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In this episode, co-hosts Yvonne Guibert and Rafael Gonzalez talk with expert defense attorney and educator Jeff Adelson in a candid conversation about two often-overlooked forces in workers’ compensation: ethics and empathy. Together, they explore how small shifts in behavior, perspective, and communication can create better outcomes for injured workers and claims professionals alike.

From managing ethical gray zones to acknowledging the human side of every claim, Jeff brings decades of insight, humor, and heart to the conversation. This episode challenges us to rethink the role of compassion in claims management and reminds us that doing the right thing and doing good business are not mutually exclusive.

💡 Highlights for Newer Professionals in Workers’ Comp

✔️ Know the Rules on Represented Parties
Jeff shares an important story about being asked to communicate directly with a represented worker. This is a legal and ethical no-go: always respect representation boundaries; communicating without counsel is prohibited and can jeopardize a case.

✔️ Doing the Right Thing Isn’t Always Easy
In a pivotal moment, Jeff explains how his firm gave up a significant contract rather than compromise its ethics. It's a lesson for anyone new to the industry: ethics must come before convenience or profit.

✔️ Ethical Issues Aren’t Always Black and White
The episode touches on how clerical issues or unclear situations, like a temporarily inactive attorney, require careful, thoughtful handling. Consulting with ethics counsel and taking the high road is always a sound strategy.

📘 Terms to Know (Episode Reference)

Ethics (in Workers’ Compensation)
The moral principles that guide behavior and decision-making within the workers’ comp system, including how injured employees are treated, how claims are handled, and the integrity of legal, medical, and administrative actions.

Empathy
The ability to understand and share the feelings of another. In claims management, empathy can foster trust, improve communication, and lead to better outcomes by acknowledging the human side of the injury.

Moral Hazard
A situation in which one party is more likely to take risks or act unethically because they do not bear the full consequences of their actions — often discussed in the context of fraudulent claims or system abuse.

Conflict of Interest
A situation where a person or entity involved in the claims process (e.g., provider, attorney, or claims adjuster) has competing interests that could improperly influence decisions or outcomes.

Good Faith Handling
The expectation that claims administrators and insurers will act fairly, honestly, and in the best interest of all parties — especially the injured worker — throughout the claims process.

Compassion Fatigue
Emotional exhaustion can affect professionals who regularly deal with others’ trauma or suffering. Often experienced by adjusters, nurse case managers, or clinicians, it may lead to detachment or burnout.

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In this episode, Yvonne and Rafael catch up with Judge David Langham, Deputy Chief Judge of the State of Florida, and a prolific writer, blogger, educator, and speaker.

If you're curious about the history of Florida’s workers’ compensation system, and you want to learn what "stare decisis" is, don’t miss our conversation with Judge Langham. He's widely recognized as the leading legal authority on this topic.

In addition to a concise and thorough history lesson on the Florida work comp system, we discuss a few other key points specific to Florida.

To access books and resources Judge Langham mentioned during the episode, including his free downloadable book: "Floridiana and the Workers' Compensation Adjudicators," visit www.dwlangham.com.

Visit his Blogger profile to check out Judge Langham's blogs (there are several).

Note: stare decisis is a legal term. According to LexisNexis, it means "to stand by things decided and not disturb settled points." They further explain, "The doctrine of stare decisis, or binding precedent, is the principle by which judges are bound by previous judicial decisions, especially of superior courts. To 'stand by things decided', the basis for the doctrine of precedent, there is no room for further examination or interpretation of a point or principle of law; the court is bound to the reasoning in the prior decision, unless there is a unique exception or the matter is before a higher court."

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In this episode, Yvonne and Rafael chat with friend and colleague Rosa Royo, Director, Workers' Compensation and Loss Prevention at Miami-Dade County Public Schools. This is Rosa's second time visiting us at Deconstructing Comp. This school system is the third largest school system in the country with 450 school sites, 335,000 students and over 40,000 employees (based on most current statistics).

We start off the episode talking about what each of us are doing creatively that we have not done before, or haven't done in a while. Rosa talks about playing string instruments, Rafael talks about getting back into tennis, and Yvonne talks about doodling and art.

Rosa talks about the need to pivot quickly and why it is important to regularly review your program for areas that are weak and need to be strengthened. She discusses how post-pandemic workers' compensation care is strained due to not having adequate access to providers and providers aging out of the system. She spends much of her time reviewing her provider network and ensuring she is doing her best to fill the gaps where they are exist.

Rosa also talks about the importance of communication, a common theme in our episodes. She personally signs over 4,000 get well cards per year that are sent out in packages to injured workers. It is a small gesture that Rosa says pays high dividends: 16% reduction in litigation when she started this practice.

