Changing discourse by changing the injured worker's course

This week's post was inspired by another blog (Managed Care Matters) as two quotes in an April 10, 2013 post hit on two very important points when discussing RTW:

"... 'there’s no condition so disabling that there isn’t someone in the US with that condition working full time today.'”

and...

"You don’t get better and go back to work, going back to work is a part of getting better!”

Disability means different things to different audiences.  According to the U.S. Social Security Administration a person is "disabled" based upon their inability to work and if:

oYou cannot do work that you did before;

oWe decide that you cannot adjust to other work because of your medical condition(s); and

oYour disability has lasted or is expected to last for at least one year or to result in death.

Here's an experiment for you to try at home.  Ask someone what they think of when they first think of a disabled person.  I would be inclined to state that their initial response includes some description that focuses on the physical abilities or limitations of the person rather than the limitations placed on their ability to earn wages.  Now, ask someone what they think of when they think of someone out of work due to a work-related injury.  Was their response the same?  I'd be inclined to state that their response related to the monetary impact.

Why?

In workers' compensation cases, disability is often defined in relation to earning power or wage loss as the result of a work related injury.  An example of this includes whether an injured worker is totally incapacitated as a result of the work injury or if they are able to perform some type of work, but as a result of the injury, is experiencing reduced wages or hours, they are considered partially disabled.  Each state's WC laws define what constitutes temporary and permanent disability, as well as total and partial disability.  Notice that the focus is on pre-injury wages, not pre-injury capabilities (i.e., climbing stairs, lifting more than 25 lbs., etc.).  Of course, one could conclude that if an employee regains their pre-injury capabilities, the pre-injury wages should follow. 

This demonstrates the framework we use to think about disability and how it differs depending on the cause of the disability.

When we refer to the "disability mindset" we're describing the individual's perception that he/she is incapable of performing any job.  How do we intervene and help prevent the disability mindset?  We must demonstrate that there are plenty of things that an injured worker can do within their restrictions -- via modified duty! Another important step is to have the injured worker's physician medically clear them to return to work.  Except in rare cases, every injured worker is capable of doing something.  Sure, that something may require some training, maybe even a little bit of creativity, but I'd be willing to bet that there is something that can be found, even in today's economy.  A little bit of effort can go a long way.  We've all seen examples of people who are doing amazing things despite their physical limitations -- whether it's in the grocery store, a local not-for-profit, or any other place of work.

When we start focusing on what injured workers can do, as opposed to what they cannot do, we're likely to find more opportunities for modified duty, indentify ways to help the injured worker improve their recovery, and intervene before the disability mindset takes over.  To take it a step further, when we start focusing on the wages an injured worker can earn or the productive work they can perform, it will start to change the way we approach modified duty and injured workers.   We will start to take a "glass half full" approach, viewing their experience as one that creates alternative opportunities as opposed to one of misfortune and limitations.

The way we view disabilities, work-related and not, feeds into the disability mindset as individuals are regarded as "too disabled to work."  Imagine that one person, somewhere, with that disability, that is performing work.  It can be done and one of the places we have to start looking is in their workplace.  By changing how we discuss injured workers' situations, we can begin to change our framework and approach to helping them recover and return to a state of wellness, rather than sinking into a disability mindset.