Tuesday, August 21, 2018

10:00 – 5:10 pm
Crystal Ballroom C
Convention Level
(Entrance to G2)

Occupational Medicine

Presented by the Florida Association of Occupational and Environmental Medicine

10:00 – 12:00 pm
Crystal Ballroom C
Convention Level
(Entrance to G2)

10:00 – 12:00 pm
Medical Marijuana: How To Keep Your Claims From Going to Pot

Moderator:
Cori Repp, MD
Florida Director of Medical Operations
Concentra
Bradenton, FL

Panel:
Robert Bennett, Attorney
Bennett, Jacobs and Adams, PA
Tampa, FL

Richard Johnson, MD, MPH, FACOEM
Concentra
Largo, FL

Medical use of marijuana is a topic that raises many questions from both a medical and legal standpoint. Join our panel of a lawyer, doctor, medical review officer, and substance abuse specialists to discuss how medical marijuana relates to workers’ compensation, especially return-to-work issues, and urine drug screening. Do you know what your rights and responsibilities are as an employer, adjuster, or safety professional when you get the drug screen result back? Learn what a marijuana card is, what products are covered, and join in a review of cutting-edge research on the future of drug testing for marijuana.

12:00 – 1:00 pm
Lunch (on your own)
Purchase lunch in the Exhibit Hall. Visit the “Comp Time” Diner… grab & go, or sit and network with clients and exhibitors!

 

Chiropractic Breakout

Presented by the Florida Chiropractic Association

1:00 – 3:00 pm
Crystal Ballroom C
Convention Level
(Entrance to G2)

Welcome and Introduction of Speaker

Program Moderator:
Mollie Frawley, RN, CHCQM
Florida Chiropractic Association
Oakland, FL

Avoiding and Minimizing Opioid Use with Chiropractic

Moderator:
Mollie Frawley, RN, CHCQM
Florida Chiropractic Association
Oakland, FL

Panel:
Dan A. Dodd, DC
Dodd Chiropractic Clinic
Jacksonville, FL

Matthew M. Antonucci, DC, DACNB, FACFN, FICC
Director
Neurological Rehabilitation and Optimization
Orlando, FL

Terry D. Sandman, DC, MPH, DACBR
Diagnostic Radiologist
Sandman Radiology Consultation and Services
St. Petersburg, FL

Bruce A. Hansbrough, DC, DACBOH, DA CACD
Integrative Health Services Director
Coastal Detox
Stuart, FL

Justin K. Spooner, MD
Beaches Laser Spine and Pain Medicine
Jacksonville, FL

This program is intended for all stakeholders concerned with the opioid crisis: primary care physicians, pain management physicians, therapy practitioners, adjusters, case managers, and both claimant and defense attorneys. As the opioid crisis continues, injured workers’ lives are threatened and the insurers’ and employers’ resources are depleted. Our panel of five physicians will discuss what chiropractic offers to facilitate avoiding and minimizing the role of opioid use. The chiropractic primary care physician will address his/her function of identifying the root causes of pain and minimizing the need for narcotics through chiropractic techniques. Chiropractic specialists in radiology, neurology, pain management, and nutrition will discuss their roles in evaluating and treating pain from their perspectives. Whether your needs are to keep injured workers off narcotics, minimize their need for narcotics, or get their narcotic use under control, this program is for you.

3:00 – 3:10 pm
Break

 

Pain Medicine Breakout

Presented by the Florida Society of Interventional Pain Physicians

3:10 – 5:10 pm
Crystal Ballroom C
Convention Level
(Entrance to G2)

Moderator:
Miguel de la Garza, MD, DABA, DAPM
Comprehensive Pain Management Partners
New Port Richey, FL

Presentation of Case Report: Successful Treatment and Weaning of High Dose Opioid Therapy in a Refractory CRPS Patient

Speaker:
Miguel de la Garza, MD, DABA, DAPM
Comprehensive Pain Management Partners
New Port Richey, FL

Complex regional pain syndrome (CRPS) can cause severe permanent restrictions in the injured worker despite aggressive treatment and care. This represents a significant demand upon medical, administrative, and fiduciary resources for the carrier. A real-world case of CRPS with years of failed treatment including a spinal implant will be discussed, including how we were successful in weaning this patient off high-dose opioid therapy. We will also provide up-to-date information on a high-dose opioid therapy, how to determine if a CRPS claim is pre-existing, the latest treatment for CRPS, including medical cannabis, and ketamine infusions.

