Occupational Injury Disputes Put Doctors in a No-Win Position

If your workers are injured on the job, providing them with the best medical care is ultimately in your organization’s best interest. Superior doctors provide better medical results, usually returning your employees to productivity more quickly.

Most self-insured and insurance carriers turn to occupational medical providers when evaluating employees injured at work or on long-term disability. But even highly skilled medical practitioners can stumble sometimes, especially when employees lack the motivation to return to work. Doctors then find themselves caught in that no-win position between their patient, for whom they must advocate, and the insurance carrier.

Across America, organizations struggle with several key challenges: returning injured workers to productivity and helping those on long-term disability return to work. This we know both from studies and intuitively– worklessness is bad for people. According to Dr. Jennifer Christian, a national advocate in preventing needless work disability, we all operate with three “pillars of identity” – our bodies, our family and our work. Any loss of bodily integrity leads to grief, anger and ultimately may lead to a depression so debilitating that it may be impossible to return the employee to the workforce.

Inactivity, according to Dr. Christian, impedes healing and leads to chronic pain. With worklessness comes an increased likelihood of suicide attempts, poorer general health, higher rates of medical interventions and hospitalizations and a higher risk of death. While employees may consider a work injury settlement a “cash cow,” a 2001 Rand study found employees reported significant declines in income for five to ten years post injury after a workers’ compensation settlement. If doctors know this, and many studies document the problems associated with worklessness, then why aren’t they driving the horses on the return-to-work bandwagon?

Many family physicians treat injured workers. They may be unaware of these studies and are definitely in a bind when it appears they side with the employer against the employee’s wishes in return to work decisions. This is where employers may need to intervene and insist on second opinions. Also, many employers whose employees are out on Family Medical Leave or other medical absence are uncomfortable phoning doctors for more thorough explanations.

Communication is the key to managing injuries and returning employees to work. For example, one human resources officer reported receiving vague notes from employees’ physicians stating employees could not work certain hours. A phone call to the physician may reveal he or she is simply honoring the employee’s wishes that she not work an earlier or later shift. There may be no medical reason the employee cannot work the shift. One simple phone call may help to end this and other difficult to manage absence practices.

Disability is no longer the bane of the aged. According to a 2004 article in Health Affairs, disability rates are on the rise among those ages 18 to 59, fueled in part by a growing weight problem. These trends are potentially catastrophic and each employer, no matter how small, should be concerned about the impact of increasing disability on their workforce.

There are solutions, but employers cannot manage disability in a vacuum. They must partner in work associations and workshops with other human resources managers and workers’ compensation providers to determine best practices. This will help return their work force to productivity as quickly as possible. After all, it not only benefits the organization, it ultimately benefits the employee and society, as well.