my employee is in obvious pain, but won’t get medical treatment

by Alison Green on February 3, 2025

A reader writes:

One of my employees, “Pam,” has been having pains that I won’t specify for the sake of anonymity. Her condition is degenerative but can be managed quite successfully through physical therapy and occasional steroid injections. I happily made several doctor-recommended accommodations and alterations to Pam’s workspace, at the expense of the company, to make the eight hours a day she spends here more manageable.

Pam went to several weeks of physical therapy sessions, but then stopped going because it turns out physical therapy “isn’t really enjoyable for me” (is it for anyone?). She also stopped the steroid injections, because she hated waiting so long each time she had to go in. She had shown marked improvement and relief while she was being treated, and our insurance plan covered the treatment fully. All this is info that she openly volunteered to me.

Now, for the past three months since she stopped treatment, everyone in our office has been subjected to near-constant moans and groans of pain. The worst is in the morning when Pam shuffles in and groans with every step. Several of her coworkers have come to me saying that the constant groaning is taking a toll on people’s sanity.

I do not know how to handle such a sensitive issue. Pam’s decision to not take care of her very treatable medical needs is subjecting the entire company to misery and lots of eye-rolling.

I answer this question over at Inc. today, where I’m revisiting letters that have been buried in the archives here from years ago (and sometimes updating/expanding my answers to them). You can read it here.

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{ 126 comments }

{ 126 comments… read them below or add one }

  1. Jason*

    While you can’t force someone to get medical treatment you can make the expectations of keeping her job very clear. If she can’t perform because she refuses medical treatment then it comes a different conversation.

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    1. Unpopular_Opinion_Ahead*

      ANNNNNNND if it’s impacting the quality of life/work/being a distraction to those around her. “I’ve had complaints that your visible and audible expressions of pain are making it difficult for others to get THEIR jobs done, PLUS they’re worried about you. How can we fix this?” is how I’d approach it.

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  2. Tom R*

    if this person is in the US it’s possible that the real reason why they aren’t doing the medical treatments is that their insurance isn’t covering enough or have denied her and she can’t afford the copays and deductibles

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    1. Tradd*

      From the letter: “She had shown marked improvement and relief while she was being treated, and our insurance plan covered the treatment fully. All this is info that she openly volunteered to me.”

      Insurance covered the treatment fully, from the letter, per above quote. Insurance not covering the cost was my first thought for the employee’s refusal to continue treatment, but that’s not the case from the letter.

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      1. anonymous here*

        Covered the treatment fully for the number of visits she made.

        BTDT with physical therapy — there may very well be a limit to the number and length of appts for the employee;s condition.

        Same with steroid injections. Last time I went in for a steroid epidural, because I know that while it isn’t terrible now, it will be if not treated ahead of time and I do not want to be back in the hospital again, I was told that, per the insurance company, my pain levels weren’t high enough and I could instead do a trigger point steroid treatment. If that didn’t work, my pain doc could reassess and then request that the epidural be covered. In other words, I couldn’t do the intelligent thing which would save everyone time and money in the long run.

        OP does not know all the ins and outs of the employee’s insurance situation.

        American health insurance. Even a pretty good policy can suck.

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        1. JB (not in Houston)*

          True, but according to Pam, that’s not why she stopped treatment/therapy. She stopped PT because it wasn’t enjoyable and stopped the injections because the appointments were inconvenient. It’s possible that Pam was lying about all that, but nothing we have in the letter suggests that.

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    2. Cookie Monster*

      The LW says: “…our insurance plan covered the treatment fully. All this is info that she openly volunteered to me.”

      Now maybe the situation changed, but we don’t know that.

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      1. LifebeforeCorona*

        Maybe the treatment is fully funded but the problem is the process. When I needed an approved medication I had to pay upfront and be reimbursed later. An extra $300 a month was a stretch. The LW should look into that possibility.

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        1. JB (not in Houston)*

          Maybe, but if that’s the case, then Pam was lying about why she quit. I’m not sure it’s on the LW to look into that being the issue when Pam has already provided a different reason.

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    3. Physics*

      That’s fair! If you were the manager here would you take any steps to make sure that the health insurance was up to par for treating concerns like this?

