What’s wrong with the scenario outlined in my previous post about taking a medical leave for job stress?

Most consequentially, –the protective aspect is simply too appealing.  All too often in my practice I have seen stressed patients go from one doctor to another in search of that all-powerful prescriptive demand:  Time Off Work Due to Stress.

What seems to function best is to visit a walk-in clinic where the doctor doesn’t know the patient, or obviously, the circumstances of the worker’s problem, but where the physician, after listening to the emotively displayed symptoms of stress or depression, is willing to help by providing a note.  The worker’s relief is palatable.  The stressed person seems to be saying:  “At last, someone understands, someone is on my side and someone can grant me salary-continued relief from the source of my stress. “

Forgotten is that the doctor knows little about the client’s working environment other than what he or she is told by the patient.   In reality, the doctor’s decision was shaped by a worker’s prior decision to seek relief.  The more cosmic irony is that almost a quarter of the worker’s colleagues, maybe even his boss, is suffering from as much stress.  If sufficiently motivated, they too could be at the doctor’s office asking for a similar note.

Many do exactly that, as witnessed by the epidemic of stress-related disability claims in recent years.   Insurance companies who pay the disabled employees salary over the disability period are suffering. To cope, many insurance companies have begun to question the validity of the distress.  Regrettably, the rules governing validation are again medical, specifically; does the claimant have a bona fide psychiatric diagnosis.  In other words, are the specific criteria, as outlined in the Diagnostic Statistical Manual for Mental Disorders, being met?

As a result, the validation of a disability claim often moves to an adversarial climate where employee is fighting his or her own employer while being judged by a newly created band of medico-legal experts providing so-called “expertise.”  Baril has made reference to one company in Quebec where over 70% of the claims are being questioned.  Of course, the worker reacts to this questioning not with academic interest as to how many of the DSM criteria for anxiety or depression are being met, but with anger and hostility that he or she is not being believed.   The break in the implicit contract between employee and employer sometimes far outlasts the actual duration of the disability.

I’ll talk about how the system can be improved in my next post