I, too, didn’t have a huge epiphany. I didn’t wake up one morning deciding to embark on a 30-year insurance career. For me, armed with a college degree and fresh out of the Army, I needed a civilian job, any job, and the U.S. Dept. of Veterans Affairs was hiring a high-level GS-9 (government schedule) claims examiner. Over time, I not only managed claims; but guided injured military members through some of the hardest moments of their lives following service-related injuries.

Now, still early on in our year 2025, I can’t help but reflect on the challenges injured workers everywhere face. In California, for example, the maximum weekly compensation for temporary total disability is 66.67% of the pre-injury average weekly wage. For a family of six, living on two-thirds of their income is daunting. And that’s just the financial side of the story. Imagine not being able to lift your child, clear the table, easily take a shower, or participate in so many family activities because of an injury. The physical, emotional, and social toll is immense.

This is where adjusters step in, balancing empathy and expertise to help injured workers navigate these challenges. They’re more than claims managers—they’re lifelines. Their dedication makes all the difference. Nowhere did I feel that was more evident than when I attended the So. Cal PARMA (Public Agency Risk Management Association) Holiday Chapter Event on December 12, 2024, in Buena Park, California, and met Alex Shaner. Alex is a 26-year-old injured Carlsbad Ocean Water Lifeguard who is not only fortunate to be alive, after a near drowning, but also lucky enough to be aided in his recovery by a sympathetic and very well-seasoned claims adjuster working for AdminSure, Inc.

On August 17, 2017, Alex was out in the ocean, at Carlsbad State Beach off Beech Street. He was with his board, on routine patrol, when a rogue wave struck and pummeled his body onto the sandbar sideways. He hit his head and shoulders and was knocked unconscious. When he regained consciousness, he was faced down in the water unable to move. At first, he assumed it was a concussion, he batted down his panic, did a quick analysis, and tried to conserve oxygen and slow his heart rate down.

Unbeknownst to him he had just shattered his C-4, 5 and 6 vertebrae. Eventually, he blacked out. It would be 20 minutes, 20 minutes without oxygen, when a body boarder, Jordan Fisher, 20, of Vista spotted him and turned him over and brought him to shore. By that time, Shaner’s skin pigment was no longer pink but a very deep bluish-purple (normally a sure sign of death). Quick thinking fire paramedics performed a jaw thrust (to open his airway), a sternum rub (to assess his level of brain function), packaged him-up, and an air ambulance transported him to Scripps La Jolla where his C4-C6 was fused. Afterwards he spent a week in ICU on an intubation machine since he was unable to breathe on his own. His parents were devastated by the tragedy.

Carlsbad firefighter and Shaner’s friend, Kyle Lloyd, said one key to saving Shaner’s life was the city’s decision to staff that portion of the beach, which had gone years without coverage. He said no one saw the accident because of the evening glare from the sun off the water. If it weren’t for Fisher, Shaner would have drowned, Lloyd said. There were three Carlsbad firefighters/paramedics and one guy who was retired who responded.

Soon Shaner was transferred to Englewood, Colorado for a multi-months’ stint, at Craig Hospital’s Neurorehabilitation Center, as an in-patient undergoing intensive rehabilitation to learn how to be mobile again. Doctors had diagnosed him with paralysis from the chest down. His days were filled with classes about living with a spinal cord injury, learning to live in a wheelchair, physical therapy, occupational therapy and therapeutic recreation. By Aug. 31 of that year Shaner was able to move his thumb and big toe and flex his thigh muscle. By the time he left in-patient, he was walking 200 feet on his own. His determination is the reason he is walking today.

As I stood next to him, Shaner revealed to me that he felt blessed to be able to walk again even if it is with a visibly lopsided gait. I wholeheartedly agree. No one ever would have thought you could put a price on walking until it's taken away from you. Just as important, Alex Shaner did not lose his sense of self and excitedly let out, “Hey! I’m alive!” with a big smile that you only see in scripted dramas. From that candid moment I got a real sense that Shaner knows the reaper passed too near and that he is fortunate to have been given not only a second shot at life but at a near normal life as possible.

Shaner’s goal was to eventually get back to lifeguarding or working EMS (Emergency Medical Services). Unfortunately, being a lifeguard requires unrestricted full duty status and mobility, which wasn’t an option. But the City of Carlsbad wanted to let Alex Shaner know they valued him and that they were there for him and wanted him to thrive. So, they offered him a permanent modified position as a Fire Specialist, and he accepted. Six years after his work-related injury, and without the need of an attorney, Shaner’s workers’ compensation claim was resolved on August 23rd 2023 via Stipulated Award for 90% permanent impairment ($218,442) with access to lifetime medical care and a life pension to boot. In all my years of handling workers’ comp claims, I have never – ever- seen someone with a 90% permanent disability rating look and act so impeccably well! Still, I sure wouldn’t wish that level of impairment on anyone as the real damage lies beneath the skin and is unseen. The terms and conditions were agreed upon by Mr. Shaner and the city, are public, and had been recommended by AdminSure Inc., the city's workers’ compensation administrator, and Safety National, the city’s excess insurance carrier. As the claim had pierced the Self-Insured Retention rate, the excess insurance, Safety National, wagered to reimburse future expenses.

Throughout his claim, Shaner expressed gratitude for the professional care that his workers’ compensation claims adjuster, Diane Aceves of AdminSure, Inc., provided and continues to provide. It is because of those actions where the adjuster opened every gate without delay, that filled Shaner with positivity and gave Alex Shaner the best chance in his recovery.

So, why do I do what I do? It is all to extend a lifeline to legitimately injured workers like Alex Shaner and return them to meaningful work feeling their best!

Alex Shaner towers over most, including V.P. of Workers' Compensation Claims Jorge Alexandria, who stands 5' 9".  Photo taken at So Cal PARMA (Public Agency Risk Management Association) Holiday Chapter Event on December 3, 2024 in Buena Park, California.

Jorge Alexandria, writer, is the Vice President of Workers' Compensation Claims for the J. Morey Company, an Ori-gen company, and former Director for the U.S. Labor Department, 18th Compensation District. He is also an Army combat medic veteran who received a Master's degree in Public Administration. He can be reached at Riskletter@mail.com

Lonce Lamonte, publisher, editor, adjustercom; copyright by Lonce Lamonte and adjustercom; all rights reserved. lonce@adjustercom.com