Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Unique Differences in Workers’ Compensation

The nature of health care provided is likely not significantly different between private pay patients and workers’ compensation patients.

There are vast differences, however, in the way the worker’ compensation system is structured when comparing highly educated managerial type patients and marginally educated semi-skilled labor workers.

I have treated a fair number of claims adjustors, nurse case managers, and college educated injured workers in general. In all cases, they feel a sense of lack of control over their care, feel that they are former gatekeepers now locked outside the gates.

They cannot financially manage on $400 per week, cannot readily adjust to having to have medical procedures authorized before being delivered and know enough about how they, themselves, have managed claims to feel apprehensive now that they are in the patient role.

More importantly, when you are educated enough to understand diagnostic and therapeutic procedures, you are most often uncomfortable with not having control over when, how, who or even if such procedures are provided.

These highly educated injured workers feel a great lack of control. They feel powerless in a system that is structured for the passive, compliant or even indifferent patient. Also, most often, injuries among managerial staff are characterized by an intense need to return to work. While a semi-skilled laborer may be accustomed to months in which there is no available work, managerial employees have consistently worked and are ill prepared for the weeks-on-end of nonproductivity.

While the educated worker often benefits more from psychological care, they also more often require it. They are quite often highly verbal and expressive individuals who are expected to remain passive in the patient role.

The injured worker with appreciable education represents a management dilemma that is uniquely different, and the nature of workers’ compensation does not readily fit with their needs.

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