News

Customizing an Injured Worker’s First Wheelchair for a Near-Perfect Experience

Monday, April 10th, 2023

Steven Killius (left) receives his first wheelchair after incurring a spinal cord injury at work. ATF Medical’s David Bedard (right) customized the chair, which is a manual with a power assist.

Our Manager, Complex Rehab Technology, David Bedard, ATP, CHAMP gets excited when he gets to customize a workers’ comp patient’s first wheelchair. “You want the patient to have a positive experience so you need to get it as close to perfect as possible,” he said.

Recently he customized a manual chair for Steven Killius, an injured worker who suffered a spinal cord injury during a motor vehicle accident. ATF Medical received the referral while Steven was treating at Brooks Rehabilitation in Jacksonville, Florida. David met with Steven and collaborated with his physical therapist, Erica Walling, to create this mobility solution.

“Brooks has a great neurological program. The physicians are very good about prescribing assistive technology, and the clinic has a wide variety of chairs for the patients to try out,” David said.

Steven, who is in his mid-40s, is a paraplegic with good upper extremity function and his team decided on a Permobil TiLite with its SmartDrive Power Assist that extends the length of a push. The user can push once and the chair continues to glide, sometimes twice as far.

“The amount of power you give it determines how far it will roll or how quickly it can climb a hill,” David explained. “Power assists reduce the number of pushes, preventing wear and tear on shoulders, wrists, and elbows.” With them, users can more easily traverse a large area, such as a warehouse the size of a football field.

This model features a wearable, a watch that can control the chair. The injured worker can hang their wrists on the side of the chair instead of pushing the on and off switch.

Another customization is the Invacare Matrx positioning back. Its carbon fiber shell is lightweight and durable. Because this injured worker has good torso control, the chair has a low back to allow him to reach behind himself to grab a water bottle or phone.

Steven was grateful for the power assist and wearable. “This technology will make a big difference for me when I’m using the chair to navigate day-to-day routines,” he said. “And it will help save my shoulders.”

Because he will probably spend 10-15 hours a day in the chair, selecting the right cushion was vital. The team chose a hybrid combination of air cells and high-density, positioning foam made by Roho. The air cells in the rear allow users to immerse themselves in the material, which disperses pressure over the greatest possible area. This helps with pressure release so patients can maintain skin health and avoid pressure injuries. The front of the cushion, composed of a higher density memory foam, carves out a place to cradle his legs to maintain natural, neutral sitting positions and sitting balance.

Its rigid, titanium frame is durable and energy efficient. Carbon fiber Spinergy wheels cut the chair’s weight. “Removing as much metal as possible keeps the chair as light as possible, making transfers easier,” David added.

David and the Brooks’ team took care to think through the patient’s needs and customize a manual chair to help him keep exercising as much as he can. Since he was very active before the injury, he will likely want to test his physical limits in the chair.

David demonstrated the chair’s features when he went to Brooks to deliver and fit the chair.

“But I encouraged him to use it as is, first, then add the power assist features gradually,” he said. “Patients already receive so many instructions when they go home from rehab, we don’t want to overwhelm with the tech.”

Complex rehab technology (CRT) can make someone’s life better if the configuration is right – at least as close to perfect the first time. ATF Medical’s specialists pay attention to the details to set patients up for success. Next time you have a claim requiring CRT, mobility products, or home modifications, email us at referrals@ATFMedical.com. We’re dedicated to helping injured workers regain their independence, mobility, and functionality.

Recognizing the Value OTs Bring to Workers’ Compensation During OT Month

Wednesday, March 29th, 2023

ATF Medical joins the American Association of Occupational Therapists (AOTA) in celebrating April as OT Month.

OTs are frequently associated with helping individuals redevelop and maintain the ability to perform activities of daily living, such as dressing, eating, and grooming. They do that … and much more.

You’ll find OTs practicing in nearly every realm of medicine, including mental health and sleep assessment. Their overarching role is to help people regain strength and functionality after an illness or injury. One thing that makes OTs unique is their ability to look at a situation holistically – which helps deliver the best outcomes.

