Discussing Work Contribution Part 3: Beliefs and Communication

Blog - Discussing Work Contribution Part 3: Beliefs and Communication

Dr Mary Wyatt | Published: July 13, 2015
If a person believes their work contributed they may be understandably worried that going back to that activity / job will do more harm. 
Basing assessments of work contribution on beliefs, including the employee’s beliefs and the employer’s beliefs, can cause all sorts of complications.  
Employee beliefs
We are a determinist people.  We look for a cause for whatever health problem we face. The mother who has a child with cerebral palsy looks for what might have occurred during the pregnancy to cause the condition. The person who gets cancer looks to identify what might have contributed to or caused their cancer. It’s human nature.
Similarly, when we develop a sore back we look for the cause. I have heard so many different statements about this. They include, “I’ve developed back problems because I sit all day,” “I’ve developed back problems because I do a lot of lifting in my job,” “I’ve developed the back problem because I sit and stand at various times over the day, and have to make that transition many times.”
I have also seen doctors write, “The person has no other risk factors therefore his work has caused his back problem.” This ignores the fact that back problems afflict some 70% of the population, including around 70% of the population who are not employed. 
I have previously talked about the importance of using research and the associated challenges. The research on this particular topic is still developing and is not well understood. As a result, doctors don’t communicate the topic effectively, because they don’t understand it well. They may decide to base their assessment on the patient’s beliefs and/or advice about their condition. 
Employer beliefs
Employers come to this area with their own set of judgements.  A common example might be “We’ve been operating this machine for ten years and no one has ever had tennis elbow before.”  On this basis, they are dubious that work contributed to the condition. 
An employee may initially tell someone at work that their condition is not work-related, or they do not immediately lodge a claim. 
When claims are lodged weeks, months or years after the incident stating that the injury was work related, employers may be dubious. It is not uncommon to hear an employer say, “The person could not identify any specific work incident” or “They said their problem was not work related when they first told us about it” as the basis for believing the condition has not arisen from the job.  
For example, consider an employee who develops De Quervain’s tenosynovitis, a quite specific tendinitis which affects the thumb. Only after a specialist review and advice that repetitive activities are the most likely cause does the person lodge the condition as a work-caused problem. That person did not, and shouldn’t be expected to, understand what has caused their problem.  Despite this, a late claim cause employers to be suspicious.
When there is a liability assessment, rejecting a claim may be framed as a legally worded letter from the doctor. This leaves the patient feeling disenfranchised and as though they haven’t been believed. 
Alternatively, if the condition is accepted as work-related but the employer still doesn’t believe it is, the employee may feel disenfranchised.  
We need to be able to communicate the issues to both the employees and employers in plain language, in a way they can understand. It might be a short paragraph, explaining the reasoning, but it should also acknowledge the employee’s condition. It should furthermore be backed up by evidence for the employer.
Employee and employer beliefs and understanding about health conditions can form the basis for many misunderstandings. Getting off ‘on the wrong foot’ is a poor start to a claim.  
As health outcomes are poorer when a condition is dealt with under the workers compensation system, it is an important area to deal with well.