Hi Grant - I just wanted to give you some feedback from both myself and my injury management advisor upon showing her your email. I'll start by saying the following feedback is definitely unique from my 6+ years of experience case managing claims and working with workplace rehabilitation providers. Firstly, I was impressed with your thinking and particularly with your attachment referencing the Stories/Narratives that we each develop and share with others. It made me reflect on the way that my story has changed over the years and what has lead me to who I am today., I like that you share this with the injured workers and the idea of engaging them to re-write their stories, particularly as many injured workers can be consumed with their stpory being that of injury rather than what the future holds beyond injury. I am impressed by your level of service and thinking outside of the square that you develop for each case to fully engage workers in the process and their sense of ownership that you are developing. Your methods of engagement, rapport building and tailored approach towards each worker whilst remaining focused on the legislative requirements is refreshing and I am certain will result in positive outcomes for all stakeholders. I look forward to see how everything develops! With regard to my injury management advisor's feedback, well in simple tems she felt like sending a copy of your email to other workplace rehabilitation providers we engage showing them how things can be done and the level of thinking that can be applied to engage workers and provide them with tools and strategies outside of standard job seeking application in promoting recovery and return to work. Just wanted to take the time to thank you for the feedback and strategies for each of my referrals so far and let you know I have noticed that your approach with each of them is very much tailored to their individuality. Great work Grant! Claims Officer, Claims Operation Branch, Workers Compensation Insurance Division WorkCover Authority of NSW
Claims Officer - WorkCover Authority of NSW - WorkCover Authority of NSW

Humanising Workers Compensation: The Missed Opportunity

24 Apr 2017

Humanising Workers Compensation: The Missed Opportunity 

In preparation for dipping my toe into the public arena of the RTW summit I read through the training material generously provided by the energetic convenor, Mark Stipic. I am a podcast addict and I have been absorbing Marks podcasts (RTW Nation) on my daily bike ride. His positivity is infectious.

Mark encourages the presenters to give some thought to our why? I find this exercise difficult. Given that so much of our decision making is non conscious, I find myself wondering if my why can be accurate or, at best, just a random grab at plausibility.

So rather than articulate something that can only be temporary and incomplete, because I am  always changing my mind, I am more attracted to the thinking of Psychologist, Dr Jordan Peterson [1] who suggests;

Think, learn and talk & get yourself strong enough so you can stand up for what you think is true - thats not what is true because what the hell do you know? You don't know a damn thing - everything you say is gunna be stupid but you have to say it in order to be corrected and maybe you won't be so dumb and then maybe other people wont be either and we can muddle through a little longer without having everything fall apart.

This forum provides an opportunity for me to frame myself up as an expert. But i would rather not. Not because I am modest, the humility I muster does not come easily. After 20 years in the injury support arena I find myself easily seduced by the idea that I am an expert. What a comfortable little space that is. It takes considerable cognitive effort to keep raising doubts and remind myself that i am a student. Conveniently in this endeavour, I am also a father, a role that provides a fertile environment for raising awareness of ones fallibility and biases.

Daniel Kahneman [2] ponders;

The puzzling limitation of our mind: our excessive confidence in what we believe we know, and our apparent inability to acknowledge the full extent of our ignorance and the uncertainty of the world we live in.

And, as if it is not interesting enough that we are largely overconfident, it seems that, even when presented with explicit evidence that we are overconfident, we remain overconfident.

So with my fallibility and overconfidence in mind I submit my thesis for scrutiny.

I feel like we are missing an opportunity.

My thesis is that by caring for people authentically, not only do we support their recovery, but we can strengthen their relationship with their work, with their colleagues and with their employer.

Injury management tends to be treated as a cost control exercise. I wish I had a dollar for every time I have heard words to the effect that.

The workers health is of course, our main concern, but, you know (*tortured facial expression with paternally raised eyebrows*), we also have to have a commercial focus.

IIt is a comment that seems to arise when the list of unknowns grows beyond an organisations comfort zone. It is the beginning of binary and pejorative narrative that reveals a disconnect between an organisations espoused values [3], (often words to the effect of people being their greatest asset) and the underlying assumption that commercial considerations are somehow incompatible with a colleagues wellbeing. The disruption surfaces the underlying assumptions.

This narrative reveals how our thinking can become infected by the anthropological assumption that people are cogs in the wheels of a commercially focussed organisation, it allows us to wind back support. It allows for dehumanisation.

