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Workers’ Comp from the Other Side: Pain Management
Many people have a negative perception of the benefits and treatment one receives through the workers’ compensation system. What examples are there of the system working, and what can injured workers do to help proactively manage their pain as they recover?
In this episode of Workers Comp Matters, host Alan Pierce speaks with Rebecca Curtis about her work-related injury, her road to recovery, and the company she founded to help other injured workers like herself. Rebecca recalls her car accident during a trip home from a speaking engagement and how it left her with a spinal fracture and no feeling from the neck down. She opens up about her surgeries, having to learn to walk again, and the excellent workers’ compensation services and support she received. Rebecca also provides insight into her battle with pain management during her recovery process and how a program helped her to realize that there are many options available for pain management. She closes the interview with a discussion on how this experience inspired her to start her company, Take Courage Coaching, and dedicate her life to helping others struggling to manage chronic pain.
Rebecca Curtis is the founder of Take Courage Coaching. She is an international speaker on chronic pain management, has been a regular speaker at PAINWeek®, and trains, coaches, and travels extensively speaking to medical groups about the role of coaching in pain management.View transcript
Workers Comp Matters
Workers’ Comp from the Other Side: Pain Management
Announcer: Hello listeners. This episode originally aired at June of 2016, and we are rebroadcasting it, because it’s about one woman’s inspirational journey from a life-altering accident to recovery dealing with pain management. So stay tuned, we hope you enjoyed the episode.
Intro: This is ‘Workers Comp Matters’ hosted by attorney Alan S. Pierce; the only Legal Talk Network program that focuses entirely on the people and the law in workers’ compensation cases. A nationally recognized trial attorney, expert, and author, Alan S. Pierce, is a leader committed to making a difference when workers comp matters.
Alan S. Pierce: Welcome to ‘Workers Comp Matters’. This is Legal Talk Network, and this is your host, Alan Pierce, delighted to have you listen to our show today. I am with the law firm of Pierce, Pierce & Napolitano in Salem, Massachusetts, where we represent injured workers and their families in workers’ compensation cases.
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On this edition of ‘Workers Comp Matters’, I am pleased to have with us Becky Curtis. Becky founded a company called Take Courage Coaching, about seven years ago, and Becky has a rather compelling story to tell as to how one day her entire life changed and how she not only had an horrible injury in the course of her employment but how this injury allowed her to recover in a most amazing way and start this company called Take Courage Coaching.
So Becky, thank you very much for being with us today on Workers Comp Matters.
Rebecca ‘Becky’ Curtis: Thank you very much. It’s a privilege to be here.
Alan S. Pierce: All right, so take us back to 2005. You are from Bozeman, Montana or somewhere nearby?
Rebecca ‘Becky’ Curtis: Right. Yeah, I am from Bozeman, Montana.
Alan S. Pierce: And back in 2005 tell us what happened on that day that everything changed for you?
Rebecca ‘Becky’ Curtis: Well, my family and I were driving, we were in two separate cars and I was driving in front of my husband — oh, actually he was in front of me, I am sorry. And I fell asleep while I was driving and when my wheel hit the gravel on the side of the road, I woke up and I overcorrected and rolled my Jeep Grand Cherokee on about a hundred yards from where I went off the road to where it ended. And when the car came to a stop I knew that I had broken my neck. I couldn’t feel anything from the neck down. I also had two collapsed lungs, broken ribs, broken clavicle, and we were in middle of nowhere here in Montana. I was just returning from doing a speaking job. They were paying my mileage and so this was a work-related injury. And so that was the beginning of a very long journey for me.
Alan S. Pierce: And you suffered a spinal cord injury, did you not?
Rebecca ‘Becky’ Curtis: Yes. It was a C4 burst fracture. So I am an incomplete quadriplegic and that “incomplete” is a wonderful word, a lot of people don’t understand that. The spinal cord is about as big around as your pinky, so it’s pretty small, and the bones in my vertebrae C4 had burst and those shards of bones were squeezing and bruising and cutting on my spinal cord but did not sever it. If it would have been severed I wouldn’t have any function from the neck down. Because it wasn’t severed, I had a lot of possibility for recovery and have recovered quite well.
Alan S. Pierce: And you and I met probably a month or two ago in Dallas when you were attending a summit on workers’ compensation and giving your perspective as an injured worker who had somehow navigated through the workers’ comp system. And I was amazed when you introduced yourself, clearly you had a little bit of difficulty ambulating, but when you mentioned you are an incomplete quadriplegic and I saw the level of function that you had, it was eye-opening, and obviously it took a lot of work both between you and your medical team.
