Drunk, Injured, and Fully Qualified for Workers Compensation

In many states, if you get injured on the job and your drunk or using drugs, it is assumed that your injury is a direct result of your being intoxicated or under the influence. Hence, no workers' compensation. Well, South Dakota has a whole new reason to fire up its efforts to get EAPs in every workplace.

You see, the State tried to reverse this doctrine, but the legislature didn't go for it. It said "NO!" When you're drunk on the job in South Dakota and get injured, you still get workers' compensation. Being intoxicated is not relevant, unless the employer can prove it was the direct cause of your injury. You don't have to prove that the drinking or drug use was not the cause of your injury. It's assumed. The State of South Dakota tried to reverse this rule and make injured employees prove the drug or alcohol use were not the cause their injury.

Link to the article: http://www.kxmb.com/News/197227.asp

It is still the burden of the employer to prove that the employee's alcohol or drug use was the cause of the accident. If they can't prove that a drunk or drugging employee's behavior caused the injury (that can be tough) then the Workers' Compensation still pays.

Ouch! So, what is the solution. The answer lies in having decent EAP services with strong core technology integration (integration in my book means integrated within the organization's system, not an EAP mixed with an insurance product) that provide tons of supervisor training and good supervisor referral procedures. Drug testing? Well, what about the alcoholic with a .00 BAL who is hungover and shaking and at greater risk in withdrawal than if was at a comfortable .15 BAL? His belligerence is the gateway to intervention, not intoxication. He won't look, act, or possibly smell intoxicated. In fact he may be the most well-liked, compentent and socially accepted employee in the company unless he's not drinking! Business and industry is still not getting the EAP message. They got the managed care message. The EAP message is still asleep. Or those in control of the EAP message are asleep at the switch. That's us. Me. You. EAPA.

Why are we still talking about these basic issues of EAP theory and the core technology? Why is South Dakota--today--not in the headlines with a massive effort to get EAPs into every business in the State? The rate of alcoholism in the workplace there is enormous because it has a high native American population with biogenetic susceptibility to addictive disease.

Stay tuned to this blog. I am going to discuss new frontiers of the core technology and unexplored galaxies of EAP opportunity. Ever here of something called EAP Behavioral Risk Mapping? Stay tuned.

FREE Workplace Violence Video from Feds (Click Here)

Folks, this is great. You may have missed this FREE resource in between appointments and workplace crises. Your tax dollars are working, it's just you don't always get notified effectively. A FREE training and educational DVD is available from the National Institute for Occupational Safety and Health (NIOSH) that provides employers, employees, safety professionals, and others with information for preventing work-related homicides and assaults.

VIOLENCE ON THE JOB discusses practical measures for identifying risk factors for violence at work, and taking strategic action to keep employees safe. It is based on extensive NIOSH research, supplemented with information from other authoritative sources.

Anyone-- HR manager, EAP, or Occupational Health Professional, citizen---can download the movie in any of several different formats. You can put it on a CD or load it to your Web site, view it online, whatever. You could even email a link to supervisors and employees throughout the company.

"The DVD format offers exciting new capabilities as an engaging, interactive, and effective tool for safety and health education in the workplace," said NIOSH Director John Howard, M.D. "We are confident that this new DVD will help meet an ongoing demand by businesses and employees for information they can use to keep their workplaces safe from acts of violence."

Included in the new DVD are:
A 21-minute training and education program designed to engage a wide variety of workplace audiences.

A bonus video on a program in New York State for preventing workplace violence in state drug treatment facilities. The case study includes discussions by a labor representative and a management representative who were instrumental in developing and implementing the program.

The Occupational Safety and Health Administration’s (OSHA) guidelines for preventing workplace violence in health care workplaces, late-night retail settings, and taxicab services.

Access to additional materials and resources on preventing workplace violence. Here is where to get. (Click the title of this post to reach the NIOSH page.)

Here is where to get it the video. If you can't see the link below, click the title of this post. It's a live link to the video page at NIOSH. www.cdc.gov/niosh/docs/video/violence.html

LINK: http://www.cdc.gov/niosh/docs/video/violence.html

DUI Clients = More Alcoholic EAP Clients

Employees of your company, or the companies you serve may get arrested for drunk driving. How many do you find out about? And how can these employees become clients of the EAP, thereby boosting EAP utilization with every EAP's most valuable client--an alcoholic in recovery?

