Deconstructing Comp

Yvonne Guibert & Rafael Gonzalez

Now in Season 5! We are still breaking down complex issues of workers' compensation 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 similar things, 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 their industry friends and colleagues, learn more about their roles, laugh, and have fun on the journey. You might learn something along the way! See you soon! ¡Hasta pronto!

  1. قبل ٢٠ ساعة

    Tammy Boyd: For The Kids!

    Send a text In this episode of Deconstructing Comp, Yvonne Guibert and Rafael Gonzalez welcome Tammy Boyd, newly appointed President of Kids' Chance of Florida, for a meaningful conversation centered on service, leadership, and the life-changing impact of educational scholarships for children affected by workplace injury or fatality. Tammy shares how her career in workers’ compensation shaped her understanding of the human ripple effects of injury, and why Kids’ Chance became a mission she felt called to lead. The discussion highlights the heart of Kids’ Chance of Florida’s work: providing hope, stability, and educational opportunity for children whose families have experienced devastating loss because of a work-related injury, or in some cases, a death. Tammy reflects on the organization’s impact, the stories behind the scholarships, and the collective effort required to sustain and grow the program. She also explains how the Florida chapter fits into the broader Kids' Chance of America network, which supports students nationwide through locally driven chapters united by a shared mission. Throughout the episode, Tammy emphasizes that Kids’ Chance is more than a charity; it is a long-term investment in people and communities. She offers a call to action for the workers’ compensation community to get involved, reminding listeners that behind every claim is a family whose future can be profoundly changed through education. This episode is a powerful reminder that when an industry comes together in service, its impact reaches far beyond the system itself. Tammy shared that the Florida chapter started in 2015, and to date, has awarded over 100 scholarships totaling over $450K in support of students impacted by workplace injury. At the national level, Kids Chance of America has helped more than 11,000 students with over $42 million in scholarships through its network of 50 chapters, one in every state in the US.  Upcoming Kids' Chance of FL events: Flagship event: WCI Golf Tournament (August 23, 2026) Breaking news! New for 2026: 2 golf sessions will be available 5K Fun Run in South Florida (coming soon!) For more information and to find a chapter in your state, please visit https://www.kidschance.org/ ¡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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  2. ٢٧ يناير

    Season 6 Intro: 2026 Key Issues

    Send us a text Our key issues for 2026: 1. Mental Health Goes Operational Mental health is no longer fringe in workers’ comp. Our real challenge now is operationalizing access to timely, evidence-based mental health care so it supports recovery instead of becoming a barrier. 2. End of Healthcare Subsidies = Cost Shifting Risk With federal funding changes, i.e., the loss of funding tied to healthcare subsidies and the Substance Abuse and Mental Health Services Administration (SAMHSA), watch closely for cost shifting into workers’ compensation, a pattern the industry has seen before. 3. CMS Civil Monetary Penalties. This is a brand-new layer in the Medicare Secondary Payer landscape. CMS is expected to release CMP documentation in March.  4. Complex Claims = The Biggest Opportunity.  Early identification of red flags, faster access to evidence-based care, and better education for claims professionals prevent complexity → chronicity → runaway costs. 5. Presumptions Are Expanding. Presumptions continue to shift the burden of proof to employers, especially for PTSD, firefighter cancer, and potential infectious disease claims, with high cost and policy implications.  6. Employee Well-being & “Quiet Cracking.” Quiet cracking, marked by disengagement, burnout, and feeling stuck, is emerging as employees remain overloaded and unsupported. Organizations that treat wellbeing as a core risk management strategy see stronger engagement, faster recovery, and lower overall costs. ⚡ Rapid-Fire Watchlist DEI & Diversity – Organizations that lean into diversity perform better and attract stronger talent.Education & Mentorship – The next generation of WC professionals needs mentorship from experienced leaders. Explore mentor/mentee programs. Artificial Intelligence (AI) – It's time to embrace adaptation. Education is key to using AI wisely. Challenge yourself to adapt as AI is changing rapidly and becoming more integrated in our daily lives. Self-Leadership as a Core Competency – Especially for claims professionals. Self-leadership improves empathy, self-regulation, and decision-making.California Premium Increases – California is an outlier worth watching as other states stabilize or decline.🤝 In-Person Events: Where Professional Growth Accelerates Connection, learning, and candid conversations happen best face-to-face. Wherever you sit in the workers’ comp ecosystem, attending even two industry events a year sharpens perspective and strengthens relationships. Yvonne’s Top Picks Workers’ Compensation Research Institute (WCRI) – March | Boston, MANational Council of Self Insured  (NCSI) – June | Rancho Mirage, CAWorkers’ Compensation Institute (WCI) – August | Orlando, FLELEVATE Conference – September | San Diego, CANational Comp Conference – September | Las Vegas, NVBonus: Your state or regional workers’ comp conference!Rafael’s Picks Claims and Litigation Management Alliance (CLM) – Annual Conference (March), WC Event (May), Claims College (Fall)Workers’ Compensation Claims Professionals (WCCP) + Florida Bar – April | Orlando, FLNational Medicare Secondary Payer Network – October | Bethesda, MDAlso mentioned: PARMA, PRIMA, NCCI, NRR ¡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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    Darrell Mathis: O-Block Grit and Work Comp

