Workers' compensation for psychological injury

Workers' compensation claims for psychological injury represent a significant drain on financial resources. Most commonly, occupational stress research has focused on individuals still at work. As a consequence, pathways from developing work related stress conditions to lodging a workers' compensation claim have received little attention. This investigation was concerned with identifying the factors that may contribute to an individual lodging a workers' compensation claim for psychological injury. Four groups were involved in this study including individuals who had made a claim for workers' compensation for psychological injury, a group of workers who had sought professional assistance for symptoms relating to work stress but who had not lodged a claim, a group of workers who had experienced stress symptoms at work but who had not sought professional help or lodged a workers' compensation claim, and a group of workers who had experienced stressful events at work but who had not developed psychological symptoms. An intensive design was employed with participants being involved in all studies. The process of occupational stress is a complicated one. A considerable number of factors related to onset, experience and consequences of occupational stress have been identified. A model developed by Berry (1998) was adopted for the present study to guide the investigation of the factors that influenced the lodging of a workers' compensation claim for psychological injury. Five studies were conducted using this model as a guide. Initially, details regarding the participants' work history were determined by a verbally administered questionnaire. In relation to Study 1, self-report questionnaires were administered to determine the influence of factors relating to the individual. No significant group differences were evident on measures of dysfunctional attitudes, irrational beliefs, career beliefs or coping resources. There was no evidence that these factors contributed to either the development of occupational stress or claiming workers' compensation for psychological injury. In Study 2, self-report questionnaires were administered to determine the influence of work-related and nonwork environmental factors. There were no group differences in relation to stressful life events outside of work or daily hassles. In contrast, work environment factors did differentiate groups. The compensation group reported poor relationship factors including less involvement and less staff support in combination with more work pressure. In Study 3, specific work stressors were considered using self-report questionnaires. There were a range of work stressors that distinguished the compensation group from the other groups. For example, stressors that were related to high levels of pressure, little reward, and little support were characteristically reported by the compensation group. Study 4 examined the psychophysiological and psychological responses to stressful and nonstressful work events as they occurred by using a personalised, staged, guided imagery technique. Although stressful work events elicited greater arousal and more negative psychological responses than did nonstressful work events, the responses of all groups were similar. In Study 5, self-report questionnaires were administered to determine differences in outcome measures. The compensation and assistance groups were the only groups who experienced clinically significant psychological symptomatology with these two groups demonstrating unique symptom patterns. Differences in the adoption of coping strategies also were noted. Finally, a series of stepwise regression analyses were performed to determine the factors that significantly contributed to selected outcome variables. It was interesting to note that factors that did not distinguish the groups still predicted the development of negative consequences of occupational stress. The results were discussed in relation to the factors that could be used to predict a claim for workers' compensation for psychological injury with the aim of developing appropriate intervention and management strategies. Directions for future research were considered with particular focus on a suggested examination of the decision pathways that lead to a workers' compensation claim for psychological injury.