In workers’ compensation, these highly skilled and highly educated clinicians are valuable members of an injured worker’s care team. Within workers’ compensation, OTs have several different areas of practice, including adaptive housing/home modifications.

A home modification OT’s goal is to maximize a worker’s independence and safety in their home. An assessment of the person and environment is conducted with a focus on what activities the IW is having difficulty performing in the home and what physical barriers the home presents. Then the OT will then develop a plan for a better “person-environment fit.”

This plan may include a scope of work, floorplan drawings, recommendations for structural modifications, medical equipment, complex rehab technology, and/or assistive technologies. Common projects include planning for home entrances, emergency egresses, along with bathroom and kitchen accessibility.

OTs that specialize in work rehabilitation concentrate on the worker in their vocational role. This OT conducts Functional Capacity Evaluations (FCEs) that determine an employee’s work capacity and barriers to performance and writes a customized rehab plan to foster recovery. This may include work conditioning, strengthening, worksite ergonomics, worksite modifications, or task modifications – all with the goal of facilitating the worker’s return to work.

April is the month to recognize the value OTs bring, so thank the OT on your claim for their expertise and service. Tagging them on social media is one way to show appreciation.

March is Brain Injury Awareness Month

Tuesday, March 14th, 2023

March is the month the Brain Injury Association of America has selected to bring awareness to brain injuries. The organization’s tagline #MoreThanMyBrainInjury reminds us that someone with a brain injury is a person first. This message aligns perfectly with ATF Medical’s consistent patient-centric approach. We wrap ourselves and resources around all our injured employees, including those who have suffered a brain injury.

What are brain injuries?

There are two overarching types of brain injuries: traumatic and acquired. Acquired or non-traumatic brain injuries occur when the brain is altered by internal factors. A lack of oxygen, exposure to toxins, pressure from tumors, and strokes are a few examples of the acquired types.

If an external force, such as being hit in the head, a fall, explosion, a gunshot wound, or vehicular accident causes the brain injury, it’s a traumatic brain injury (TBI). These impact injuries can be open (penetrating) or closed.

About brain injuries in workers’ comp

Approximately 20% of work-related injuries of work-related injuries involve a TBI, according to the Centers for Disease Control and Prevention. Severity ranges from mild concussion to severe brain injury, and TBIs are typically associated with high medical costs and long-term disability.

The industries most likely to incur brain injury claims are construction, transportation, and agriculture. And the claims tend to be expensive. The National Council on Compensation Insurance (NCCI) put the average cost of a claim involving a TBI at $84,000 in 2017. Medical inflation has pushed that number higher in the past five years.

About the impact on the injured worker

A brain injury cuts to the core of a person. It affects who the injured worker is—how they think, act, and feel. Symptoms vary greatly from person to person, and no two brain injuries are exactly alike.

Patients with brain damage can have functional issues, such as physical weakness and a lack of coordination in the limbs. Visual impairment can be a symptom, and a brain injury can affect mobility and limit a person’s independence.

Cognitive effects, including confusion, memory loss, poor organizational skills, and poor reasoning skills can affect these injured workers. They tend to have trouble sleeping and suffer from fatigue.

They can be emotional, given to tears, and unable to control their anger. There can be a lack of impulse control. Many patients are depressed, anxious, and feel vulnerable and isolated. (Feelings of isolation are likely more prevalent with injured workers than other patients because they suddenly lose contact with most of their colleagues along with the sense of purpose working provides.)

When patients with brain injuries head home

Injured workers with serious TBIs spend time in a hospital and a post-acute care rehab center. These facilities are highly structured and keep patients busy most of the time. Returning home after living in such a regimented environment can be disconcerting. Suddenly, the injured person has to figure out how to live, while dealing with the loss of some routine capabilities.

Naturally, the home must be adapted to provide a safe and accessible environment. Ramps, roll-in showers, and door widening are typical home modifications. At the same time, rehab equipment is placed. These could include ceiling lifts, hospital beds, special mattresses, door openers, and wheelchairs.

Payers need to determine what modifications and rehab technology a particular worker needs and not let the contractor or equipment providers go on autopilot. Clinically focused specialists, like occupational therapists, Certified Environmental Access Consultants, Assistive Technology Professionals, and those holding the Executive Certificate in Home Modification should collaborate with contractors to design an appropriate plan.

