In this opening segment of her presentation at the 2013 Florida Workers' Compensation conference, Margaret Spence—President and CEO of Douglas Claims and Risk Consultants— emphasizes the central importance of viewing injured workers as valued employees rather than claimants. She shares a vivid case of a paramedic whose return‑to‑work placement as a janitor illustrated how devaluing an employee erodes cooperation and outcomes. Spence argues that the workers’ comp system is stuck in a dated, claimant‑victim mindset and lacks innovation, despite available technology. She calls on every attendee—whether HR, risk manager, nurse, vendor, or adjuster—to see themselves as return‑to‑work coordinators whose purpose is to preserve employee value, foster teamwork, and break the cycle of cynicism. She stresses that devaluation leads to poor attitudes and system failure, while maintaining value drives better return‑to‑work results. Spence also cites the National Safety Council’s figure of 60 million lost workdays annually to illustrate the cost of inaction, urging a shift toward proactive, innovative practices.
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Margaret Spence is President and CEO of Douglas Claims and Risk Consultants and is the author of From Workers' Comp Claimant to Valued Employee. Margaret is a workers' compensation consultant, speaker, and trainer who ranks among the experts in the field of injury management and return-to-work implementation. Her speaking topics focus on aligning workers' compensation best practices with prudent HR policies. She is an advocate for implementing proactive return-to-work programs that retain ill and injured employees in the workforce rather than giving them monetary settlements to leave their jobs behind. Margaret writes and speaks extensively on workers' comp, disability, wellness, and strategic organizational leadership. She's been quoted or had articles published in HR Florida Magazine, HR Magazine, Workforce Management, American Chronicle, Risk Management Quarterly, and National Underwriter Magazine. She also has her blog that she works very hard on, and that is was awarded the 2010 Top 25 Workers' Compensation Blog by LexisNexis. Please welcome Margaret Spence.
Good morning, everyone. I'm coming to get it.
Sorry.
Okay, good morning everyone. Good morning. I was just telling Sue Margaret Spence, my good friend, that I'm probably one of the rare people that gets up every morning and says, "I absolutely love what I do." And the reason why I love what I do is because I absolutely see the value of injured employees. I see their value, and I also see that I need to educate and employers specifically, and adjusters more intently, on what it means to the employer to return to— for the injured worker to return to work. So part of what I want to do today is to say to everyone in this room, I have 30 minutes, and my entire goal today is to motivate one person in this room to do this job with a ton with a ton more passion than we did it yesterday. So this is a different talk. I'm not giving you the 10 steps to get people back to work. There's lots of people on our panel who's gonna do that. What I wanna do is get everybody excited as I am about return to work and why it's important. So one of the questions that I wanna ask you is why do we do what we do? And the main reason why we do what we do is because it is extremely important to value the employee post-accident. This is 100% about employee value. So let me give you an example of why I say it's all about employee value. A couple weeks ago, I was doing a claims review, and out of that claims review, there was a claim that jumped out at me, and it reeked of value., and it reads a B value, okay? This injured worker was a paramedic. He'd worked as a paramedic for 20 years, and in the process of working as a paramedic, he got an injury. He lifted a stretcher, he hurt his knee, and in hurting his knee, he had a debilitating condition that prevented him from being a paramedic. Now, What got me and what stirred the pot for me is that the return-to-work position for that paramedic was as a janitor. Hmm. Okay? So let me tell you why I get stirred up, why my pot gets stirred up. Everybody in this room can tell you about workers' comp, but I'm gonna say to you today that when you're making the placement of the injured worker, It is all about maintaining that person's value. And if you devalue the employee, you turn around and you wonder why that employee is not going to cooperate with you, why they have an attitude, why they're not going to do what you're asking them to do. It starts with value. If you devalue me the day I get the injury, I'm going to be devalued for the entire time that I'm in this workers' comp system. So if there's one thing that I want everybody to take out of this room that's working in workers' comp, that's managing injuries every day, is the very first thing that we need to do is say, am I doing a process that devalues the employee, or am I doing something that's gonna show them that they're important and that their importance matter. And despite the injury, they're going to be a contributing member of our team. And if we step out of the box and check our egos at the door, leave it there, and we deal with the injury as what it is, and we don't devalue the injured worker, we will have better outcomes. 'Cause it doesn't matter what happens at the clinic, if the employee returns to your workforce every day, and they don't feel that they should be there, or that you want them there, or that they're as valued as when they were giving you 10 or 15 years of service, the outcome for the workers' comp system is never gonna be good. So I'm gonna run you through what I see. I see a system that's working its way to being a dinosaur. We're not innovative. We're not thinking out of the box. We're still stuck in the mindset of claimant, employer, victim, victimizer. And we've gotta change that mindset. We have to get innovative with what we do. There is lots of technology out there, but we're not putting technology into the workers' comp system. We're still operating on, let's get on that bunny wheel called workers' comp, and we're gonna get on that wheel, and we're gonna keep going around and around and around on that bunny wheel. And the same things are gonna happen, and the same frustrations, the same unhappiness is gonna be the outcome. So what I'm saying to you is we've gotta think outside of the box. If not, we will become a relic. And I know we're not thinking outside of the box because according to the National Safety Council, on any given year, we have 60 million lost workdays. So we're still not thinking out of the box. Because employees don't get it. Let me walk you through why I say what I do. Everyone in this room is a return-to-work coordinator, period. If you showed up for this session, whether you're a vendor, whether you are an HR person, whether you are a risk manager, a nurse, you are a return-to-work coordinator. It is your single purpose to assist everyone and build a team of people who believe in the workers' comp system, who don't take the cynicism and put it in the system. Because guess what? As cynical as we want to be about workers' comp, we created this disaster. Okay? And we can't take the one injured employee that goes awry and use that as our benchmark for every injured employee that gets injured in our organization. So this is the main reason why I do what I do. I see ability. Every time I see an injured worker, I see ability. And when I sat in the adjuster's desk, I saw ability, and unfortunately every employer that I talked to saw inability. Because I can't tell you how many conversations I heard that went something like this: "Well, you know, he wasn't all that great to begin with." Really? He was a problem.
