Some injuries are obvious to everybody. A broken leg, a burn, a cut or bruising: to co-workers, supervisors and family members, it makes sense that a worker suffering from a visible injury needs time off work and income support while they’re recovering, or perhaps simply reduced hours and modified duties in the workplace.

Visible injuries are not only obvious, they’re hard to argue with. “Invisible” injuries, however, are another story.

Invisible injuries include:

• Many musculoskeletal problems;
• Mental health problems, including depression, anxiety and other psychological injury; and
• Chronic pain.

Although such problems are common amongst the working age population, employer processes and workers’ compensation systems are not necessarily set up to deal with them successfully.

In fact, workers with invisible injuries are more likely than others to suffer the negative consequences of compensation systems. Why? And what can be done?

Consider the experience of a South Australian worker, suffering from an invisible musculoskeletal problem...

“It is more difficult if you can’t see the injury—people with visible injuries are better off. If you look alright and if the injury doesn’t show no-one takes any real notice. Work is my life and I didn’t want to re-aggravate. I just felt embarrassed.

“There was a definite stigma. Relationships with workmates went through the window and I didn’t tell anyone I had an injury unless I had to. Workmates were supportive at the time of the incident but it wore off i.e. out of sight out of mind. It was stressful to hear them gossip.”

This worker wants three key things from his workplace:

1. To have his injury acknowledged as genuine, despite its invisibility;
2. A safe and speedy return to work; and
3. Support from co-workers and supervisors throughout the process.

However, because there is no visual sign of a health problem, workers with invisible injuries may be more likely to experience:

• Stigma in the workplace;
• Accusations of fraud;
• A lack of sympathy from co-workers and supervisors, who resent having to pick up the slack for a ‘shirker’;
• Multiple medical investigations—for example x-rays and other tests—and non-therapeutic treatments, as health professionals try to get to the bottom of their problem;
• Multiple Independent Medical Examinations (IMEs), during which the worker is obliged to repeat their medical history.

The potentially poor consequences of such experiences include:

• The worker becoming demoralised and unmotivated;
• Psychological barriers to healing develop, because the worker feels they need to prove they have a serious problem;
• Delayed recovery; and
• Process-related injury, where the worker sustains an additional psychological injury, as a result of their experiences in ‘the system’.

Quick solution: Invisibility vision for supervisors, line managers and RTW Coordinators

If those in charge treat invisible injuries as valid, this attitude is likely to permeate the workplace.

Don't make--or tolerate--comments about the injury being "dodgy" or the worker a "bludger", even if these are intended as jokes.

Don't assume that just because an injury isn't visible, the claim isn't valid.

Do handle all claims' investigations with sensitivity. (Our article on stress claims investigations might come in handy.)

Do go the extra mile to  workers with invisible injuries. In fact, we're such a fan of schmoozing that we've compiled a top ten schmooze-a-thon extravaganza. For use with all ill / injured workers, not just the "invisible" ones!

This article was inspired by a conversation with Dr Douglas Ezzy, from the University of Tasmania.

The experiences of the South Australian worker described above are drawn from a 2003 paper by Dr Christine Roberts-Yates, entitled ‘The concerns and issues of injured workers in relation to claims/injury management and rehabilitation: the need for new operational frameworks’, Disability and Rehabilitation, 25, 898-907