ReAudio: ReAssess Your Workers Comp Toolbox

Reimagining Employee Care with Sandy Avina

ReEmployAbility Season 4 Episode 114

Join Sandy Avena, Claims Service Manager at California Schools JPA, as she discusses how kindness can reshape the workers' compensation landscape. By treating injured workers as individuals and focusing on their well-being, organizations can reduce litigation, speed up return-to-work times, and combat compassion fatigue among adjusters. 

Sandy also explores strategies to improve workplace culture, build trust, and foster stronger employer-employee relationships. The conversation touches on the importance of mental wellness in the industry and offers practical steps to support mental health, providing valuable insights for anyone seeking a more empathetic approach in the workplace.

Speaker 1:

Perspective. Perspective is spelled P-E-R-S-P-E-C-T-I-V-E. Perspective the 30,000 foot view. Perspective put on someone else's shoes. Perspective can also refer to the state of existing in space or one's view of the world. Perspective R-E-A audio.

Speaker 2:

Reemployability. What is the kindest thing that you've done for someone this week? Think really hard. Was it for a friend or a family member, Someone at work, Maybe a stranger? And we all know what kindness is.

Speaker 2:

But what we experience in our hearts as a kind act is relative and depends a lot on context, and sometimes it actually feels better to do the kindness than it feels to have the kindness done to us. Look, I love my mother-in-law Truly. She's a giving, caring, selfless person, but what she perceives as kindness sometimes is overwhelmingly overbearing. She'll take on projects and do things even when she's asked not to, and it comes from her heart but isn't always necessarily regarded as kindness. Now, on the other hand, there are times when I could be kinder or even just do something kind and choose not to.

Speaker 2:

Have you ever been in a mood and not let somebody merge in front of you on the highway or maybe not paid as close attention to your kids as you should have? Kindness is defined as the quality of being friendly, generous and considerate, and November 13th is celebrated as World Kindness Day, a global observance dedicated to promoting and celebrating acts of kindness. So we thought we'd take this opportunity to help put kindness into a different context when it comes to dealing with all the players in the workers' comp game, no matter what position or role you're in. Sandy Avena is the Claims Service Manager at California Schools JPA and a super creative frequent poster on LinkedIn. The perspectives and approach she takes at California Schools JPA utilizes small, simple bits of kindness to make tremendously powerful impacts in the lives she and her team interact with.

Speaker 1:

Kind means generous, helpful and thinking about other people's feelings.

Speaker 2:

California Schools JPA. Tell us what that is and how did you get involved with it. Tell us what that is and how did you get involved with it.

Speaker 3:

So in California they allow public entities to come together to form a unique individual legal entity for the purpose of purchasing insurance. And that's what a JPA is. It's a joint powers authority. So you'll see that a lot with cities and counties and school districts where we come together and we form a JPA, and that's what California Schools JPA is. So clearly we care to public school districts and community colleges and our JPA is unique because we actually have two JPAs under our umbrella. So one of them is for employee benefits, that type of insurance, and the other side is for risk management. So your workers' comp, your property and liability, and I've been here for five years now and just really excited to be part of this risk pool that serves school districts and get to work with educators and the folks who are in charge of, you know, educating the next generation.

Speaker 2:

Well, and what you do. You take a little bit different approach with your injured workers, as we were kind of talking about before we came on, and I think you know. I want to also preface the reason, sandy, why I had actually asked you to come on the podcast. You are very active on LinkedIn and you had made a post that really caught my attention with regards to an article that you wrote in Blue Magazine about compassion fatigue in the insurance world, and you know REA Audio.

Speaker 2:

We always try to focus on the injured worker as a human being, not just a number on a spreadsheet. And when you talked about, you know, adjusters and what compassion fatigue is, and we'll talk about that in a little bit. You know I'm guilty of not always thinking that way about the adjuster, right, I'm always thinking about injured worker and how can, what can adjusters do to be better in tune with injured workers, but we forget about the other side of things and the constant pressure and things that adjusters and folks on the insurance end you know have to deal with. And, like I said, we'll talk about that in a few minutes and how you're addressing that, which is really important. But what you're all doing currently you take a little bit of a different approach with injured workers. I think kind of similar to what we do at reemployability, as far as looking at them as like a human being right.

Speaker 3:

Yeah, I think what makes our program unique it's something we're really proud of is we formulate everything in terms of what is best for the employee experience in workers' comp.

