The News You Need for Dec. 31
The mental health of remote workers is still a challenge for employers and a New Jersey case.
Supporting Employee Mental Health in a Remote Work Era: Lessons for Workers’ Compensation
HR Homeroom
The COVID-19 pandemic redefined workplaces globally, accelerating a shift to remote and hybrid work environments. We are approaching 2025, almost five years since organizations were rocked by a pivotal trajectory, changing everything we thought we knew about the workforce and organizational development. While offering flexibility and convenience, remote work introduced unique challenges, particularly regarding employee mental health. This shift has changed the landscape for employers and workers, with mental health challenges becoming a central focus for maintaining productivity and well-being. Addressing these challenges is not just a reactive measure but a proactive strategy that empowers employees and sustains organizational growth. It's a shared responsibility that we must uphold as professionals in the workers' compensation industry, HR managers, and organizational leaders. By addressing mental health concerns proactively, we can foster healthier, more resilient workplaces.
Understanding the Impact of Remote Work on Mental Health
The pandemic forced a rapid transition to remote work, leaving many organizations unprepared to address its psychological ramifications. According to a 2021 study by the American Psychological Association, three in five employees reported experiencing negative impacts of work-related stress due to remote work dynamics. This stark reality underscores the need for organizations to reassess their approach to workplace mental health. Understanding the specific challenges of remote work, such as isolation, blurred boundaries, and communication difficulties, is crucial for developing effective strategies that support employee well-being. These issues often compounded existing mental health challenges, creating an environment where stress and burnout became prevalent. For workers' compensation professionals, these challenges underscore the importance of understanding how mental health affects employee recovery, engagement, and overall well-being. Remote work amplifies stressors, making adopting holistic workplace wellness essential. Recognizing the interconnected nature of physical and mental health in the workers' compensation journey is critical to improving outcomes for injured employees.
Key Challenges in Remote Work Environments
Isolation and Loneliness: Remote employees often feel disconnected from their peers and the organizational mission. This lack of connection can lead to feelings of anxiety and depression, which negatively impact job satisfaction and overall well-being. For employees recovering from injuries, this disconnection can hinder emotional recovery and delay their reintegration into the workplace. Addressing these feelings requires intentional efforts to build virtual connections and foster a sense of belonging within the team.
Blurred Boundaries: Without clear distinctions between home and work, employees struggle to "turn off," resulting in overwork and burnout. This lack of separation also affects injured workers who need rest and recovery time but feel pressured to stay accessible. Employers must set boundaries and encourage employees to define work hours that allow for personal time and recovery. Establishing these boundaries reinforces the importance of work-life balance and helps prevent long-term mental health issues.
Collaboration and Communication: Relying heavily on digital tools in remote settings can lead to fatigue and misunderstandings. Miscommunication in remote environments can exacerbate conflicts and decrease efficiency, making it more difficult for employees to feel supported. Effective communication, a cornerstone of the workers' compensation process, becomes even more vital in such environments. Prioritizing clarity and regular interaction fosters a collaborative and supportive atmosphere.
Strategies to Support Mental Health Through Organizational Policies
Offer Structured Mental Health Days: Employers should encourage employees to take mental health days without stigma. Structured mental health days allow employees to recharge and address personal challenges, improving well-being and productivity. Organizations can schedule these days to ensure they are accessible and used effectively, promoting a culture that values self-care and holistic health. This approach also reduces burnout and supports sustained engagement across teams.
Provide Flexible Work Schedules: Accommodating individual needs through flexible hours can enhance work-life balance, particularly for employees recovering from injuries. Flexibility allows employees to adapt their schedules to manage personal responsibilities while remaining productive. This approach fosters trust and demonstrates the organization’s commitment to employee well-being, making it a win-win for both parties. Tailoring schedules to individual needs helps prevent the stress associated with rigid workplace expectations.
Ensure Access to Counseling and Wellness Programs: Organizations should integrate mental health support into their benefits, including access to counseling, wellness programs, and mental health apps. These resources empower employees to prioritize their mental well-being and provide them with tools to navigate stress. Making these programs easily accessible reinforces an organization's commitment to supporting employees' mental health. Employers can encourage participation by actively promoting these resources and normalizing their use.