    Send us a text In this episode, Yvonne and Rafael talk with Darrell Mathis, Director of Workers’ Compensation for the City of Chicago, and explore his work to modernize and manage one of the nation's largest municipal programs.  Darrell shares his 33-year journey from the private sector to public service, offering candid insights into program reform, transparency, and talking about “paying what we owe.”  He discusses how Chicago has transformed litigation strategy, reduced claim backlogs, and improved fairness for injured employees, all while supporting first responders facing unimaginable risks.  City of Chicago is self-insured and works with a TPA to administer claims. With over 33,000 employees and 3,600 open claims, Darrell’s team is setting a new benchmark for municipal excellence in workers’ compensation. This conversation is a must-listen for anyone interested in the intersection of leadership, accountability, service mindset, and compassion in public-sector risk management. Darrell also opens up about his own health journey and how dedicating himself to the City of Chicago and the work he loves became a key part of his recovery. Key Takeaways How municipal code changes, litigation reform, and payment integrity reshaped Chicago’s comp program.Why “paying what we owe” builds trust and accelerates resolution.The real challenges of managing 3,600 open claims and a $700M reserve.Strategies to motivate and retain adjusters in a high-pressure environment.Chicago’s commitment to care for catastrophically injured police and firefighters.Darrell’s vision to make Chicago the global gold standard for workers’ compensation programs. Darrell mentioned some folks who help him keep the lights on at the City of Chicago Workers' Compensation program:  Donald “Taylor” Chittick – Asst. DirectorTiffany Williams – RTW Project ManagerKathleen Heenan – Workers’ Compensation LiaisonTomeka Long – Workers’ Compensation LiaisonAshley Chen – AdminDarrell mentions his devotion to faith and service. He is an ordained Deacon at the Progressive Baptist Church. His Pastor is Dr. Charlie E. Dates. As an officer of the Church, he is involved with many aspects of the ministry. Black Boy Lit is an initiative of Progressive Baptist Church and Salem Baptist Church. Dr. Dates is the Pastor of both churches.   Additionally, he and his wife chair a capital campaign for the church, called DREAM.  ¡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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    Jeff Adelson: Soft Skills in a Tough System

    Send us a text 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. ¡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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    David Langham: Floridiana and Work Comp

    Send us a text 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." ¡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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    Rosa Royo: Getting Creative in Miami

    Send us a text 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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    Gina Jacobs: Defending Claims With Purpose

    Send us a text 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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Now in Season 5! We are still breaking down complex issues of workers' compensation 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 similar things, 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 their industry friends and colleagues, learn more about their roles, laugh, and have fun on the journey. You might learn something along the way! See you soon! ¡Hasta pronto!