Rebecca ‘Becky’ Curtis: Yes. There was a lot of work and nothing from the neck down worked, so I had to learn how to walk and function, everything I had to learn, how to work again. And so, it was quite an uphill battle, but like you said I had really good care and I have nothing but positive things to say about the work comp system that I went through, but I know that’s not always the case.
Alan S. Pierce: It is not always the case and usually either when we talk with injured workers, we talk with people who have been through the workers’ comp system or currently going through it. We all sort of focus on the problems and the areas in which the system is lacking.
I believe your employer was covered by Liberty Northwest, which is Liberty Mutual actually, by coincidence it’s a company that I started my career with back as a claims adjuster many years ago, and I was a lawyer for Liberty, and I remember, even back then Liberty Mutual focused quite extensively on putting a lot of money and putting a lot of research in spinal cord injuries and recovery.
So it looks like all of their efforts kicked in on all cylinders for you. Tell us a little bit about what your recovery entailed? I know you had a syrinx or a cyst on the spinal cord that was inoperable.
Rebecca ‘Becky’ Curtis: Right.
Alan S. Pierce: So what was your treatment? Did you have surgeries at all?
Rebecca ‘Becky’ Curtis: Well, when it first happened, of course, I was taken to the emergency room to a trauma center, where they took all those little broken shards of bone out and stabilized everything and fused me back together. I am fused from C3 to C5. I also had surgery. I had a non-clavicle break, so I had a shoulder surgery and — but those were the only surgeries that I had.
Two years after my injury I developed burning nerve pain, central nerve pain from the neck down. And about — just about stressing out I really thought that I would have this injury and I would just — I would recover. I would just keep getting better and better and better. And in some ways that was true but in other ways this pain just really I was not expecting pain, and so that was a really challenging time, probably for my adjuster, my physicians and for my family, because I wasn’t expecting that. And it was all caused by a fluid-filled cyst in the middle of my spinal cord called the Syrinx that causes burning nerve pain. And it is inoperable because they would have to go through healthy spinal tissue to get to it, and I could lose more function, so that was a really, really difficult time.
Alan S. Pierce: And I know you mentioned at the beginning of this story that you were actually driving in the middle of nowhere as you put it following your husband and family, and of course, the first thought most people would have, is why is this a workers’ comp claim, but as you mentioned you were out on a speaking engagement for your employer and because you were considered still in the course and scope of your employment, the injuries on route from the place where you last did business to your home, presumably were found to be covered under workers’ comp, which is not always the case. Is that correct?
Rebecca ‘Becky’ Curtis: Yes, that is correct.
Alan S. Pierce: Okay.
Rebecca ‘Becky’ Curtis: The rules in this state, I guess, if they are paying mileage then it’s covered under workers’ comp.
Alan S. Pierce: Yeah. Those are one of the factors. That’s one of the main factors of traveling employees, whether or not the travel is somehow made part of the employment by the payment of mileage or other reimbursement for the travel. And for people listening in different states, of course, every state jurisdiction could be a little bit different, but I think what you described seems to be the majority view.
So you came in contact with a system of workers’ compensation that you probably knew very little about and it took care of your medical and hospital and rehabilitation bills and paid you some lost wage disability benefits while you were recovering and unable to earn a living.
Rebecca ‘Becky’ Curtis: Right.
Alan S. Pierce: And I assume that occurred without too much friction or too much difficulty?
Rebecca ‘Becky’ Curtis: Really, there was very little friction. The biggest difficulty was all the comments that people would make when they found out that I was covered under workermen’s compensation, pretty much without fail everybody said, this is going to be terrible experience. It’s just going to be awful. They are not going to want to pay to things and you can’t trust them. I heard all these kind of different comments pretty much constantly.
I did not have that experience. I had a very good case manager. I had good adjusters. I had wonderful medical care all the way through, and I am very, very grateful. I really feel like the lack of friction really helped me as I moved forward, just knowing that what I needed was taken care of.
Alan S. Pierce: Well, as an attorney who has been on both sides of these cases, I have seen this before, not as frequently as I would like, but it is heartening nonetheless to see an injured worker and an insurance company working together to achieve as good a result as possible.
I know the insurance company can only provide money for medical care and the doctors and hospitals have to do their thing, but I do know that a lot comes from the injured worker herself and I am — without knowing you very well I can tell from meeting you briefly and hearing from you that you played a big role in this, in your family as well because this is not a journey you can walk alone.
Rebecca ‘Becky’ Curtis: Oh, thank you.
Alan S. Pierce: Yeah, but you were left with pain and as a result of that what did that teach you and what has that enabled you to do career-wise since then?