This year, establish a relationship with your local Alcohol Safety Action Program affiliated with the court. Build a relationship and encourage them to contact you directly when an employee of a company you serve is arrested for DUI. Let them know what companies you serve. You can use the referrals, manage treatment, and these folks will love you for it because they are always swamped. Being swamped and under-staffed means alcohol troubled DUI clients fall through the cracks. If they work for a company you serve behavioral risk continues.

Some ASAP offices will accept the EAP's assessment, recommendations, and with the client's permission, allow the EAP to do the follow-up. Most employees will readily accept a referral to the EAP when the ASAP counselor says, "By the way, we know you have an EAP with your company. The EA professional is so-and-so. We would like you to take advantage of the EAP's services. It's confidential."

The chances are that employees arrested for DUI are alcoholics. (Like you needed to hear that one.) This means your addiction utilization will go up. There is nothing more valuable to EAPs longevity and survival than helping alcoholic employees. Most EAPs don't see as many as they used to, and it is frustrating. As you know, ASAP clients don't usually end up in treatment. Education, yes. Treatment, no. Many get missed, or there is little incentive to deal with the full problem. That changes when you come into the picture.

If these DUI arrested employees do enter treatment through ASAP, it is usually a half-measured attempt that includes no follow-up worth a hoot, failed antabuse use, and the effectiveness of many treatment programs is poor without good follow up. Relapse is virtually certain. Alcoholics, and addicts are the most costly employees on a company’s payroll. So be a hero and start getting these referrals. I've done it. It works.

Call your ASAP office today. Meet to set up a cooperative relationship with staff, and test this utilization improvement strategy.

FIGHTING EAP CONFIDENTIALITY ATTRITION

1. Employees are concerned about confidentiality. That's nothing new. But here's what you might not know: Fear among the workforce that the EAP might not be confidential is a continual and natural force for every EAP and it never goes away. Don't be fooled. Your ethics and confidentiality guidelines are not enough to fight what I call "confidentiality attrition."

2. Confidentiality attrition is the erosion of the "perception of confidentiality" caused by naturally occurring fear and its result: misinformation among employees that the EAP is, or might not be confidential. Confidentiality attrition occurs when EAPs neglect to promote confidentiality frequently, regularly, and non-stop. Confidentiality attrition is a natural phenomenon. The bottom line: Any EAP that does not market and promote its confidentiality boundaries continually will eventually be seen as not confidential by a significant percentage of the workforce -- no matter what the reality.

3. Like a wave coming from the other direction, this perception will overtake your program unless it is fought with marketing techniques that continually communicate confidentiality. To fight the wave you must beat it back, and there is no end to this process. Talk about confidentiality in many different respects - how staff are trained, what laws they follow, discuss informed consent, discuss staff boundaries, releases, and the organization's commitment. Mention confidentiality in your employee newsletter. Look for confidentiality breaches. For example, do your clients meet each other in the main waiting room of an EAP office, or do you have private EAP waiting rooms? Many EAPs are modeled after "therapy offices" but EAPs aren't therapy! Separate entrances and exits help maintain the confidentiality and help market your program by word of mouth. A challenge, true, but do you see the logic in moving toward such a goal?

4. Beyond confidentiality, no EAP staff should socialize with an employee in the host organization who could potentially become an EAP client. This is a critical EAP ethical boundary you won't read about in any EAP manual or book, but you should adopt it. This boundary underscores the unique role of EA professionals in the workplace. Socializing with employees - going to lunch, joining social clubs, attending personal parties and social engagements, hiring blue-collar trade staff from the organization for personal domestic projects, etc. will damage the perception of confidentiality among the workforce. All these things have happened in EAPs we know. These practices alienate employees, disturb the fragile confidentiality boundary, and create dual relationships in conflict with each other that kill EAP utilization. New EA hires should commit to these types of expectations and you should bring them to the attention of other EA professionals to enhance the viability of the EAP profession.