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      1. Unpopular_Opinion_Ahead*

        But the OP explicitly stated that it was “fully covered” and the reason given for stopping were “I didn’t like it” (paraphrase) and “I had to wait too long” (in the waiting room presumably?). Neither of those is IMHO a reason to discontinue treatment and inflict YOUR distress on other people. I suspect she may be a sympathy junkie. If you’ve never met one, bless you, but there are people who really enjoy moaning and groaning and describing every ache and pain because the “oh you poor thing” and “Oh is there anything I can do/doctors can do” “I’m so sorry you’re going through this” etc… are addicting. Not saying it’s that for sure by any means, but someone who refuses what sound like pretty minor inconveniences for sustained chronic pain definitely has something going on!

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            1. C*

              It’s a take rooted in the assumption that Pam must be, on some level, lying about her motivations – that her real reason for stopping treatment is not the inconvenience or discomfort, but because she wants to milk the sympathy cow for all it’s worth.

              But if we’re going to assume Pam is being disingenuous then we really still don’t know why she stopped treatment. Maybe she has other reasons that you’d agree are good ones, but for whatever reason she considers those reasons to be both personal and private.

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              1. EDIA*

                And what does it matter to Pam? Pam made decisions for herself, not everyone agrees they were to best decisions. That doesn’t have anything to do with the fanfiction of “What if insurance doesn’t cover her case?” And it’s incontrovertibly fanfiction. The LW wrote their letter, and a nonzero number of commenters are responding with “But what if the situation was different?” Completely irrelevant. Useless to LW.

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        2. A. Lab Rabbit*

          Pam sounds a lot like my mother, actually. Refused treatments/stopped treatments even though they were affordable, just so she would have something to complain about to whomever would listen. And now she has no friends.

          I’m not saying that’s happening here, but it is a possibility. But it still doesn’t change the advice given. The impact on Pam’s work and others’ work is the main issue LW has to deal with.

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          1. Dust Bunny*

            I see we are secretly siblings. My mother has landed herself in the hospital several times via neglect of chronic health conditions, and acts surprised when you tell her it’s a problem. She doesn’t remember much of the hospital stays and seems to assume that she is only inconveniencing herself and not, you know–everyone who has to manage everything when she’s there. But she has never liked to answer to authority figures, and that now includes doctors, so she hides her problems from them and from us until she’s incapacitated and we’re forced to take over.

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          2. Anonymouse*

            This is what my grandma did too. Stopped her fully covered physical therapy because it was uncomfortable and eventually lost mobility. I’ve seen this in other cases as well. Some people would rather wallow and suffer than suffer productively.

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            1. Anon for this*

              My dad was like this when I was growing up. He liked to wander around the house groaning dramatically in pain to make a point about how men suffer in silence for their families. It did not seem to occur to him that bellowing like a wounded elephant is not, in fact, silence.

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        3. Liz Bender*

          My initial thought is that the shots and the physical therapy are painful! And that’s why she doesn’t want to do it. She gave some other reasons that may seem flimsy, but physical therapy to mitigate pain, is not an immediate relief, takes a lot of consistent work, and might even make things hurt worse for a bit. The long wait in the waiting room for the shot, if sitting is uncomfortable, that could feel like a VERY long wait.

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        4. MK*

          Unless someone is a masochist , I cannot imagine they would trade constant pain for occasional expressions of sympathy (unless, again, she is exaggerating the pain, which takes it to a mental disorder. However, the issue with treatment isn’t that it’s not enjoyable, it’s that it’s often an added aggravation. From my limited experience with physical therapy, it gets worse before it gets better; I personally only see the benefits during the last sessions and afterwards. And if she has no one to go with her to the doctor, the issue might not be that she, like most people, is bored in doctor’s waiting rooms, but that going there, waiting, getting the shot and getting home is actually a hardship for her.

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        5. NothingIsLittle*

          Are you physically disabled? Because I am. No one in my life believes me about my levels of pain or my treatment decisions. “IMHO” you have no idea what you’re talking about because you don’t actually know the person in question.

          “It wasn’t enjoyable for me,” can mean, “it was too physically painful for me to be able to manage emotionally,” or, “the physical therapist spent the entire session telling me if I would just lose weight I would feel better as though I’m not already trying to do that,” or, “I’m desperately depressed and can’t manage the motivation to do PT.”