I have also heard the ubiquitous argument that good injury management leads to lower premiums and, the prevention is better than cure trope, continually expressed as truisms. But I worry that these are close cousins of the commercial focus theme. I understand both but my observation is that they fertilise attributions with a dehumanising trajectory in the form of trendy reductionist interventions and narratives.

Having made this point, I want to be explicit. A commercial focus and/or a preventative emphasis are not to be dismissed. I am just suggesting wariness about what comes next.

For example;

When the school principal started the conversation with the caveat that, you know me James, you know me to be a caring and compassionate person right?, I could not help thinking of the ubiquitous precursor, no offence, but, that so often precedes a gratuitous insult. And then, the third party report that the worker had been seen at a bbq, laughing and socialising and clearly, in no pain at all. My response, which suppressed my intuitive reaction, was tempeiI do not want this to sound patronising, I stumbled. Go ahead, I was encouraged, speak your mindOk, I started, how do we measure someone elses pain experience? The response was reflexive, oh I know, of course, yes, as we nodded and bonded over the greyness. But we both knew a suppressed assumption had surfaced. That easy oversimplification that allowed plausibility to trump [4] accuracy - had been put on the table.  Can you be sure his injury is genuine? I was asked of a man who has devoted the last 13 years of his career to working with teenagers who have been rejected by mainstream high schools. How can we tell hes not trying to secure a non-teaching role? I was asked of a man who had had his forearm jammed in a door by a violent student and had subsequently had surgery and has not ridden his beloved surfboard for more than a year. A man who has not been able to enjoy his holidays and is fearful of recurrence in an unpredictable and volatile environment where the police are on a first name basis with the staff.

The discussion about suitable duties was equally as frustrating and familiar. After doing my best to prime a busy school principal by using the word creative several times. After doing my best to emphasise the unique skill set of a man who has spent his career anticipating violent outbursts and distracting and encouraging and listening to rejected teens, I posed the question, how can we utilise this mans special skills in an outpost where staff have been seeking him out to help them problem solve during his theoretical absence? The answer, sadly, demonstrated and confirmed Ken Robinsons lament [5] that schools and educational institutions value a structured, industrialised routine over creativity. We will have to carry him, he said.

Nassim Taleb [6] speaks of anti-fragility. He asks the question, what is the opposite of fragile? The most commonly anticipated response is robust? Robust is a word that is often used to describe an organisation with good systems or a person who is strong.

But Taleb is not satisfied. He asks what if the opposite of fragile is something, or someone, that / who gets stronger as a result of being damaged or hurt. This is not a new concept, just a new word - antifragile. We love to talk about personal growth in response to adversity. A broken bone invokes a physiological response that lays down more bone at the fracture site. Muscles that are challenged and stressed become stronger.

In fact he takes this further;

Taleb [7] looks at modern society with a critical eye. He examines how it intends to smooth out life by interfering in massive systems like the economy. Taleb argues that this interference does not make society a better place but that it actually destroys the volatile environment that is essential for antifragility.

Taleb argues for an evolutionary paradigm. Where volatility ensures mistakes. Where mistakes provide the stimulus for learning, growth and creativity. When we are paralysed by our fear of mistakes, or pre-occupied looking for someone to blame, the opportunity for learning, growth and creativity is diminished. The opportunity is missed.

When people are injured at work their lives are disrupted. The fear of the unknown looms large.  When we care for them authentically they notice. When we care for them to care for the premium I think they notice that too. Authentic care can be transformative, it can make them stronger. It can inflate their discretionary effort, their sense of belonging and their self-efficacy. And it can impact the carers too. I was heartened to hear an insurer recently state that they have given their claims managers permission to care.

Injuries provide us with an opportunity to care. And by care I mean genuine interest. The interest we show, and it has to be authentic, is inadvertently therapeutic.

[1] https://www.youtube.com/watch?v=DAncrmE6YV0

[2] Kahneman, Daniel Thinking Fast and Slow

[3] Schein, Edgar H., Organizational Culture and Leadership (2010), John Wiley & Sons, San Franscisco

[4] How apt is the word trump in this phrase?

[5] https://www.youtube.com/watch?v=iG9CE55wbtY&t=57s

[6] Taleb, Nassim Nicholas (2012) Antifragile: Things that gain from disorder. Random House, USA.

[7] from Summary of Antifragile: Things That Gain from Disorder by Nassim Nicholas Taleb|Key Concepts in 15 Min or Less

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