The phrase “workplace injury” typically conjures a physical ailment—a back injury, a laceration, a respiratory illness—but there’s another, often overlooked consequence of on-the-job injuries that can affect both employees and a company’s bottom line: depression.

1. The phrase “workplace injury” typically conjures a physical ailment—a
back injury, a laceration, a respiratory illness—but there’s another, often
overlooked consequence of on-the-job injuries that can affect both

2. employees and a company’s bottom line: depression.
According to the Centers for Disease Control and Prevention (CDC),
depression “is one of the leading causes of disease or injury worldwide for
both men and women,” with a resulting total economic burden in the
United States of $210.5 billion in 2010. CDC’s National Health and
Nutrition Examination Survey indicated that between 2009-2012, 7.6
percent of Americans over the age of 12 struggled with depression, and
nearly 43 percent of those who suffered from severe depressive symptoms
also experienced “serious difficulties in work, home and social activities.”
The workplace is clearly not immune from the effects of depression. CDC
stresses that depression can lead to loss of work, absenteeism and lower
productivity, and it may also put individuals at greater risk for substance
abuse, smoking or other mental disorders. A study published in the
Journal of Clinical Psychology revealed that depression resulted
in workplace-related costs exceeding $51 billion in the year
2000[i].Depression presents additional challenges for employees who have
suffered an injury in the workplace. In fact, the aftermath of an on-the-job
injury may create circumstances that can lead to depression—all of which
can impact workers’ compensation and an injured employee’s transition
back to work.
The Injury-Depression Connection
A serious workplace injury can upset multiple aspects of an employee’s
life. According to Lawrence Raymond, MD, Medical Director,
HEALTHWORKS Division, Carolinas HealthCare System, injured
employees experience not only loss of functional capacity at work, but
disruptions to income, home life and hobbies. If that worker is also in
chronic pain, the risk for depression is further worsened. As a result,
depression can put strain on the workers’ compensation system.

3. “Depression is likely to prolong the [worker’s] disability and the costs
associated with that injury,” Dr. Raymond says. “Depression in and of itself
is also a risk factor for low back pain and smoking. And then there’s the
issue of presenteeism, in which a depressed worker comes to work, but his
or her productivity is impacted. This, in turn, may spill over to other
workers and influence their productivity.”
Despite the potentially far-reaching effects of depression, treatment for
depression that manifests as a result of on-the-job injury might not be
covered by workers’ compensation benefits. If that’s the case, employees
who suffer from depression may be less likely to receive either medication
or cognitive therapy—and a lack of appropriate treatment could result in a
longer time away from work or impacted performance once they do return.
To avoid these complications and ensure injured workers can make a
smooth transition from workers’ compensation back to a normal work
routine, employers must take proactive steps to address depression in the
workplace.
Workplace Prevention and Intervention
Dr. Raymond stresses that employers can do one simple thing to help
identify and prevent depression in the workforce: pay attention.
An observant, attentive supervisor may be able to identify a potential
problem and take appropriate action, such as making a referral or asking
the worker if he or she needs help. Dr. Raymond advises employers to be
on the lookout for the following warning signs, especially in the cases of
injured employees who have recently resumed work: difficulty adjusting
after returning to the workplace, changes in appearance or attention to
grooming, appearing listless or sad, a decline in productivity or struggles
with timeliness on the job.

4. “Problems in these areas are pretty big tip-offs,” Dr. Raymond explains.
“Even a supervisor not medically trained would pick up on those signs. In
an ideal case, there would be an adjunct form of therapy available to all
workers through an employee assistance program (EAP), but smaller
employers might not have access to that. Either way, a savvy supervisor
should size up workers returning to the job to determine if depression is
part of the picture.”
But supervisors needn’t wait for the injured employee to return to work
before taking action. Dr. Raymond advises supervisors to gather other
workers in advance to explain the situation and ask everyone to keep an
eye out on the returning worker. This strategy allows employees to look out
for one another and assumes the employee has given the supervisor
permission to let coworkers know relevant information about the reason
for their absence.
“This is a worthwhile intervention,” Dr. Raymond says. “It demystifies the
process.”
More generally, providing education surrounding depression in the
workplace can head off future problems. Dr. Raymond applauds employers
who host “lunch and learn” sessions to bring physicians, physical
therapists or mental health professionals into the workplace to discuss
health issues with staff. Such programs can help erase the stigma of mental
health illness, prevent fear avoidance among injured workers and generally
help all staff look out for signs of depression—a process that helps ensure
the workforce is less inclined to stigmatize a depressed worker, whether
that worker suffered an injury or not.
Programs like Carolinas HealthCare System’s Mental Health First Aid
training offer free support to employers who are committed to addressing
depression among their workforce. Mental Health First Aid, a national
program that HEALTHWORKS has adapted for the Charlotte, N.C. area,

5. Source URL: http://www.ehstoday.com/sponsored/effects-depression-workers-compensation
trains staff to identify risk factors and warning signs surrounding mental
illness and addiction, outlines strategies for coping with crisis situations
and provides information about where to turn for help.
This type of intervention can help ensure an injured worker is best
equipped to recover and resume a healthy and productive life—both at
work and at home. Depression doesn’t affect workers in a vacuum, after all,
so employers need to be invested, aware and ready to reach out.
“Be in touch with the worker. If he or she cannot return to the workplace,
don’t lose touch,” Dr. Raymond advises. “Make a phone call or a house call.
Don’t let the worker feel uncared for, because the workplace is a very
important part of life.”
To learn more about workplace health, visit
CarolinasHealthCare.org/EmployerSolutions .
[i]“The Economic Burden of Depression in the United States: How Did It
Change Between 1990 And 2000?” Journal of Clinical Psychiatry. Dec
2003; 64:1465-75. https://www.ncbi.nlm.nih.gov/pubmed/14728109