2016 NWCDC
Addressing Behavioral and Social Issues
Understanding how an employee feels about their job and their surroundings can hold one of the keys to their recovery, according to a workers’ compensation medical expert.
And using a three-pronged approach to addressing a disabled worker’s recovery helps return employees to the job faster, said Dr. Marcos Iglesias, vice president and medical director at The Hartford.
To improve success, add new approaches to better identify and understand an employee’s behavioral and social issues, Iglesias said during a mega session, “Preventing Prolonged Disability by Assessing and Eliminating Psychosocial Barriers,” at the NWCDC on Dec. 1 in New Orleans.
About 10 percent of claims have one or more psycho-social elements, yet they account for 60 percent of costs. The bio-psycho-social model Iglesias presented gives claims managers keys to empower injured employees to return to function.
First, identify the employee’s expectation of recovery by simply asking, “When do you think you’ll return to work?” If the response is more than 14 days, the patient may be at risk of delayed recovery.
Follow up questions can then identify additional issues such as unfounded beliefs about the injury or care, catastrophic thinking and fear of future events, Dr. Iglesias said.
Another barrier could be an employee’s perceived injustice related to the injury and treatment. To identify if an employee is laboring under a possible misconception, ask why they think the injury happened.
Questions about the patient’s condition, he said, should steer away from pain and focus on function: “What are you able to do today that you couldn’t do last week?”
Employees must feel empowered to recover. Passivity, a belief that someone else such as a doctor or spouse, is in control of the injured worker’s return to work could be a red flag, Dr. Iglesias said.
Ask: “What do you like about work; what about your job do you look forward to?”
Disabled workers identified as at risk may benefit from a team of dedicated coaches who offer a functional restoration program that addresses not only medical concerns but also any behavior and social barriers that hamper return to work, he added.