CALIFORNIA COMPENSATION CASES
Vol. 88, No. 5 May 2023
A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions...
By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board
In 2022 there were 7,490 wildfires in California. They burned 362,455 acres...
By Christopher Mahon
Should temporary workers be treated separately under workers’ compensation law due to additional employment and income risks they may incur after workplace injuries? A new study...
Here's a noteworthy panel decision where a family member conveyed essential information to the AME on behalf of the injured employee. The Lexis headnote is below.
CA - NOTEWORTHY PANEL DECISIONS...
Oakland, CA – Part II of a California Workers’ Compensation Institute (CWCI) research series on low- volume/high-cost drugs used to treat California injured workers identifies three Dermatological drugs...
A recent webinar discussed mental health and well-being in the workplace and looked at some of the impacts on workers’ compensation
Concerns with workplace safety and worker health are obviously not new among workers’ compensation system participants, but traditionally most of that concern has been for the physical health and safety of workers. However, as recognized in a recent webinar on “The Impact of Mental Health and Well-Being in Workers’ Compensation,” the modern workplace can be a very stressful place and there is a growing recognition of and concern for the impact made by mental health conditions.
Mental Health Stressors and the Workplace
Webinar participant Bryon Bass, Senior Vice President at Sedgwick Claims Management Services, notes many of the factors that can make the modern American workplace a stressful environment: American employees are working more hours per week than ever in a relentless quest for greater productivity in the face of increasingly global competition; the pace of technological advances often means having to cope with rapid changes in the workplace; the potential for mergers or acquisitions make job security an illusion at best. Given that we spend a majority of our waking hours on the job, it should come as little surprise that an estimated 20% of American adults suffer from mental health issues.
Stressors such as these and others can have a direct effect on worker health and return to work issues, with Bass also noting that mental health disabilities are among the longest lasting and mental health conditions such as depression commonly exist as comorbidities with other diagnoses. Moreover, mental health conditions, which often go untreated, are some of the most costly health issues to treat and also result in harder-to-quantify costs in the form of lost productivity and absenteeism. Workers with these issues are also more likely to exit the workplace earlier. As mental health disability is apparently more frequent in young adults, the issue becomes even more important as more of that population enters the workforce.
As described by another webinar participant, mental health issues can enter workers’ compensation claims in three ways. The most common way is when a physical injury leads to a mental health issue, such as when pain from an injury leads to depression. Another, albeit less common, way is when a mental health issue leads to physical damage, such as mental or emotional stress leading to a heart attack. Finally, mental or emotional stimulus might cause a diagnosable mental health issue, although it should be noted that state workers’ compensation laws generally provide that it has to be unusual and extraordinary stress to be covered, specifically excluding emotional stressors such as legitimate personnel actions.
The numbers apparently support the conclusion that work is becoming more stressful to mental health. Bass states that mental health claims are growing by more than 10% annually and now account for 30% or more of corporate disability. One study mentioned showed that within the first twelve months after an injury, 50% of workers experienced clinically related depressive symptoms during their claim, with the highest rate occurring during the first month. The news is not all bad, however, as appropriate treatment works some 60 to 80% of the time, although less than 1/3 of adults with a diagnosable condition receive treatment each year.
Social and Cultural Contributors
Factors outside the workplace can also have a major impact on the recognition and treatment of mental health issues associated with work. Maggie Alvarez Miller, Director of Operations and Product Development for Aptus Risk Management, discussed the role that a worker’s cultural heritage and family life can play in the treatment of work-related mental health conditions. She described, for example, that members of her own Hispanic culture tend to be more stoic and less receptive to taking medications, which might result in less compliance with a treatment regimen. She also notes that “some cultures rely on the entire family’s participation in the injured worker’s recovery,” suggesting that communicating with family members about treatment goals can sometimes be critical.
In addition to overcoming these hurdles, the stigma attached specifically to mental health problems and the self-identification of mental health issues is a general societal problem. Bass noted that in today’s society, media portrayals of mental health issues are generally stereotypical, negative, or wrong, often showing persons with mental health problems as criminal or violent and often looking different from others. In these portrayals, psychiatric treatments often cause more harm than good and patients never recover. These negative portrayals can influence self-identification and treatment decisions, as over 35% of respondents in a 2015 national survey cited “societal concerns” as a reason for not receiving mental health services. This stigma has carried over to the workplace, as Bass noted that 10% of survey respondents indicated that they felt if they got care for a mental health issue it would create a negative image at work.
Strategies for Improvement
Companies are becoming more cognizant of these issues and we are apparently seeing an increase in focus on building healthy workplace cultures. Drawing from research on the topic, Bass describes some of the conditions that can foster “mental healthier” workplaces:
—Employees are provided with sufficient resources to do their job and management communicates with employees about how each job fits into the company’s larger business goals.
—Employees are given a sense of control over their job, including time control over how and when work gets done and breaks taken.
—Employees are allowed to find a balance between their work and personal lives.
—Employees are given some sense of job security and are not in constant state of worry.
—Employees are able to develop work relationships and feel a sense of belonging with coworkers and bosses.
Brian Downs, Vice-President of Claims for Workers’ Compensation Trust in Connecticut, addressed some of the hurdles facing claims professionals in order to facilitate better handling of the increasing number of mental health-related claims. He stressed that claims professionals need to be educated to identify mental health issues, including knowing what questions to ask of injured workers, and know where to send patients for appropriate treatment. He also recognized that establishing ongoing relationships with providers who handle these patients is critical, although he also noted that the current level of mental health professionals is inadequate to handle the workload. Alvarez Miller added that adding timelines to ensure continuous communications among claimants and claims processing professionals in order to monitor a worker’s progress toward a return to work is critical to improving mental health disability treatment.
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