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At the California Coalition of Workers’ Compensation Conference in Anaheim a couple of weeks back, one of the presenters made a comment that resonated with me. The topic was related to innovative claims management practices and had shifted to discussions of return to work and the role of physicians. One of the panelists made an emphatic point of being tired of being given a list of restrictions related to the injured workers in their care. They said, “Why can’t the doctor tell us what a worker is capable of doing, instead of what they cannot do?”

It was a great point and reflects a bigger problem within the workers’ compensation industry. The very nature of our work forces us to view negative connotations and conditions. As a result, we spend a great deal of time focusing on the “can not’s” rather than the “still can.” Our culture has evolved to focus on disability rather than ability. The comment regarding physician restrictions could not have been a more distinct example of that reality.

This blog contains numerous discussions on the topic of disability. I’ve personally come to detest the term, at least in the manner in which it is used. I made my case against it back in 2019, in a post titled “What is Disability, Really?,” when I wrote:

It is no secret that I have grown to detest the word “disability.” It is unfortunately for many a self-fulfilling prophecy. We take people with a level of physical or mental impairment, and we declare them disabled. In so doing we condemn some of them to a future defined by restrictions and limitations. We categorize them by what they can no longer do and ignore the abilities they may still possess.

For some injured workers, it becomes an integral part of their narrative in a larger story of general victimization. The sad thing is they are right. Our system assigned them that designation and role. They are disabled because we told them they were.

The term “Dis” has nothing but negative connotations. As a verb, it means “To show disrespect to, often by insult or criticism” or “to treat in a disrespectful manner; to insult, disparage or belittle.” Appended to any word, it immediately implies a deleterious nature. Disability, disable, disavow, dismiss, disreputable, disgraceful, dissatisfaction, and the list goes on.

The workers’ compensation industry today concentrates on what can no longer be, when the message we should be conveying is that, for many, life is still possible. An impairment does not have to be a disability. A permanent injury may mean that the worker must change the way they do things, but we should not automatically define them as no longer capable of such ability. We still today often focus on the negative. The comment related to physician’s restrictions highlighted that tendency very clearly.

We can change our culture and shift our attitude. We are awakening to the reality that there is a better way forward, where treating the “whole person” and focusing on abilities can produce better outcomes for all stakeholders. In doing so, we can put the “dis” culture behind us once and for all.

Our failure to do so would be disappointing and distasteful, and will continue to leave too many souls disheartened, discombobulated, disenfranchised, discontented, and disenchanted.

Trust me. If we do this right, we will never miss the “dis.”

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All posts From Bob’s Cluttered Desk are available on www.bobscluttereddesk.com

Accidents can happen in the blink of an eye, as can other mistakes in the workplace. A recent minor mishap reminded me that when an error or accident occurs, the best thing you can do is accept the reality and roll with it as best you can. Sometimes, literally. It is a maneuver based on something I call “the art of the tumble.”

I traveled to Wisconsin this weekend to attend the wedding of my niece. She and her (then fiancé, now) husband own a beautiful 18-acre tract of land just south of Madison, near the hamlet of Brooklyn. Well, I assume there is a hamlet named Brooklyn, although I never actually saw it. There are numerous quaint little towns throughout the area, interspersed between voluminous tracks of green rolling hills and corn. Lots of corn. All I really know about the area is that my hotel, in Verona, was, according to Waze, 22 minutes from anywhere I wanted to be. It didn’t matter what address I plugged in. It was 22 minutes of driving through the country. But I digress…

The land they bought two years ago had been horribly neglected and was vastly overgrown. They worked diligently to clear the overgrowth, plant grass seed, and prepare a large area by a pond to host their 250-guest wedding. Much of the work involved turning the soil and cutting/clearing miles of viny roots that had infested the area. They had the place looking terrific and had cleared all the hazardous roots from the now grassy knolls. Well, almost all of the viny roots were cleared. I found one that was not.

There was a cocktail hour prior to the outdoor ceremony, and as guests began to arrive and the service bars were opened, I ordered a vodka tonic (with lime, of course) and drink in hand, headed with some family members across the lawn towards the house where much of the wedding party was gathered. As we walked, I felt my right foot get caught under a root that had been concealed in the grass, embedded in the ground on both ends. Immediately my body lurched to the right, with my right shoulder turning inward as I lost my balance.

