527 minMEC ConnectFailed Back Syndrome with Jeff PackHosts Matt Yehling and Patty Reinecke are joined by Jeff Pack, a Medical Management Consultant at MEC, to discuss failed back syndrome. Jeff shares his experience dealing with complex back injury claims that often start as sprains or strains but can lead to multiple surgeries and the diagnosis of failed back syndrome. The episode explores common trends in these cases, potential interventions, and advice for managing claims involving failed back syndrome.Discussion Points:Sprains and Strains Leading to Excess Claims: Jeff explains how many back injury claims that reach the excess layer...2024-03-1815 minMEC ConnectMigratory Sprains & Strains with Dana DorseyHosts Matt Yehling and Patty Reinecke welcome Dana Dorsey from MEC's Medical Management Unit to discuss sprains and strains. Dana, with her extensive background in field case management, dives into the definitions, treatments, and prevention of these injuries, highlighting how they can lead to complex claims if not managed properly from the outset. The episode focuses on practical advice for both employers and employees to handle and prevent these injuries effectively.Discussion Points:Defining Sprains and Strains: Dana explains the differences between sprains, which involve ligaments, and strains, which involve muscles or...2024-03-0413 minMEC ConnectExploring Migratory Claims with Kam GarrettIn this episode of MEC Connect, hosts Matt Yehling and Patty Reinecke sit down with MEC Senior Claims Analyst Kam Garrett to delve into the complex world of migratory claims. Kam shares a real-life example of a migratory claim that spanned over a decade and the challenges involved in handling such cases. They also discuss recurring trends, resources, and strategies for managing migratory claims effectively.Discussion Points:Real-Life Example: Kam provides a detailed example of a migratory claim that took almost 13 years to resolve, emphasizing the persistence required in managing such cases.2024-02-0512 minMEC ConnectAn Introduction to Migratory Claims with Sherrie MurrayHosts Matt Yehling and Patty Reinecke interview MEC’s Sherrie Murray about the challenges of "migratory claims"—claims involving injuries that start simple but spiral into complex cases involving endless treatments and prescriptions. In this episode, we explain MEC’s approach to these thorny claims, focusing on appropriateness of care, prescription issues, and ultimately settling cases.Discussion Points:Nature of Migratory Claims: Common types of injuries in migratory claims, particularly involving the spine.Challenges of Migratory Claims: The medical, psychological, and employment-related challenges faced in these claims.2024-01-2209 minMEC ConnectCAT Claim ResolutionIn our final episode of Season 1, Matt Yehling and Patty Reinecke speak with Geoff Jones, Senior Claims Attorney at Midwest Employers Casualty (MEC) about resolution of catastrophic claims.Topics covered include:If and when a catastrophic claim can be settled.Situations where a settlement is not possible or recommended. Considerations for indemnity or medical only settlements.The people involved in resolution of a catastrophic claim.How Medicare Set-Aside trusts affect settlement.Send us a text and let us know what you think!2022-11-0721 minMEC ConnectLong Term CAT Claims ManagementIn episode 8, Kelly Loos, Senior National Catastrophic Claims Analyst at Midwest Employers Casualty (MEC), teams up with Matt Yehling and Patty Reinecke for a conversation about claim management once an injured employee has achieved medical stability.Topics covered include:Factors that need to be addressed before a CAT claim can be considered stable.Who is involved with following a catastrophic claim over the long term. How to reserve for a claim – both initially and after the claim is stable. Send us a text and let us know what you think!2022-10-2417 minMEC ConnectReturning Home After a Catastrophic InjuryIn episode 7, Matt Yehling and Patty Reinecke welcome back Phyllis Ramondetta, Senior National Catastrophic Medical Consultant at Midwest Employers Casualty (MEC). They will discuss the factors involved for an injured employee to achieve the goal of returning home after a catastrophic injury.Topics covered include:Services and modifications that need to be in place before the employee’s return home. How MEC helps facilitate