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F I F T H A N N U A L N E V A D A Workers Compensation Educational Conference Presented by DIVISION OF INDUSTRIAL RELATIONS Tuscany Suites Hotel Las Vegas, Nevada In cooperation with the International Workers Compensation Foundation, Inc. (IWCF), a non-profit corporation dedicated to workers compensation research and education.

FIFTH ANNUAL NEVADA WORKERS COMPENSATION EDUCATIONAL CONFERENCE The Nevada Department of Business and Industry, Division of Industrial Relations, and the International Workers Compensation Foundation are jointly sponsoring an Educational Conference which is unique in Nevada. The goal of this conference is to educate those who participate in the Nevada workers compensation system regarding current rules, procedures, policies and forms and to provide an opportunity for dialogue among these participants. Breakout sessions will be utilized to discuss certain topics in specific detail for a more specialized view while other topics will be presented from a more general perspective. Who Should Attend? All employers, employees, insurance adjusters and agents, self-insurers, third-party administrators, safety and human resource managers, injured workers and attorneys, health care organizations, managed care organizations, researchers, medical providers and vocational rehabilitation counselors are encouraged to attend. In fact, anyone interested in the workers compensation system in Nevada will receive valuable information at the conference. Registration Fee The cost for attending this informative conference is: $325 per person paid on or before July 1, 2015 (early bird rate) $375 per person paid after July 1, 2015 Registration fee includes conference materials and special functions, including continental breakfasts, evening reception and luncheon. Casual attire is appropriate for all functions. Location Tuscany Suites Hotel 255 E. Flamingo Road Las Vegas, NV 89169 (877) 887-2261 A block of rooms has been reserved at the conference hotel at the conference rate of $55, single (additional person in the room will be $20 per person). Room rate will be $105 per night Friday & Saturday. The rooms will be held through July 20, 2015, unless this block becomes fully reserved prior to this date. Register early! Indicate you are attending the 5th Annual Nevada Workers Compensation Educational Conference when making your reservations. Continuing Education Credits Participants may be eligible for continuing education credits for conference attendence. CEU applications are pending for approval in the following disciplines: rehabilitation providers (CEU for CRC, CDMS, CCM), attorneys (CLE hours), human resources professionals (HRCI), and insurance producers.

EXHIBITOR/SPONSORSHIP REGISTRATION FORM FIFTH ANNUAL NEVADA WORKERS COMPENSATION EDUCATIONAL CONFERENCE ATTENTION EXHIBITORS Fee of $800 includes two (2) complimentary registrations for exhibitor representatives. Additional registrants will be accepted at the early bird rate of $325 each. A separate registration form should be completed for each additional registrant. Space is offered on a first-come, first-served basis. For additional information regarding exhibit area, contact the IWCF office at (386) 677-0041. Booth setup will be in the exhibitor area on Wednesday, August 19, 2015, from 5:00 pm to 6:30 pm. Teardown will be on Friday, August 21, 2015, at 11:30 am. Refreshment Breaks will be held in the Exhibition area. Registration fee includes one 6 draped table and two chairs, identification sign, registration for two representatives and twenty-four hour security. Full fee forfeiture if unable to attend. EXHIBITOR INSURANCE HOLD/HARMLESS CLAUSE Exhibitor assumes entire responsibility and hereby agrees to protect, indemnify, defend, save and hold harmless the International Workers Compensation Foundation (IWCF), employees and agents, Chelsea Place Meetings and its employees and agents, and the Tuscany Suites Hotel against all claims, losses and damages to persons or property, governmental charges or fines and attorney fees arising out of or caused by exhibitor s installation, removal, maintenance, occupancy or use of the exhibition premises or part thereof, excluding any such liability caused by the sole negligence or concurrent comparative negligence of the Tuscany Suites Hotel and their employees and agents, Chelsea Place Meetings and its employees and agents, as well as the IWCF, its members, employees and agents. In addition, exhibitor acknowledges that the Tuscany Suites Hotel, Chelsea Place Meetings and the IWCF do not maintain insurance covering exhibitors property or potential liabilities and that it is the sole responsibility of the exhibitor to obtain business interruption insurance, property damage insurance and liability insurance covering such losses by exhibitor. Exhibitor shall obtain and keep in force during the term of the installation and use of the exhibit premises, policies of comprehensive general liability insurance and contractual liability insurance and specifically referring to contractual liability set forth in the foregoing paragraphs hereof, in an amount not less than $1,000,000.00 combined single limit for personal injury and property damage. The Tuscany Suites Hotel, Chelsea Place Meetings, and the IWCF shall be included in such policies as additionally named insureds for this convention only. AUTHORIZED SIGNATURE: DATE: SPONSORSHIP OPPORTUNITY You are invited to register as a sponsor for the Fifth Annual Nevada Workers Compensation Educational Conference. The following sponsorship levels are available: Silver: Gold: $500 Contribution Organization name will appear on a large Thank You Sponsor sign in exhibit area. $1,000 Contribution Organization name and contact information will appear in conference program Organization name will appear on a large Thank You Sponsor sign in exhibit area. CHECK CATEGORY WHICH APPLIES: q EXHIBITOR AND/OR q SPONSORSHIP: q Silver q Gold Company Name: Specialty: Contact Person: Title: Address: City: State: Zip: Telephone: Fax: Email Address: EXHIBITORS ONLY Comp Registrant #1: Title: Comp Registrant #2: Title: (Please print names as you wish them to appear on name tag) Two registration options are available for exhibitors, gold and silver sponsors 1. Payment by Credit Card (MasterCard, VISA or American Express) - go to www.iwcf.us/iwcfevents.html and click on link to Online Registration under NEVADA. 2. Payment by Check Complete, copy and return this form, along with a check made payable to the IWCF (International Workers Compensation Foundation, Inc.) and mail to IWCF, 570 Memorial Circle, Suite 320, Ormond Beach, FL 32174. For additional information contact the IWCF office at: Phone (386) 677-0041 Fax (386) 677-0155 iwcf@bellsouth.net