It happened very fast, yet it is amazing what you can think about while something like this is occurring. My initial reaction was to try and recover my balance. As I stumbled forward, falling further and further to the right while consciously trying to save the drink in my hand, I realized that I was failing quite badly in the recovery. In mid-contortion, I remembered a couple of previous falls where I had essentially injured myself by trying to avoid the inevitable, and realizing I had surpassed terminal velocity, succumbed to the now unavoidable fall. I recall giving in to inertia, tucking my shoulder in, and going in for the crash. I hit the ground hard, shoulder first and then my legs. I recall hearing the ice cubes from my drink whizzing past my left ear. The plastic cup I was holding was now gone. Unfortunately, the fall was not yet complete. I landed at the top of a small embankment and continued to roll down it. I could hear the shocked reaction of my family as I rolled, and wondered what parts I was losing as I tumbled to a stop.

I stood fairly quickly and was surrounded by people concerned with my condition, helping to dust off my suit.

First, I must emphasize that my vodka tonic, which died way too young, was my first drink from the bar (well, except for a tequila shot earlier during setup – tequila shots are practically mandatory with one wing of my family at functions). This was not an alcohol-related incident. Besides, I couldn’t drink much that night. I had a 22-minute drive through the corn fields ahead of me on the return to my hotel. I can also assure everyone that I was not hurt by the incident. I banged my left knee a bit and wounded my pride but am otherwise fine.

And I attribute that to the fact that once I recognized a mistake that could not be corrected, the best strategy was to roll with it as best as I could.

The same philosophy can be applied to workplace errors and injuries. Whether it is an injured worker suddenly dealing with an unexpected impairment or an adjuster who missed a mandatory check deadline, accepting the reality of what happened and rolling with it offers much better outcomes than fighting the inescapable. Continually trying to prevent, disguise or deny a mistake will simply exacerbate the problem.

And like the helpful people who dusted dirt and grass off my suit, letting people help you after the fact is the smart thing to do.

Everyone has to at one point deal with mistakes, or even injuries. Avoidance maneuvers or denial beyond a certain point will not help alleviate the problem. The best thing you can do in those situations is adapt and roll with it.

You can minimize the damage from a stumble when you understand the art of the tumble.

We have written before about the misaligned incentives often found in workers’ compensation. I have referred to it as “treating injured workers for fun and profit,” reflecting situations where actions and processes are applied that may not be in the best interest of the worker, but financially benefit the people who are supposed to be helping them. There is a great deal of responsibility upon those of us in the industry not to abuse that fact, as workers are often further hurt in that process.

That process is commonly known as “the churn.”

A session at last week’s CCWC Conference in Anaheim, CA, touched on this point. The session was “Mitigation Strategies: A Holistic View of Claims.” The panelists were Chad Coleman, Jamie Goff, and Danny Thorn. It was moderated by Brian Arnold. Danny Thorn, who is with Benchmark Claims Administrators, discussed these misaligned incentives that can exist in the system and made the reference that the injured worker was, in those cases, a “piggy bank” for unethical players in the industry. He described the worker as the traditional ceramic object with a slot in his back, where coins could just keep being added. Those coins, of course, come in the form of unnecessary medical procedures, or legal actions that increase disability that happen to financially benefit legal counsel (my examples, not Thorns). It was a very effective visual illustration.

And that is without pointing out that the way you get your money out of a traditional piggy bank is by smashing it when it is time to “cash out.”

This point was especially poignant in California, where the costs of benefits delivery is still exceedingly high. Estimates are that employers pay $1 for every $2 in medical and indemnity benefits provided. That is not a very efficient system, and it indicates they have more than a few piggy bank employees in the state.

How do we address the entire issue of misaligned incentives? Of simple greed? We know that given the opportunity that most people will do the right thing, but how do we control those who put personal greed over their ethical responsibilities? This is an issue that goes beyond the ability of legislation and regulation. Time and time again we have witnessed legislated solutions to specific abuses, only to watch creative miscreants generate almost immediate workarounds. It is like squeezing the air in a balloon; you can push in on one part to remove the air, but it simply bulges out elsewhere. No, this is a bigger issue that will take the commitment of all honest players to address.

It stands to reason that ethics should be part of any training program comp professionals participate in. It is also up to the rest of us to start calling out abuses when we see them. The bad players in the industry are often known to many, yet they are allowed to continue their abusive acts unchallenged and unabated. There have been several high-profile fraud cases in California in recent years that prove that point. Many within our industry knew there was a problem, but it took the Feds to intervene to address the fraud. Silence can be acceptance when we know something is wrong but fail to stand up to it, and the reputation these actions create stains an entire industry.

And if we refuse to do anything, perhaps it is a reputation we deserve.

Viewing the injured worker as nothing more than a piggy bank violates the very principles of our industry, and often further injures the worker. Most within the industry do not do that, but our silence can be deafening. To quote a phrase that has become all the rage, “If we see something, we should say something.”

As a vocal community, we can prevent abuses. As a silent community, we are part of the problem. You can (piggy) bank on that.