Speaker 3:

And a lot of programs. Look at cost containment. When you hear about workers' comp programs, the key word is cost containment. What are we doing to contain costs? But cost containment has a point of diminishing returns. If you have somebody who's injured, your costs are never going to be zero. You're always going to have costs, and sometimes we're controlling costs that are the symptom of a poor employee experience, right. So litigation can be the result of a poor employee experience and then that increases your costs, so we kind of flip that. So instead of focusing so much on the cost containment, we focus on what can we do to make sure that the injured worker knows that they are valued, that we care about them, that we want to make sure that they are receiving quality treatment, that they receive it timely, that we are helping them navigate this process and we're establishing that trust with them, and that, in turn, is going to end up controlling your costs, because they're less likely to get an attorney because they're returning to the workforce sooner.

Speaker 3:

So a lot of the design of our program comes from what is the experience like for the employee, and part of that is the adjuster right, so it's they have to build that relationship with the employee.

Speaker 3:

And when I was an adjuster, I remember what it was like to be in that world. It can be a very thankless job. It can be a job where you have very high caseloads and that diminishes your ability to care for somebody appropriately right Because you're barely able to take care of yourself. It is exhausting and you reach burnout. And a lot of adjusters who do become jaded. It's not that they don't care, it's a method of protecting themselves.

Speaker 3:

And so nobody should be in that situation where we're just like in survival mode to get through the day because that's a poor that ends up being a poor result for the injured worker. So for adjusters, in our program we cap the cases at 125. It's in our contract with our TPAs and we want that low caseload because we want the adjusters to have time to develop that relationship with the employees, to build that trust.

Speaker 3:

And then that in turn means that they have less litigation. So our litigation rate for the last four years has been between two and four percent. Super proud of that because in California the average according to WCIRB, they're the statistical insurance agent, the statistical agent for workers comp. In California, 11 percent is the average.

Speaker 1:

Wow.

Speaker 3:

Significantly lower than the average in California and that really goes to show when you focus on employee experience you bring down your litigation. That brings down your overall cost, so that focusing on the employee first really does have a great ROI.

Speaker 2:

So my, my wife is a teacher. We're in Florida so obviously the setup for the teaching may be different from state to state, from county to county. However you have it set up, I believe people who get into teaching get into it. For most of the time it's really really good reasons and I think teachers can get jaded as well, right? So it's important to kind of look at them and look at them with some a little bit of a different perspective, I think, than some other folks, not to treat them any differently, but just understand. I think you know there's a certain mentality that gets you into teaching and when those people are injured on the job or even other folks in the education system, I think that different approach certainly helps to get them recovered faster. Now is what you're doing with California Schools, jpa, and the approach you're taking. Is that unique to your organization, like in all your previous experience in workers' comp and insurance? Is this a different approach than what you're used to?

Speaker 3:

Oh, very much so. So I have experience on the TPA side and I have experience on the insurer side. And on the insurance side you really are looking at cost containment because you have to stay solvent. But for a risk pool, our focus is the employer and that's something that not that the TPAs and carriers don't consider, but that's not top of mind for them. For us, we want the employer to have a good relationship with their employee. That's the difference of the risk for employer focus. So we're looking at not just what can we do to contain costs for claims, but how does this relationship carry on after the claim is over? Right, and that goes back to that employee experience, because experience is going to compound positively or negatively. So if they have a bad experience, they're telling everybody, they're telling everybody, they're telling their co-workers they're putting a review on Glassdoor.

Speaker 3:

They're going to be on LinkedIn, but if they have a positive experience, that compounds too. So that's the different focus is we want them to have a good relationship with their employer, because at some point they have to go back to the workforce and we want to reinforce that positive culture. So that's really important to us in a way that you don't necessarily see that focus with insurers or TPAs.

Speaker 3:

And that is the beauty of JPAs and risk pools, because you have that ability to be more creative in designing your program that is more focused on the employer and the relationship with their employees.

Speaker 2:

So, practically, can you tell us some of the things, some of the actionable things that you do to help improve that relationship?

