“HEAD, SHOULDERS, KNEES, AND TOES” 2011 Fall Conference

Suburban Collection Show Place
Novi, Michigan

2011 MSIA FALL CONFERENCE GOLD EXHIBITORS
CompOne Administrators, Inc. 888-298-9043 – www.compone.net Brown Rehabilitation Management, Inc. 800-575-5175 – www.brownre.com Data Surveys, Inc. 800-284-7001 – www.datasurveys.com GENEX Services, Inc. 888-464-3639 – www.genexservices.com PTPN 800-349-7774 - www.glptpn.com Medical Care Coordinators 800-382-1841 – www.medcarecord.com Advantage Consulting, Inc. 248-689-0468 – www.advconsultinginc.com

CALL FOR PRESENTATIONS – 2012 CONFERENCES *Submissions accepted through December 31, 2011

The Michigan Self-Insurers’ Association (MSIA) is accepting proposals for educational presentations for the 2012 Spring Conference. The event will take place May 30, 2012 – June 1, 2012 at the Grand Traverse Resort & Spa in Acme, Michigan. We are also accepting proposals for our 2012 Fall Conference, which will take place at the Suburban Collection Showplace in Novi, Michigan on Thursday October 18, 2012.
Check your attendee and exhibitor packets for application and details

Agenda
8:00 – 8:45 AM 8:45 – 9:00 AM 9:00 – 10:00 AM Registration & Breakfast Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors
10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C.

11:35 – 1:00 PM
1:00 – 2:00 PM

Lunch/Visit Exhibitors
Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors

2:00 – 2:30 PM

2:30 – 3:00 pm
3:00– 3:15 PM

RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College
Prizes / CEUs / Adjournment

2011 MSIA FALL CONFERENCE Business Meeting – Audit Committee – Nomination of Officers – Ratification of Board Members

Michigan Self-Insurers’ Association
Gerald M. Marcinkoski - Executive Secretary BOARD OF MANAGERS
Amway Lorraine Climer City of Grand Rapids Mari Beth Jelks Consumers Energy Doug Wright – 1st Vice Chair DTE Energy Doug Green Ford Motor Company Jonathan Parker – Chairperson Kellogg Company Tara Albaugh General Motors Corporation LLC Susan Azar Ilitch Holdings, Inc. C. Michael Healy – Treasurer Kelly Services Lesley Zielinski Marathon Petroleum Barbara Parker – 2ndVice Chair Meijer Sherri Miller AT & T Michigan Lisa Bruno Spectrum Health Steve Ohman Trinity Health Teresa Fisk Wayne State University Pamela Galloway Wayne Co. Airport Authority Leigh Stepaniak Parker Hannifin Corporation Sally Perrin

Advisory Group
Libby Child Chrysler LLC Neil Levins Michigan Chamber of Commerce Wendy Block Michigan Manufacturing Association Jennifer Spike Smith Haughy Rice & Roegge Danielle Susser

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00– 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

Changing Times
H.B. #5002
A Summary

What H.B. #5002 does:
Modernizes Workers’ Compensation Act
– Fixes Trammel – Interest – Professional Athletes – “for whatever reason” language

What H.B. #5002 does:
Codifies Current Case Law
– Vacillations of Supreme Court – H.B. 5002 puts Rakestraw/Stokes-Sington into statutes – H.B. 5002 puts “Lofton”’s understanding into statute – Corrects Petersen – Extends time of employer control over treatment

What H.B. #5002 does not do:
Change law on police and firefighters
Adopt “theoretical wage earning capacity”

Who to contact regarding H.B. #5002
Delaney Newberry
– Michigan Manufacturers Association – Phone: 517-487-8530 – E-mail: newberry@mma-net.org

Wendy Block
– Michigan Chamber of Commerce – Phone: 517-371-7678 – E-mail: wblock@michchamber.com

Department of Licensing and Regulatory Affairs [LARA]
Steven H. Hilfinger Director

Mike Zimmer Chief Deputy Director

Steve Arwood, Deputy Director Employment Security and Workplace Safety

Michigan Administrative Hearing System [MAHS] Mike Zimmer Executive Director

Workers’ Compensation Agency Kevin Elsenheimer, Director

G. Jay Quist, Division Director Employment Services

Lisa Klaeren, Chairperson Board of Magistrates

Jack Wheatley, Chairperson Michigan Compensation Appellate Commission

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00 – 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00 – 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

CLAIM SCENARIO
Mary is an inventory clerk for Builder Bob’s Home Improvement Stores She “took a tumble” in aisle 7, near “Tubs & Tiles” where she injured her right wrist, shoulder, and struck her small toe

CLAIM SCENARIO CONT’D
Employer Complications:
– Late Reporting – Late Authorization of Surgery – Lack of modified duty work availability – Delay in providing proper safety training – Employer has pre-conceived notions regarding the value (or lack thereof) of nurse case management

