The Injury You Can’t See: Why Addressing Behavioral Health in Disability Claims Is Essential to a Worker’s Recovery

When a worker becomes physically injured, the behavioral health implications must be addressed as well.
By: | December 21, 2020

A workplace injury or illness can be daunting. Life becomes uncertain. Questions arise about having enough money or retaining the same physical abilities after recovery. The mental anguish can make the entire situation worse.

“Facing a major illness or injury, the prospect of not working, and other stressors can contribute to behavioral health issues that can easily be comorbid conditions requiring extra care and more time for recovery,” said Trish Ward, associate director of clinical services at Sun Life U.S.

Ward shared her view during a recent webinar, “2020 Tools & Tactics: Innovations in Clinical Claims Management,” presented by Sun Life and the Disability Management Employer Coalition (DMEC) held on December 8.

She advocated for behavioral health to be addressed with every disability claimant — whether it’s the primary diagnosis or not.

Addressing Behavioral Health in Every Disability Claim

Addressing behavioral health on every claim is no easy task.

Carrie Bibens, associate director of vocational rehabilitation services, Sun Life U.S.

Many in the workers’ comp and disability space are hesitant to address behavioral health issues in claims, especially if they are not already a compensable part of the claim. For years, payers were hesitant to “buy the psych claim” and the stigma is still prevalent.

Addressing mental health issues often starts with front-line managers, but they may not be trained in behavioral health issues, or may think that approaching an employee could violate the Health Insurance Portability and Accountability Act (HIPAA).

The best practical takeaway for managers? Simply check in with injured or ill employees and ask how they’re feeling.

“It really gets down to the basics of how you interact with employees,” said Carrie Bibens, associate director of vocational rehabilitation services at Sun Life U.S.

“Set up regular one-on-one discussions and check-ins. Spend time getting to know them. That’s pivotal to setting the stage for your employee to feel comfortable to engage in those conversations and be honest if they need help.”

Another potential setback is the siloed nature of the disability management process. Treatment should be a collaborative process between doctors, vocational clinicians, case managers, providers, employers and behavioral health providers. Too often, that’s simply not the case, Ward said.

“This can result in prolonged leave duration and less effective recovery in the return-to-work process. We often talk about the whole person in healthcare and the same should go for disability,” she said.

A Person Is Healthiest When They Can Work

Another topic addressed in the webinar was the importance of timely return to work. The panelists argued that when employees get back to work after an injury, they regain a sense of purpose and adopt into a healthier schedule — ultimately leading to better medical results.

“A person is healthiest when they can work,” said Ward. “They can provide for themselves and their families and contribute to society. Returning to work has important sociological benefits, in addition to health and financial benefits — and it means the employer retains a valued employee.”

Workplace accommodations for someone dealing with behavioral health issues are different, however, and employers need to consider these factors.

While a physical injury might require light duty or changes to equipment, a behavioral health situation might require a schedule change or shift in work environment.

Early intervention is a major driver of good outcomes for both employee and employer, the panelists said.

For the employee, starting the process earlier means finishing sooner and getting the right treatment from the outset. For the employer, it means stronger risk management, better regulatory compliance, minimizing loss of productivity, and improving employee morale.

“Claims are processed more quickly, accommodations can be arranged before the disruption of work,” said Bibens, “and behavioral support can be incorporated sooner for better outcomes.” &

Jared Shelly is a journalist based in Philadelphia. He can be reached at [email protected].

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