『Deconstructing Comp』のカバーアート

Deconstructing Comp

Deconstructing Comp

著者: Yvonne Guibert & Rafael Gonzalez
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Now in Season 6! We are still breaking down complex workers' compensation issues into bite-sized nuggets, one conversation at a time, with one slight twist. We are finally doing what we set out to do when we started: discuss the nuances of our fascinating system in "Cliff Notes" style summaries.


Yvonne Guibert and Rafael Gonzalez approach workers' comp conversations from different backgrounds. Still, they share many things in common, such as their love for family and friends, a passion for Latin culture, and good old-fashioned belly laughs. Join them as they chat with industry friends and colleagues, learn more about their roles, laugh, and have fun along the way. You might learn something along the way! See you soon! ¡Hasta pronto!

© 2026 Deconstructing Comp
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  • Andrea Mills: Empathy as Infrastructure
    2026/08/05
    Send us Fan MailIn our latest episode, Yvonne and Rafael talk to Andrea Mills, President of Ametros.Guest BioAndrea Mills | President, Ametros | Workers' Comp Professional AdministratorNearly 20 years in the workers' compensation industry8+ years with Ametros, currently in her ninth yearLeads the largest professional administration company in the workers' comp space, serving both workers' comp and liability casesSince the recording of this episode, Ametros has expanded Medicare Advantage Plan support and is now available in all states except New York. For more information, visit info.ametros.com/medicare-consultation. Any references to savings are for informational purposes only. Savings are not guaranteed, and past performance or historical results are not indicative of future outcomes.Here are highlights of our conversation with Andrea: 1. The Settlement Cliff: When Support Suddenly StopsInjured workers spend an average of six years in the workers' comp system with full support: medical care, case managers, adjusters. Then settlement happens. Suddenly, most of that infrastructure disappears. They're left managing complex healthcare needs, settlement funds that need to last them years or a lifetime, and ongoing medical treatment entirely on their own.This is the gap Ametros fills.DC micro lesson: The industry has built systems for managing active claims. But we haven't built strong systems for managing the post-settlement phase. There's a resource cliff, and injured workers are expected to navigate it alone. Ametros stepped in to solve this problem. 2. Professional Administration Isn't Process. It's Presence.Ametros helps injured workers manage settlement funds, navigate their healthcare journey, and access the support they need after settlement. Referrals come from adjusters, Medicare Set-Aside vendors, and plaintiff attorneys who all recognize the same truth: injured workers need expert, compassionate support they can actually rely on after their claim is settled. DC micro lesson: Professional administration is about showing up for someone vulnerable and saying, "We're going to help you figure this out." It's about showing up for injured workers and helping them feel at ease and secure about their future medical care. 3. Medication Management: The Invisible Cost of Chronic ConditionsAfter settlement, injured workers face the full cost of their prescriptions for the first time. Chronic pain medications can cost thousands per month. Ametros works with injured workers to find the best alternatives, manage costs, navigate insurance, and ensure medications and care remain affordable.DC micro lesson: What happens to prescriptions after settlement is not a sidebar in the claim story. It's often the center of the story. Ametros helps injured workers think through their long-term care needs and identifies the best options. 4. Empathy Isn't Soft. It's Infrastructure.Ametros doesn't just talk about empathy; they've operationalized it. It's woven into hiring, training, and accountability. It's infrastructure. When injured workers interact with Ametros, they feel seen. That's not accidental. DC micro lesson: We need to stop treating empathy like it's a mindset hack. Start asking: How is empathy built into your processes? How do you hire for it? Coach for it? Help people build capacity for it? Until you answer these questions, you're not operationalizing empathy. You're just talking about it.5. Capacity Comes From Boundaries, Not Gritting It OutAndrea models protecting her own capacity: family time, travel (hello, Italy!), life outside work. Ametros's leadership team protects these boundaries for their teams too. You can't show up for injured workers if you're running on empty. You can't make people feel seen if you're depleted.DC micro lesson: How your team shows up for injured workers is directly connected to how you show up for your team. Capacity isn't something you demand from people. It's something you protect for them.A Final ThoughtAmetros solved a problem the industry had been overlooking: injured workers settling their cases and then disappearing into a resource void. They stepped into that gap and said, "We can do better." That's how you move an industry forward.Kudos to the team at Ametros for winning the Gold Stevie® Award for Sales & Customer Service in the Contact Center of the Year – Other Service Industries category. This recognition is well-earned by a team that puts injured workers' needs first.¡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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    40 分
  • DJ McConnell: Communication changes everything!
    2026/07/22

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    In our latest episode, Yvonne and Rafael talk to DJ McConnell, President and Owner of Bailey-McCaffrey, LLC.

    Guest bio:

    DJ McConnell | Nurse Case Manager & Owner of Bailey McCaffrey | New Orleans, Louisiana

    • 15+ years in the workers' compensation industry
    • Worked at Bailey McCaffrey for 13+ years, recently became President and owner.
    • Brings a healthcare/clinical lens to claims work and organizational leadership

    Yvonne wishes we had talked more to DJ about taking over the company where he worked for 13+ years. We'll have him back to have a deeper discussion on leadership! Thank you and kudos to DJ for stepping into this new role. We wish him all the best!

    1. Good Communication Comes First—Learn Why

    DJ (like many of us) learned this the hard way: the medical side of workers' comp is predictable. The hard part that nobody teaches you in school is how to communicate with injured workers and their family after a severe or catastrophic injury, and how that first communication impacts the entire claim.