Rebecca ‘Becky’ Curtis: Yeah, the pain, we tried all kinds of different medications and we were getting ready to have a pretty invasive procedure, spinal cord stimulator put in. So my insurance company and my provider decided they were trying to send me to a functional restoration program. And I assumed that while I was there I was going to be having a spinal cord stimulator put in and that’s what I was prepared for.
I got there and the doctor who was going to be doing that procedure said, would you mind going to our program instead or at least before we do this? And my mouth said yes, but in my head I was thinking, what is this going to do? I mean, I don’t understand how going through a program is going to help this intense central nerve pain, and I don’t see what good this is, but sure.
So I went ahead with it and while I was in that program I learned that pain is an experience, it’s not a sensation it’s an experience, and there were a lot of things that I could do to manage my real experience of pain, and as I let go of fear and started moving and started thinking about my pain in different ways I really started doing a lot better and I went home and I implemented all the things that I’d learned in that program and started reading and researching and decided that I wanted to spend the rest of my life helping people with pain, so that is kind of it in a nutshell.
Alan S. Pierce: Well, you know it, and one of the hottest issues in workers’ comp right now is how the workers’ comp system deals with pain and especially dealing with pain in the setting of the prescription of opioids and strong narcotic medication and the habit that wrecks in some people’s lives.
So in a few moments after this break we’re going to talk about the company that you founded to deal with these issues and we’re going to take a short break and upon our return we will speak for other with Becky Curtis.
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Alan S. Pierce: Welcome back to ‘Workers Comp Matters’, we are speaking with Becky Curtis and her successful, physical, and emotional recovery from a devastating workers’ compensation accident that occurred a number of years ago.
Becky, you described the central nervous system pain and this program you underwent in California, and apparently it has been successful to a great degree, you’ve founded a company, could you describe the company that you founded and what your mission is?
Rebecca ‘Becky’ Curtis: Sure. It’s called Take Courage Coaching, and it’s based on just the whole premise that most people that have been in chronic pain, have been in chronic pain for quite some time, at least most of the people that we work with, and what people need to get out of that, what I needed was support.
Like I said in the last segment, I came home from that pain clinic anxious to learn all I could learn about managing pain, I was able to get off all my meds and be retrained as a coach, but I didn’t want to just be any coach, I wanted to develop something special for this group of people, these people that have chronic pain.
And so, basically what we do is we work telephonically so we work all over the United States. I now have 20 coaches, we are training nine more and we will continue that to just keep training more-and-more because there is a real need. We work telephonically with people for one year which sounds like a long time, but a lot of times what we find is these short programs are great, but people go home and they don’t have the support they need to make the real changes that they need to make to become active managers of their own experience of pain instead of pacification. And, I would like a little bit to just describe to a little bit the sinking of someone who’s gone through something like I’ve gone through.
Alan S. Pierce: That’s exactly what I was going to ask you to do. Go right ahead.
Rebecca ‘Becky’ Curtis: Okay. Well, yeah, you have this acute injury and you need surgeons, you need physical therapists, you need all of these, psychiatrists, occupational therapists, you need these people to help you get out of what you’re in, you need surgery pills, procedures, all of these kind of things, but there comes a place where the two shoe heels but the pain persists, so this is what we call chronic, and I actually like to call it complicated pain instead of chronic pain. Complicated pain makes it sound like there is something that can be done, which there is. Chronic just sounds like it’s going to go on forever and it’s very depressing.
So anyway as we move past the acute stage into the chronic stage we also need a paradigm shift, and that’s what we help people with is just that paradigm shift and it does take time. That paradigm shift needs to go from, I’m going to bring myself into your office and you’re going to fix me to, you know what, I have all the tools I need here to manage pain myself and I do go and see my doctor once a year only because Liberty Mutual insists that I do, but most of the time I don’t need him.
Every once in a while some complication comes up and I do, but I think I went two or three years without seeing my doctor, I am not on meds, I’m doing everything actively I can to manage pain, and so the cure me mentality goes away and I become an engaged self manager of my own experience of pain, and so that’s what we’re doing with people. We are helping them with that paradigm shift and it takes time.
Alan S. Pierce: Do you have any prerequisites for people to engage in your program? Do they have to voluntarily go off meds? Can they do this and as they wean off do they have to pledge? What are the requirements?
Rebecca ‘Becky’ Curtis: That is a really good question and it has several parts, and the medication piece, that is something they do with their doctors. We have 74% that have decided to get off their meds and that’s really exciting, I wish it was a 100%, but that’s something, we are coaches, we are not medical providers. So once they get the tools on board that they need to be self managers, that’s when we notice people just saying, hey, you know, I’m ready, I want off these things, I’m sick and tired of feeling like this, and that seems to be at about the six months mark, which is why we have the one-year program.