CONFERENCE REGISTRATION FORM FIFTH ANNUAL NEVADA WORKERS COMPENSATION EDUCATIONAL CONFERENCE Registration Fees: $325.00 per person paid on or before to July 1, 2015 $375.00 paid after July 1, 2015 Two registration options are available. 1. Payment by Credit Card (MasterCard, VISA or American Express) - go to www.iwcf.us/iwcfevents.html and click on link to Online Registration under NEVADA. 2. Payment by Check Complete, copy and return this form for each attendee, along with a check made payable to the IWCF (International Workers Compensation Foundation, Inc.) and mail to IWCF, 570 Memorial Circle, Suite 320, Ormond Beach, FL 32174 Name: (Please PRINT name as you wish it to appear on your name tag) Payment by check only Business Name: Title Address: City: State: Zip: Telephone: Fax: Payment by check only Email: Area of Interest: n Employer n Employee n Insurer n Attorney n Health Care Provider Other: LODGING - The Tuscany Suites Hotel invites you to discover one of the best kept secrets of Las Vegas! A block of rooms has been reserved at the rate of $55 single (additional person in the room will be $20 per person), plus applicable taxes. Room rate will be $105 per night Friday & Saturday. This rate will be available through July 20, 2015, unless this block becomes fully reserved prior to this date. Indicate you are attending the Fifth Annual Nevada Workers Compensation Educational Conference when calling to make your reservations. Register early by calling the Tuscany Room Reservation s department at (877) 887-2261. CANCELLATION REFUND POLICY - Cancellation of preregistration must be made before 5:00 pm on August 7, 2015. Substitution of personnel is recommended in lieu of cancellation after that date. The full registration fee will be forfeited if you fail to attend or cancel timely. SPECIAL NEEDS - Individuals attending the conference who may need auxiliary aids or special services are requested to provide notice of their needs in writing no later than 10 working days before the conference so that appropriate arrangements can be made. DRESS CODE - Casual clothing is appropriate for all events. For further information contact the IWCF office at (386) 677-0041, Fax (386) 677-0155, or email: IWCF@bellsouth.net. Please Specify Net proceeds from this event, if any, go to the International Workers Compensation Foundation (FEIN# 35-1737364), a non-profit organization, to further its work in workers compensation education and research.

