Opioid Champions Among Us

I never cease to be amazed by the amount of really good people doing really great work on behalf of injured workers. Melanie Armstrong, RN, Medical Services Manager with American Mining Insurance is one of those shining stars. After speaking with her on the phone, I was immediately compelled to write about her and her team’s efforts on opioid use and getting workers back to work.

As you can imagine, American Mining Insurance insures difficult risk. We are talking mine operators, explosive contractors, mechanics, manufacturing, and transportation, truly the gamut of heavy duty, physical work. Melanie started her position back in 2006 with a goal to reduce the hundreds of injured workers on opioids down to less than one hundred. She’s done just that and she’s still not finished!

Melanie is an exceptionally knowledgeable and compassionate champion for good care on behalf of injured workers. She has worked closely with her business partners over the years to set up controls on opioid dispensing for new claims.  She has built a network of group physicians strategically placed to help with her program. The physicians hold each other accountable, agree to follow evidence based medicine and also agree to the company’s vision and objectives. As Melanie puts it “you meet with the providers, explain that this is the program and do you agree with that? And what we see is each doctor nudging the other to do the right thing. So you meet your goals, you meet the objectives because it’s peer to peer communication and more importantly it positively impacts the injured worker’s treatment plan by being safer and cost effective.” The examiners at American Mining believe this too, they are also questioning use and medical necessity at the front end of new claims.

But more importantly, Melanie continues to work tirelessly on those legacy claims with opioid use. You know the ones. Where some payers may tend to try to settle or just continue paying for maintenance opioid drug use, Melanie works that much harder to get them off the drugs. Data, really digging into its use to have conversations with physicians, comparing opioid use against their peers’ trends and impact on improved outcomes (RTW) makes a difference.

Melanie also recognized the key to winning the opioid war is collaboration. She engages ALL stakeholders in the process beyond just the injured worker and physician, but also the examiner, lawyer, nurse, labor and even judges. And she’s admitted that even if the judge doesn’t agree with the opioid reduction plan, Melanie continues to keep fighting on the claim where many of us would have rolled over and continued to pay for more drugs.

Melanie believes deeply that all workers can return to work without continued use of opioids. Her medical background certainly lends her credibility, but its her tireless belief that no one should be on opioids long term that keeps her up at night finding prescribers that will work with American Mining and be in alignment with their claims management philosophy.

I intend to follow up this blog with more details from Melanie on her program at American Mining Insurance and share those best practices with you. Everyone needs a Melanie, American Mining is sure lucky to have her and so too are their injured workers.


Missing 33% Keeping Women from Reaching the Top

The combined forces of the Executive Women in Work Comp and Women in Work Comp were in full swing at this year’s National Workers Compensation & Disability Conference.  The two organizations recently joined together to form “The Alliance of Women in Workers’ Compensation” to talk about women and leadership.

The Alliance is a unique organization bringing together professional women (and men too) in the work comp industry to work together for the common good.  The Alliance’s goal of inclusivity manifests in not only encouraging women and men alike to work together for the advancement of women but with the benefit of industry improvement all around.

For the past three years, the Alliance has hosted the pre-conference event on the Tuesday before NWCDC.  The focus for this year’s event included what women are not told about leadership, what moves women from middle management to the top and developing business, strategic and financial acumen.  Quite an agenda!  And with a packed room of over 400 women, there was certainly a lot of excitement, exchanging and engaging going on!

Nina Smith, General Manager with Mitchell International and an Alliance Board Member, kicked off the event by getting us excited, up and out of our seats, clapping/dancing to some foot-stomping tunes.  It was enlightening to see a respected industry executive like Nina relaxed, having fun.. and still leading!

Next up was the keynote speaker Susan Colantuono, a recognized leadership expert, author, TED Talk extraordinaire and CEO of Leading Women.  If you were unable to attend the Alliance event, at least check out Susan’s TED Talk (click here) which will provide you with some good takeaways.

Susan’s discussion was enlightening:

  • Women are not told the essential skills for moving up, executives look for business, strategic and financial acumen.
  • Women don’t always know how best to speak the language of POWER

EQUALS= what Susan called the “missing 33%” of a woman’s professional background that keeps her from reaching the top.

So what do we do about it? Well that led to the workshop susanportion of the Alliance program, where each table began exchanging dialog on their jobs and practicing speaking the language of power.  Instead of “I feel confident I’m the right person to lead the organization” we practiced using power words such as “I understand the business, I have the cash numbers to talk about what new markets can help fuel our growth, I know our bottom line in terms of what’s needed in ROI and I know our customer…”  It’s a shift from being taught throughout our lives to be strong, confident, assertive, knowledgeable to then speaking the language of a CEO from the business acumen perspective.  It’s an important nuance.

It is no longer enough to understand the business, but women must speak to where the business is headed and her role in getting it there.  As to engaging, here’s where I believe women have a competitive edge that we don’t leverage enough.  We are THE BEST AT ENGAGING!  It’s what we do!  We engage every day from a personal level with family, our community, our faith which is then parlayed into how we interact at work.  Women not only lead, but do so with an engagement experience that sets us apart from men.  Women are great networkers and mentors, it’s in our DNA.  When you combine our natural talents with business acumen, glass ceilings should be blown away.

Leadership is using our own greatness, achieving and sustaining extraordinary outcomes and engaging the greatness in others.  Achieving and sustaining outcomes is the key to advancement, this is the business, strategic, financial acumen necessary to open the door to the top.  We can do this, it’s not only building our confidence but more importantly learning the business for advancement opportunities.

I believe there are already great women leaders in work comp today, I looked around the room and saw many of them there.  Many of them not only exhibit business acumen, but bring their compassion for helping the injured worker, building teams that provide world class service and are constantly trying to improve themselves and their businesses.  I met CEOs, nurse case managers, risk managers, general managers, senior vice presidents…so many in the room, so many that were excited, exchanging and engaging for the betterment of the industry and their businesses.

The Alliance proves that good things can and do happen in our industry.  It was energizing participating in this year’s event, knowing you are a part of a larger network and helping one another work towards professional greatness.  It’s inspiring to know women are not only committed to a career, but dedicated to the work comp profession.  We may not have solved the gender gap in a day, but I can tell you we all left the room with a better understanding of leadership and career success.

The Alliance continues to grow as an organization with local chapter events, pre-networking events at work comp conferences and an Ambassador Program.  For more information, please visit their website at


Shayne’s Remarkable Journey following a Work-Related Brain Injury

“Shayne’s Story” portrays the rehabilitation of one patient whose work related brain injury resulted in severe deficits, limiting him in cognition, physical ability, balance, and regaining core life skills. Yet Shayne has made remarkable progress, has begun an educational journey to return to work, and is making A’s in his classes.

His journey is chronicled in “A Meaningful Recovery,” a video series produced by Centre for Neuro Skills, a postacute brain injury rehabilitation facility with locations in California and Texas. CNS emphasizes relearning life skills that aid in re-entry to work and returning to productivity (  shayne