Workcover and the term Psychological Overlay


In the quest to curb costs, the WorkCover system often engages in counterproductive actions or inactions such as delaying care, inadequate care, denial of responsibility and minimization/ downgrading of the injury. Way too often, the depressed injured worker learns that delayed or inappropriate medical care has resulted in a chronic condition, and they are told that this could have all been prevented had you seen a doctor/surgeon earlier, but the (Eg. nerve damage, whatever) is now permanent. The injured worker already felt a sense of frustration, fear, and helplessness, but with that information, they now feel angry and hopeless. In addition to that many WorkCover case managers will take the liberty to fabricate intricate mumbo-jumbo cover letters that are sent to a cherry-picked independent medical examiner, together with some irrelevant medical information. One of the more common cover letters we have seen states that “… it has been alleged that there may be a psychological overlay…“.

Workcover and the term Psychological Overlay

It actually implies being difficult, exaggeration, even malingering and it is a call out to contain costs!

What is the meaning of Psychological Overlay?

Looking at various dictionaries, the term Psychological Overlay actually implies that an injured worker begins to / or is exhibiting increased signs of entitlement and resentment! Essentially this means that the injured worker is seeking (monetary) benefits and it implies that the injured worker should be managed in a way as to achieve the necessary “cost containment”. This can mean looking at denying further surgery, physiotherapy, pain specialists, anything… as the injured worker is “out for monetary compensation” and is seeking “revenge”. Nice one huh!?

Furthermore the term Psychological Overlay, as used by WorkCover insurer’s in their cover letters, also includes being told that the injured worker is “a difficult claimant”, that s/he is being sent to the “worst doctors”, or “wrong doctors” or is trying to settle the case so that money is saved and/or wanting the injured worker to return to work long before truly capable!

Unfortunately for the injured worker who happens to see such a distressing cover letter, s/he may have little in life to offset what has been told to him/her, or to the independent medical examiner. The injured worker is left to ponder why these accusations were made in the first place and whether these accusations will have a negative influence on the independent medical exam. It can be extremely distressing for any seriously injured worker to be accused of a “psychological overlay” (which is a consequence of injury, having to repeatedly prove you are injured and endless banging your head on a brick wall (as in dealing with your case manager). It only adds insult to injury, humiliation to pain, paranoia to permanent impairment / disfigurement and a sense of bewilderment and MORE loss of control.

The injured worker may have no or little other activities other than living a painful restricted life, sitting in doctors’ offices and listening to the complaints of others and hearing their interpretation of their own care. People such as our WorkCover case managers are very free with “advice”, “allegations” and” “insinuations” without regard to its impact upon others – the seriously injured workers.

We like to refer to this allegation as causing “the distrustful injured worker“. The injured worker becomes paranoid to a degree and starts to worry even more.

Perhaps instead of writing such a deceiving cover letter, our WorkCover case managers may want to learn the proper term “Psychological Overlay”, and actually actively prevent it from occurring. Here is a good PPT presentation to get you started.

Strategies for WorkCover case managers include:

  • Increase behaviour that serves the person’s  (the injured worker’s ) best interests
  • Makes it possible to have a conversation and be heard
  • Assist recovery express genuine empathy and specific understanding
  • Create realistic positive expectations
  • Present choices and consequences
  • See yourself as a teammate
  • Walk your talk
  • Make the recovering person feel valued
  • help him/her get a sense of the future
  • Give (more) control to the injured worker
  • Be fair
  • Do you ever hear the words “ I’ve already told you that!”?, Not following through on what you promised? Not returning calls in a timely manner, Unnecessary delay…? Think about it and how it AFFECTS injured workers!

and STOP

  • Treating the injured worker (who is a person) like he or she is “just another client” to you
  • Keep them guessing/don’t commit yourself
  • Make decisions for him or her
  • Show no empathy or common aim
  • Don’t do what you say you’ll do

The bottom line is that one can never compensate for the distortions being fed and fueled by others within the adversarial WorkCover system, including its so-called case managers.