Stress occurs whenever there is a demand upon an individual's physical or psychological systems. Under normal conditions, stress is considered healthy, necessary (as a motivator), and even sought after (e.g. roller-coaster rides)! However, stress can turn to distress if an individual's capacity to cope with a stressor (something which causes stress) is exceeded.
Reactions to a stressor can be very individual. For example, if a person collapses at work, and two staff members successfully administer first aid, one staff member might find their intervention extremely rewarding and satisfying while the second person could find the event frightening and difficult to overcome. Also, a combination of home, social and work factors can be in the "mix of stressors" present for any individual at any given time.
Thus, the factors influencing a response to stress include the:
- intensity and relationship of the stressors;
- individual's perception of these stressors;
- individual's capacity to respond to them.
The response to stress may be a normal physiological adaptation, or may be manifest in a range of physical and/or psychological symptoms.
WORK STRESSORS
Work stressors may be single or multiple, and may relate to a single event or alternatively actions (or lack of action) over a period of time.
Longer acting stressors can be:
- excessive job demands;
- lack of job control;
- unclear job role;
- lack of skills associated with a higher responsibility to perform;
- management practices;
- personality conflict and bullying.
As a guide, clues to stress may include increased absenteeism, deteriorating work performance, withdrawal, loss of interest, excessive use of coffee, nicotine, alcohol or medicines etc.
CLAIMING COMPENSATION FOR STRESS
The initial reaction of some managers to receiving a First Medical Certificate citing stress arising from employment is anything from shock and disbelief to blaming the victim for their distress. However, the employer has a 'duty of care' to ensure the report is not ignored and to take immediate steps to deal with the problem. Complicating the acceptance of the claim may be the apparent intangibility of the stressor and the fact that other people in the workplace do not perceive the stressor in the same manner as the claimant.
The determinant on the stress claim validity is whether the employee has a disability or disease under the Workers' Compensation and Rehabilitation Act 1981. Several specified circumstances causing stress may be declined in relation to demotion, retrenchment, discipline, transfer or not gaining promotion or reclassification, provided the actions of the employer are not considered to be "unreasonable and harsh".
EARLY INTERVENTION STRATEGY
The decision on the validity of the claim should not be the determinant in the employees return to the work place, but rather the employees fitness for work and the initiation of steps taken to resolve the issues.
From an employer's perspective the best response to a stress claim is to establish a checklist for dealing with the issues
- contact the employee immediately and offer early support counselling through an Employee Assistance Program (EAP) or other means, and mediation for resolution of the issues.
- notify the insurer immediately by lodging the necessary workers' compensation claim forms.
- complete a thorough investigation and discuss with the insurer whether external expertise is required utilising appropriately trained professionals.
- discuss with the insurer whether an opinion is needed from a psychiatrist to determine the existence of a psychiatric condition.
- consider early rehabilitation intervention .
CHALLENGES
The best outcome for the employer is to return the employee as soon as possible to gainful employment. As determination of the claim is made by the insurer, not the employer, it is important that early intervention occur regardless of the employer's opinion on the claim validity.
One of the main challenges faced by employers revolves around funding a return-to-work program prior to claim acceptance. The insurer may agree to provide funding for such a program on a "without admission of liability basis".
Early access to professional treatment may significantly reduce the costs of the claim by providing expertise to treat the employee's psychological condition. The provision of limited funds for the services of a Clinical Psychologist, again on a "without admission of liability basis", can also be discussed with the insurer.
It is not uncommon for employees to have used up their sick leave credits prior to lodging a claim. Investigations should be undertaken when the employer first becomes aware that an employee has been absent due to "stress". If not undertaken in a timely manner investigations can often be marred by poor memory or recollection of events and insufficient documentation.
What can an employer do to minimise opportunities for stress to develop?
- appropriate Human Resources policies and practices (e.g. grievance policies, mutual respect commitments)
- information sessions, promotional material on stress management techniques
- having in place effective workplace change strategies etc.
CONCLUSION
Stress and the illnesses associated with it are increasing. As an aid to risk management employers should develop action plans to reduce their exposure to stress whether or not the illness is compensable.
Ultimately, prevention is better than reaction. Although much research is required, it seems logical to have organisations where there is:
- clarity of employees' roles;
- a job profile that is interesting but not over demanding;
- worker participation in the determination of workplace operations;
- a policy platform that allows for equal opportunity and issue resolution;
- availability of employee support services such as counselling.