Unfortunately moderate to very serious workplace injuries continue to occur. Some of these workplace injuries result in substantial lost work time, permanent and partial impairment and disability, and … chronic pain. [Major] Depression, in particular following a more severe injury impacts not only the injured worker but also the worker’s family. Some workplace accidents also include traumatic events which can precipitate acute stress disorder or post traumatic stress disorder.
Psychological counseling vital for seriously injured workers
As the time between a more severe workplace injury and recovery extends over weeks, months and sometimes years, the emotional toll rises both on the injured worker and his/her family (and friends). Financial problems accrue, often marital problems increase and the injured worker’s (and his/her family) long-held future plans become no longer possible.
For many injured workers, the sad reality is that there is no back-up or alternate career. Many injured workers never saw (or see) themselves working in a different field, learning a totally different skill set, and sometimes they believe they are too old to return to school or to learn a new trade.
Of importance is that most injured workers’ treating doctors and surgeons, and even pain doctors don’t often recognise or explore non-physical problems affecting the injured worker. Their main task is the restoration of physical health, or “making the person whole” so they can return to their pre-injury state. Those doctors may see that the injured worker as irritable, inattentive, forgetful, perhaps a tad ‘down’ or tearful, and maybe gaining or losing weight. They often attribute this to medication (e.g nerve pain medication) or to the pain itself, but not to an injured worker’s emotional state and issues. And injured workers, especially males, loathe to admit that they suffer from ‘depression’.
Many of our treating doctors don’t know that being on ‘workcover’ causes a myriad of psychological problems and that workcover is bad for our health (mental and physical – see below).
Psychological evaluation and treatment in the form of counseling of injured workers, especially those with severe injuries, those in chronic pain with permanent limitations is really vital for the injured worker as a way of support and assistance.
The most common disorder we see among injured workers is what is referred to as an “Adjustment Disorder”.
Stressors for people of any age include things like divorce or relationship problmems, general life changes, illness / health issues in yourself or a loved one, moving to a different home or a different city, unexpected catastrophes, and financial worries.
An adjustment to a stressor becomes an “Adjustment Disorder” when the injured worker has a difficult time coping, and the reaction is stronger or greater than what would be expected for the type of event that has occurred.
Adjustment Disorders generally arise in response to a specific stressor that has occurred during the past 3 months .
An Adjustment Disorder:
- causes impairment in social and occupational functioning.
- causes distress that is greater than we would expect (and see) when others are exposed to the same stressor.
The injured worker may exhibit defiance, impulsive behavior, anxiety, tearfulness, withdrawal, and even physical complaints.
By definition it has been said, in an adjustment disorder, once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.
If the symptoms persist for longer than that period, other clinical diagnoses such as anxiety disorders recently or depressive disorders must be considered.
WORKCOVER can be bad for your health
This is no secret to doctors, lawyers, trade union and employer advocates who specialise in workers’ compensation matters.
Nor is it a surprise for many workers caught up in the WorkCover system after a serious injury.
What is not so well-known is that the pressure many injured workers experience as a result of being on compensation creates such a grinding sense of despair and hopelessness that they start thinking about suicide as a solution to their problems. Most don’t follow through, but a few do.
A large part of the problem is that workcover schemes are inherently adversarial, often resulting in claims disputes that have anti-therapeutic effects on the people they are supposed to help.
Disputes over the amount of weekly payments workers are entitled to, ongoing eligibility for compensation, return to work plans and other claims management issues all provide fertile ground for the creation of adversarial relations between injured workers, insurers and employers.
Most people injured at work are back on the job within a month, usually without any adverse effect as a result of being on the WorkCover system. But for those with more serious injuries, it can be a very different story.
Being unable to return to work for an extended period can have a devastating effect on a worker’s self-esteem. Not being able to work following an injury also frequently means being unable to enjoy the amenities of life the rest of us take for granted – like going for a walk, playing with the children or being able to get through the day without pain-killing drugs.
No job, claims managers that don’t believe you’re really injured, and a dysfunctional, one-size-fits-all rehabilitation system all too often mean injured workers are stripped of their humanity and reduced to nothing more than a “claim” or a number.