Really?
No, he wasn't, because you kept him. You paid him. You kept him on the payroll. So he wasn't a problem. He's a problem today because your ego's bruised. He's not a problem because of anything else other than your ego's bruised. So this is my reason. I understand value, but let me show you what I want you guys to start looking at. This is how we think, not like the dinosaur, but we think differently. In your organization, how many of you can tell your CFO, your CEO, what absence is costing your organization in dollars and cents? We can't get supervisors to buy in if we haven't done the numbers ourselves. So we've got to get out of the silo of thinking that we've got to fit into the workers' comp mold. We've got to start to think a little bit differently. 54% of organizations don't know what absence costs them. 50% of hourly employees leave their job within 120 days. Okay? 75% of the employees who work in your organization today do not feel that they are valued. They have not had a claim yet, These people are still working for you. That 75% is still in your workforce. So you have a multigenerational workforce. You've got the traditionalists, you've got the boomers, the Gen Ys, but let me tell you something about this person, and this is my son. He's 20. And when I added him to the slide, he's like, "Mom, are you kidding?" You couldn't— why? He is not going to put up with our traditional nonsense. When his generation gets into the workforce, he's going to be doing things differently. He's going to be tweeting about your bad behavior, as he's going to put it. He's going to get on Facebook and rag your company out. He's going to get on social media and say, I tried to come back to work, but John's company wouldn't let me come back to work. So while we're busy on the workers' comp wheel, the next generation of people coming in the door aren't going to be thinking the way we think. So if we don't start innovating how we manage injuries, we're going to miss the boat completely. This generation wants instant gratification. They want to know that you care about them. They want to know that they feel valued. My son took a job with a department store last summer. His second day on the job, he said to me, "Mom, these people are crazy. They're crazy. They cannot possibly keep moving the bar every day. I don't think I'm going to do this." He's a junior in college. Do I see him working for somebody who's going to move the bar every 15 minutes? Nope. So what I'm saying to you is we've got to figure out ways now to be be much more innovative than we were before. Let me talk to you really quickly about what I call and what's known in the HR world as the cycle of engagement. Employees are either in two camps. This is before the injury. They're either frustrated and disheartened, resentful and pessimistic, angry, resentful, unaware, or self-absorbed, or they're in the camp of inspired, innovative, conscientious, unproductive. If you get an injured worker who's in already frustrated, already resentful, already angry, already self-absorbed, and they have an injury, you have the dynamics of a bad outcome. So while we may blame the doctor for the outcome, the outcome was already predetermined by the way that injured worker felt about themselves, and felt about working for your organization before they entered the workers' comp system. And when they got into the workers' comp system, they became our problem. So it doesn't start there. The second part of this that I want you guys to see is this is what your workforce looks like. 9% of your workforce are benchmark— benchwarmers. This is a Nielsen study. They're warming the bench. They can't leave. They hate you. They come in hating you every day. They're never gonna like you. That was never their intent, but unfortunately economic situation forces them to be there. Now give them an injury. 50% are disengaged, meaning they didn't really want to be there and you've never engaged with them. You gave them an orientation, you thought you instilled safety, but you really didn't do it because they still hate you. And they're showing up, okay? 7% are free agents. For 50 cents, they will bail. And when they bail, they're going somewhere else. So if they're bailing with the workers' comp injury, the Lord help us, okay? Now, add the injury to this dynamic. This is the reason why we say sometimes, When I'm dealing with a particular injured worker, boy, that injured worker is quick, he's getting back to work, he's really loyal to the organization, he's happy. Well, you know what, guys? He was in that 34%. He was that star employee before he got to your desk. The ones that get to your desk and give you problems were already problem people before they got there. They were sitting in one of these other cycles. So when I'm saying to you, you've got to think outside the box, for those of you— by a show of hands really quickly, Who in this room is with an employer? Okay, so you've got to go back to your organization and figure out where your people are and start engaging them before they have the injury.