The end product needs to accommodate the size and weight of equipment while fostering mobility, independence, and functionality for a specific injured employee with specific symptoms and needs.

Communication among specialists, with the payer’s claim representatives, and especially the injured employee and their family are essential ingredients to delivering clinically appropriate solutions. The injured employee’s journey to recovery – or acceptance of their condition – is arduous enough. They and their families do not need the stress and frustration that comes with receiving equipment they can’t use or not knowing when the construction crew will come or the powerchair will arrive.

Paying attention to the family

Family dynamics is a major psychosocial barrier to recovery. And adjusting to a new reality, and in some cases, a new personality, is hard on everyone, especially family members living in the home.

Dealing with the patient’s mood swings, depression, and anger drain reserves, The day-to-day duties and constant vigilance wear down the most diligent caregivers. And divorce rates among seriously injured employees are high.

Families often benefit from professional psychological services and support groups. The BIA provides a list of virtual support groups, organized by states.

Returning to work

The severity of the injury and the status of recovery dictate when and if an employee can return to work after a brain injury. Some workers return to their previous positions with no problem and others can resume their roles with help from assistive technology and ergonomic adaptions and/or reduced responsibilities.

In other cases, flexible, hybrid, work-from-home, or part-time schedules are appropriate. Transferring to a different position in the organization or receiving vocational rehabilitation and seeking a different job are other routes to explore.
Employers and employees should have frank, empathetic, and open discussions about the person’s abilities and stamina and the workplace environment as they select the best option.

Summary

Living with a brain injury calls for a wide range of resources and strategies. The people who manage their claims and providers who care for them need to be empathetic. And they need to advocate for the best home and work environment possible.

ATF Medical’s specialists and other staff members do just that as they simultaneously contain costs by avoiding unnecessary expenses and waste.

Getting to Know Brendan Swift, ATF Medical’s New Vice President, Payer Partnerships & Marketing

Tuesday, February 7th, 2023

We are absolutely delighted to welcome Brendan Swift into the ATF Medical family. With more than 22 years’ experience in workers’ compensation, mobility and accessibility services along with payer and provider operations, he’ll be hitting the ground running starting February 13th. Many of you already know him and can reconnect with him at the Property & Casualty Complex Claims & Litigation Forum later this month in Las Vegas (Feb. 27-March 1). He and our Executive Director of Business Development, Rick Wyche, will be there so visit our Booth #303 and find out how we can help you and your injured workers. Meanwhile, here is an introduction to Brendan and some of his ideas on our industry and company.

What drew you into the workers’ comp industry, and then eventually into rehab technology?
I started my career in group health operations, working for Oxford Health Plans and then UnitedHealthcare after the acquisition. After that, I went to work for Coventry and became interested in the workers’ comp side of the business. In 2011, I moved over to Coventry DMEplus, leading their national provider relations team. Later, I served as National Vice President of Payer Relations and Strategic/Key Account Management for a national complex rehab technology (CRT) company and led the implementation of its national workers’ compensation service program.

What do you enjoy about the workers’ compensation industry?
I’m consistently amazed by the passion and heart that the entire workers’ compensation community has for the injured workers they serve – especially those with complex injuries. It’s a very special space. It’s meaningful and people feel fulfilled when they help a seriously injured worker regain their independence.

What appeals to you about the accessibility/mobility aspects?
I truly love the superior levels of collaboration across all partners to ultimately get injured workers what they need for the highest levels of independence possible. Payers, clinicians, technicians, manufacturers, ancillary providers, contractors–all these special people–wrap themselves around the injured worker to do the right thing. I have a deep passion for partnering to ensure that our injured workers receive the most clinically appropriate mobility devices, accessibility technologies, and home modifications–all these critical and required services.

What attracted you to ATF Medical?
The company is laser-focused on workers’ compensation and on delivering a high-quality clinical solution to injured workers and partners. I’ve always heard how great ATF Medical is, about the level of dedication and heart its people bring to injured workers and their caretakers. In addition, ATF Medical promotes a people-first culture, which is directly in line with my leadership style. Our people and our injured workers should always come first. Excited to get started working with and for a true people-focused organization.