a smooth and successful transition for the employee and their family. Options for attendant care, if required.The advantages of returning home versus long-term facility care.Send us a text and let u...2022-10-1019 minMEC ConnectPost-Acute Care After a Catastrophic InjuryIn episode 6, Matt Yehling and Patty Reinecke welcome Phyllis Ramondetta, Senior National Catastrophic Medical Consultant at Midwest Employers Casualty (MEC), for a discussion on what to expect after the acute phase of a catastrophic injury.Topics covered include:Types of rehabilitation options available after hospital discharge.Injuries that benefit from post-acute rehabilitation programs.Characteristics of an effective rehabilitation program.Considerations for reaching an individual’s best possible outcome.Send us a text and let us know what you think!2022-09-2617 minMEC ConnectUsing Centers of Excellence (COE) to Rehabilitate Catastrophically Injured EmployeesIn episode 5, Matt Yehling and Patty Reinecke welcome back Midwest Employers Casualty’s (MEC) Chief Medical Officer, Dr. Fernando Branco. The three discuss the significant role Centers of Excellence (COE) play in the rehabilitation of catastrophically injured employees.Topics covered include:Explain why MEC may recommend a COE for the treatment of a catastrophically injured employee.Differentiating COEs from other centers and how to choose the appropriate COE. Measuring treatment outcomes at a COEThe COE’s process and level of communication prior to admission, treatment, and discharge.Determining fair pricing.Send us a text and let us...2022-09-1222 minMEC ConnectSignificance of Immediate Medical Care for Catastrophic InjuriesIn this installment of MEC Connect, Matt Yehling and Patty Reinecke chat with Midwest Employers Casualty’s (MEC) Chief Medical Officer, Dr. Fernando Branco. Dr. Branco addresses the importance of proper medical treatment to achieve the best outcome for the injured employee. Topics discussed include:Initial steps of a successful catastrophic medical care plan.Trauma center classifications.The importance of investing in quality care.Treatment considerations.What constitutes a good outcome for a trauma center. Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.For inquiries about MEC Connect, email MECConnect@mecasualty.com.2022-08-2919 minMEC ConnectCAT Claims Investigation Best PracticesIn Episode 3, Matt Yehling and Patty Reinecke welcome Dan Dalton Chief Claims and Regulatory Counsel at Midwest Employers Casualty (MEC). Dan addresses the benefits of having a lawyer involved in catastrophic (CAT) claim investigations. Topics covered include:Necessity of attorney retention and involvement on day one in catastrophic losses. The “grand bargain” of the no-fault system of workers’ compensation.Overview of third-party liability and subrogation.The methodology and importance of a thorough claim investigation to a successful outcome.Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.For inquiries about MEC Connect...2022-08-1522 minMEC ConnectHow Communication and Teamwork can Set CAT Claims Up for Successful OutcomesMatt Yehling and Patty Reinecke welcome back Courtney Waltz, Senior National Catastrophic Claim Analyst at Midwest Employers Casualty (MEC), to continue their discussion about MEC’s unique approach to CAT claims management. Topics covered include:Why the right team matters.How MEC has utilized technology to enhance the CAT claims round table process.The importance of communication to enhance the quality of care.How MEC makes a difference.Learn more about CAT Claims here: https://mecasualty.com/claims-admin/cat-claim.For inquiries about MEC Connect, email MECConnect@mecasualty.com.Send us a tex...2022-08-0112 minMEC ConnectAn Introduction to CAT Claims with Courtney WaltzWelcome to the first episode of MEC Connect! Special guest Courtney Waltz, Senior National Catastrophic Claim Analyst at Midwest Employers Casualty (MEC), joins cohosts Matt Yehling and Patty Reinecke for the first in a series of discussions about catastrophic (CAT) workers’ compensation claims.Topics covered include:· How the MEC dedicated CAT Claims team defines CAT claims · Who makes up the CAT Claims team· The initial reporting process for these types of claims· Why immediate action for CAT claims is critical to helping achieve better resultsLearn more about CAT Claims here: https...2022-07-1812 min