CLAIM SCENARIO CONT’D
Initial Diagnosis: Comminuted fracture of the right wrist (distal radius), right shoulder contusion, left small toe fracture Pre-existing medical: Non-insulin dependent type II diabetic, high blood pressure Prior history of being on a medical leave for “depression”

CLAIM SCENARIO CONT’D
Employee Complications:
– Husband is unemployed due to prior injury – Employee takes care of 6 year old grandson – Financial hardship – Narcotic & anxiety medication being prescribed by the treating physician – Indications of “depression” due to her injuries and additional stressors at home secondary to the injury – Husband is not supportive

CLAIM SCENARIO CONT’D
Updated Status Mary has had surgery of the right distal radius to reduce the fracture. Pins and metal plate were inserted into the wrist during surgery Therapy began 2 weeks post-op Hardware was removed 6 weeks post-op

CLAIM SCENARIO CONT’D
Increase of complaints regarding left foot Burning, electric shock type pain Cannot stand anything to touch the foot Unbearable pain with temperature changes Ongoing pain in right wrist Therapist feels symptoms in foot point to CRPS/RSD

CLAIM SCENARIO CONT’D
Physician has diagnosed Mary with Chronic Regional Pain Syndrome (left foot) Requesting referral to pain management specialist Mary is requesting adjuster to pay for psychiatric therapy and anxiety medication, as well as further care for her wrist pain

CLAIM SCENARIO CONT’D
Adjuster’s Plan of Action:
– Obtain a psychiatric IME to determine causation of current depression/psychiatric conditions, and if related determine appropriate treatment recommendations – Obtain an IME to determine diagnosis of the left foot condition to rule in/out RSD diagnosis, & determine appropriate recommended treatment – Obtain an IME on the ongoing wrist complaints to determine need for ongoing treatment, and suggest treatment plan if necessary

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00– 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

Psychiatric IME & Presentation
Dr. Harvey G. Ager, M. D., P.C. Board Diplomate, American Board of Psychiatry & Neurology
29355 Northwestern Hwy., Suite 140 Southfield, MI 48034 (P) 248-356-8050

Differential Diagnosis of Pain
Somatoform disorders
– Pain disorders associated with psychological factors – Pain disorders associated with both psychological factors and a general medical condition – Pain disorders associated with a general medical condition – Hypochondriasis

Somatization disorder Mood Disorder due to a medical condition Factitious disorder Malingering

Dynamics of a Psychogenic Pain Disorder
Predisposing personality issues: histrionic and dependent Primary gain: unresolved psychological conflicts Secondary gain: External rewards (addictive drugs; sympathy from others; financial gain; avoidance of unpleasant tasks) Genetic factors

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00 – 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00 – 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

Orthopedic Exam Distal Radius Fractures

Mark Kwartowitz, D.O.
Board Certified & Fellowship Trained

Lederman Center for Orthopedic Surgery, Sports Medicine, & Physical Therapy Located in Lakes Medical Center West Bloomfield, MI

Mechanism of Injury
Fall Motor Vehicle Accident Trauma

Classifications (extensive and complex)
Extra articular Intra articular
– Displaced – Angulated – Comminuted

Treatment Options
Conservative (non-operative)
– Closed reduction – Cast immobilization – Splints

Treatment Options
Surgical Intervention
– Percutaneous pin fixation – External fixation – ORIF

Associated Injuries
Ligamentous Distal Radioulnar Joint Nerve Injury

Complications
RSD/CRPS Nonunion Malunion

Orthopedic Exam RSD/CRPS of the Foot

Ronald Lederman, M.D.
Board Certified & Fellowship Trained

Lederman Center for Orthopedic Surgery, Sports Medicine, & Physical Therapy Located in Lakes Medical Center West Bloomfield, MI

RSD/CRPS
May be caused by minor or major trauma

Signs and Symptoms
Hypersensitivity Skin Discoloration Temperature Changes Nail Bed Changes Hair Follicle Changes Atrophy Decreased ROM

Treatment Options
Aggressive ROM/PT Desensitization/PT Lyrica Speed Gel 7 MLS Laser Therapy

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00– 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00– 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Schoolcraft College Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00 – 3:15 PM

“It Happened to Me” My Journey to Recovery

Susan Cyrulnik, Schoolcraft College & Workers’ Compensation Professional

Happy Mother’s Day
Beautiful Sunny Day Enjoyed a wonderful Brunch with my family Needed to walk off those calories Let’s go to the park and walk the dogs!

Whoops!!
Along come some joggers Bump into me! I fall, using my right hand to break the fall CRUNCH! PAIN! EMBARRASSMENT… Dogs!

Hand Specialist
Confirmed the CRUNCH to be a Comminuted Displaced Fracture of the Distal Radius Surgery Metal Plate, Screws Hospital Stay! YIKES! I REALLY DID IT THIS TIME!

The Hospital
No problem! No pain! OMG! The anesthesia wore off! PLEASE GIVE ME ANOTHER BLOCK!

Post-Op
Keep your arm elevated at all times – even at night Take your pain medicine! Start occupational therapy Exercise your fingers Rotate your arm Take your antibiotics. Do you need more pain medicine?