Leveraging Technology for Connection and Support
Regular Check-Ins and Team Meetings: Structured virtual meetings maintain transparency and collaboration. These check-ins offer employees opportunities to discuss challenges and share updates, fostering a sense of inclusion. For workers’ compensation claims teams, these meetings provide a platform to address concerns, celebrate progress, and reinforce team cohesion. Leaders can use these interactions to gauge employee well-being and adapt support strategies accordingly.
Virtual Social Opportunities: Incorporate "happy hours" or team-building activities via digital platforms. These events encourage informal interaction, helping employees bond and reduce feelings of isolation. Virtual activities can include games, trivia nights, or shared interests to create a sense of camaraderie among remote teams. Such opportunities bridge the gap between professional and personal interactions, enhancing team dynamics.
Training on Digital Tools: Provide comprehensive training on remote work technologies to minimize fatigue and improve efficiency. Ensuring employees are comfortable with these tools is crucial for their productivity and mental health. Training sessions should also address best practices for managing digital workloads and maintaining focus. By reducing frustration with technology, organizations create a smoother, more supportive remote work environment.
Cultivating a Supportive Culture in Workers' Compensation
Train Leaders in Empathy and Mental Health Awareness: Managers should identify signs of stress and burnout, especially in injured employees navigating recovery. Empathy-driven leadership fosters trust and resilience, encouraging open communication about challenges. Training leaders to address mental health proactively helps create a workplace culture that values employee well-being. Leaders who model empathy set a standard for others to follow, strengthening organizational culture.
Promote Work-Life Balance: Encourage boundaries, such as logging off after hours, to prevent overwork. Organizations can reduce burnout and improve overall job satisfaction by supporting employees in maintaining a healthy balance. This balance is especially important for claims professionals managing high caseloads, who are at risk of overextension. Clear policies prioritizing work-life balance demonstrate the organization's commitment to sustainable work practices.
Encourage Feedback and Open Communication: Provide anonymous surveys and open-door policies to understand employees' needs better. Transparency strengthens trust and collaboration, ensuring that employees feel heard and valued. Encouraging feedback also helps identify areas for improvement in workplace policies and support systems. Organizations that act on employee input reinforce a culture of continuous improvement and mutual respect.
Measuring Success and Enhancing Well-Being
Monitor Employee Wellness Metrics: Track absenteeism, turnover, and employee satisfaction metrics. These indicators help identify areas for improvement in workplace culture and highlight the effectiveness of mental health initiatives. Regularly reviewing these metrics ensures that strategies remain relevant and impactful. Organizations can use data-driven insights to make informed decisions about resource allocation and program development.
Assess Claims Management Effectiveness: Evaluate how mental health initiatives impact claims outcomes, including recovery rates and employee satisfaction. Analyzing these outcomes provides a clear picture of the program's success and areas for enhancement. Strong claims management processes prioritizing mental health contribute to improved recovery experiences and organizational efficiency. This assessment aligns mental health strategies with broader organizational goals.
Solicit Employee Feedback: Regularly seek input on wellness programs and adjust strategies based on real-world needs and outcomes. Feedback ensures that programs remain relevant and responsive to employee concerns. Encouraging open dialogue about mental health initiatives reinforces trust and engagement among teams. Incorporating feedback into program adjustments demonstrates a commitment to continuous improvement and employee well-being.
Adapting Lessons to the Workers' Compensation Industry
Transitioning to remote work has taught us the value of proactive mental health strategies. In workers' compensation, these lessons extend beyond office dynamics to the injured worker's journey. By addressing mental health at every stage—from pre-injury planning to post-claim recovery—we can create a more compassionate, effective system. Recognizing remote work's unique challenges is essential for building a resilient workers' compensation framework. As we integrate these lessons, it is important to realize that mental health is a collective responsibility. Employers, managers, and employees must collaborate to build resilient, supportive environments prioritizing well-being. This approach improves outcomes for the workers' compensation sector and reinforces a culture of care and respect. Together, we can ensure that mental health support becomes a cornerstone of modern workplace practices, benefiting employees and organizations.