Why is having a close focus on workers’ comp so important?
Most rehab technology providers don’t focus solely on work comp; they’re used to the group health and the CMS space. Our injured workers and our work comp payer partners require a more detailed level of proactive service. There’s also more need for speed and continual, clear communication among numerous stakeholders. ATF Medical built its service model around injured workers and the work comp payer requirements and has honed this concept over 20+ years. Our team of clinical specialists and dedicated care coordinators understand the communication standards along with the wide variety and ever-growing market of mobility and accessibility products and services. We know how all the pieces work together so our recommendations are clinically sound and cost effective. ATF Medical gives partners the ability to work with a single-source provider that helps manage an integrated approach to mobility and accessibility. The company works hard to remove the fragmentation and eliminate re-work.

What do you feel are the main challenges when it comes to mobility and accessibility in workers’ comp?
Cost, quality, communication, and unnecessary delays on these very complex cases. For the most part, as I mentioned, the CRT and accessibility industry is fragmented. For example, on a large file, one company generally handles the mobility, another may handle other rehab technologies, another may handle the home mod/construction or ramping, and possibly another provider is brought in for DME or vehicle needs. Throughout the life of the file, these vendors don’t necessarily know each other, they don’t communicate with each other, and do not have channels set up for collaboration. As a result, many times the equipment doesn’t fit or work right for the injured worker, the powerchairs are too heavy for the lift, etc. This causes re-work and quality issues which ultimately delay the injured worker’s discharge and the number one goal of getting them home and on quick path to independence. Now, there’s expensive re-work and the injured worker may have to spend extra days in a hospital or post-acute care center because the home isn’t ready. The family and injured workers are frustrated and unnecessary costs are added to the claim. The best way to control costs is doing things right the first time and doing them quickly. You need an integrated, clinically driven approach where everyone is collaborating on an integrated solution that will help the injured worker recover and achieve as much independence as possible.

What are your goals as you begin your new position?
My first priority will be to increase the awareness of ATF Medical as a one-stop-shop, single-source partner for all things mobility and accessibility and articulate the deep value and partnership that we can bring to our payer partners, nationally. That is, providing fully integrated, cost-effective mobility and accessibility solutions. Our clinical specialists collaborate, and we communicate file updates proactively and consistently with the goal of delivering rehab equipment and home mods with appropriate speed allowing our injured workers to get home without delays. From there, it’s about securing long-lasting trusted relationships with our payer partners, nationally.

Tell us a little about your personal life.
Well, I’ve been married for 22 years to Katie, my high school sweetheart. And this was the smartest decision I have ever made in my life. Katie and I were both born and raised on Long Island, NY and recently moved to Tampa, FL from Franklin, TN. We have three amazing kids, two girls who are 21 and 16, and an 11-year-old boy. We’re very involved in our son’s travel soccer team and our middle daughter’s competitive cheer. Our oldest daughter is very focused on finishing up her Physician’s Assistant degree and graduating this May up in New York. My kids inspire me and motivate me daily. As a family, we love anything outdoorsy, especially hiking, spending time at the beach and traveling.

What’s your favorite TV series and what is the last one you binged?
I am a huge Sopranos fan. In my opinion, it really was the dramatic series that helped pave the way for such an enormous takeover of powerful new series and shows coming out over the last 25 years. How did that first air 25 years ago?! I also have to mention Breaking Bad, as it was an incredibly well-done show. Also love good documentaries … recently watched a few on climbing, Free Solo and The Dawn Wall. If you want to sit on the edge of your seat, give those a watch. I had to pause them and walk out of the room several times.

What was the most influential business book you’ve read?
I love a meaningful leadership book. One I always recommend and have read probably 20x over is titled “The Feiner Points of Leadership” by Michael Feiner. I have had the privilege of working with Mike one on one as an executive coach and have applied real-life situations I have gone through to the laws he writes about in his book. One of my favorites is THE LAW OF THE ONION. High performance leaders look beneath the surface and never assume anything. Peel back the layers … GET TO KNOW YOUR PEOPLE AND GET INTO THE DETAILS. It’s been very rewarding putting these laws into practice over the years. They have become “core principles” for me to apply every single day.

