Tag Archives: Modified Duty

Psychosocial Issues: Costly Problems Delaying Recovery

According to the New Jersey Workers’ Compensation Rating & Inspection Bureau, over the most recent five-year period total incurred costs for head injuries were $113,000 per claim; per claim costs for concussions during the same period were $83,000. Those costs suggest a lot of time away from work for New Jersey’s head-injured workers.

Many of the injuries involved psychosocial issues not identified until well into the claim. Research shows that these issues significantly delay and impede recovering and returning to work.

With that as background, let us propose a thesis:

Our nation’s current system for treating injured workers with mental health issues is uncoordinated, overly fragmented, highly wasteful and does not focus enough on speedy return to work. There is a critical need for a more systemic approach as well as an integrated coterie of clinicians and practitioners, trained in workers’ compensation, whose goals are to provide compassionate treatment with a steady return to work trajectory. 

The issue is compounded by the way claim adjusters, supervisors, nurses and defense attorneys view psychological issues. No one wants to ”buy a psych claim,” and many  believe that referring a claimant for behavioral health treatment does nothing more than create a lifetime annuity for a psychologist. Time and again this view has been proven correct.

What to do about that? Ay, there’s the rub. For in that question lies a host of difficulties. These, for instance:

  1. Most mental health professionals do not understand workers’ compensation. They do not realize either its statutory requirements or the concept of maximum medical improvement. They have spent many years being trained to treat the entire person. The players are the patient and the therapist, and it is like sitting on a two-legged stool. They do not fathom that, in workers’ compensation, the stool has five legs, with the other three occupied by the employer, the treating physician and the claim adjuster.
  2. Too often, by the time an adjuster or nurse recognizes that psychosocial issues may be impeding recovery and return to work the claim may have gotten a little long in the tooth; it could be months old, or more.
  3. It can take a claim adjuster weeks, in rare cases, months, to find a psychologist and schedule an appointment. It can also take weeks or months for a report to make it back to the file. Moreover, finding a clinician with even a smattering of workers’ compensation knowledge or experience is often problematic (See 1, above).
  4. Because there is no mental health electronic health record system for workers’ compensation, every report is its own island, sometimes good, sometimes bad.
  5. Everything is paper-based, which wastes claim adjuster time and increases expense.¹
  6. Although psychologists understand the value of work as therapy, many see no reason to help coordinate early return to work with employers, claim adjusters or medical providers

These are deep and difficult considerations. Tomorrow, we’ll describe how we created an entirely new approach that successfully addresses each of them.

¹ Claim adjusters also report that a not insignificant number of these reports are essentially unreadable, because they are handwritten.

Psychosocial Barriers in Returning to Work Following an Injury

If you want to know whether your employees expect to return to work following an injury, try asking them! In a recent study, 530 injured employees rated their outlook in terms of anticipated recovery and ability to return to work. Of the 162 respondents who predicted that their injury would prevent them from returning to work, 96% never went back to the workplace. Their negative expectations became reality!

Because expectations and beliefs greatly affect an injured employee’s motivation to return to work, even the best return-to-work program can’t guarantee that injured employees will return to the workplace. Some of the factors that may negatively influence an employee’s outlook include inadequate understanding of the medical condition, unrealistic expectations about recovery, and fear that returning to work may create further injury.

There are also various psychological and social factors that can affect how an injured employee feels about returning to work, including:

  • Level of overall job satisfaction
  • Support at home and/or at work
  • Relationships with supervisor and colleagues
  • Beliefs about the cause of injury or pain

How can employers proactively tackle these concerns before an injury occurs?

  1. Build and maintain positive relationships with employees.  Open communication fosters positive relationships and leads to higher levels of workplace satisfaction. Encourage your employees to share their ideas and concerns with you to demonstrate that you are interested in their well-being and value their contributions.
  2. Flexibility can help motivate employees. Understand what motivates your employees and be prepared to create new options. Some employees seek new challenges while others may want more flexibility in terms of work hours or job tasks. In general, employee motivation may be greatly influenced by your willingness to share planning decisions and adjust work environments or job tasks. Employees who enjoy their jobs are typically loyal to their employers and more eager to return to their workplace after an injury. These principles also apply when establishing a transitional work assignment for an injured employee.
  3. Explain your company’s return-to-work policy. Make sure that all employees understand your company’s motivation and commitment to helping injured employees return to work safely after an injury. You will boost company morale by actively engaging your employees to assist and encourage their recovering co-workers.

Although severe injuries can prevent an employee from ever returning to work, the good news is that an employer can directly and positively impact an injured worker’s recovery outlook and outcomes.

Although the path back to work can sometimes seem like a minefield for both employers and injured workers, the highly trained clinicians and therapists at Work Comp Psych Net are here to assist claims adjusters, employers and injured workers every step of the way.

Recovery: Sooner, Faster, Smarter 

Modified Duty: An Employer’s Silver Bullet

Time away from work can be frightening and debilitating for injured workers. They often begin to think of themselves as “disabled.” The longer they stay out of work, the harder it becomes to even approach getting back into the work routine. When that happens, depression and other mental health issues rear their heads.

Consequently, it is crucial to speed recovery through the use of modified duty, one of the most important tools an employer has to reduce lost time and costs. This is just as true for injuries compromised by behavioral or mental health issues as it is for the common slip and fall.

Modified duty is a bridge back to full duty, keeping workers active and part of the team. If you’re an employer, you should instruct your medical provider to focus on what the employee cannot do while injured, clearly delineating work restrictions.

To prove the point, for a moment, put yourself in the skin of the injured worker and imagine you are talking with your doctor about your injury. Would you want the doctor to list for you the potentially countless physical tasks you could actually still do while injured? Or, would you want the doctor to tell you the realistically few things you should not do? The latter approach is the one doctors prefer, too.

Once you have the medical restrictions, work with your supervisors to develop progressive, short-term transitional jobs and tasks. Most important, make sure that injured employees and supervisors carefully follow the physician’s restrictions: The goal is to speed recovery, not aggravate the condition and make things worse. As medical treatment continues and your medical provider gradually lifts restrictions, increase job demands to ease the employee back to his or her original job.

Until now, the traditional method for mental health clinicians to counsel injured workers was to approach the thing as if sitting on a two-legged stool. It was the clinician and the worker. Pretty precarious and often ineffective. But the clinicians and therapists at Work Comp Psych Net know they are sitting on a solid, five-legged stool held up by the worker, the clinician, the employer, the claims adjuster and the medical provider. Our clinicians have been trained in the proper use of modified duty. They know that their job also involves helping the worker return to the workplace as soon as possible with appropriate medically supervised work restrictions.

And they will work with you to make that happen.

This is good for the worker and produces large cost savings for the employer.

That is one more way we keep our pledge to you: Recovery: Sooner -Faster – Smarter.