Give people tools, let them make the decision themselves and start weaning off with the help of their provider and things are going to go a lot better than if they are forced to do something they don’t want to do or they don’t have the coping skills to do.
Alan S. Pierce: Have you engaged the medical community, the medical schools in your approach and could you tell us what type of feedback you are getting?
Rebecca ‘Becky’ Curtis: I just spoke at UC Davis, to the pain management fellowship last Thursday, just a few days ago and I had wonderful reviews. They were just really excited about what we’re doing. I am also a regular speaker at PAINWeek in Las Vegas every September. It’s a large provider conference and I’ve been speaking there. I think this year will be my sixth year speaking. I always get really just great feedback.
The only drawback for them is, who’s going to pay for this, and at this point workers’ comp has that option to say, yeah, this is something that this person needs and we’re going to pay for it. Group Health hasn’t done that yet.
Alan S. Pierce: Does any other governmental, Medicare/Medicaid, any other program?
Rebecca ‘Becky’ Curtis: Yeah Medicaid Waiver in the State of Montana. The lady who is in charge of it here in Montana heard me speaking and came up afterwards and said, we really need you and she gave me a provider number and a code to use.
We also have two VA contracts and those are in the State of Oklahoma and we’re working with a pain clinic there and doing this study and we’re having great results, and I just spoke for a consortium for the VA and it was telephonic, so it was nationwide here, and that went over really well as well.
So I haven’t had really any negative feedback on this. It’s just people know that this is something that the chronic pain community needs, and so my hope is that some day it will be standard of care, but at this point I’m still pulling that train uphill.
Alan S. Pierce: All right, before we get your contact information so people who might be interested in learning more or perhaps contacting you for their own situations, I want to reintroduce a feature to ‘Workers Comp Matters’. I don’t want to catch you off-guard, but we have a feature called ‘Case of the Day’ and as you know from your involvement in some degree with workers’ comp that there are a whole variety of ways people find themselves injured and find themselves dealing with workers’ comp.
So I want to describe an interesting case to you and just get your opinion as to how you think it came out, and this case came out of the State of New York. It involved an assistant manager of a supermarket who had been suffering from post-traumatic stress disorder that was pre-existing but was not impacting his ability to do his job, and one night he called a coworker at her home to discuss a work-related matter and the phone was answered by the co-worker’s husband who thought that this assistant manager and his wife must be having an affair. So he contracted unsuccessfully for a murder-for-hire individual and he also was — he contacted the supervisor of the assistant manager regarding the suspected affair, triggering an investigation and a decision by the assistant manager to seek transfer to another store, and during that whole period of time his post-traumatic stress disorder, which was not really giving him any problems, really flared up and caused him not to be able to work. So he brought a workers’ compensation claim.
How do you think that claim came out? Do you think he should be entitled to workers’ compensation under those circumstances?
Rebecca ‘Becky’ Curtis: Oh dear. Well, that sounds like a really sad case. I guess, it sounds to me like it was — post-traumatic stress was pre-existing, but he was able to work. I guess, I would say that it sounds like a really sad story but I don’t think it really sounds like a workers’ comp case.
Alan S. Pierce: Well, the insurance company for the supermarket didn’t feel it was a workers’ comp case; however, the case did go to the Workers’ Compensation Board where they affirmed a decision by the judge awarding benefits and it was appealed to the appellate courts in New York, so it was one of those cases that an argument could be made either way and the appellate court indicated that if there was any nexus; however, slender between the motivation for the assault and the employment then a workers’ compensation award was appropriate, and here where the work-related phone call triggered the subsequent harassment that was enough according to the court to bring this all within the workers’ compensation system, but these are tricky cases and they could go either way.
So getting back to your company, Take Courage Coaching, how does somebody contact you?
Rebecca ‘Becky’ Curtis: Well, HYPERLINK “http://www.takecouragecoaching.com” takecouragecoaching.com is the website and my e-mail is becky@takecouragecoaching, and the phone number is (406) 381-2726.
Alan S. Pierce: Well, Becky, I want to thank you very much, not only for being a guest on ‘Workers Comp Matters’ but sharing this extraordinary story with us and demonstrating your courage and your ability to take charge of your own life, because one of the problems here is that a lot of people who get caught in this system through no fault of their own feel victimized by the system and don’t realize that if they take affirmative steps for themselves they can make the outcomes a whole lot better.
So thank you for being a guest and thank you for all the good work you’re doing, and for those of you listening please tune in again to ‘Workers Comp Matters’. This is Alan Pierce, go out and make it a day that matters.
Outro: Thanks for listening to ‘Workers Comp Matters’ today on the Legal Talk Network, hosted by attorney Alan S. Pierce.
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