Perfect Patient?
“Doctor & Therapist – I promise to follow instructions to the letter – EXCEPT taking that pain medication” “I have seen too many injured workers become addicted to pain medicine during my career” “You won’t get addicted. You need to give your body a rest from the pain”

Recovery
Still wearing a cast Occupational therapy 3x per week Fingers still swollen Pain is tolerable Exercising at home

Gee, I wish I could get a good night’s sleep already!

Good News – Bad News
It has been 6 weeks, let’s remove the screws! Great! They are irritating, especially when exercising! Post-Op – Dr. isn’t pleased. Hand is VERY red, swollen, warm – and it feels like it is on FIRE! This pain is different – “Please DO NOT touch my hand!”

What is Happening?
My hand is going from bad to WORSE

Occupational therapist calls the doctor
Back to the doctor:

– – –

“Sometimes Susan, the nervous system has an adverse reaction to trauma” “I’m going to change your therapy regime” “Are you taking your pain meds? You need to.” “Sometimes, but I really don’t want to get addicted”

I CAN’T HAVE RSD! This can’t be happening to ME!

Despair and Disbelief
How could this happen to me? This is my dominant hand – will I ever be able to use it again? Work again?

The pain is exhausting
Therapy is discouraging, my fingers are so swollen I can’t bend them at all

Don’t Give Up Hope!
Let me introduce you to another patient with the same injury and RSD diagnosis She is 3 months ahead of you My guardian angel!

She CAN bend her fingers now!

Help Is On The Way!
Guardian angel turns out to be an orthopedic surgical nurse Her recipe for success?
– Get to a specialist in treating RSD – Make your recovery a full-time job – Stay off the internet! Too much gloom and doom!

RSD Specialist
Physical Medicine & Rehabilitation Specialist:
– You have 2nd stage CRPS – Caught relatively early – may take up to TWO years to fully recover – BUT YOU CAN RECOVER! – Need to reduce the pain and swelling
Neurontin for “nerve pain” Cortisone injections for “swelling”

Nerve Blocks & LOTS of Therapy
My least favorite part: Sympathetic nerve blocks – Series of 3, every other day Have block and head directly to therapy Gives the therapist ability to be more aggressive

Slow and Steady Progress
Swelling is down Pain is tolerable again Able to slightly bend my fingers and wrist Osteopenia is retracting

I’M A HAPPY CAMPER!

Danger Ahead
More surgery – plate removal Fear of what happened after last surgery

Doctors theory was that my body adversely reacted to the trauma of surgery What if this happens again?

Not AGAIN!
Had a block before surgery
CRPS Symptoms Returned WORSE THAN BEFORE Couldn’t tolerate COLD

Keep the Faith “Just a Set-Back”
Start over again
– More Blocks – More Cortisone – Increase Neurontin – Change therapy regime – Pain meds to sleep – Wear gloves to go outside

Road to Recovery
Needed more than ever to adhere to home exercise program and very aggressive occupational therapy

KEEP A POSITIVE ATTITUDE – DON’T GIVE UP!

Lessons Learned
CRPS is a real condition It is a very painful, emotionally challenging, and life disrupting condition Patients can feel hopeless Treatment is costly – an added worry to patients and/or employers If caught early and treated aggressively, one CAN recover

What helped my recovery?
Early diagnosis Aggressive treatment plan Positive attitude Making recovery my job Multifaceted medical team
– Surgeon or PMR for initial injury – Pain Specialist – Physical or Occupational Therapist

Encouragement
CRPS is real and can be a difficult diagnosis in both work related and nonwork related situations There will be ups and downs, but with the right treatment and perseverance recovery is possible!

Agenda
8:00 – 8:45 AM
8:45 – 9:00 AM 9:00 – 10:00 AM

Registration & Breakfast
Welcome / Overview / Business Meeting Changing Times Jerry Marcinkowski - Executive Secretary , MSIA Jay Quist - Director of Employment Services Division Kevin Elsenheimer -Director, Workers’ Compensation Agency

10:00 – 10:30 AM Break / Visit Exhibitors 10:30 – 10:45 AM Re-enactment of a complex claim scenario Rose Wohlgemuth, Trinity Health Patricia Stegner, ESIS Inc. Mari Beth Jelks, City of Grand Rapids 10:45 – 11:35 AM Mock Psychiatric IME & Results Dr. Harvey Ager, M.D., P.C. 11:35 – 1:00 PM 1:00 – 2:00 PM Lunch/Visit Exhibitors Mock Orthopedic Upper Extremity IME & Results Mock Orthopedic Lower Extremity RSD/CRPS IME & Results Dr. Mark Kwartowitz, D.O. Dr. Ronald Lederman, M.D. Break/Visit Exhibitors RSD/CRPS – “It happened to me” Susan Cyrulnik, Workers’ Compensation Professional Prizes / CEUs / Adjournment

2:00 – 2:30 PM 2:30 – 3:00 pm 3:00– 3:15 PM

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