Speaker 3:

Absolutely so. On top of the case low cap we have a pass through program for utilization review. So in California we have a utilization review process where treatment has to go through UR to determine whether or not it's appropriate. But there's a very low level of authority that the labor code allows the adjuster to authorize at their desk level. Because we're a risk pool and we have flexibility, we allow the adjusters to authorize much more treatment than what's outlined in the labor code. And the purpose of that is I don't want the employee waiting for something to go through utilization review, to wait for it to be reviewed, to get the approval letter, and delay the care. When it's something conservative, like physical therapy, over-the-counter medications, those are the sorts of things that the adjuster should be able to do at their level to get the employee care as quick as possible.

Speaker 3:

So we let the adjusters authorize a lot more at the desk level and we also listen to our adjuster's suggestions. So if they say, hey, this was denied by utilization review, but I think it should be overturned and here's why why we have the low case, low cap, so that they can develop the relationship and they can say, hey, I built this relationship with this employee. I think if we just get this additional chiropractic treatment, I think this is going to be good and we're going to get them to MMI and we're going to be able to resolve the case. Great, let's do it. So we're looking at what can we do to make sure that we build in that relationship. We trust the adjuster to get the employee the care that they need.

Speaker 3:

We also have a great occupational management program, occupational clinic management program, and we'll go down to the clinics. We develop relationships with the operations manager at the clinic. We talk about things like wait times, about the timeliness of reporting, about ambiguity with work restrictions. That's a big one. So if a doctor writes a work restriction that says no heavy work, that ends up creating a lot of issues with the employer and the employee because we may have very different ideas about what heavy work means right and then the employee's like, well, that's not what I think it means and that breakdown in trust starts. So making sure that there's clarity from that from the get-go, so that it creates a easier interactive process for the ADA, so the employer can bring them back and everybody knows okay, no lifting with your right arm over 10 pounds. We all know what that means and that makes it easier. So making sure that we have those relationships and we fix those problems at the root issue.

Speaker 3:

And then we also have a manager training, because I've seen in the past, in my past experience, a lot of employers will go radio silent on an employee once they're off work, for whatever reason it's either. They well, they're off work, I don't have to talk to them at all and it's really confusing for the employee because they often think they're being punished. I haven't heard anything from my employer, nobody's reached out to me. And then sometimes there's confusion because they'll call the adjuster about things the employer sends. Well, I got FMLA paperwork. What does this mean? So it's just making sure that the managers understand hey, you can still keep in contact with your employees, you can still say, hey, like hope, you're getting better. Let them know that you don't have to ask for a diagnosis, but you can still have a human connection with somebody and facilitate that return to work process, because the employees don't know that they're wanted back, that's the key is we want to make sure that they know we want them back, they're not being punished for having an injury.

Speaker 3:

We don't think that they're less than than having an injury. And then the last two items were really specific to our program. One is a get Well Card contest. So for our school districts we have a contest periodically where the students all submit their artwork and then some winners are selected. The winners get gift cards and then we take that winning artwork and we turn it into Get Well Cards and then we give those to our districts to give out to employees when they're off work. So it's just a nice touch to get something in the mail. It's not just to get well card but also get well card that was made by the kids in your district that you work for. So it's a super awesome program. It's something that I don't think I've ever seen before in my prior experience outside of the JPA. And then the most recent addition we've had is a partnership with Kind Souls Foundation, and I don't know if you're familiar with Kind Souls.

Speaker 2:

Oh yeah, very much, Great, great organization.

Speaker 3:

Yeah, we were really excited to partner with them because I think that really is a missing gap in the claims process is there's statutory benefits under workers comp, but sometimes somebody who has a disability has needs outside of what workers comp can provide. But it's less than I normally make and I'm having trouble, you know, being able to cover basic necessities. I'm having trouble affording food or maybe I need affordable child care. Workers can't really help with any of that, but kind souls can they give you those resources. But they also follow up with the employee and that's the component I love.

Speaker 3:

It's not just the 800 number where you call and you say, well, do you have resources? In my area they're following up to say, hey, how did that go? Did you use the resources? Did that work out for you? They're looking for that feedback and then they follow up again. So it's just I wish I would have had that as a resource when I was an adjuster for employees who are struggling, because you do have people who really struggle financially as a result of their disability. Yeah, of course, and workers workers comp doesn't cover everything. It covers a statutory benefit. So it is a great way to again create a better employee experience, provide them a little extra outside of the workers comp through these additional resources, and so all of those are steps that we have in parts of our program that again reinforce what are we doing to take care of the employee. No-transcript.

Speaker 2:

As part of my role at re-employability, I get to travel around and speak with our clients, but while I'm on the road I always make sure to visit the nonprofits that are our partners. No matter where I am, there's always a nonprofit and many times they will have injured workers that have been placed there through our program. Too many times when I'll talk with the injured worker I'll hear a story like you know, we got the job offer letter in the mail and I showed up here and I really didn't know what to expect. It's because the employer is afraid, and I think that's really what it is. It comes down to fear no-transcript, but but employers are afraid to position it that way and talk to them about it, and so they just kind of punt it over to us and let us send out the offer letter and hope that the injured worker shows up. And it is.

Speaker 2:

It's really sad and you know it's the little things that you've mentioned in everything that you do. It's not necessarily earth shattering, world changing things that you're doing. You're sending out cards to people you know I mean seriously Kind Souls Foundation. What tell me about the level of relationship? Like, what do you do? Do you just let them know that it's available, or how does that work?

Speaker 3:

So for Kind Souls Foundation we have a flyer that goes into the new loss packet that the employers hand out, right? So once the employee files the injury, the employee gets a new loss packet and it'll have a flyer in there with information and so that way they know it's available there. But we also let our TPAs know that we're partnering with them so that if the adjuster is talking to the injured worker and they mention something, they can make sure that they use that as a resource. Yeah, and we've also made sure that the HR teams with our employers know that this is available. Because what I love about Kind Souls is this fits into work perfectly because they really service anybody who's had a work displacing event.

Speaker 3:

But that could be anything outside of Workers' Comp, right? Somebody could be on FMLA, for maybe they're a caregiver, maybe they are on Workers' Comp for a non-industrial condition, so anything that really is a work displacing event. They can access Kinesals. So we tell our HR teams this is part of our Work Comp program, but by all means make sure everybody knows that this is a resource. And we even had some conversations recently with our districts who said you know what? This might actually be? A great parent resource. Some of our districts have parent resource Web site pages where they can make sure that you know this affects parents too.

Speaker 3:

Some parents may have a workers placing event, so really just spreading that word because it really supports not just the injured workers but the employees of the district. The parents of the students that attend Just really excited about the applicability of this service to everyone in the community.

Speaker 2:

It's a matter of just saying something right it's about knowing the resources that are available and telling somebody about it.

Speaker 2:

You know this is I hope this doesn't come across as goofy it I hope this doesn't come across as goofy, but I had an epiphany one time when somebody told me that it was okay to give somebody a compliment.

Speaker 2:

You walk by somebody in the office and you're like, hey, your shoes look nice today. A lot of times I would just think it and not say it. You have no idea how just smiling at somebody passing them in the hallway or making a kind comment that maybe you thought but didn't want to say, or for whatever reason, just didn't say, say it, give people compliments, smile to people. You have no idea how that's going to impact their lives. You know, you never know when somebody is going to need that, and I think that says a lot about the way your program is moving forward with regards to just those little things that make huge differences, is obviously translating into great successes, for what your organization is doing. Is this scalable company? Do you see this approach being able to, you know, take over the industry in a way that might benefit others who aren't able to be a part of your organization?

Speaker 3:

I think it absolutely can, but it needs to come from the employer level, as opposed to the TPA and the insurer, because at the end of the day, this has to fit in with the employer's value system, right? So if you have a TPA or carrier who says, hey, you should implement this, but the employer's like, nah, I don't think we want to do that.

Speaker 3:

Our managers don't really want to talk to them once they're off work. Then that's the disconnect, that's the problem. So it really does have to happen at the employer level, and then your TPAs and your carriers can be partners in that. But any organization, I don't care who they are your employees are the greatest asset you have. So I don't know why anyone wouldn't want to take this approach. I think there's an ROI to kindness.

Speaker 1:

That's the hill to die on.

Speaker 3:

Yeah, there really is, and our program really is evidence of that, and I hope that with that success, other employers will see that and say, oh, we might be able to do this at our level as well, and if we take care of our employees, we're going to see that cost containment just as a result of that, as opposed to making cost containment the central focus and not really looking at the employee experience.

Speaker 2:

Have you faced any hurdles within the organization in implementing any of these things?

Speaker 3:

Have you faced any hurdles within the organization in implementing any of these things? I think not within the organization, but just explaining to people, the ROI. So in a very metrics-driven world, which insurance is, sometimes it can be difficult to explain. Here's how we're going to reduce costs by focusing on employee experience, because people are used to looking at specific metrics and we see that as the result.

Speaker 3:

But in the beginning these are soft benefits that it can be sometimes difficult to measure and project. But we have really great school district members. We have a fantastic board who absolutely believes in taking care of their employees, because they know that their employees are the ones taking care of the kids in our community.

Speaker 3:

So, they are all in with it, so it's just making sure that they understand the benefit, but when we bring these benefits forward they usually are all in because they know that's going to create a better relationship between the district and their employees.

Speaker 2:

So, with the folks that work and take this approach, you know again, going back to that article that you wrote in Bloom about compassion, fatigue, talk a little bit about how this approach helps folks on the adjuster side who are taking on these, I guess, additional responsibilities. To be nice. I mean, I hate to say it, but when you get into that mindset of checking the boxes because I'm overloaded and I just have to get through this one to get to the next one, you are asking people to pause, step back and kind of reevaluate their approach.

Speaker 2:

Do you see that that helps the mental wellness of the people that are actually taking the approach, those adjusters?

Speaker 3:

I think it does, because it's making sure the adjusters understand the benefit that they provide and that this really is about community service. So some adjusters and again it depends on the account that you're tied to, because some accounts have a very different approach Some accounts are not community-minded, they're not focused on employee experience I've worked with challenging accounts in the past. Experience they can be. You know, I've worked with challenging accounts in the past and that can really be very defeating as an adjuster because it makes it difficult for you to really help somebody If you know that the employer is not engaging in the interactive process, they're not acting in good faith and that can be stressful because you want to be able to help. But if you have a client who is not community minded and they don't want to help or say they're just going to control their costs, that becomes stressful. That really feeds into that burnout and that compassion fatigue because you feel like you're steering the ship by yourself. You're trying to help this employee but you know that they're not getting any help on the employer's side or there's no resources for them outside of just the workers' comp benefits.

Speaker 3:

So in the Bloom article I talked about my own experience of you know somebody who had a really catastrophic injury and the employee's wife had called and she was just struggling just with what this meant for her and her family. The employee had been hospitalized for several months and I really it just hurt my heart because I felt like I had nothing else to give her outside of statutory benefits. And when we designed this program that really is the goal is for adjusters to know there are other things you can offer the employees outside of just the statutory benefits, and that's the resources that the employer partners with so Kind Soul Foundation, the Get Well card, making sure that the employee feels supported, and that way it's not the adjuster carrying that load, because that's a lot to put on the adjuster. If the employee is getting no communication from the employer, then who's getting the calls for the insecurity and the fear and the anxiety that the employee has?

Speaker 2:

The adjuster is.

Speaker 3:

And we don't know how to answer those questions if there's no communication from the employer. So it puts the adjuster in a really bad spot when there's no communication from the employer. Or, even worse, there's bad communication from the employer, where the employer is making comments like oh, you know, must be nice to have a paid vacation or, you know, we're all having to work harder because you're gone and we all had to pick up your slack. That makes the employee feel worse and then they call the adjuster because they don't trust the employer. So that just puts that additional burden on the adjuster and that again contributes to that burnout. So I think that really is. The difference here is we're trying to create a positive environment. So it's not the adjuster just getting the call, where they're being dumped on for everything or because they're the only one who's communicating with the employee. They are now just the person who gets the blame for the lack of communication with the employer.

Speaker 3:

You know, for their poor medical experience. With medical care, the adjuster gets blamed for things that are outside of their control, right.

Speaker 1:

Yeah so that's.

Speaker 3:

I think that really does help. If you have a program that is focused on employee experience, on a positive employee experience, it just creates a an environment where the adjuster really is able to focus on relationship building with that employee, as opposed to it being purely negative.

Speaker 2:

So all these things we talk about really relate to mental wellness and mental health, and that's a big buzzword now. Everybody talks about mental wellness and you even talked about it in your post on LinkedIn today about you know, it's a trendy. You didn't say trendy, I'm saying trendy, but it's a trendy thing to talk about and everybody's quote-unquote aware of it. But what actions can people take to improve that mental wellness? Because, as an injured worker, you need to be able to take those steps. As an adjuster, you need to be able to take those steps, and it sounds like there's a lot of employers that need to take that step as well, because, at the end of the day, if we're all just in better mental fitness or better shape, we're going to be better people to each other. So talk a little bit about mental wellness and some of those actions you can take. And then mental health first aid, which is really really interesting.

Speaker 3:

So I'll start with a little story about how I found out about mental health first aid. I worked for an employer, a health plan about 10 years ago. They sent all the managers to a class and it was a mental health first aid class and I thought I've never heard of this before. So I go to this class. It was a full day course and what I loved about it because I went in thinking, just like you mentioned, oh, this is going to be about awareness, mental health awareness, but what it really was was a how to for addressing mental health with your employees, with people in your family, with friends, but how to have those conversations.

Speaker 3:

And I think it's one of the reasons why we talk a lot about awareness but not action is because we don't know how to start the conversation and we're uncomfortable with like, well, what do I say anything? Are they going to get offended if I asked? And am I going to be more helpful? Or is this unhelpful? Or what if I say the wrong thing? So we get so stuck in our own heads that we end up saying nothing and that's the problem and this course really outlined.

Speaker 3:

Here's exactly what you say, here's scripting, here's how you approach it. Here are, you know, some myths and what may be holding you back, and here's what's beneficial and here are the resources available. So if somebody is struggling, you understand, okay. Is it depression, anxiety and eating disorder? Is it, you know, suicide risk, all these different things? And that's what I love about the course is it goes through a variety of different mental health diagnoses and you don't have to be a clinician to do it. It's just the awareness of the diagnosis itself, but then the action plan for you as an individual in terms of how you approach, because it is still a first aid model. So it's what you can do to give somebody support before they get additional professional help.

Speaker 3:

And it's important to make the distinction of. You can have a lot of people who have a mental health challenge. That's not the same thing as a diagnosis or a disorder, right? So it starts with the challenge and if we address it at that level, at the first day level, when we see those behaviors, those emotions and we identify those, then it helps support somebody so that maybe it doesn't progress. But you have to start with being comfortable with the conversation and part of that is knowing what to say.

Speaker 3:

And that's what I love about this course is it tells people here's what you can say, here's what's helpful, here's what's not, here's what you can expect them to, how they might respond when you say that, and it really gives you the how to and the action item. Because right now, the reason we don't have the conversations isn't because we don't have the desire to help, we just don't know how. We don't have that confidence level yet. So I took the course 10 years ago and I would always. It really changed the way I interacted with my employees and whenever I would talk to somebody about it, I was always surprised that nobody had heard of this before and it's been around for 20 something years.

Speaker 3:

So it's not new, but I thought, well, I'll just get certified to teach the course because everybody should know about this. And in my opinion everybody should know about this course. If I'm still talking about it a decade after I took it, I think everybody should know about the course. So I think that really does provide kind of a foundation for giving people the tools to know how to have these conversations.

Speaker 3:

So we're not just talking about awareness, we know what to do when we see those behaviors. Because in an employer situation, I think the really unfortunate thing is you have somebody who has a mental health challenge. It starts that way and then we don't address it until it becomes a performance issue, where now we have absenteeism, we have, you know, poor work product and we're addressing it as a performance issue when really it might be a symptom of a mental health challenge. And we see signs. That's the most frustrating part is people see signs when it's going that route, but employers don't address it until it becomes a performance issue and there are so many ways to support somebody before it even gets to that point.

Speaker 2:

And I would imagine a course like this not only benefits you in an employee setting, but it can help you with your family and your kids too, right?

Speaker 3:

Yeah, I mean, I use the. I like to tell people this. I've taken first aid, CPR, AED courses, you know, every two years to get my license. Ask me how many times I've ever used AED or CPR?

Speaker 3:

Right, well, thank goodness I've never used an AED or CPR, you know, fortunately. But I use the skills that I've learned in mental health first aid every month, every month when I talk to somebody, it's that kind of the action plan they give you. I use those skills. So that's really what I love. It's not, you're right, it's not just for employers, it really is for anybody that you interact with.

Speaker 2:

Yeah, that's awesome. So you are an incredibly upbeat, positive person and, again, the reason why we connected was something that I had noticed you'd done on LinkedIn, and your LinkedIn stuff is so creative and, and I gotta be honest, sandy, it's not, it's a rarity in this industry to find somebody that is so positive for such a long period of time. Right, you can start and you're like ready to go and you're jazzed, but you know, undoubtedly people will start to get that jaded feeling as they're, as they're doing what they're doing here. How do you keep your positive attitude and your mental wellness?

