Many useful facts and observations come to light in Don DeCarlo and David Torrey’s “Workplace Stress: Past, Present, and Future”, an up-to-date review of stress-related developments in the workers’ compensation sphere. The authors offer a 50-state legal analysis of laws related to first responder claims (i.e. firefighters, law enforcement, emergency workers and others). Here are some introductory selections that we believe will prove insightful.

Modern-day stresses are said to cause accidents, illness, disease, and death; incite marital duress and contribute to the dysfunction of families; promote job dissatisfactions and create other organizational ills. It also has been attributed to an increase in drug/alcohol abuse and mental disabilities ranging from anxiety to paranoid schizophrenia among workers at all levels in all occupations. The cost to the U.S. economy is roughly $100 billion yearly, and that cost is expected to continue to rise.

Dr. Hans Selye [editor’s note: Dr. Selye is internationally regarded as one of the world’s leading authorities on endocrinology, steroid chemistry, experimental surgery and pathology and is often referred to as “the father of stress research” within the medical community] defines stress as the “non-specific” response of the body to any demand made upon it. Stress, generally considered synonymous with distress, was defined as “physical, mental or emotional strain or tension” or “a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.” However, any definition of stress should also include good stress, known as “eustress.” As time passed, Dr. Selye went on to redefine stress as “the rate of wear and tear on the body,” and in the twilight of his career, when asked to define stress, he told reporters, “everyone knows what stress is, but nobody really knows.”

It is important to note that the focus of this book is primarily related to workplace stress which is clearly on the rise. The National Institute of Occupational Safety and Health (NIOSH) lists stress as one of the ten leading work-related problems, and many organizational consultants unequivocally place stress at the top of the list. The American Psychological Association conducted a survey in 2019 to determine stress levels and the main sources of stress for Americans. Among the stressors that the survey tracks each year, work (64%) and money (60%) continue to be the most commonly mentioned personal stressors. These figures are up from the 2017 survey, which had these same two stressors ranked numbers one and two, although inversed with money (62%) listed first, closely followed by work (61%). Frequently cited sources of work-related stress include workload and time pressures, quality of management, relationships with supervisors and coworkers, contact with the public or customers and, among workers in blue-collar and farming occupations, the threat of job loss or change due to economic conditions or technological innovations.

“Stress not only affects employees’
lives away from work, it also impacts
performance on the job.”

According to the American Institute of Stress, “last year, Americans reported feeling stress, anger, and worry at the highest levels in a decade.” So stated Gallup’s State of the American Workplace survey of more than 150,000 people around the world.”

Stress is not only affecting employees’ lives away from work; it’s impacting our performance on the job. The Gallup poll looked at how engaged U.S. workers are in the workplace when stressors are considered. The study found that more than 50% of workers are not engaged at work as a result of stress, regardless of where that stress comes from, leading to a loss of on-the-job productivity. Similarly, a recent survey conducted by Colonial Life showed that 41% of workers say stress has caused a drop in their productivity. Furthermore, stress statistics in the workplace, also reveal that a third of surveyed employees say stress leads to lower engagement levels at work, while 15% say increasing pressure (a form of stress) at work has pushed them to look for other jobs.

It is important that we begin controlling stress factors that are creating psychological disorders in the workplace that manifest in physical and cognitive symptoms that interfere with employee productivity. A study conducted between 2007 and 2017 revealed that mental health and substance use insurance claims more than doubled in that decade.

According to the FAIR Health survey between “2005 to 2014, the total number of hospital stays for mental health/substance use disorders rose 12.2%—the only category of hospitalization that increased in that period.”

In this book’s coverage of workers’ compensation claims, the stress-related workers’ compensation cases may be broken down into three distinct categories.

1) A “mental-physical” claim is one in which a worker has developed a physical disability, such as an ulcer, or suffered a heart attack, due to the mental stress of being on the job.

2) A “physical-mental” claim is made when a person develops a mental disability related to a physical injury suffered while working. Examples of mental disability include depression, anxiety or panic attacks, or a nervous breakdown. A typical case might involve a construction worker who was injured by malfunctioning equipment and developed an insurmountable fear of working with any such equipment thereafter. These physical injury cases are aggravated by things such as conversion neurosis or post-traumatic stress disorder.

3) This category comprises “mental-mental” claims, in which a mental disability results from mental stress on the job. In a mental-mental case, neither the stress nor the disability is easily tied to a physical event or condition of the claimant. Generally, a difficult work environment or work-related experience may result in a mental health diagnosis—a diagnosis which causes significant impairment—preventing the claimant from functioning on a daily basis. For example, employees forced to work long hours in a high-stress environment on a consistent basis, or any employee who has been harassed may develop an anxiety disorder or depression that makes it impossible for them to cope with the daily responsibilities of their job.

What makes the prospect of a stress epidemic even more threatening is that earlier workers’ compensation claims were at least confined to a finite population of workers. Stress, however, is a universal phenomenon affecting all workers at every employer as nearly everyone who works experiences stress on the job. In light of the liberal legal standards that have traditionally applied regarding what is a valid claim under workers’ compensation law, and the societal shift to relax previous claims standards, a much larger group of employees could develop potentially compensable cases on the basis of stress.

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