You Don’t Have to Hire the Psychologist, But You Must Understand the Psychology

WorkersCompensation.com President and CEO Robert Wilson

There are a number of constants in the world of workplace injuries and workers’ compensation. One of them is the fact that employers hate the idea of paying for psychiatric care, and they will work to avoid it like the plague. Part of that extends from a (not wholly unearned) belief that psychology is like chiropractic care for the mind; once psych starts, it never stops, and the employer will be on the hook for every possible malady as they arise.

The concept to them is clear; paying for psych is crazy. That concept notwithstanding, employers are making a huge mistake.

They often have a similar guttural reaction when someone starts talking about the psychosocial factors that affect the injured in their ranks. However, when we speak of the psychosocial factors we are not saying they need to hire the psychologist, rather that must understand the underlying psychology that is influencing their injured workers. A failure to do so can mean the difference between a successful outcome and a long, drawn out injury that comes completely off the rails.

In this industry it is not uncommon to focus on the injury itself without regard to its relation to the person as a whole. We almost treat it as an isolated element unassociated with anything else. The reality could not be more different. Even the most isolated injury affects the whole person, and it turns out that their reaction to that injury may be entirely unexpected; driven by events and conditions established long before the wound occurred. The best quote I have encountered about this phenomenon comes from friend and fellow blogger Mark Pew, who tells his audiences that, for an injured worker, “what happens between the ears and at home is as important as what is physically wrong with the body.”

Many of us have seen cases where two injured workers with nearly identical injuries take two completely different paths in recovery. The difference is not the physical manifestations of the injury; but instead how their mind chooses to deal with that event.

There are tests and flagging systems that employers can use to help identify workers whose recovery may be impeded by these psychosocial factors. They can help determine the employees “ability to cope,” which is the fundamental issue behind many claims gone bad. One of the best examples I know of is the program established by Bill Zachary at Safeway, where they partnered with Kaiser Permanente in a program to identify at risk individuals early in the recovery process. The result of their program was better targeted care that improved outcomes and saved the company millions of dollars.

I continue to be amazed that more employers have not seen the light on this. Years after Zachary’s groundbreaking efforts, the program at Safeway sadly remains an outlier in the field. An extremely effective outlier that offers better care while saving money, because it recognizes the power and influence of the injured workers mind.

And it is the failure to understand this concept that is what’s truly crazy.