Determining Whether the Injury is Pre-existing, an Aggravation or an Exacerbation in a CRPS Patient?

Speaker:
Harold Cordner, MD
Florida Pain Management Associates
Sebastian, FL

We see the terms pre-existing condition, exacerbation, and aggravation every day, but do we really understand what they mean or how much they affect a workers’ compensation claim? This session will review the definitions, and using case examples, help you to understand how to determine if a condition is pre-existing or an aggravation or exacerbation of a pre-existing condition. We will examine the differences and nuances between these terms, how that definition will affect the evaluation of of CRPS in a patient, and what it means for physicians providing care and adjusters authorizing treatment.

Complex Regional Pain Syndrome (CRPS) Update

Speaker:
Julio Paez, MD
Southlake Pain Medicine and Anesthesiology
Clermont, FL

Treatment for CRPS is most effective when applied in a multidisciplinary approach including medications, injections, and physical and psychological treatments. All treatments work best in early-stage CRPS. First-line analgesics for CRPS include anticonvulsants, antidepressants, and opioids. Nerve blocks reduce pain and help determine if pain has migrated to the deep pain centers of the spine and brain, which is more difficult to treat. In such cases, spinal implants, oxygen therapy, and intravenous anesthetic infusions may be necessary. Supportive psychological therapy should focus on an individual’s coping style, while reinforcing healthy coping behaviors. Treating the emotional component may be necessary to steer a chronic pain process to a successful outcome in the injured worker. We will review the current literature to provide best practices to return an injured worker with CRPS back to gainful employment.

Is Opioid Therapy Appropriate for Workers’ Compensation Claimants?

Speaker:
Sanford M. Silverman, MD
Sanford M. Silverman, MD, PA
Pompano Beach, FL

The current opioid epidemic has forced many physicians to curtail the use of opioids for the treatment of acute and chronic pain. The treatment of chronic pain is under attack from legislators, law enforcement officials, insurers, and regulators. The belief is that physicians prescribe too many opioids to patients and this has led to the current opioid epidemic. This presentation will outline some of the statistics used by The Centers for Disease Control (CDC) on the opioid epidemic and treatment strategies that physicians can employ to help manage patients via supervised withdrawal methodologies.

Ketamine Infusion Protocols to Wean Opioid Therapy

Speaker:
Ashraf Hanna, MD
Florida Spine Institute
Clearwater, FL

Intravenous ketamine therapy is useful for pain reduction, functional improvement, and returning injured workers to work. Clinical outcome data from Complex Regional Pain Syndrome (CRPS) patients that underwent intravenous ketamine therapy protocols will be presented. Representative videos showing the clinical course of select patients will be shared to illustrate the efficacy of intravenous ketamine for improving pain and disability associated with CRPS while minimizing or eliminating the use of potent opioid analgesics. Various ketamine protocols will be discussed that highlight variables that can affect clinical outcomes.

Is Medical Cannabis a Viable Alternative to Opioid Therapy?

Speaker:
Orlando G. Florete, Jr., MD
Institute of Pain Management and the
Florida Institute of Medical Research
Jacksonville, FL

The United States is facing a national opioid epidemic. New guidelines were created to decrease availability of opioids in an effort to combat the problem. Medical marijuana has been legalized in many states. Expanding access to medical marijuana has resulted in a clinical conundrum: is medical cannabis a good alternative to opioid therapy? There is lack of standardization of medical marijuana dosages and drug-to-drug interaction of opioids and medical marijuana is not well understood. Differences in providers’ treatment philosophies, medical liability as well as the legal issues limit widespread acceptance. We will review the current safety, efficacy, and medical literature for medical cannabis and compare it to current opioid data. Transitioning from opioids to medical marijuana to decrease opioid utilization, abuse, misuse, and diversion while improving function and quality of life may be a key to returning an injured worker to gainful employment.