Paper: The stigmatization of injured workers: The construction of "unworthiness" in the compensation process

Author(s) and Affiliation(s):
Joan M. Eakin, University of Toronto
Ellen MacEachen, Institute for Work & Health
Elizabeth Mansfield, University of Toronto
Judy Clarke, Insitute for Work & Health (retired)
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Room: St. David Room, 3rd Floor
Objectives:

Injured workers claiming compensation can experience considerable social "stigma" – disapproval and negative stereotyping - that can be deeply morally discrediting and increase suffering and impede rehabilitation. Our previous research identified a "discourse of abuse" (presumptions of worker bad faith and misuse of the system) surrounding work-related injury, compensation claiming, and return to work, and documented its stigmatizing and disabling consequences for injured workers. This study and others suggest that such a discourse is produced and sustained through societal, legal, and administrative policies, structures and practices. The purpose of this paper is to extend this line of inquiry by reflecting on the stigmatization of injured workers in the light of findings from our subsequent study of front-line service work in a compensation agency.

Methods:

This project investigated, from a sociological perspective, the nature of front-line service work with clients in Ontario’s Workplace Safety and Insurance Board (WSIB). A variety of interpretive qualitative strategies (e.g. discourse analysis, structural-interactionist induction) were employed to collect and analyze data from individual interviews with front-line staff (adjudicators, nurse case managers, employer account administrators, team managers), "go-along" ethnographic observations of daily work practices, and institutional texts (e.g. policies, performance guidelines).

Results:

Work at the front lines is characterized as a "professional assembly line" on which staff mediate the competing accountabilities of the WSIB as an institution (e.g. serving conflicting stakeholder interests) and navigate the difficulties and uncertainties associated with human service work. To accomplish their work in this context, front-line staff engage in strategic "discretionary" and "discursive" practices, some involving the construction of worker "unworthiness". Such constructions are tied to the perceived failure of workers to play the role expected of them, the moral illegitimacy of economic motivation for workers, and the functional administrative uses of unworthiness as a basis for keeping the work process moving and evaluating claims. These and other aspects of the WSIB-client encounter (e.g. telephone based interaction, exclusion of the social and non work-related dimensions of injury) create conditions that can undermine and fracture injured workers’ identity and sense of being understood, and perversely and unintentionally stigmatize them.

Conclusions:

The sources and sites of stigmatization are subtle and deeply embedded in institutional structures and process, and cannot be redressed without systemic change in the occupational health and safety system and in society more generally. Ontario’s WSIB has recently been engaged in serious self-inspection and reform in a promising effort to reduce its own contribution to the problem.