Dive into the full episode and hear what else Rosa has to say.

¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp

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In this episode of Deconstructing Comp, Yvonne and Rafael welcome Gina Jacobs, a defense attorney with Hamilton, Miller & Birthisel LLP, to share what it’s like navigating workers’ compensation from the defense side. Joining from Orlando, Gina brings a candid look at how defense counsel approaches claims, collaborates with employers and carriers, and works toward fair resolutions within Florida’s workers' compensation system.

Gina’s journey into law is one of purpose and passion. After spending more than 10 years as a claims professional, working with Crawford & Company, Zenith Insurance, and Gallagher Bassett, she made the leap to law school to deepen her understanding of the industry she already loved. Today, that background shapes her work as a defense attorney, giving her rare empathy for claims adjusters and a deep appreciation for how every stakeholder impacts the outcome of claims.

Throughout the conversation, Gina shares how she balances advocacy with understanding, why communication remains at the heart of every successful case, her commitment to partnerships, and how she’s using her experience to mentor and educate the next generation of professionals in workers’ compensation.

This engaging episode offers a thoughtful and balanced look at what it means to defend claims while staying true to the people and purpose behind the process.

¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp

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In this episode of Deconstructing Comp, Yvonne and Rafael talk to Paolo Longo, a claimant attorney based in Florida, to explore the realities of representing injured workers, especially first responders. Paolo shares how his career path led him from the state attorney’s office to becoming a dedicated advocate for employees navigating the workers’ compensation system.

He explains the unique legal protections and presumptions that apply to Florida’s firefighters, police officers, and other first responders, particularly around heart disease, hypertension, and other conditions presumed to be job-related. Paolo also highlights the burden-shifting process that makes these cases unique, and why communication and education are at the heart of effective advocacy.

A powerful part of the discussion centers on the fears and concerns first responders face after an injury. Paolo notes that the first question nearly every client asks is: “Am I going to lose my job?” Beyond that, they worry about whether they’ll ever return to work, finish their careers, or continue providing for their families. These uncertainties, coupled with a lack of clear understanding of the claims process, make strong legal guidance and compassionate communication for injured workers essential.

Another key legal point Paolo discusses is the “120-day rule.” While its meaning varies by state, in Florida, the focus of Paolo’s practice, it sets the timeframe for an employer or insurance carrier to decide on a claim. Once an employer begins providing benefits, they have 120 days to either deny the claim or continue paying benefits. If they don’t issue a denial within that period, the claim becomes compensable by law, unless the employer can later prove new “material facts” that weren’t discoverable during the initial investigation.

This rule is critical because it can determine the outcome of a case, whether benefits continue, or whether a carrier can still attempt to deny responsibility for an injury. Paolo explains how this plays out in practice and why it’s such a pivotal part of representing injured workers in Florida.

From candid reflections on the challenges of the system to insights on what truly makes a difference for injured workers, this conversation offers a rare look at the claimant’s side of workers’ compensation.

¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp

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In this episode of Deconstructing Comp, Yvonne Guibert and Rafael Gonzalez welcome Scynthia Syfrett, Workers’ Compensation Program Manager at SHARP Healthcare in San Diego. Scynthia offers her perspective on managing a large deductible program, with a $1 million per-claim deductible, and the lessons in risk that come with operating at this scale.

Our conversation examines how large deductible programs shift a significant portion of the claims exposure back to the employer, presenting both opportunities and challenges. Scynthia explains why careful oversight, proactive claims management, trusted vendor partners, and tailored processes are essential to ensure every claim is handled with both financial accountability and employee care.

She also highlights why healthcare systems, with thousands of employees, must maintain clear strategies for managing risk, controlling litigation, and supporting injured employees within such a high-stakes framework.

You'll also learn that Scynthia is passionate about education, just like Yvonne and Rafael!

Key terms and concepts mentioned in this episode to help guide your listening:

Large Deductible Program – SHARP's program features a $1 million per-claim deductible, shifting a significant portion of the financial responsibility back to the employer.

Risk Management – In workers’ compensation, risk management means recognizing and addressing financial, legal, strategic, and safety risks that can affect both employees and the organization.

Litigation Review – The process of evaluating claims before escalating to legal action; Scynthia discusses SHARP’s unique approach.

Return to Work (RTW) – Supporting employees in safely resuming their roles, often with modified duties.

Safety – Preventive measures and tracking of safety incidents within an employer's environment.

Employee Education – SHARP’s investment in training employees to understand workers’ compensation processes and responsibilities.

Trusted Vendor Partners – External claims, legal, and medical partners who work closely with an employer to manage claims effectively.

¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp

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Disclaimer: The views expressed in this episode are Judge Robert Rassp’s personal opinions and do not reflect the official position of the State of California, Department of Industrial Relations, Division of Workers’ Compensation (DWC), or the Workers’ Compensation Appeals Board (WCAB).

In this episode of Deconstructing Comp, Yvonne and Rafael are joined by Judge Robert Rassp for a straightforward discussion about the fundamental benefits of workers’ compensation and why they are important.

Judge Rassp walks us through the foundation of the system, from medical treatment to temporary and permanent disability benefits, and explains how these core protections are designed to support injured employees while balancing employer responsibilities.

The conversation also explores how utilization review, independent medical review, and evolving case law influence the delivery of these benefits. Judge Rassp emphasizes the importance of fairness, education, and due process in ensuring that both injured employees and employers understand the system and can navigate it effectively.

According to Rassp: “Temporary disability keeps food on the table during recovery. Permanent disability recognizes when someone’s life has been permanently changed by an injury.”

Please join us for this informative episode with one of our industry's most experienced and esteemed educators. Judge Rassp is also an adjunct professor at Pepperdine University's Caruso School of Law, where he teaches workers' compensation law, and he's a founding member of the CC&R Band, a parody band that performs classic rock and roll hits at many Southern California industry events.

Key Terms from the Episode:

• Medical Treatment – Care provided to cure or relieve the effects of a work-related injury or illness.
• Temporary Disability (TD) – Wage replacement benefits provided to an injured employee while recovering and unable to work.
• Permanent Disability (PD) – Benefits awarded when an injured employee has lasting impairment that affects their ability to earn wages.
• Causation – the link establishing that an injury or illness arose out of and in the course of employment, or more simply put, that the injured employee's work contributed to their injury or illness. This is also referred to as AOE/COE.
• WCAB (Workers’ Compensation Appeals Board) – The judicial body that adjudicates disputes in California’s workers’ compensation system.
• Utilization Review (UR) – The process by which an employer or insurer evaluates a medical treatment request for appropriateness and necessity.
• Independent Medical Review (IMR) – The appeal process when a treatment request is denied through UR, conducted by an independent physician reviewer.
• Case Law – Published court or WCAB decisions that interpret statutes and guide future workers’ compensation cases.

¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp

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In this episode, Yvonne and Rafael talk to Dr. Marcos Iglesias, Chief Medical Officer at AF Group. Dr. Iglesias shares his journey from occupational medicine to the executive level and the lessons he’s learned about helping injured workers recover faster and more fully. Drawing on decades of experience, Dr. Iglesias offers candid, practical advice for younger clinicians entering the workers’ compensation space, emphasizing the importance of looking beyond symptoms to understand why a patient isn’t improving.

He explains how focusing on what an injured worker truly needs to feel supported can reduce frustration for clinicians, improve communication with claims and employer teams, and create better outcomes for all parties. From breaking down barriers to recovery to fostering stronger provider relationships, Dr. Iglesias underscores that when clinicians approach care with curiosity, empathy, and collaboration, everybody wins.

Listeners will leave with actionable insights into how new medical professionals can navigate the complexities of workers’ comp, make a meaningful impact on injured workers’ lives, and help shape a system that works better for everyone.

Key Terms and Definitions in this episode:

Biopsychosocial Model of Care – A holistic approach to healthcare that addresses the biological, psychological, and social factors influencing an injured worker’s recovery, promoting comprehensive and individualized treatment plans.

Chief Medical Officer (CMO) – Senior medical leader responsible for developing and overseeing clinical strategies, ensuring medical best practices, and aligning care delivery with business goals.

Claims Operations – The department or function responsible for managing claims from the first report of injury through closure, including investigation, evaluation, and settlement.

Early Intervention – Identifying and addressing potential issues in a claim as soon as possible to prevent delays in recovery and reduce claim duration and costs.

Employer Engagement – Active participation of the employer in the claims process, including communication with the injured worker, accommodations for return-to-work, and collaboration with claims teams.

Evidence-Based Care – Medical treatment decisions based on the best available research, clinical expertise, and patient-specific factors to ensure optimal outcomes.

Occupational Medicine – A branch of medicine focused on the prevention, diagnosis, and treatment of work-related injuries and illnesses.

Provider Network – A group of medical professionals and facilities contracted to deliver care to injured workers under negotiated terms.

Psychosocial Barriers – Non-medical factors—such as mental health concerns, fear, social isolation, workplace relationships, or financial stress—that can delay or prevent recovery.

And here are a few references to things Dr. Iglesias mentioned during our discussion:

On Ambient Scribe Technology

Open Evidence (chatGPT for medical professionals)

¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp