Send us a text

Disclaimer: The views expressed in this episode are Judge Robert Rassp’s personal opinions and do not reflect the official position of the State of California, Department of Industrial Relations, Division of Workers’ Compensation (DWC), or the Workers’ Compensation Appeals Board (WCAB).

In this episode of Deconstructing Comp, Yvonne and Rafael are joined by Judge Robert Rassp for a straightforward discussion about the fundamental benefits of workers’ compensation and why they are important.

Judge Rassp walks us through the foundation of the system, from medical treatment to temporary and permanent disability benefits, and explains how these core protections are designed to support injured employees while balancing employer responsibilities.

The conversation also explores how utilization review, independent medical review, and evolving case law influence the delivery of these benefits. Judge Rassp emphasizes the importance of fairness, education, and due process in ensuring that both injured employees and employers understand the system and can navigate it effectively.

According to Rassp: “Temporary disability keeps food on the table during recovery. Permanent disability recognizes when someone’s life has been permanently changed by an injury.”

Please join us for this informative episode with one of our industry's most experienced and esteemed educators. Judge Rassp is also an adjunct professor at Pepperdine University's Caruso School of Law, where he teaches workers' compensation law, and he's a founding member of the CC&R Band, a parody band that performs classic rock and roll hits at many Southern California industry events.

Key Terms from the Episode:

• Medical Treatment – Care provided to cure or relieve the effects of a work-related injury or illness.
• Temporary Disability (TD) – Wage replacement benefits provided to an injured employee while recovering and unable to work.
• Permanent Disability (PD) – Benefits awarded when an injured employee has lasting impairment that affects their ability to earn wages.
• Causation – the link establishing that an injury or illness arose out of and in the course of employment, or more simply put, that the injured employee's work contributed to their injury or illness. This is also referred to as AOE/COE.
• WCAB (Workers’ Compensation Appeals Board) – The judicial body that adjudicates disputes in California’s workers’ compensation system.
• Utilization Review (UR) – The process by which an employer or insurer evaluates a medical treatment request for appropriateness and necessity.
• Independent Medical Review (IMR) – The appeal process when a treatment request is denied through UR, conducted by an independent physician reviewer.
• Case Law – Published court or WCAB decisions that interpret statutes and guide future workers’ compensation cases.

¡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

Send us a text

In this episode, Yvonne and Rafael talk to Dr. Marcos Iglesias, Chief Medical Officer at AF Group. Dr. Iglesias shares his journey from occupational medicine to the executive level and the lessons he’s learned about helping injured workers recover faster and more fully. Drawing on decades of experience, Dr. Iglesias offers candid, practical advice for younger clinicians entering the workers’ compensation space, emphasizing the importance of looking beyond symptoms to understand why a patient isn’t improving.

He explains how focusing on what an injured worker truly needs to feel supported can reduce frustration for clinicians, improve communication with claims and employer teams, and create better outcomes for all parties. From breaking down barriers to recovery to fostering stronger provider relationships, Dr. Iglesias underscores that when clinicians approach care with curiosity, empathy, and collaboration, everybody wins.

Listeners will leave with actionable insights into how new medical professionals can navigate the complexities of workers’ comp, make a meaningful impact on injured workers’ lives, and help shape a system that works better for everyone.

Key Terms and Definitions in this episode:

Biopsychosocial Model of Care – A holistic approach to healthcare that addresses the biological, psychological, and social factors influencing an injured worker’s recovery, promoting comprehensive and individualized treatment plans.

Chief Medical Officer (CMO) – Senior medical leader responsible for developing and overseeing clinical strategies, ensuring medical best practices, and aligning care delivery with business goals.

Claims Operations – The department or function responsible for managing claims from the first report of injury through closure, including investigation, evaluation, and settlement.

Early Intervention – Identifying and addressing potential issues in a claim as soon as possible to prevent delays in recovery and reduce claim duration and costs.

Employer Engagement – Active participation of the employer in the claims process, including communication with the injured worker, accommodations for return-to-work, and collaboration with claims teams.

Evidence-Based Care – Medical treatment decisions based on the best available research, clinical expertise, and patient-specific factors to ensure optimal outcomes.

Occupational Medicine – A branch of medicine focused on the prevention, diagnosis, and treatment of work-related injuries and illnesses.

Provider Network – A group of medical professionals and facilities contracted to deliver care to injured workers under negotiated terms.

Psychosocial Barriers – Non-medical factors—such as mental health concerns, fear, social isolation, workplace relationships, or financial stress—that can delay or prevent recovery.

And here are a few references to things Dr. Iglesias mentioned during our discussion:

On Ambient Scribe Technology

Open Evidence (chatGPT for medical professionals)

¡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

Send us a text

In this episode, we talk to Kirsten Kaiser Kus. She is a defense attorney and an equity owner at Downey & Lenkov LLC, leading their Indiana practice. She brings deep experience from both the plaintiff and defense sides of workers’ compensation. She shares how her involvement with CLM and litigation education shaped her expertise and helped grow her professional network.

We explore the many stakeholders in the workers’ compensation system. Kirsten discusses distinctions between plaintiff-side and defense-side stakeholders and how they interact—or clash—within systems that vary state by state.

On the plaintiff (applicant) side, she highlights challenges such as unrealistic expectations, lack of understanding of legal metrics, and client control issues. Then she systematically breaks down the far more complex defense side, detailing the roles of carriers, TPAs, hearing members, medical providers, mediators, ombudsmen, vendors, brokers, excess carriers, self-insured clients, and even how politics play out in our system.

Throughout our conversation, Kirsten emphasizes one central principle: communication is critical. Where, oh where have we heard that before? Whether navigating expectations, coordinating stakeholders, or managing the risk of expensive cases, clear, proactive, and coordinated communication is what drives effective outcomes.

Stakeholders in the Workers’ Comp Ecosystem:

Injured Worker
The employee who was hurt at work and seeking benefits.

Applicant’s Attorney / Claimant’s Attorney / Plaintiff's Attorney / Petitioner’s Counsel
The lawyer representing the injured worker (term varies by state).

Defense Attorney
The attorney representing the employer or insurance carrier.

Employer
The company where the injured worker is employed; also referred to as "the insured."

Insurance Carrier
The insurance company providing workers’ comp coverage to the employer.

Third-Party Administrator (TPA)
An outside company that manages the administration of claims on behalf of self-insured employers or insurance carriers.

Broker
An insurance advisor who helps employers obtain and manage coverage.

Self-Insured Employer
A company that pays claims out-of-pocket, often with excess insurance coverage.

Excess Carrier
The insurer that covers costs beyond a self-insured employer’s retention layer.

Hearing Member / Judge / Commissioner
The official who hears and rules on workers’ compensation disputes.

Ombudsman
A state-provided guide who assists unrepresented workers.

Mediator
A neutral party who helps both parties involved in a litigated case try to settle the case before trial.

Medical Provider
Doctors and other clinicians who treat the injured worker.

Nurse Case Manager (NCM)
A licensed nurse who helps coordinate medical care and communicate with all stakeholders. NCMs are often called in to help coordinate more complex claims.

Vendors
Service providers such as interpreters, transportation, Medicare compliance experts, durable medical equipment (DME) suppliers, and home modification specialists.

Subrogation Counsel / Third-Party Recovery
Attorneys or departments pursuing reimbursement when a third party (not the employer) caused the injury.

Family Members
Often involved in influencing the injured worker’s decisions and expectations, an important perspective to keep in mind througho

¡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