Speaker 3:

I think one is being aware of the negativity bias. I think that really is a challenge in our industry, and not just in workers' comp, just insurance in general. So what happens is you have somebody who abuses the system. Right, in any system you'll have somebody who has a claim that's fraudulent and then employers or adjusters will see that and it doesn't feel good to be lied to and they think like, oh well, I'm not going to let that happen to me again. And then you end up painting everybody with that brush where everybody's trying to cheat you, everybody's trying to lie, nobody wants to go back to work, they're getting attorneys just because they want money. And that's the negativity bias because realistically, that is a tiny, tiny portion of your claims. And once I switch that mindset of understanding that it really is the formula of looking at how many employees are in an employer right and how many of those have claims, and how many of those are those claims that are, you know, the red flags that you're thinking of, where there's abuse in the system, it's such a small percentage. I like to tell employers. I want you to think of all of your medical only claims that you never talk about at the claim review because they're medical only, that you never really think of, they're out of sight, out of mind. Those are your success stories that you never really think of, they're out of sight, out of mind. Those are your success stories. And that's probably a good half of all the reported claims.

Speaker 3:

So, just keeping in mind that sometimes the jadedness comes from that negativity bias of thinking, this is the industry where you know there's a lot of fraud and a lot of abuse, and not that it doesn't occur. But it's just important to remember that really is a small component and absolutely we address it and attack it when we find it. But that's not your workforce, it's not the majority of injured workers. And just remembering that that there really is so much, a lot of people want to go back to work. I see it all the time with the schools that we work with. When you talk to people, they want to go back to work, they want to be in the classroom, they miss their kids.

Speaker 3:

So it's remembering those positive experiences that really, unfortunately, it takes such an effort to focus more on the positive than the negative, because we naturally want to be aware of the negative, because we don't want to feel that somebody has lied to us or misled us, but it's just making sure that you have that mindset where you're focusing just as much in the positive, you're looking at everything holistically and not just the bad things that happen. So that's what I try to do. I try to remember that there's so much good in the system. There's a lot of great people who you know are medical only claims. They got hurt but they got their treatment. They're back to work full duty. That's the success story.

Speaker 2:

Right and it's. You know, most of us in this industry haven't been injured workers and so sometimes I feel like it's kind of like a not an us against them, but it's almost tribal Right. And and I actually heard at a conference one time a statistic that said that only 20% of the fraud in workers' compensation is done by the injured worker. The other 80% is done by insurance companies and employers. So when we're at a conference and we're laughing at the videos that the investigator took of the person who says they have a back injury and they're throwing their kid up in the air, right, you got to remember that that is not the majority of the injured workers out there and I agree with you 100% In my experience, most people truly just want to get back to work, they want to get done with what they're going through, they want to get better and they want to be productive people.

Speaker 2:

And I think you're absolutely right. Just keep that mindset and remember that it's a very, very small amount that are actually trying to do something outside of what they should be. Is is not the case in the case, in most cases. So for mental health first aid, if somebody is interested in the course or learning about that. How can they find you?

Speaker 3:

They can connect with me on LinkedIn. I'm very active on LinkedIn. I check my messages so they can send me a message. Feel free to connect with me. I accept all connections because I love to connect with folks in our industry. So, sandy Avena, mba at LinkedIn and let me know if you're interested in the courses. I work with organizations, but I also will try to set up courses. If individuals are interested in taking it, I'll set something up on on a weekend, a Saturday, where they can go through the course.

Speaker 2:

Well, happy World Kindness Day. That's why you're here, and I think everything you talked about fits right in super, super well. So, sandy, thank you so much for your time today. It's been really a pleasure talking to you, and I'm going to keep watching you on LinkedIn, because it's actually one of the joys of my morning is to see what you're posting. You're doing great stuff, so thank you so much.

Speaker 3:

Thanks, todd, thanks for having me.

Speaker 1:

World Kindness Day is an international observance on 13th of November. It was introduced in 1998 by the World Kindness Movement, a coalition of nations kindness NGOs. It is observed in many countries, including Canada, australia, nigeria and the United Arab Emirates.

Speaker 2:

Thanks for listening to REA Audio. Please make sure to follow us on Spotify or Apple Podcasts or Stitcher or wherever you get your podcasts. We appreciate you. Have a great rest of your week. We'll see you next time.

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