EAP Skill Builder: Before You Hang Up with the Referring Supervisor

Making an EAP assessment go smoothly and completely is always your goal, so when a supervisor phones to consult with you prior to referring a troubled employee, be sure to ask about or address these six issues that are key to an easier assessment:

1) Ask the supervisor to ask the employee being referred to sign a consent for the release of confidential information. Signing a release is voluntary for the employee, but the employee is more likely to be successful in treatment or counseling if a release exists. An employee assistance professional who pops the question of signing a release during the session usually has to explain why and motivate the employee to understand how signing a release is in his or her best interest. You’ll make this part of your assessment easier and quicker if the employee anticipates signing a release before reaching the end of an assessment.

2) Ask the supervisor if he or she has information about the nature of any personal problems the employee is facing. Firsthand knowledge or information shared by the employee with the supervisor becomes appropriate to share. No, this is not asking the supervisor to be an amateur diagnostician, and it does not encourage getting personally involved with the employee. This can save you untold hours of interviewing time in the pursuit of discovering the nature of the employee’s personal problem. Consider this popular checklist for supervisors.

3) Ask the supervisor if this is the first attempt to refer the employee to the EAP and if not, what happened the first time. Was it an informal referral or an encouraged self-referral? This question can help you understand how supervisors view the EAP and how soon they are likely to consider using it to manage troubled employees.

4) Ask for a complete picture of the performance issues, preferably using a checklist. A checklist helps you better prepare for an assessment. It can help you see patterns associated with the personal problem and will aid you in coming to a diagnostic conclusion. It will also allow you to ask more effective questions during the assessment interview.

5) Ask the supervisor what is planned if the employee’s performance does not improve and whether the employee knows about this next administrative or disciplinary step. Recommend to the supervisor that the employee be told what this next step is. This interrupts an enabling pattern and helps the supervisor commit to change, rather than making hollow threats, which causes employees with behavioral-medical problems to get sicker. Committing to change helps the employee feel motivated to cooperate with the EAP and also make commitments to personal change.

6) Calm the supervisor down. Determine if the supervisor is emotionally charged and “involved” in the pursuit of punishment rather than discipline. There is a difference, and the attitude of the referring supervisor can support or sabotage the employee’s progress and motivation. Don’t let the supervisor undermine the helping process.

Musings on Mandatory EAP Referrals

Mandatory referrals indeed do have leverage, but it clearly appears that they are unethical and in violation of EAP practice standards despite their wide-spread use. It is an "elephant in the room" of the EAP field. Although I have not seen EAPA take a stand on this issue (someone correct me if I am wrong) mandatory referrals appear to violate a key principle in the helping professions--client self-determination. EAPs are voluntary in the EAPA standards. A mandatory referral is coercive and contrary to the spirit and intent of the standards it seems to me. Many of my core technologist colleagues agree. I first mentioned this dilemma at the 2002 Boston EAPA Conference. I had no one walk up and disagree. There is a better way to go, and a more powerful approach to motivating a troubled employee to voluntariy accept help.

Forcing an employee to the EAP by stating they have no choice (mandatory) disregards self-determination and it is unethical practice. It is also unethical for clinical social workers to cooperate or promote such a practice—according to the General Counsel of the National Association of Social Workers (NASW). (Based upon a personal conversation I had with her several years ago regarding this practice.)

A firm choice agreement maintains the ethical boundary, yet creates a sense of urgency equal to a mandatory referral--perhaps more--yet it is distinctly different and conforms not only with the core technology but the historical foundation of supervisor referrals as designed originally in occupational alcoholism programs. Firm choice agreements cause employees to act on their own behalf and seek help from the EAP or face consequences for legitimate job performance problems or rule violations--not because of failure to attend the EAP as in the case of mandatory referral. The agreement by the employee to attend the EAP while discipline is held in abeyance, in accompanied by the requirement to participate fully in its recommendations. The quality of the EAP interview with firm choice referrals is infinitely more productive. For these reasons, mandatory referrals are no longer permitted by the U.S. Department of Personnel in civilian government agencies according to its well-followed Federal Personnel Management Directives.

The result of a mandatory referral for an employee is "resentment" and sluggish cooperation at best. At worst, an uncooperative client is created and hate of the EAP is engendered. Use of the mandatory referral also harms and erodes the effectiveness of EAPs and their natural ability to attract employees and remain apart from the disciplinary process. Feel free to have your web site link to this free explanation on mandatory referrals to the EAP that brilliant explains all.