    DC micro lesson: Before you worry about process, policy, or procedures—understand that how you communicate will determine the entire trajectory of a claim. If you don't teach yourself this early on, you'll spend years learning it the hard way.

    Ask yourself: What do I know about crisis communications? What do I still need to learn?

    2. Meet People Where They Are—Not Where YOU Need Them To Be

    DJ explains how early intervention should be carefully managed. When you show up within 24 hours of an injury, clipboard in hand, asking questions to someone who is in shock or hysterically crying, you've already lost. They're not in a state to receive or give information.

    DC micro lesson: Your job on the first contact isn't to gather data. It's to establish that you're a human who sees them and will be there when they want or need answers. That's enough. The information can wait.

    Think about this: What would change if you showed up to the first contact with an injured worker, not with a clipboard but with 100% presence?

    3. Non-Negotiables Are Infrastructure, Not Luxury

    DJ talks about his non-negotiables for maintaining his capacity: sleep, family time, and holding boundaries. We talk about the importance of boundaries and what it costs when you don't maintain them. But he's learned the cost of not protecting them: capacity disappears, communication suffers, presence evaporates.

    DC micro lesson: Non-negotiables aren't selfish. They're the foundation your capacity is built on.

    Honest check-in: What are your three non-negotiables? How do you actually protect them?

    4. Self-Awareness: Notice Before You Break

    DJ models self-awareness in his personal and professional life: noticing his emotional response at dinner, acknowledging lack of boundaries, addressing fears as a new business owner. He's not hiding (avoiding) the gap between knowing and doing; he's paying attention to it. So important!

    DC micro lesson: Self-leadership starts with noticing. What's happening inside you right now? When do you notice your state of mind shifting? When do you realize you're operating from scarcity instead of capacity? How are you addressing the shift when you notice?

    This is the internal work nobody talks about, but what everybody needs to do.

    5. Building A Strong Foundation

    DJ shares how he mentors his team. He role-plays with them. He shows them what presence looks like, what first contact without a clipboard looks like, what protecting your non-negotiables so you can show up for others actually means.

    DC micro lesson: Mentoring can take many forms. DJ talks about how he's practicing with his team. They role-play together. Sometimes mentoring is being willing to look clumsy while you learn together. DJ is building a company culture where communication and presence aren't nice ideas. They're coached, practiced, and reinforced through real mentoring relationships.

    That sounds like a good recipe for building a strong foundation!

    ¡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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    44 分
  • Jill Dulich: Injured and guideless?
    2026/07/03

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    Recently, we sat down with Jill Dulich to discuss how the workers' compensation system has changed over the past 50+ years. Here's a summary of our conversation:

    Guest: Jill Dulich | Director of Claims and Operations, California Self-Insurers Security Fund
    Expertise: 52 years in workers' compensation (Marriott, 32 years; CSSF, 11 years)
    Geographic Scope: Jill has managed claims in all states west of the Mississippi

    ABOUT JILL

    She's a living archive of what workers' compensation was, and could be again. Jill has spent 52 years in this industry, partly by maintaining her own humanity outside it: she walks to clear her head, loves to travel internationally (recent trips to New Zealand, Australia, France, Greece), and loves to explore other cultures with genuine curiosity.

    THE CORE QUESTION

    52 years ago, claims professionals were measured on early and frequent contact with injured workers.

    Today, injured workers often feel "lost on an island with no support."

    So, what changed? And what has it cost us?

    THEN vs. NOW

    THEN (52 Years Ago)

    • Role: Claims professionals guided injured workers through the complex system of workers' compensation
    • Measure: Early, frequent contact and communication with injured workers
    • Benefit: Injured workers felt supported; employers got predictability and faster resolution on their claims

    NOW

    • Role: Claims professionals manage procedures and systems
    • Measure: High caseloads, case closure, compliance, efficiency
    • Cost: Injured workers feel abandoned; employers lose goodwill and face more friction and litigation

    THE PARADOX

    Jill talks about how she struggled with anxiety early in her career as a claims professional. She didn't know she could ask for help. The work has always demanded emotional presence, and it takes a toll. It requires holding someone else's crisis while managing your own capacity.

    Hmmm. Have we talked about managing capacity before? Yep!

    At places like Marriott, where support was offered to claims professionals, it didn't eliminate the struggle. It made it survivable. Jill said it allowed her and others to show up, day after day, with empathy and compassion.

    Now? The job is harder, and we removed the safety net.

    Complexity has increased exponentially. We've fragmented the role. And we've stripped away the human support mechanisms that made it possible to guide injured workers with empathy and compassion. Then we wonder why claims professionals are burning out at such a high and fast rate?

    THE INSIGHT

    Workers' comp was designed around one simple truth: Claims professionals are there to guide injured workers through complexity, and when that happens, everyone wins.

    We optimized for procedure. We lost sight of our mission.

    The cost: We didn't just sacrifice the role's humanity; we sacrificed its effectiveness and the core mission. And somewhere along the way, we made the job unsustainable for our system guides: claims professionals.

    WHAT YOU'LL HEAR

    • How the claims role was originally designed, and why it worked
    • What we traded when we prioritized systems over relationships
    • Why injured workers and employers both lost
    • Are we ready to redesign for what actually works?

    A DIRECT QUOTE FROM JILL

    "We've sort of lost sight of who we're really here for. That's the injured worker—to make sure they are being taken care of, that they know what's happening, that they're communicated with and educated on the system."


    A Socratic reflection: If you were measured on early, frequent contact with injured workers instead of case closure (speed), how would your day change?

    ¡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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    40 分
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