WORKERS' COMP THOUGHT LEADERSHIP SERIES
Presented by Plethy Recupe
Simple Ideas for a Complex System
The Five Stages Of Grief
by Bill Zachry, SCIF Board Member
The sense of self-worth, value, and identity are closely associated with that person’s job or occupation. Everyone needs an adequate income to survive. Everyone wants to be a part of something bigger, be valued for their contributions, and be a part of a community. Work provides these and more. That is why it is much more than just an economic catastrophic event when someone loses their job due to a work-related accident. They go from being productive to thinking of themselves as an “INJURED WORKER.”
The loss of a job is an economic, emotional, and physical catastrophe for the injured worker. The loss of a job reduces life expectancy. The loss of a job destroys families. The loss of a job results in the loss of housing due to the loss of income.
What is not commonly understood in the workers compensation claims community is that when workers lose their jobs, they go through the same emotions as when they lose a loved one. The five stages of grief.
The five stages of grief are denial, anger, bargaining, depression, and acceptance.
This paper explains the five stages of grief and how it applies to injured workers when they lose their job.
By understanding this phenomena, medical professionals and claims examiners can do a better job of recognizing the behavior and support the worker in dealing with their pain.
The first stage denial helps the injured worker minimize the overwhelming pain of loss. As they process the reality of the loss, they are also trying to survive emotional pain. In the moment of loss, the worker’s reality shifts completely. It can take their minds some time to adjust to this new reality. They reflect on the experiences they shared with their co-workers. They find themselves wondering how to move forward in life without their job.
The worker has may be overwhelmed by the extent of the information to explore and also have to deal with painful imagery to process. Denial attempts to slow this process down and take them through it one step at a time, rather than risk the potential of feeling overwhelmed by their emotions. Denial is not only an attempt to pretend that the loss does not exist. It is a coping mechanism to help the worker absorb and understand what is happening.
It is common to experience anger after the loss of a job. The worker is trying to adjust to a new reality and is likely to be experiencing extreme emotional discomfort. There is so much to process that anger may feel like it allows them an emotional outlet.
In workers’ compensation, many times the anger is focused on the employer and at the claims adjuster. Sometimes the anger is focused on the system, the applicant and defense attorneys, and even on the Judges or doctors. This anger may manifest itself in verbal outbursts against the claim examiner, or even in deliberately missing doctor’s appointments or court dates.
Anger allows the injured worker to express emotion with less fear of judgment or rejection. Anger does not require the worker to be vulnerable. It tends to be more socially acceptable than admitting the worker is scared.
Unfortunately, anger tends to be the first thing workers feel when they begin to release emotions related to loss. The anger can result in the worker feeling isolated because the worker can be perceived as unapproachable by others in moments when they could benefit from comfort, connection, and reassurance.
When coping with loss, it is not unusual to feel so desperate that the injured worker is willing to do anything to get the job back. Losing a job can cause the worker to search for any way they
can avoid the economic pain they are anticipating from loss. There are numerous ways they may try to bargain.
When bargaining starts to take place, the worker is often directing their requests to a higher power, or something bigger than they can influence to get a different outcome. There is an acute awareness of their vulnerability and humanness in these moments when they realize there is nothing, they can do to influence change or a better result. The overwhelming feeling of helplessness is the result. Bargaining also tends to focus the injured worker on his/her personal faults or regrets. People who are “bargaining” tend to make the drastic assumption that if things had played out differently, they would not have lost their job.
During the experience of processing grief, there comes a time when the worker’s imagination calms down, and they slowly start to look at the reality of their present situation. Bargaining no longer feels like an option and they are faced with what is happening.
As their panic begins to subside, their emotional fog begins to clear, and the loss feels more present and unavoidable.
In those moments, they tend to pull inward as the sadness grows. They find themselves retreating, being less sociable, and reaching out less to others about what they are going through. Although this is a very natural stage of grief, dealing with depression after the loss of a loved one can be extremely isolating.
When the injured worker comes to a place of acceptance, it is not that they no longer feel the pain of loss. However, they are no longer resisting the reality of their situation. And importantly they are not struggling to make it something different. This is when the worker stops thinking of themselves as a worker and begins to think of themselves as “an injured worker.” Sadness and regret can still be present in this phase, but the emotional survival tactics of denial, bargaining, and anger are less likely to be present.
Types of Grief
It is important to note that people grieve differently and may or may not go through each of these stages, or experience each of them in order. These stages often may be blurred. The person may move from one stage to the other and back again before fully moving into a new stage.
There is no specific time suggested for any of these stages. Someone may experience the stages quickly, such as in a matter of weeks, whereas another person may take months or even years to move through to a place of acceptance.
The five stages of grief and the injured worker
The pain of the loss of a job is unique to each injured worker. After going through the five stages of grief this results in the worker believing that they are disabled rather than a productive member of society.
Misplaced financial incentives
One of the worst aspects of the workers’ compensation system is the misplaced financial incentives. Unfortunately, these incentives all too frequently result in creating disability rather than resulting in a productive return to work. The best examples of this are when a treating doctor focuses on the business of medicine and not the correct treatment of the injured worker or when the applicant’s attorney attempts to maximize the disability (to maximize their income) rather than focus on return to work.
An excellent example of how the five stages of grief impact the injured workers is in litigated cases. When injured workers think of themselves as an “injured worker” they unconsciously do not want to go through the five stages of grief (again) to give up their “status” as an injured worker. As a result, their settlement demands are considered “unreasonable.” In these situations, it usually takes a strong effort on the part of the applicant’s attorney (putting the injured worker through the five stages again) to talk the injured worker into settling the claim.
Encouraging the injured worker to move on with their life is one reason lump-sum settlements to fully close the claim are good for the injured worker. Full settlements allow the injured worker to get on with their lives rather than only focusing on their “disability.” Claims examiners and treating physicians should recognize when the injured worker is dealing with the emotional loss of a job and provide assistance and support to allow the patient to focus on their abilities and returning to work.