Duty Status and the Injured Worker

At first glance, it’s pretty straight forward – sprain your ankle, don’t walk; strain your back, don’t lift or bend much; injure your shoulder, no overhead reach. All seem reasonable to the point of common sense. Ah, but there are unseen forces lurking beneath the seas of calm rationality.

The injured worker can himself be pretty conflicted. He may actually feel so much pain he doesn’t think he can work. The other extreme may also occur where he feels only minor discomfort, but really dislikes his job, and believes this injury presents an opportunity for an unexpected holiday. Most injured employees fall somewhere between these extremes. The average injury may be too badly injured to do their regular job, but they certainly are capable of doing something useful for the employer while they recover.

There are countless studies in occupational medicine literature that prove an injured employee released to light duty will heal quicker, return to full capacity sooner, and have less pain and medical expenses. This is pretty persuasive stuff. Let’s talk about why this is true.

If an injured employee is removed from the workplace, he is removed from his co-workers, who are his friends and confidants. This isolates the employee from peer pressure. If the employee is recovering at the workplace, his co-workers are encouraging him to get better. This is a strong motivating force to recovery.

The off-duty worker will also notice an evolved home life. Families figure out how to operate on less income. Maybe paid childcare can be replaced with “free” childcare provided by the injured worker parent. After these changes are made, it is much harder to motivate complete recovery from the injury.

The distraction factor also needs to be considered. Most of us know that pain is much more noticeable at night. The reason is that we are simply too busy during the day to pay much attention to pain. Work is also a distraction. While you are busy at work, you don’t have much time to dwell on your discomfort. Substitute a quiet day at home, and pain can become the center of attention and much less bearable.

A related phenomenon is how firmly you hold onto something. Conventional wisdom says you cannot let go of something you hold too strongly. When every part of an employee’s life revolves around the injury, its treatment, medications, physical therapy, home exercise programs and insurance calls, it is virtually impossible let go/get well. Perhaps a bit “Zen,” but the truth of the above occasionally becomes inescapable.

Another problem with off-duty status is de-conditioning. Often we see older workers that do heavy work five days a week. This can only continue because of physical strength and conditioning as a result of the job. Take the job away for a month or two, for any reason, the employee may find it almost impossible to return to the heavy physical job.

The off-duty status can also put up roadblocks to healing on the employer’s side. The employer will need to fill the job if the absence is prolonged. Maybe the employer will discover he doesn’t need this employee. The work situation can evolve rapidly when the employee is at home for awhile. This is much less likely to occur if the employee is at work, even in a reduced capacity.

For many reasons, accommodation of the injured worker at the workplace will almost always be helpful to both the injured worker and the employer. The worker will heal faster, return to full duties sooner and have much less chance of a long-term disability. The employer will get partial use of his employee body and full use of his mind. The employer’s workers’ compensation expense will also be reduced and his workforce normalized as soon as possible. It truly is a win-win for everyone.

Stay well,

Dr. B

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