One of the most overlooked aspects of successful recovery from a work-related injury is the injured worker's mindset. Nick was a friend of mine who played racquetball. Famously, he hated to lose. One day, he told me that he was scheduled for a back fusion. As a claims adjuster, I had seen the usual time for recovery of a low back fusion to exceed two months. He turned to me…
Executive Summary Informed consent and patient advocacy are crucial concepts in healthcare, but they serve different purposes and involve different responsibilities. This paper examines the concepts of informed consent and patient advocacy, highlighting their key differences and importance in modern healthcare. Informed consent is a legal and ethical requirement, ensuring patients understand the potential benefits, risks, and alternatives of proposed medical procedures. Patient advocacy involves supporting and representing patients' rights…
As a claims adjuster, I used to think that if I got the injured worker to show up for their medical appointments and if they followed the doctor's orders (at least most of the time), they were doing what they were supposed to and that they would recover and return to work. I never thought of physical therapy and what happened there. That activity was below my radar as a…
Eeyore, the gray and gloomy donkey from Winnie the Pooh, is famous for his pessimistic outlook: "I miss my tail," "It was a nice tail," and "Sure would be nice to have it back." He always sees what's missing, what could go wrong, or what already has. In a world filled with more energetic (and charismatic) characters, Eeyore remains part of the team—sometimes overlooked but always consistent. In the workplace,…
The Fastest Horse in the World A horse owner was selling the fastest horse in the world. “How do you make him run fast?” the buyer asked.“Say ‘Giddyup,’” the seller said. “He takes off like a bat out of hell.” The buyer responded, “How do you make him stop?”“You hit him over the head with a two-by-four.” was the reply. “Does that stop him?”“Nah,” the seller said. “But it gets…
Introduction: The Power of Faith in Recovery Whether rooted in spirituality, organized religion, or a personal belief system, faith offers profound comfort and resilience during life’s most challenging moments. Faith can be a transformative force for injured workers, fostering emotional strength and psychological well-being. Yet its role in recovery is often overlooked in the workers' compensation system, as claims administrators, physicians, and attorneys may hesitate to address spiritual concerns due…
Permanent Disability (PD) is a defined workers' compensation benefit and a critical medical and legal concept. It represents indemnity payments for lasting physical or psychological restrictions resulting from work-related injuries or illnesses. PD is central to the workers' compensation system, compensating for the loss of a body part (or its function) or the diminished ability to earn income after reaching Maximum Medical Improvement (MMI). Despite its importance, the definitions and…
The Freeway's Ghost: A Pragmatist's Reckoning with the Remote Work Revolution For years, California freeways told the story of the American workweek. Monday mornings meant the grind was beginning, and Friday afternoons signaled the great escape. From my office, I had a direct view of the freeway leading through the Central Valley of California to the Sierras and, ultimately, Lake Tahoe. Every Friday after one o'clock in the afternoon, that…
A Crisis of TrustTrust in the medical system has long been a fragile commodity in workers' compensation. Unlike private healthcare, where patients select their providers and develop long-term relationships with physicians, injured workers often find themselves assigned to doctors they do not know and may not trust. This lack of choice, combined with the perception that medical providers serve the interests of employers and insurers rather than the patient, creates…
The Transformative Impact of Positive Expectations A powerful kindergarten experience illustrates the profound influence of positive expectations. A young boy, who was just three and a half years old, had been identified as needing special education services. He received the services for several years. When he started kindergarten, his teacher took a unique approach. She talked to her mother about setting expectations on the first day of school and was…