          “I had to wait too long,” can mean, “I have a life and responsibilities that can’t accommodate waiting 4 hours past my scheduled appointment time (not an exaggeration, this has happened to me),” or, “the receptions are super rude and loudly complain about the patients in earshot while I’m waiting to be taken back,” or, “they take me back to the appointment room and I wait there, alone, with bad service and my clothes off for an hour and I don’t really want to do that.”

          Have I tried treatments that were more effective than my current ones? Yes! And the side effects nearly killed me. You don’t have a right to discuss someone else’s medical decisions full-stop and if you have a problem with someone else’s expressions of pain your right is to discuss the impact they’re having on you not why the other person is in pain.

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    4. BridgeofFire*

      The LW took that into account. It’s mentioned at the end of the second paragraph.

      “She had shown marked improvement and relief while she was being treated, and our insurance plan covered the treatment fully. All this is info that she openly volunteered to me.”

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    5. Coverage Associate*

      Yeah, typically “fully covered” from an American health insurer means that the treatment was deemed medically necessary. It doesn’t mean that no deductible, co pay, or co insurance applies. My health insurance says my out of pocket costs were over $10,000 for me and my spouse last year, obviously with insurance.

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      1. Physics*

        Yup! That’s how I interpreted it as well. Even when my insurance approves me getting a treatment there is still a co pay or I pay for it until I hit my out of pocket max, depending on the plan.

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      2. Unpopular_Opinion_Ahead*

        No medically necessary, or authorized and “fully covered” are 3 different terms to insurance companies and mean 3 different things. “Fully Covered” means “fully covered by the insurance company” not just approved. I am “fully covered” for steroid injections in my spine every 3 months. I pay nothing. My ER visits are “fully covered”. I pay nothing. For anything NOT “fully covered” I pay a deductible and a co-pay, even those that are deemed medically necessary (e.g. my migraine medications and heart meds. I pay co-pays for those prescriptions).

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        1. Rainy*

          I know we’re supposed to assume the letter writer is correct about facts stated, but I’ve had both American health insurance and a boss before, and the amount any boss I’ve ever had knew about whether our insurance would cover something that they had never had to deal with themselves was MINISCULE. And I’m not throwing shade, just that until you are trying to deal with it you probably have zero idea what it actually looks like.

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          1. Anon in the academy*

            But the LW is not speculating about coverage or basing that comment on their insurance benefits! They say: “our insurance plan covered the treatment fully. All this is info that she openly volunteered to me.” The treatment being fully covered is by Pam’s own account. While I suppose we could decide Pam was misrepresenting the situation to the LW, that seems like a rewriting of the facts.

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            1. HideInTheBushes*

              Also, do we even know if OP and Pam are based in the usa? Everyone talking about american insurance when we don’t even know if it’s a relevant perspective here.

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      3. Typity*

        “Fully covered” is virtually synonymous with “fully paid for” the way most people understand the terms. Very, very few people would say “My surgery was fully covered” if they meant it was approved but they still had to meet a deductible and/or make a co-pay.

        OP was told by Pam herself that the expense was covered, and Pam gave other reasons for not getting treatment. And physical therapy is indeed a boring slog for many people (enjoyment is very far from the point), and nobody likes waiting in doctor’s offices, especially if it’s a regular thing.

        I think it’s very reasonable to take what OP wrote at face value and not deflect to an issue that was not raised.

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        1. Anon for this one*

          I’m one of those few people, then. My current course of chemotherapy is $50,000 a dose billed to insurance. I pay a $35 copay. Damn straight I describe it as “fully covered”.

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      4. Yorick*

        I’m from the US and I would only say something was fully covered by insurance if it cost me $0 or maybe no more than my regular copay for an office visit ($35).

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    6. Rainy*

      Yeah. “Our insurance covers it” comes with a pretty huge asterisk. My last workplace switched to CVS Caremark and my well-controlled asthma became not that well-controlled because I couldn’t actually afford to spend $600 every summer on a supplemental medication that had previously cost about a third that much. My doctor tried to help but CVS kept moving the goalposts–I got prior authorization so it should have been $75/60 days instead of $150/60 days? Too bad, you got prior auth for the medication, but the amount is wrong, you need prior auth for the amount (because the med only comes in 60 day increments). Your doctor filled out the amount auth form? Well, your medication auth is expired, she should have done both, sorry, pay up. Oh, she did the med auth and the amount auth? Whoops, there’s also an INTERVAL auth, we already sent the medication and charged the card on file. You want to remove the card on file? No, sorry, we have it now and you can’t remove it. We’ll just charge you whenever we f’ing feel like it. Too bad.

      When I took a new job and we moved out of state, I’d been working with one of my legislators for over a year to try and get some legislation passed to omit the loophole my employer had found that let them subject us to the tender mercies of CVS. I’m probably on a list somewhere and I don’t care.

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    7. Cloud Wrangler*

      We’re supposed to be taking the LW at their word and not adding made-up scenarios.

      Many people with excellent, fully covered expenses, still ignore medical care.

      Reply ↓
      1. Dust Bunny*

        This. We have a good plan and we’re in a big city with ready access to doctors for virtually everything, and our workplace encourages us to use medical time off, and I still have a few coworkers who basically use the ER for routine care when their various medical concerns get out of hand.

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      2. L.H. Puttgrass*

        Also, we’re all aware that the U.S. health care system is awful. Alison has asked us in multiple threads not to derail on that topic.

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      3. daffodil*

        yeah I can’t believe how many people here have never avoided doing something good for them because it’s hard or unpleasant. Obviously access and cost is the biggest problem with US healthcare, but the soul-destroying nonsense of making, keeping and attending appointments will also take it out of you.

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        1. Bee*

          Even just like. How many people have gym memberships that they pay for and rarely/never use? If you aren’t able to get over the mental+physical hurdle that makes something a habit, “what do you mean I have to keep doing this forever” is a very compelling reason to quit something that’s good for you but you don’t enjoy.

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      4. Pescadero*

        …and many people describe their insurance paying – but having a deductible and copay – as “fully covered”.

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      5. Falling Diphthong*

        Yes. People with the treatment right in front of them have decided it’s not worth it. And I wish I had practical advice to give, but suspect this falls into how you cannot make people do sensible things that would help them.

        In any given PT office, I expect some cartoons about how PT is torture. Like, it’s a running joke for a reason. Also that spurt of incandescent rage when you struggle through the last few reps and the PT says “now ten more.”

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      6. umami*

        My spouse is a home health nurse, and yeah, this is … pretty typical behavior, sadly. There’s little reason to believe that Pam’s care wasn’t at least substantially covered (if you disagree with the statement that it was fully covered) and that she would rather moan and groan than put in the time to fully recover.

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    8. Kay Tee*

      Agreed… while it’s important to believe LW is being truthful (to the best of their ability), I’m not sure we should be so sure that Pam is telling them the whole story. Doesn’t Alison often suggest breezily responding with a half-truth when someone at work is prying into something we don’t want to share?

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    9. The Coolest Clown Around*

      I think the “real reason” is sort of a red herring here – it’s up to the employee to make their own medical decisions, and they don’t owe an explanation to their employer. The relevant facts are that she’s experiencing meaningful pain and that she’s being disruptive as a result of that pain. I agree with Alison that the easiest way to move forward is not to speculate about WHY it is, and just accept it for WHAT it is.

      Reply ↓
  3. Apex Mountain*

    That’s a tough one – what is the answer if the side effects of the steroid injection are worse than the moaning? You can’t force someone to get a specific treatment.

    Can you construct a “Cone of Silence” type of device in Pam’s workspace so at least she can keep the noise to a minimum?

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      1. Physics*

        IKEA sells some sound reducing panels that seem helpful, and maybe those who have been complaining about the noise would want some too?

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    2. This time*

      Yeah I know that Pam said it was the hassle, but often treatments have terrible side effects or issues if you use them long term. It’s possible she didn’t want to talk about those in the office so Alison’s last statement about assuming you don’t know everything was spot on.

      Reply ↓
      1. Unpopular_Opinion_Ahead*

        True, but the OP also said there was marked and noticeable improvement while on the medications. And the employee told her the reasons she chose to quit. She seems pretty open about it so “the side effects were a bit much” doesn’t seem out of line with what she has shared if that were the case.

        Reply ↓
        1. With A Y*

          Steroid can cause liver failure and make one immunocompromised. They have high instances of severe sode effects.

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          1. WellRed*

            But Pam doesn’t like the long wait. She didn’t say anything about worrying about side effects. At any rate, if the pain is that bed the potential for side effects is probably negated by the pain factor.