N.J. Top Court Applies Exclusive Remedy Rule, Policy Language to Find No Duty to Defend
Case File
The Garden State's exclusive remedy rule along with policy language prevented a contractor from enforcing a duty to defend against its insurer. Simply Research subscribers have access to the full text of the case.
Case
Rodriguez v. Shelbourne Spring, LLC, No. 089044 (N.J. 12/12/24).
What Happened
While on the job, a worker for an electrical contractor opened an electrical panel on a breaker and injured himself. The worker initially filed a petition for workers' compensation benefits, and the contractor's insurer complied with its contractual obligation and processed the petition.
After the worker began receiving workers' compensation benefits, he filed a personal injury complaint seeking money damages for his workplace injuries and named the contractor as a defendant.
The insurer disclaimed an obligation to provide a defense, determining that the policy excluded "any obligation imposed by a workers' compensation ... law."
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The contractor filed a third-party complaint against the insurer, alleging that the insurer wrongfully disclaimed defense coverage. In response, the insurer filed a motion to dismiss, which the trial judge granted.
After its motion for reconsideration was denied, the contractor appealed and Appellate Division affirmed, prompting the contractor to appeal to the New Jersey Supreme Court.
Rule of Law
A duty to defend arises from an insurer's contractual obligation on the language of the insurance policy, and an insurer is contractually obligated to provide the insured with a defense against all actions covered by the insurance policy.
Additionally:
+ A duty to defend comes into being when the complaint states a claim constituting a risk insured against, regardless of the claim's likelihood of success.
+ A duty to defend will arise even if the claims are poorly developed and almost sure to fail, so long as they comprehend an injury that may be within the policy.
+ Liability of the insured to the plaintiff is not the criterion for a duty to defend; it is the allegation in the complaint of a cause of action, which, if sustained will impose a liability covered by the policy.
+ Whether an insurer has a duty to defend is determined by comparing the allegations in the complaint with the language of the insurance policy. When the two correspond, the duty to defend arises, irrespective of the claim's actual merit.
+ An insurer has no duty to defend against a claim that measured by the pleadings, even if successful, would not be within the policy coverage.
Regarding the role of workers' compensation benefits, in New Jersey, as in other states, workers' compensation is the exclusive remedy for injured employees who qualify under state workers' compensation law, with the only exception being injuries caused by intentional wrongs for which an employee may seek redress under common law causes of action.
The test for determining when an employer's conduct rises to the level of an "intentional wrong" was spelled out in Laidlow v. Hariton Machiner Co., Inc., 790 A.2d (N.J. 2002):
(1) The employer must know that his actions are substantially certain to result in injury or death to the employee.
(2) The resulting injury and the circumstances of its infliction on the worker must be: a) more than a fact of life of industrial employment; and b) plainly beyond anything the legislature intended the Workers' Compensation Act to immunize.
Additionally, the Laidlow case detailed that an intentional wrong is not limited to actions taken with a subjective desire to harm but also includes instances where an employer knows that the consequences of those acts are substantially certain to result in such harm.
What the New Jersey Supreme Court Said
According to the Garden State's top court, the trial judge mischaracterized the worker's argument as "specifically and solely" amounting to a Laidlow claim. Looking to Van Dunk v. Reckson Associates Realty Corp., 45 A.3d 965 (N.J. 2012), the court noted that the "'dividing line between negligent or reckless conduct on the one hand and intentional wrong on the other hand must be drawn with caution' to avoid employees finding a loophole to the Act's exclusivity bar."
In the worker's case, his negligence, gross negligence, and recklessness claims were limited by the Workers' Compensation Act's exclusivity bar.
So Was there a Duty to Defend?
The insurer did not have a duty to defend the contractor, according to the New Jersey Supreme Court, because money damages for negligence-based tort claims did not fall under the policy language, “benefits ... required by a workers’ compensation law,” which instead included recovery of medical benefits; death benefits for dependents; and temporary disability benefits, permanent total benefits, or permanent partial benefits regardless of fault.
