Fear of the Unknown: Understanding Worry in Workers' Compensation

Workers’ compensation is a unique dynamic. It is a complex and highly regulated industry when looking at the benefits in which an injured worker qualifies. When an employee is injured, there is an instant fear of what will come next, as this is not the most straightforward system or process to understand. Nearly everyone in the world worries from time to time as worrying is a normal response to a problem, especially when adding injury to a situation. Couple the injury with a fear of returning to work, fear of knowing where the next paycheck will come from, fear of returning to their regular abilities and healing fully… this becomes a snowball of worry.

In life, there is productive worry and unproductive worry. If we can identify programs and use effective problem-solving strategies, this would be considered productive; however, if we use worry as a coping mechanism for problems we cannot change, that is unproductive. From whatever circle of influence you have in the workers’ compensation system, you can either add to the productive worry, coaching an injured worker at effective problem-solving strategies, or contribute to their fear generated from lack of knowledge or understanding.

When we fail to assist injured workers to our most full capabilities, we add worry and anxiety to an already unpleasant experience from the injury, increasing the injured workers’ suffering. Unreturned phone calls, checks issued late, updates not provided, lack of communication to the employer, the adjuster has a lot of power in alleviating many of these issues.

The way this fear of the unknown or, as I am considering ‘worry’ works is that thought pops into our mind and quickly escalates into a whole storyline. Let us examine a lack of response from an employer once an employee is injured. With an employer not reaching out, communicating, or providing basic check-in to see how the injured worker is doing or the process is going, this can create a ripple in the injured workers’ minds quite quickly. Whether it be regarding finances, career, family, or heath in restoring their function post-injury, the human mind plays out hypothetical scenarios in our imagination, often in the form of a ‘what if’ question. What if I lose my job? What if I fail my physical abilities test? What if I reinjure myself? What if I am unable to pay my mortgage? What if I cannot play with my children?

Because we cannot know the future, we try to create one in our minds to feel like we have some control over it. For example, suppose an employee’s direct leader does not follow up post-injury in a workers’ compensation matter. In that case, an injured worker might conclude in their mind that they are replaceable, no one cares about them, they are in trouble, or people are mad. The mind swiftly works this way to seek control. When there is no objective fact to fill the void in the injured worker’s mind at this point by the absence of communication, this can steamroll quite quickly.

Another example of this unrelated to workers’ compensation but illustrates this concept is when someone fails to respond to a text message. Perhaps it was a family member’s birthday, and you forgot to acknowledge it. You realize this later in the week and shoot over a quick text message to remedy the issue. There is no response. Maybe you call or send another message, and still no response. The next day, you may begin to wonder if the family member is mad at you as a result. When you finally connect with this family member, you find out they lost their phone, and the silence had nothing to do with your failure to recognize their birthday. This example illustrates a scenario where the mind will arrive at a story to assume control over a situation when the absence of fact exists.

Follow me back to the workers’ compensation example above, where we visit an illustrative example from the employer seat of the equation. If there is no reach out from the direct leader and human resources things, the insurance company or TPA will handle everything. Where does the care come from on the employer’s side? Are colleges of the employee reaching out to check-in, or does everyone assume silence due to a work injury? If the injured worker was scared into thinking they may lose their job and the injured worker is not getting any communication from the employer, this can escalate. This scenario can escalate, especially if other colleagues are not checking in because an injured worker may assume everyone is mad. Are my co-workers upset because they have to take on my extra work? And just like that, if an injured worker worries enough, it can become a habit in this process, and these thoughts become a hard-wired response pattern of the mind.

What can we do? From the seat in which you sit in this space when problems arise, we need to assist an injured worker in observing them calmly and objectively. If we fail to do this, we can create chronic fear of the unknown throughout this process. This fear can interfere with the injured worker’s sleep, concentration, healing, and overall well-being.

What tools do we need to help an injured worker along this journey to recovery? When worries pop up and take an injured worker for a ride, the first step is to help them create awareness. If we can help them begin to realize they have fallen into a loop of worried thought, they can start to recognize this is happening. Listen. Listen to the feelings, thoughts, and what is said. Pay attention to what the injured worker is communicating. Is there any validity to what is the injured worker said? If there is, what can be done to alleviate these fears causing so much worry? And what accountabilities from the adjuster desk, or the employer seat, can be put into place to make sure it stops? For example, if an employer hears an adjuster is not returning phone calls to the injured worker, does this need to be addressed, escalated, or brought to the attention of leadership? Or is the injured worker getting caught up in a storyline full of imaginary projections of the future?

The same can occur at the adjuster’s desk. Is the injured worker presenting with valid concerns? Are they nervous about an upcoming medical appointment? Is their fear to return to their employer? What is causing the worry, and what can you do to help provide objective facts to alleviate the concern? Find ways to help alleviate these issues. If there is no valid concern and the scenario becomes a multitude of what-ifs, allow the injured worker to identify they are getting caught up in a storyline full of imagined future projections. Are their worst fears going to happen? How can they know this? Is it likely that what the injured worker is worrying about might have varying possible outcomes? And everything is not so black and white? Help the injured worker find a way to breathe in this space of uncertainty.

So much of life is uncertain. Adding injury and disruption to employment on top of daily life, it is not surprising this type of emotional hijacking occurs. People head down the path of worry due to the fear of the unknown. If we can help injured workers take a few breaths and gently assist them in pulling back into the present moment, this can help break the string of worrying thoughts. It will not simply be a one-time issue and will need practice by all parties involved in the system.

The workers’ compensation industry as a whole suggests, emphasizes, and requires an excessive amount of training around statutes, rules, and regulations. There is an incredible training gap surrounding emotional well-being and leadership needed to change the focus of how adjusters are trained. Emphasis is given to checked boxes while noticing psychological patterns of worry and fear are pushed to the wayside. Paying attention, understanding, and learning how to help psychological patterns can have a meaningful and purposeful impact on injured workers throughout their recovery process in workers’ compensation. Suppose we can educate adjusters, nurse case managers, medical providers, and employers about the power of the mind in these scenarios. In that case, we can help injured workers unhook their minds from excessive worry. There is no way to be sure of the future, and we need to be supportive during a recovery process. There are only benefits assimilated to alleviating worry along this process.

My suggestion for working with injured workers along this process: Take a minute to listen. Listen to the concerns expressed. Ask the injured worker to inhale deeply, then exhale. Tell them that everything will be okay and even more so, it is going to be better than okay, because, in life, it usually is! Ask the injured worker what they can say to themselves the next time they head down this path of worry. What steps can be put into place to alleviate the fear of the unknown and focus on the moment?

We can help make this experience better. In the workers’ compensation space, we have the power to make it so. We all have a part to play and starting by helping those in their worst moments is the very beginning step into making this system better than it has ever been before.

Join me.

By Claire Muselman

Dr. Claire Muselman is a workers' compensation enthusiast (and Vice President at North American Risk Services).

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