Inside Disruption Blog

Talking to injured and ill employees is easy, once you know how

Les Kertay
January 18, 2017

In the world of worker’s compensation and disability, we all learned to “talk about return to work early and often.” We’ve heard it so much that it makes sense and feels natural. The only problem is that it’s wrong.


OK, I overstated it. There is indeed good evidence that being at work is an important part of recovery. There is also strong evidence that the employee’s expectations about being able to work are one of the best predictors of when he or she will return. The problem is that we who work around claims, whether as adjusters or treatment providers, believe that our expectation will drive what the employee wants. That’s where it gets more complicated, and how and when we state our expectations becomes more important. Spoken too soon, without first establishing trust, expectations that contradict the employee’s own will just create resistance.


You can demonstrate the principle for yourself. Recall the last time you sprained your ankle. The natural tendency is to get off the ankle. To rest. And in fact, for a severe strain RICE (rest, ice, compression, elevation) is a mantra. But best practice for a minor injury is to use the affected part as normally as possible, as soon as you can. Bearing weight and moving as normally as you can is the fastest road to recovery.


Now imagine I told you that fact just after you sprained your ankle, before I let you finish telling me what happened, before I checked out your ankle, when it was still hurting in those first acute moments. How inclined would you be to take my advice?


Yeah, me neither.


I could have substituted any injury or illness for the ankle strain, including anxiety or depression, and it works the same. People in pain want to be heard before they are ready to move on. Talking about return to work before the employee feels heard, understood, and cared for will simply increase resistance. Talking about it before the employee believes it’s possible will decrease trust. Both are counterproductive.


So what’s the alternative? The solution is to offer just what you’d want if you were in the same situation. Actively solicit information about the employee’s experience. Ask how they are doing. Listen. Be interested, and get the details.


And then let them know that you’ll help all you can while they need the support, as they recover and get back to their life.


What you’ll notice in that message is that 1) I listened to the story, 2) I offered support, and 3) I naturally assumed that they would get back on their feet. I “set the expectation” normally, without forcing the issue or tying it to something they aren’t sure they can do.


It really is that simple.

Les Kertay

Guest Author

Les Kertay is a licensed and board-certified clinical psychologist. He has extensive experience and expertise in the arena of mind-body health including disability medicine, chronic pain, health behaviors, crisis response, and managing workplace absence. With over 15 years in executive leadership positions in the medical and vocational areas of the disability insurance industry, Dr. Kertay has presented at national and international conferences on topics related to the psychological aspects of work and disability, practical approaches to managing psychosocial issues in medical practice, pain management, somatoform and personality disorders, and professional ethics. Also, in addition to other publications, he is a contributor to three books on psychosocial aspects of complex disability claims and is lead editor for the AMA Guides to Navigating Disability Benefit Systems. Dr. Kertay is also a practicing clinician and industry consultant.