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            1. The Coolest Clown Around*

              There are a lot of side effects that an employee might very reasonably choose not to share with their employer, or that might prohibit medication use regardless of pain levels, and a polite lie is a perfectly reasonable response to feeling pressured to share medical information. Ultimately, Pam gets to make her own choices about her own body, and the LW will be better off focusing on the specifics of the problem that are within their control.

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        2. NothingIsLittle*

          I am physically disabled with chronic pain. I’ve taken medications where I appeared to be doing well from the outside, but there were invisible side effects like such significant fatigue that I couldn’t be awake for more than 12 hours at a time and I thought those side effects were the result of my autoimmune disorder until another one of my doctors realized the problem started when my medications changed.

          It’s none of your business how someone else decides to manage their health and if you have a problem with their expressions of pain, then you discuss the impact of those expressions rather than the health issues causing them.

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        3. Kt*

          It’s god OP to decide if the benefits outweigh the detriments of a treatment someone else is receiving. Erring on the side of ‘maybe there are things Pam hasn’t shared’ is really the only smart way forward.

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      2. Grumpy Elder Millennial*

        Yup. I did quarterly steroid injections for a while and it tanked my immune system and had some very bad psychological effects. Neither of which I was warned about.

        Reply ↓
  4. metadata minion*

    Just to expand on that last paragraph, it’s possible that Pam is either understating the problems she has accessing treatment, or is assuming she’s being clear when she isn’t. It’s baffling that someone would decide to stop injections that are helping just because she hates waiting (who doesn’t have to wait at the doctor??), but it might be more of a case of “I can’t keep losing an entire day for these treatments between travel and the fact that they’re always running so late”.

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    1. Nonsense pt2*

      When my mom was getting steriod injections, she used to sign up for 7am doctor’s slot because that was the only way to be sure they’d see her by noon. And that was pre-Covid – I can’t imagine how bad it is now.

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      1. Dahlia*

        And if you’re already in pain, a 5+ hour wait in an uncomfortable doctor’s office could take you out for a week. At that point, is the treatment doing enough to make it worth it?

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          1. Dahlia*

            From Nonsense pt2’s comment, where they said their mother would book a 7am appointment and not be seen until 12pm, noon. That’s 5 hours.

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    3. Caramel & Cheddar*

      Re: your last line, I’d be curious how that factors into the company’s sick leave policies as well. A lot of companies make staff take sick leave to attend medical appointments and I can hate why she’d hate using it all up for this if the sick leave allotment is limited.

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    4. Ace in the Hole*

      There are a lot of possible reasons someone might not want to pursue treatment.

      For example, my partner has some medical trauma that makes some usually benign things very distressing for her. There’s a big difference between “physical therapy is an uncomfortable, difficult chore,” and “physical therapy leaves me a sobbing emotional wreck for the rest of the day.”

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  5. Problem!*

    Making the assumption you’re in the US:

    Did she stop going because her deductible reset in the new year? Did you have significant changes to your insurance policy that makes her coverage different? Even with “good” insurance PT is $50-$80 per session if you haven’t met your deductible and if your doctor wants you to go 3x a week for 6-8 weeks that’s a lot of money for many folks. Steroid injections are several hundred dollars a pop. It’s very possible could have been too embarrassed to admit she can’t afford it and made up another reason.

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    1. JP*

      I just went through half a year of physical therapy that was “covered” by my insurance, but my copay was $40 for every appointment. 2-3 appointments every week for six months put a strain on my finances. Not to mention the pain of trying to make up time at work when I was out at appointments. I did make progress, but it was extremely slow. I quit when I was about 85% improved because it was just too much of a burden to keep going.

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      1. Rainy*

        My copay for my new job’s insurance is $25 and it’s the cheapest I’ve had since I lived in a country with a real healthcare system.

        Reply ↓
        1. NotBatman*

          Yes. “Covered” on my old insurance meant I was forking over $110 a month for physical therapy appointments. Hopefully that’s not Pam’s situation, but a) most people are extremely motivated not to be in pain, and b) most people are motivated not to admit to being short on money. So it’s a possibility, for all that OP tried to rule it out.

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      2. Caramel & Cheddar*

        I had a similar co-pay, with the bonus of our coverage topping out at a certain amount that worked out to 6 sessions for me. At twice a week, I had to start paying in full after three weeks. Our HR team would tell you we had great coverage because we had it at all, when many places didn’t.

