Problem-solving not Diagnosis: Part II Medical Leave


Problem-solving not Diagnosis: Part II Medical Leave

  • By Ian Bradley
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In my prior post, I described the events leading up to a medical leave obtained for psychological reason. In my experience, something strange happens when a medical leave is granted. I would argue from this time forward, the initial workplace issues fade into obscurity.

These causative issues are replaced by a quasi-medical-legal examination about whether the person’s suffering is valid or not.  It’s easy to see why. Disability leaves often draw battle lines. The employee’s doctor, observing only the distress and suffering, easily adopts the role of advocate arguing for a period of rest and recovery away from the workplace. The company, perhaps recognizing faults in the worker or perhaps just in need of the employee’s services, is caught between the worker’s psychological welfare and the need to have a full staff complement.  The disability insurance company, covering part of all of the employee’s salary, seeks a quick resolution.

Instead of focusing on the initial problem, the continued existence of the disability leave is now judged by the legitimacy of the suffering, specifically, whether the employee’s condition has attained the level of a bone-fide psychiatric diagnosis of depression or anxiety.  In other words, is the employee really anxious or really depressed.

The question is debated by medical or psychological representatives of each stakeholder, often with the expert of the insurance company as the final arbitrator.  However, in this quasi-legal process of examinations, medical experts and lengthy reports, there is a cost.

The cost is often increased distress or anger on the part of the employee who is fully aware that the veracity of his or her distress is being examined; the possibility to the distress is being exaggerated or even worse, feigned, is forever lurking. To succeed in this game, the employees must convince themselves and others that they are psychiatric cases.

For many clients, it’s a no-win situation.  They alternate between feeling angry for not being believed or hopeless that now, in addition, to a workplace issue they are also candidates for a psychiatric diagnosis. At this phase, everyone has moved entirely away from the initial problem an examination of the validity of the distress.

I think that things could be different.

The major actors could develop a problem-solving approach. Whether the client is really depressed or really anxious is immaterial.  What is important is the fact that the person is not at work because of a workplace problem.

The central question becomes: how can we get the person back to work This requires moving the question away from a medical debate to a problem-solving approach.

Of course this problem-solving approach means that all the participants-the worker, the boss, the HR department, the doctor and disability consultant from the insurance company – have to work together.  The methods used to aid the return-to-work should be creative, varied and aimed at all any relevant stakeholder.  Increasing the supervisory skills of a boss might be just as important in the process as teaching the employees about stress management skills.  In other words, a problem-solving approach removes the focus on disabled employees, specifically their suffering, to examine all relevant variables that could be utilized to facilitate a successful return to work.

The leave of absence should be used as an indicator of a potential organizational problem.  The solution should focus on the organization its climate, practices and procedures- as much as it does on building the competency and confidence of the disabled worker.