Addressing Mental Health Recovery for Injured Workers

On August 22nd, 2023, experts in the Worker’s Compensation field came together for a panel at the Worker’s Compensation Institute Conference (WCI) entitled “Mental Health Recovery during a Worker’s Compensation Claim.” This panel focused on how to support the mental health of an injured worker while recovering from an injury. Some topics and challenges included the appropriate timing for Mental Health assessment and intervention, the use of Return-to-Work programs for injured workers, and the barriers to finding appropriate mental health professionals for worker’s compensation claims.

The panelists consisted of:

  • Debra Livingston, CEO & Founder, ReEmployAbility, Inc.
  • Michael Bunte, WC Project Manager ACCS & Business Partner Associate, Aon Corporation
  • Dr. Miranda Kofedlt, PhD, Vice President of Clinical Services, Ascellus

These worker’s compensation professionals reviewed various considerations when addressing mental health recovery for injured workers.

Challenges in Workers’ Compensation:

Challenges in adequately addressing mental health for injured workers include adapting to telehealth, navigating complex documentation, and the timing needed to ensure that the mental health interventions would result in optimal recovery. Adjusters are tasked with navigating these challenges to create the best outcomes for injured workers’ recovery. The article will review these challenges and ways to mitigate any challenges below.


Initial Assessment After Injury:

Physicians are crucial in assessing injured workers’ needs for behavioral health services. Early assessment focuses on the mechanism of injury, pain generators, function, impairment, return to activity recommendations, and risk factors for delayed recovery. Disability and claims history, return-to-work expectations, and treatment needs are considered individually. Early intervention tools are vital for mental well-being and help facilitate healing. For example, early return-to-work programs can shorten the recovery period because they allow injured workers to combat the loneliness and isolation that occurs because of an injury. Therefore, enabling better results. As such, creating early connections is essential for recovery.

Timing of Health Psychology Intervention:

Health psychology intervention is typically not considered immediately after an injury. Still, it may be considered if symptoms persist after a few weeks, as addressed by Dr. Kofedlt. Psychosocial factors, such as patient catastrophizing, anxiety, and subclinical depression, can delay recovery and warrant health psychology intervention. The severity of psychosocial risk factors may influence the choice of interventions, ranging from coaching to cognitive-behavioral therapy (CBT). On the other hand, delaying mental health intervention can lead to more severe psychological conditions, such as major depressive disorder or PTSD. 

Catching psychosocial factors early and providing coping skills and resiliency support is also crucial. Traumatic events, such as accidents resulting in deaths, can impact an individual’s mental health recovery and require early intervention. Early assessment can help determine the risk of developing PTSD and provide support before making an official diagnosis. The timing of psychological evaluation is imperative in creating a mental health plan that would be most beneficial for the injured worker.

Addressing Psychosocial Factors:

Identifying and addressing psychosocial factors, such as support systems, housing, food security, and language barriers, is essential for effective recovery. Providing injured workers with information about community resources benefits their recovery. It allows them to have more positive outcomes for their claims. As a recommendation, a list of community resources for injured workers can enable someone to build self-reliance. It’s about being empathetic, caring, and providing what the injured worker needs during this difficult time.  

Complacency can be an issue for injured workers. Complacency can be addressed with a simple change in routine, like returning to work, which can break this pattern and reinvigorate the injured worker toward their recovery.; it is often a factor with injured workers who feel isolated in their recovery and have not been given the resources to thrive. Providing help is a simple way to encourage injured workers.


Benefits of Early Return to Work Programs:

Being off work for extended periods has been proven to have a negative impact on an individual’s mental health. Return-to-work programs can significantly impact workers’ compensation costs, as 60% are driven by injured workers’ fear and anxiety. Early intervention through Return-to-Work programs can increase the likelihood of injured workers returning to work sooner. Debra Livingston elaborated on how connecting with others and maintaining human connections through work can positively affect mental health. 

Benefits of Volunteering:

Volunteering fosters human connections, a crucial aspect of mental health recovery. Injured workers engage with their communities, meet people, and socialize, positively affecting them. Many injured workers have never considered volunteering but can see the benefits once they’ve participated. 

Meaningful work helps in the recovery process and mental well-being and helps alleviate any concerns of isolation or loneliness. Interaction with injured workers is vital for their recovery. 

Telehealth and Access to Mental Health Care:

Another question for the panelists was regarding the prevalence of telehealth and how that affects mental health. Telehealth has become a valuable tool for mental health care, especially since the COVID-19 pandemic. Direct web healthcare is increasingly embraced in the workers’ compensation industry due to its effectiveness and improved access to care. Telehealth offers improved care access, faster appointment scheduling, and increased show rates. It has become essential, especially for mental health services. Telehealth is practical, convenient, and often preferred by providers and employees. In assessing the needs for mental health services or to increase the likelihood of participating in services, telehealth can improve medical access for worker’s compensation claims.

The Role of Communication:

Lack of communication leads to frustration and litigation. Injured workers may need help understanding the complex information given to them. Picking up the phone and asking how they are can build trust and reduce litigation. Employers often face criticism from injured workers who feel their employers don’t care, creating more difficulties for injured workers. We know direct and frequent communication with injured workers is crucial for their well-being and recovery. Employers are encouraged to communicate directly with injured workers. Case managers and medical directors may play a role in negotiating return-to-work arrangements with employers, allowing for the best possible outcomes for the mental health of injured workers.

Challenges in Finding Mental Health Practitioners for Workers’ Compensation Claims:

Reimbursement rates for mental health services through insurance are often low. Mental health practitioners are moving away from working with insurance, including workers’ comp. Additionally, documentation expectations can make clinicians uneasy about violating privacy. Fee schedule limitations limit the number of clinicians willing to work in this space. Making medical-legal determinations is new to many practitioners. It requires experience and training, often exacerbating the challenges when providing care for injured workers. Accessibility to mental health services is a challenge that may result in adverse mental health outcomes for employees. The stigma around mental health treatment persists despite the focus on accessibility. Finding mental health clinicians for injured workers is complicated and is often a prime hurdle for treating mental health concerns.

Additional Strategies and Considerations for Recovery:

  • Encouraging patients to maintain contact with colleagues and engage in social activities during their recovery can strengthen the employer/employee bond and maintain that connection to their workplace.  
  • Providing patients with a list of enjoyable activities to focus on during their recovery helps create self-reliance and resiliency while recovering.
  • Recognizing the importance of screening tools in identifying individuals who need support and utilizing them early and often.
  • Advocating for legislative changes to expand the role of mental health professionals in workers’ comp cases.
  • The role of a buffer or intermediary, such as in-house adjusters, can improve communication and reduce animosity in the return-to-work process.

Suggestions and Comments from Attendees:

Attendees discussed the shortage of mental health providers, especially those willing to treat workers’ comp patients. Early intervention was emphasized as a critical factor in addressing mental health issues. Screening tools can help identify individuals who may need mental health support and are encouraged to use them. Promoting engagement through social interactions and activities is essential. Finally, advocating for expanded roles for mental health professionals can help address the shortage and ultimately help injured workers.

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