Connecting Health & Productivity

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The WorkRx ®:    A work prescription (WorkRx®) is both a philosophy, as well as a practice.  The WorkRx philosophy and practice affirm that: 

●   Health and productivity are connected 

●   Corporate, employee health and productivity factors can be merged into a practical plan, protecting the short and long term productivity for the employee and employer, alike.


A Corporate WorkRx ®   guides an organization to more effectively control the impact of health and productivity issues within   its work place.  It starts with a corporate plan that organizes and directs its resources. The following suggestions can be incorporated in your organization’s WorkRx ®, offering solutions to common health and productivity predicaments.

   The Unmotivated or Just Stuck?   We are frustrated by employees: with chronic lost time, who appear to be unmotivated or have ongoing health   related job performance problems.

You are certainly not alone.   The employee who looks to be malingering generates a great deal of time and energy by the employer.    All too often the employer assumes a defensive or adversary relationship with this person.   When this happens, adversaries defend, dig in and protect themselves.  No one really wins.


The Motivation Paradox1 suggests that, contrary to the notion that ill or injured people who are unable to successfully return to work in a timely manner are unmotivated, in fact, most are stuck. They are stuck, because they either:

  Don't recognize or know how to solve the health and productivity predicament they are in

  Are fearful of moving forward, or

  Are immobilized by ambivalence and resistance to changing the status quo.


The following individuals are likely to be labeled as unmotivated:

  Individuals whose work disability seems to be exaggerated;

  Extended lost time that is influenced by co-morbid behavioral health impairments;

  Eroding or chronic health problems;

  Frequent or repeat users of intermittent FMLA;

  Individuals with poor job performance prior to the health problem.


Ambivalence and resistance are the central drivers in being stuck. Ambivalence is the push & the pull between ideas, behaviors priorities and strategies. This is the result of competing forces, natural stages of change and is typically below awareness until brought to light.


Resistance is creating & maintaining barriers that protect the status quo (SQ), reduce anxiety related to change or offers a rationale for the present behaviors.  In developing insight, please explore: 1. rewards and losses in the changing the behavior, 2. Calibrate the level of comfort/discomfort is there with the SQ?  To understand what type of resistance is offered Listen for:

§          Yes…. But

§          It is not that important to…..

§          It is not my fault……


Gaining insight to the individual’s ambivalence and resistance to return to work offers a window to:


1. Understand why a person may delay or be unsuccessful in coming back to work 

2. Why an employer may not want an individual back to work 

3. Ultimately how cynicism and an adversary relationship are generated and reduce the effectiveness of stay at work and return to work efforts.


Here are several suggestions that may reduce your frustration with the “Unmotivated”:


·   Review your current performance management process.


Are you disabling poor performers? Are you extending the poor performers lost time?

It is highly likely that your “unmotivated” employee who is on disability claim has a history of poor or eroding job performance.  Research suggests that job dissatisfaction, a high number of supervisors in a short period of time or low job performance becomes a negative influence. Likewise, if the supervisor feels this person is a poor performer, he or she may feel that having the person continue on disability is a good thing.


·   Calibrate the level of presenteeism in your work place


Presenteeism, or lost productivity due to health risks or an emerging medical condition while the person continues to work is a starting point for difficulties in return to work. If you are using a health risk appraisal within your wellness program, it likely has a presenteeism scale. If not please visit the following sites to review the application of the WLQ, Work Limitations Questionnaire or the HPQ, Health Performance Questionnaire.





·   Define the connections between FMLA leave and worker’s compensation and short term disability claims


Excessive use of FMLA (that is > 2 full or intermittent FMLA claims in a six month period) suggests an emerging employee health problem, an emerging family issue or an emerging employee relations conflict.  In either case, the employee will be required to solve a health and productivity predicament.  A common characteristic of folks who appear unmotivated are that they may be unable to solve the predicament they are in.  They are stuck!  


If this is the case, it is worth the time to explore the contributors that maybe reinforcing the lack of moving forward, timely problem resolution or looking disengaged 


A practical benefit strategy is to link the administration of FMLA with your organizations short term disability administration.   Research suggests that integrating such management pays dividends.





Table 1 illustrates this connection.




·   Develop skills in dealing with ambivalence and resistance in dealing with either health related job performance deficits or return to work initiatives


An employer’s occupational health and human resource professionals or a disability manager for a public or private disability, health or worker’s compensation insurer can focus on the client’s ambivalence and resistance by making the following commitments.


Adversary to problem solver   Adversaries make people dig in and defend….Developing a set of skills that are applied in a time sensitive, problem solving focused employer/employee relationship can lead to desirable changes.  The employee is accountable for solving his or her health and productivity predicament.


Recognition is transformational  The recognition of the employee’s priorities and expectations embedded within the ambivalence and resistance to change invites an improved understanding of what is possible and being accountable to solve the predicament


Continuous engagement Reducing isolation creates accountability, consistency and accuracy of information. Correspondingly, continuous engagement creates the opportunity to reinforce incremental success.  Time invested pays off.


Incremental change  Everybody is going somewhere, but, how far, how quickly and are they really ready to go?.. Creating incremental change offers a greater likelihood


Specific clinical skills can be acquired by participating in the WorkRx® Insight Program. Also applying the Judgment Index TM offers the opportunity to calibrate strengths and weaknesses in some 15 return to work indicators.  To consider using the Judgment Index – RTW please go to the WorkRx JI – RTW services