RETURN TO WORK
Back to Work After Trauma
— the Mind Matters
After a life-changing
barriers can hinder
a person’s ability to
re-enter the workforce.
Early intervention is a
By Michelle Kerr
Aworkplace accident can leave a worker with a spinal cord injury, an amputation, severe burns or a brain injury, turning their world upside-down. The physical toll is obvious if a worker is missing a limb or immobile. But the psychological hurdles often are hidden. Recovery can be fraught with emotions, fear and anger among
them. This complicated tangle— and the way a person handles it — can reduce
the odds that a person will ever re-enter the workforce.
According to studies, employment rates several years after injury hover around 50
percent for severe brain injuries, 35 percent for paraplegics, 25 percent for quadriplegics,
just under 70 percent for amputees, and 80 percent for severe burn victims.
Costs are jarring, too. For traumatic brain injuries alone, researchers estimate
an economic impact of $56 billion yearly, much of it due to lost productivity.
Experts believe we can do better.
Medical, surgical, prosthetic and technology advances are pushing workers
forward. Payers and care management organizations can improve outcomes by
putting more emphasis on psychosocial obstacles.
SET THE TONE FROM DAY ONE
After an injury, it takes time for an injured worker to envision any future. That’s
why the psychosocial piece of recovery and return-to-work needs to be on the
table from day one.
Some might presume that talking to an amputee or a spinal injury patient
right away about going back to work would seem callous or create pressure. But
most people equate having a job with having a normal life. Talking about work
introduces the idea of getting back to normal—even a new normal.
That’s important early on, when the injury seems terrifying. Work offers
hope for the future and gives the worker something to cling to when he might
otherwise get caught up in “my life is over” thinking.
“We’re raised to believe you survive in this world by having a job,” said Zack
Craft, vice president of rehab solutions with One Call.
“When you say you may never work again, or don’t know if you can, you have
emotional stress and that’s going to impact how you heal and how you think.”
Added Marcos Iglesias, senior vice president and chief medical officer with
Broadspire, “One of the things that effective doctors do, and I recommend we
claim professionals do, is [to ask] early, ‘What do you like about work?’ It starts
getting into the individual’s mind the idea that we’re expecting that they’ll return
to work. That work is good for them.”
Setting the stage for return to work can also help counter financial panic.
Said Craft, “[Even if] you’re not worried about today’s bills, you’re worried
about your bills in five years. And how are you going to pay for your daughter’s
wedding? Are you going to go be able to retire, to travel, and do the things that we
all look forward to in our work lives?”
Presented in a positive way, with realistic and achievable steps, talking
affirmatively about the path back to work can buoy workers’ health and
Focusing on the future can be
instrumental in helping workers heal
from emotional trauma, said Marijo
Storment, CEO of ALARIS | Encore.
“There are times when we see
injured workers just hang on to the
accident or injury so tight that they
can’t get past the actual event. That’s a
big psychosocial component and can be
a [significant] barrier.”
Storment said that workers with
traumatic injuries do best when helped
to focus on their “new normal.”
• Employment rates after traumatic
injuries are historically low.
• The psychosocial component
can be a key factor in whether
an employee ever rejoins the
• Work-at-home arrangements
provide a rich opportunity to speed
RTW during recovery.
“At centers of excellence, they
tend to know that [a patient]
needs behavioral health support
on day one — it’s not an after-
— Marcos Iglesias, senior vice president and chief
medical officer, Broadspire
More can be done to address the psychosocial challenges faced by traumatically injured workers.