The issue is inconsistent job accommodations across organizations. It makes little difference whether an employee is injured on the job and then requests an accommodation as part of a disability or leave of absence, or has the need for an accommodation in general. Circumstances should not alter the way in which an accommodation is handled.

See also: 21 emerging risks for the insurance industry and the global economy

In 2018, we encourage you to break down the RTW silos and get comfortable outside your typical area of responsibility. We should not only meet ADA requirements but also provide employees the accommodations they deserve.

Marijuana science has not caught up to the realities of today's social (and medicinal) use. (Photo: Associated Press/ALM Media archives)

No. 9: A potentially impaired workforce

Recreational marijuana is now legal in more states than ever before, with California becoming the largest state to allow use.

This may mean that a percentage of your workforce is impaired on the job.

Many employers stopped pre-employment drug testing for marijuana because too many potential workers failed the drug test, and because the presence of marijuana in your system does not mean you are currently impaired.

That's the problem: Right now there is no reliable method for employers to determine whether an employee is impaired on the job. There is no "marijuana breathalyzer," per se, that can quickly and accurately show whether a person is impaired.

Related: Using medical marijuana to treat construction workplace injuries

What can employers do?

Courts have consistently ruled that employers with drug-free workplace policies can terminate an employee who tests positive for marijuana, even if they are using medical marijuana. There is one notable exception. Last year, a Maryland court allowed an employee to pursue a wrongful termination claim under these circumstances. Will other states follow the Maryland precedent or the cases in California, Colorado, Michigan and other states where the termination was allowed? 

In addition, what happens now that the Department of Justice has rescinded the Obama administration policy memo that indicated the federal government would defer to the states to enforce marijuana laws. Does this mean the federal government will start to arrest marijuana users and producers? No one knows for certain. Perhaps this will force Congress to take action on legal weed.

Healthcare communications and technology is improved and consumer awareness and interest in digital health solutions in growing. (Photo: Associated Press/ALM Media archives)

No. 8: The digital health connectivity challenge

Digital health is a broad term related to the use of technology and health. Examples include mobile health apps, telemedicine products, tools to track consumer/patient data, education and patient reminder programs, and treatment adherence.

Related: 5 hallmarks of insurance industry digital leaders

For those working in the digital health space, connectivity is the issue. There are plenty of technology solutions, the challenge is connecting all of the stakeholders: patients, doctors and service providers, pharmacists, and insurer. Without connectivity, silos remain and the system is too clunky to be effective.

Probably the most common digital health discussion in workers' comp is telehealth. We have been slow to adopt comprehensive programs, whereas the benefits space has been at it for over 5 years. Group health has moved past triage of physical symptoms to treating mental health and, in 2018, moving into chronic disease management. Look for more hospitals to offer telehealth services as they diversify care offerings and seek to enhance their offerings.

Now is the time for workers' comp to jump on board.