Did you have a mentor?
I’ve been very lucky to have a few, two specifically in the workers’ comp space. They all exposed me to the meaning of true leadership and to leading with purpose. Leading with your heart and caring about the people you serve is what counts. As a leader, I’m here to serve them by putting their needs first. This also rings true in building relationships internally and externally with our partners.

If you’d like to connect (or reconnect) with Brendan, email him at bswift@atfmedical.com.

Navigating Powerchair Among CES 2023 Innovation Winners

Thursday, January 12th, 2023

Photo credit: WHILL, Inc.

The Consumer Electronics Show, arguably the largest gathering of technology geeks, honored 14 assistive technologies at its 2023 show.

The CES Best of Innovation Award went to an electric powerchair that helps users navigate large, often crowded venues like parks, airports and hospitals. With the WHILL Autonomous Model A, a user selects the destination on a touch screen, hits start, and lets the chair do the rest. It uses advanced mapping technologies, the latest sensors, and automatic brakes to avoid obstacles and collisions. Reducing the need for airport staff/increasing independence … what’s not to like?

Other honorees included a bidet toilet lift to give mobility-impaired users privacy and dignity and a digital system to monitor and manage digestive disorders. There’s even a handheld smart makeup applicator! Check out the complete list in this AT Today article.

What new assistive technologies have you used or heard about? Please share! Email Rick Wyche, rwyche@atfmedical.com

The CAPS Credential & Workers’ Comp

Tuesday, January 3rd, 2023

CAPS is a credential sometimes found after the names of construction professionals and other specialists involved in home modifications. It stands for Certified Aging-in-Place Specialist.

Aging in place (AIP) is a concept driven by the large numbers of baby boomers who want to stay in their homes rather than move to senior communities or assistive living facilities if they become impaired.

Developed by the National Association of Home Builders (NAHB) in cooperation with the AARP, the CAPS program teaches the business, technical and customer service skills needed to modify homes for AIP. NAHB administers the CAPS certification, which requires candidates to pass three day-long courses, typically held at building supply stores, builders’ association offices, or conference centers.

CAPS-certified contractors can be good partners in adaptive housing projects for injured workers. They’re accustomed to projects that accommodate mobility, balance and accessibility issues.

However, adaptive housing solutions for injured workers need to take more things into consideration, including their changing clinical needs and the weight and size of sophisticated rehab equipment. For example, a front-wheel drive powerchair has a large turning radius, requiring a wider door than the manual chairs typically used by older people. Power chairs, Hoyer lifts and other rehab equipment used in workers’ comp take up more room and can be much heavier than Medicare-covered equipment.

Additionally, the worker’s recovery outlook needs to be considered for cost-effective solutions. For example, a temporary ramp (pictured above) can be used when the injured worker is expected to be able to use stairs down the road.

It’s best to pair a CAPS-certified contractor with an Occupational Therapist (OT) or Assistive Technology Professional (ATP) who has a lot of experience in workers’ compensation. OTs and ATPs are better able to interpret medical records and progress notes from the rehab center and create precise specifications. They’re also more aware of rehab equipment and how to combine it with home modifications. In short, CAPS is a valuable certification for contractors and remodelers working on workers’ comp projects when they are integrated into teams with clinical specialists, which is ATF Medical’s approach.

We deliver a fully integrated mobility and accessibility solution–ALL the equipment, rehab technology, mobility products, vehicle mods, and adaptive housing projects that a complex workers’ comp case needs.

If you’d like to know more about our comprehensive solutions, please contact Rick Wyche at rwyche@atfmedical.com or Erin Zablocki at ezablocki@atfmedical.com.

ATF Medical’s Supervisor of Adaptive Housing Solutions Karissa Peffer Earns the CAPS Certification

Tuesday, December 20th, 2022

Karissa Peffer, our Supervisor of Adaptive Housing Solutions, just received her CAPS certification! CAPS stands for Certified-Aging-in-Place Specialist and is for professionals in the adaptive housing field.

