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Dynamic Chiropractic – June 14, 1999, Vol. 17, Issue 13

The Supervisor Is the Key

By Paul Hooper, DC, MPH, MS
I have long held the opinion that for many work-related injuries, a significant component of resolving problems lies with the injured worker's supervisor. A number of studies have attempted to demonstrate that the way in which a supervisor manages or deals with an injured worker will have a great deal to do with the recovery, length of disability, and whether or not the worker will even return to work. There is evidence that one of the risk factors for developing chronic problems from a work-related injury is the relationship the employee has with the supervisor. In fact, a negative report from a supervisor is actually considered a risk factor for developing chronic problems.

I would like to use my observations of a recent experience a friend of mine had to illustrate my point.

A couple of weeks ago, I had a conversation with a friend who had recently reported an injury that occurred at work. My friend (I'll call her "Sally") had been having some trouble with her shoulder for a couple of months. She'd seen a chiropractor and been told she had bursitis. She had been treated a few times with various physical therapies and manipulation, including manipulation of her spine and shoulder. She did admit she hadn't been very compliant with the DC's instructions and had missed a number of treatments, but she noted that the treatment had provided her some relief. She had not reported any problems to her employer and did not associate her problem with work. Sally is a clerical worker and spends her day sitting at a computer.

On a Friday, midway through her work shift, Sally reached behind her to retrieve a water bottle (approximately 6:30 p.m.). As she reached for the bottle, a co-worker walked past her workstation. She turned in her chair to acknowledge the co-worker. As she did, her arm hit the side of her computer and her shoulder popped. She experienced an immediate sharp pain in her shoulder. Her co-worker asked, "What was that noise?" Sally responded, "That was my shoulder."

She reported the problem to the supervisor who was currently on duty and asked if she could have an ice bag. He told her that "her" supervisor wouldn't be there for a while and she needed to wait and tell him about her problem. Nearly 30 minutes later, Sally's supervisor appeared, and she approached him. He stated that he was really busy and that she needed to wait a bit. Two hours later, Sally actually got the attention of the supervisor and, at 9:30 (three hours after the injury occurred), Sally was sent to a local hospital for evaluation. If you didn't know better, one could easily reach the conclusion that neither supervisor was too concerned for Sally's condition.

Sally was examined at the hospital and told she had an AC strain. X-rays apparently revealed no degenerative changes or pathology in her shoulder. She was treated with an ice pack and given some anti-inflammatory medication and released. She was referred to an industrial medical clinic for re-evaluation on Monday of the following week. Sally reported back to work later on the day of the injury and was told to go home for the day, which she gratefully agreed to do.

On the following Monday, prior to the beginning of Sally's shift, she was seen in the industrial clinic. She stated that the shoulder was a bit better but still sore. She was asked whether she felt she could do her job and she replied that she could. After all, she sat at a computer all day and was not required to lift or manipulate anything with her shoulder. The doctor at the industrial clinic gave Sally an authorization to return to modified work with no restrictions. Here's where it gets interesting!

Sally reported to work at her regular time on Monday, just three days after the injury had occurred. Since she did not work on the weekend, she had only missed a couple of hours of work at this point. She gave the physician's report to her supervisor, who abruptly informed her that the company did not have such a thing as modified work. He stated that if she couldn't do her job as usual, she would have to stay home and wait until the doctor gave her a complete release. Sally complained that she wasn't scheduled to see the doctor again until Friday and would consequently miss a full week of work. The supervisor stated that was too bad and she would have to live with it.

By the way, I didn't yet mention that the office in which Sally was working was being phased out by the company. The 400 employees in the office had been told that they would be laid off in 90 days and would have to find jobs elsewhere. It's interesting to note that, often during such difficult economic times, many companies find a significant increase in their workers' compensation claims. Reliable employees, who might normally work in spite of a few aches and pains, are more likely to complain about their problems. And frustrated employees, concerned about what the future holds, or angry at the company, may file workers' compensation claims in an effort to either get back at the company or get something from the company.

This wasn't the case with Sally. She had attempted to return to work and was frustrated that she was unable to. Also, Sally had been rewarded by the company each year for the past three years for perfect attendance. She wasn't the type of person who missed work and was proud of her attendance record.

Sally was instructed to return to the industrial medical clinic on a weekly basis for the next few weeks. No treatment was rendered and she missed no more work after the initial week following the injury. Approximately three weeks after the injury, Sally was scheduled to see the doctor at 12:30 p.m. Her work shift began at 3:00 p.m., so she thought she would have plenty of time to see the doctor and get to work on time. Unfortunately, the doctor was running a little behind and she was told that she would not be seen in time to get to work by 3:00. She called work to inform them of her problem and was told that she needed to cancel her appointment and make it to work by her scheduled time or she would be penalized. She consequently rescheduled her appointment for the following Monday, which happened to be the first day of a scheduled one week vacation. Sally was later told by a different supervisor that the problem could have been easily resolved. She was informed that such an occurrence happened all the time and that employees were often allowed to visit their doctor during the work day. Imagine the positive feelings that Sally was developing at this point.

So let's take a look at some of the mistakes the supervisors made:

  1. The first supervisor that Sally approached did not take her problem seriously. He told her to wait for "her" supervisor, who did not appear for 30 minutes. I wonder what would happen if this were a medical emergency?


  2. When she finally got to see "her" supervisor, he was busy. She waited another two hours before being acknowledged. What do you imagine Sally is feeling at this point?


  3. Even though she admitted that she was able to do her job, Sally was not allowed to return to work for a full week. There was no attempt to accommodate her and allow her to do her job. How difficult would it have been for the supervisor to have said, "Sally, you have an excellent record and you are a good worker. Why don't you just pace yourself for the next couple of days. If you have any problems, let me know."


  4. When Sally called in late because the industrial medical clinic was behind schedule, she was told to cancel her appointment and "get to work". She made up the missed appointment on a vacation day. I'm sure that convinced her that the company really cared about her welfare. If there is a workers' compensation attorney in the building, please identify yourself!

I have my own interpretation of this chain of events, but I asked Sally how she felt. She stated that, in all the years she had worked, she never felt like any of her supervisors really cared about the people in their charge. What a shocking statement that is! Do you think they really don't care, or are they just not equipped to deal with the human side of work injuries? Is it a lack of training, or a lack of compassion? Lack of training is manageable. Lack of compassion is another story!

Click here for previous articles by Paul Hooper, DC, MPH, MS.

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