"[The worker]'s personal injury lawsuit does not seek benefits as defined by the Act; instead, it seeks money damages as compensation for his workplace injuries," the court wrote. "[The worker] already recovered those benefits available under [the policy] for his injury, and [the insurer] satisfied its contractual obligation to [the contractor] by providing [the worker] with those workers' compensation benefits."
Additionally, the court pointed out that policy language specifically excluded from insurance coverage any claims for "bodily injury intentionally causes or aggravated by" the contractor, meaning that the insurer had no duty to defend on the worker's Laidlow claims either.
"In sum, none of [the worker]'s claims -- whether for negligent, grossly negligent, or recklessly indifferent conduct or for intentional wrongdoing -- fall [sic] within the coverage established" under the insurance policy, the court concluded.
Takeaway
A worker's claims of negligence, gross negligence, and recklessness won't be enough to trigger the “substantially certain to result in injury” exception to New Jersey's exclusivity remedies bar.
All New Jersey content on WorkersCompensation.com is brought to you by Horizon Casualty Services.
Understanding Skeletal Muscle Relaxants in Treating Workers’ Compensation Injuries
Skeletal muscle relaxants are a leading category of prescribed medications in workers’ compensation and elsewhere in health care, often prescribed for elderly patients and as “adjuvants” for treatment of chronic pain in patients with overlapping medical conditions and multiple medications.
These are a challenging group of medications to characterize because “muscle relaxant” is a “functional” description of a group of structurally dissimilar substances with differing pharmacologic and side effect profiles. They are used to treat two conditions that contribute to discomfort in workplace injuries—muscle spasticity and spasm. Spasticity is described as increased motor tone and stiffness. Spasms are involuntary localized muscle contractions that arise from acute trauma or muscle strain. Fibromyalgia, low back or neck pain are conditions commonly associated with muscle spasm. While conditions such as multiple sclerosis, spinal cord and traumatic brain injury are more frequently associated with muscle spasticity.
Antispasticity medications act to reduce muscle tone by two means, centrally in the brain or locally, by direct effect on skeletal muscles. Centrally acting agents include tizanidine, gabapentinoids (Lyrica®, Neurontin®, gabapentin, etc.), baclofen, benzodiazepines and riluzole. Direct-acting medications include dantrolene and botulinum toxin.
Many antispasm medications are U.S. Food and Drug Administration (FDA) approved for pain associated with acute musculoskeletal conditions and for muscle spasm. However, their use is generally limited to short treatment periods, as evidence for safety and effectiveness for longer-term use is lacking. Cyclobenzaprine (Flexeril®), methocarbamol (Robaxin®), carisoprodol (Soma®), metaxolone and chlorzoxazone (Parafon Forte®) are examples of these. Many are known to cause central nervous system depression and related sedation and are an additive overdose risk when prescribed in combination with opioid pain medications. Some also appear on the American Geriatrics Society’s Beers List of medications that are inappropriate for use in elderly patients.
The Official Disability Guidelines offer a conditional recommendation for the use of less sedating muscle relaxants as a second line option for two weeks or less in lower back pain and acute exacerbations of chronic back pain. “In most lower back pain cases, they show no benefit beyond non-steroidal anti-inflammatory drugs (NSAIDs) in pain and overall improvement. Also, there’s no additional benefit shown in combination with NSAIDs. Efficacy appears to diminish over time and prolonged use of some medications in this class may lead to dependence.”
The use of muscle relaxant medications may carry substantial risks for drug interactions and side effects. Their use alone, or in combination with other medicines in patients who are elderly, taking other medications or have multiple medical conditions makes careful selection of these agents and vigilant monitoring of their use critical to safe, effective care.
About the author
Cameron is a Senior Clinical Pharmacist for Enlyte Pharmacy Solutions. In his role, he serves in a client-facing capacity as part of the pharmacy benefit Management (PBM) team and is responsible for supporting and partnering with insurers, third-party administrators and direct employers in developing and operationalizing strategic pharmacy initiatives for their clinical programs. Cameron has large retail chain pharmacy experience, and he has worked the past 6+ years within the workers' comp PBM industry.
Cameron is also a regular contributor to the Ask the Pharmacist Series where this article originally appeared.
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