FIFTH ANNUAL NEVADA WORKERS COMPENSATION EDUCATIONAL CONFERENCE Tuscany Suites Hotel Las Vegas, Nevada TENTATIVE AGENDA & PROGRAM THURSDAY, AUGUST 20, 2015 7:00 am - 8:15 am REGISTRATION AND BREAKFAST GENERAL SESSION 8:15 am - 8:30 am Opening Remarks / Admin. Announcements Steve George, Administrator, Division of Industrial Relations 8:30 am - 9:45 am Keeping Good People Good: A Key to Organizational Excellence Christopher Hoye III, U.S. Department of Justice, District of Nevada, U.S. Marshal 9:45 am - 10:15 am BREAK & EXHIBIT VISITATION BREAKOUT SESSIONS 10:15 am - 11:30 am Stress, the Workplace and Workers Compensation: How Poor Mental Health Increases The Risk Of Occupational Injuries, Illnesses and Costs Jonathon C. Dopkeen, Ph.D., Clinical Assistant Professor, School of Public Health UIC 10:15 am - 11:30 am Return to Work Strategies from Employer s Perspective Darlene Rosenberg, AIC, CEBS, Principal Benefits Analyst, City of North Las Vegas Tina Sanchez, Director of Workers Compensation, MGM Resort 11:30 am - 12:45 pm LUNCH 12:45 pm - 2:00 pm Marijuana Momentum Implications for Workers Compensation Mark Pew, Senior Vice President, PRIUM 12:45 pm - 2:00 pm Employment Fraud Jay Raman, Chief Deputy District Attorney, Major Fraud Unit 2:00 pm - 2:30 pm BREAK & EXHIBIT VISITATION 2:30 pm - 3:45 pm Introduction to the American Medical Association (AMA) 6th Edition, Guidelines for the Evaluation of Permanent Impairment: Permanent Partial Disability Paul R. Pirruccello, DC, DABCO Katherine Godwin, RN, BSN 2:30 pm - 3:45 pm What Are the OSHA Expectations When There Is More Than One Employer on a Worksite? Jess Lankford, Chief Administrator Officer, OSHA 3:45 pm - 4:15 pm BREAK & EXHIBIT VISITATION 4:15 pm - 5:30 pm ACOEM via MDGuidelines : Applying EBM Guidelines for Improved Total Health & Productivity Carlos Luna, Senior Sales Executive, Reed Group 4:15 pm - 5:30 pm 2015 Nevada Legislative Updates Don Smith, Esq. Don Jayne, CPCU, Jayne & Associates, Inc., Lobbyist for Nevada Self Insurers Association Chuck Verre, Chief Administrative Officer, Division of Industrial Relations, Workers Compensation Section 5:30 pm - 6:30 pm RECEPTION FRIDAY, AUGUST 21, 2015 7:00 am - 8:00 am BREAKFAST BREAKOUT SESSIONS 8:00 am - 9:15 am Claim Denial and Acceptance: Recurring Legal Theories Dan Schwartz, Esq., Lewis Brisbois Bisgaard & Smith LLP Adam Muslusky, Esq., Muslusky Law Michelle Morgando, Esq., State of Nevada Hearings Division 8:00 am - 9:15 am Inherent Risks of Toxic Chemical Exposures to Firefighters Stephen Thompson, Paramedic Captain, Clark County Fire Department Richard Nudd, PA-C, Las Vegas Fire and Rescue Captain Richard Brenner, Clark County Fire Department, Hazardous Materials Coordinator 9:15 am - 9:45 am BREAK & EXHIBIT VISITATION 9:45 am - 11:00 am Workers Compensation Case Studies Discussion with DIR Staff and Claims Adjusters Suhair Sayegh, DIR, WCS Southern District Manager Lezlie Wooten, Claims Manager, Cannon Cochran Management Services, Inc. Jeanne Dubose, Claims Examiner, Sierra Nevada Administrators 9:45 am - 11:00 am Toxic Inhalation Exposures Brent Burton, M.D., M.P.H. 11:00 am - 11:30 am BREAK & EXHIBIT VISITATION GENERAL SESSION 11:30 am - 12:45 pm Workers Compensation Insurance: Regulation and Emerging Trends Rajat Jain, Chief Insurance Examiner, Nevada Division of Insurance 12:45 pm - 12:50 pm Closing Remarks Chuck Verre, Chief Adminstrative Officer, WCS/DIR

I W C F 570 Memorial Circle, Suite 320 Ormond Beach, FL 32174 First Class Mail US Postage Paid Daytona Beach, FL Permit #62 F I F T H A N N U A L N E V A D A Workers Compensation Educational Conference Tuscany Suites Hotel Las Vegas, Nevada Early-bird conference registration deadline: On or before July 1st Deadline for hotel reservations at conference rate: July 20th