Karissa works closely with contractors, complex rehab specialists, and occupational therapists to make sure that ATF Medical’s home modifications are appropriate for the conditions and lifestyles of our workers’ compensation patients.

In 2020, she earned the Certified Environmental Access Consultant (C.E.A.C.) certification. Both programs deal with the legal, ethical, and safety issues as well as the construction aspects of home modifications.

Karissa uses this knowledge to see that workers’ compensation patients can function safely in their homes while maximizing their mobility and accessibility. Our goal is to equip injured workers to experience as much independence as possible, enjoy their lives, and return to work when possible.

“We’re exceptionally proud of Karissa who has strengthened her expertise by earning two certifications since joining ATF Medical in 2019,” said Erin Zablocki, CDME, Master C.E.A.C., ECHM. “We salute – and support – our associates’ efforts to pursue continuing education and certifications in their chosen field.

What Does the ADA Have to do with Workers’ Comp?

Thursday, December 15th, 2022

As you probably know, the ADA is the acronym for the Americans with Disabilities Act. Among many other things, the ADA provides design standards to ensure accessibility to public entities.

The operative word is public: office buildings, libraries, courthouses and other government buildings, restaurants, and shopping centers. ADA standards help create spaces designed to be used by the largest portion of the disabled population, regardless of the disability. It’s a one-size-fits-all approach. Hence buildings have ramps, wide halls, wheelchair-accessible restrooms, and features for the visually and hearing impaired.

Similarly, universal design is the “design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.” Again, universal design is for facilities, workplaces, and other public spaces.

Neither standard applies to residences. If they did, halls would be freakishly wide and lined with handrails and every bathroom would be wheelchair accessible.

It’s fine to use contractors with these certifications, but it’s not mandatory. These understand how to build and renovate to accommodate disabilities. But they are not necessarily used to adapting a single home for a single worker with specific functional limitations.

Workers’ comp adaptive housing solutions are extremely customized. At least, they should be. To that end, ATF Medical pairs an Assistive Technology Professional (ATP) Occupational Therapist (OT), and/or a Certified Environmental Access Consultant (C.E.A.C.) with the contractor. These experts take a clinical approach to combining rehab technology with adaptive housing solutions.

Each worker is different. Each condition is different, and each adaptive housing solution is different.

Our Executive Director/Rehab Technology Erin Zablocki, CDME, Master C.E.A.C., ECHM is an expert in adaptive housing solutions and would be happy to answer your questions about the ADA or clinically driven home modifications. Email her at ezablocki@atfmedical.com

What is a CHAMP Certification?

Thursday, December 8th, 2022

You may notice the initials CHAMP after the names of some rehab or construction professionals. It’s an acronym for Certified Home Assessment and Modification Professional. It’s also short for champion, of course, and professionals who improve the lives of seriously injured people are certainly champions.

Created just for workers’ compensation, CHAMP is a contractor and accessibility specialist home modification certification program. It was originally initially designed for contractors, but over time the content expanded to include case managers and claims representatives who want to better understand adaptive housing projects.

The first step to certification involves intense onsite training. The three-day course explains the workers’ compensation market and terms like medical necessity and disability and about common injuries and medical and functional status. Attendees also learn how to complete assessments and develop a scope of work along with accepted practices for estimating and timelines. The course also discusses products and services, e.g., lifts and medical equipment.

There is also a CHAMPConnect conference that brings claims representatives together with contractors to focus on housing issues and home modifications for injured workers.

ATF Medical promotes professional development among our staff. We are proud to have certified ATPs, CHAMPS, ECHMs, CEACs, CAPS and more on our roster. Our new Manager of Rehab Technology Dave Bedard holds the CHAMP credential as well as the Assistive Technology Professional (ATP).

If you’re interested learning more about our adaptive housing solutions, please contact Erin Zablocki, our Executive Director of Rehab Technology at ezoblocki@ATFMedical.com.

Wheelchair Travelers

Wednesday, December 7th, 2022

The holidays are nearly upon us! And some of our workers’ comp patients who use wheelchairs — including those with spinal cord injuries — want to visit friends and family in distant areas. This Rehab Management article offers advice for preparing them for traveling with their wheelchairs.

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