We see the benefits of behavioral health interventions to get people back to work after a workers’ compensation injury. Frequently, though, it is has become a valuable service for helping people stay at work after an injury. Consequences of an injury on the job, such as a change in working schedules that disrupt the home environment, financial struggles and on-the-job stress can influence an injured employee’s ability to keep working and comply with necessary treatment.
According to the American College of Occupational and Environmental Medicine, 10 percent of the workers who manage to stay at work after an injury later incur significant work absences and life disruptions that can lead to lengthy or permanent withdrawal from the workforce.
Behavioral health specialists can provide valuable coaching to injured employees to help with coping skills and direction during the difficult time after an injury. I am going to describe two recent claim situations in which we were very happy to help injured employees after they returned to work. In both of the situations I describe next, the claims examiner or a nurse case manager identified that there were stressors in each of the injured employee’s lives that might interrupt necessary treatment and result in disability.
Kyle is a 35 year-old factory worker who had recently returned to work after an occupational injury. He was working full time with light duty restrictions. His telephonic case manager and claims examiner referred him for behavioral health services when it became clear that Kyle, a single parent, was struggling with parenting issues that were impacting his motivation to stay at work and continue with his treatment. Kyle told the behavioral health specialist that he was planning to discontinue treatment and stop working to take care of issues related to his rebellious teenage daughter and his two younger children at home. With his light duty restrictions, Kyle’s work hours changed almost daily based on the needs of the plant. This was disrupting his child care arrangements and his ability to be available for his older daughter in the evenings. The behavioral health specialist worked closely with Kyle over a three week period to encourage coping skills, advocate for a regular schedule, and help Kyle get connected with local resources to help with his daughter. With this extra support, Kyle managed to remain at work during this time and continue with his treatment.
Bonnie is a 42 year-old retail store employee. She suffered a low back strain when she was lifting a chair onto a display shelf. She sought treatment and only missed one day of work. Bonnie returned to work full-time with modified duty accommodations and continued medical treatment for her injury. Usually her job requires her to move around the store alternating the duties of cashiering, restocking shelves, and assisting customers in the fitting room. During her modified duty, she was required to alternate shifts as a cashier and a greeter at the front of the store. Coworkers expressed frustration with her manager that Bonnie’s modified duty assignment was putting more of the physically demanding work on them. As a result, Bonnie felt “singled out” and ostracized by her peers. She told her workers’ compensation claims examiner that it might be easier on her and less stressful if she were to ask her doctor to take her off of work until she recovered fully. “I don’t know how I can make this work.” The claims examiner quickly enlisted the help of the behavioral health specialist who validated her feelings and helped her develop some coping strategies for managing stress. After a few weeks of coaching and support, Bonnie remained at work and fully recovered from her injury.
Preventing disability and helping people deal with stressful situations in order to stay on track with their injury care is fulfilling work. With early intervention, a listening ear and tips for dealing with stressful situations, we can sustain an injured worker’s confidence and keep individuals engaged with their colleagues, families and communities.
Mark Debus, Clinical Behavioral Health Specialist