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  6. cindylouwho*

    As someone who has an illness that is also degenerative and involves chronic pain, these conditions can be incredibly complex. Certain types of therapies that work for others don’t work for me, and even certain types of physical therapy are useless at best and painful at worst. Things that work at first wear off and cause bounce back of even worse symptoms, or have intolerable side effects, etc. I’m curious how/why the LW knows this many specifics about the efficacy of treatment modalities.

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    2. Wendy Darling*

      I’m doing physical therapy right now and it’s super useful for my issue but also VERY unpleasant. Every week my husband asks me how it went and every week I tell him I just paid someone to basically torture me for an hour. I like the results so I keep going, but it’s painful! If the results weren’t SO good I probably would not stick with it.

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      1. MigraineMonth*

        I’ve gone to PT that was painful, but my issue steadily improved over several months until I no longer needed to go. I’ve also gone to PT that was painful, and over several months made my issue worse until I stopped going. I’m not sure how I’d feel about going to PT that was painful, knowing that the issue would never ever go away and all the PT was doing was slowing down the progression. (My uncle is going through this with a degenerative illness, and it’s really tough just to talk to him about it.)

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    3. NotBatman*

      Yep. My friends refer to the “migraine merry-go-round.” Most people are helped by Qulipta… for a few months. And by Botox… for a few months. And by blood pressure medication… for a few months. And by physical therapy… for a few months. And then your doctor apologetically starts you on Qulipta again, because maybe you can get a few more months out of it.

      No idea Pam’s situation, but I’ve ridden that awful carousel with IBS and have a cousin riding it with depression. So it applies to lots of medical conditions.

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  7. NerdyPrettyThings*

    A lot of people don’t want to stay on steroids injections indefinitely. They have some unpleasant side effects. Clearly, for whatever reason, she’s decided she would rather deal with the pain than with the treatment. And who is eye-rolling at someone in obvious pain? Those are your problem employees/humans, not Pam. Sheesh.

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    1. Nonsense pt2*

      Steroid injections are proven to cause/worse deterioration over the long term, which is why most people go off them. That’s obviously not a great combo when dealing with a condition that already causes deterioration.

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    2. Anon for this*

      If she’s choosing pain, she’s choosing pain, but then she needs to not make it a problem for the people around her.

      I would find it very, very distracting to sit next to someone who was making audible noises of pain all day. This is a workplace. People are there to work. If I’m at work and unable to get my work done, I get pretty grumpy with the person who is the source of the distraction.

      It doesn’t seem like Pam is playing any of this close to the vest, judging by how much the LW knows. If I knew that there was a solution, and my coworker was refusing to engage with it, and it was preventing me from doing the work that is the reason for me to be in the office to begin with… yeah, I’m going to lose patience. Such is human nature. And I would not want to be told that I had to just put up with it indefinitely. At that point, either Pam is moving to a private office (the solution offered by Alison) or I’d be asking to move myself.

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      1. hypoglycemic rage (she/her)*

        this would be my thought, too. I would understand and empathize, but only to a point, and only for so long. I’d be way too distracted by someone making noises of pain all day, especially if this has been going on for weeks..

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    3. Dust Bunny*

      She’s not dealing with the pain, though–she’s moaning at every step. I think it’s pretty reasonable for her coworkers to be put off by that, especially since as far as they know–and Pam has not said otherwise, really–there are remedies available and apparently the means to have them paid for.

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      1. My Useless Two Cents*

        At some point the co-workers empathy and good-will run out, hence the co-workers going to OP to complain. At this stage, something needs to be done for everyone’s sake. That may be a private office, work-from-home situation, or employee going on disability (temp or permanent depending on situation). And I applaud OP for trying to figure out the best way to go about doing that.

        Medical issues suck, and chronic one suck more. But employee can’t be moaning in pain all day. If they are in that much pain they really should be on disability.

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      2. NothingIsLittle*

        It’s reasonable for her coworkers to not want to listen to her loudly announce her pain all day. It is not reasonable for anyone but Pam and her doctors to insert themselves into her medical problems. There are a myriad of externally invisible reasons why someone might choose to discontinue a treatment that appears to help them and it is no one’s business but their own.

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    4. Oyo Poyo*

      That was my first thought – long-term steroid injections are not a solution, they are a temp fix until something else can be found. Their long-term effects outweigh the benefits. The LW sounds like she may not fully understand the big picture.

      FWIW I have a degenerative disease and I’d choose pain over steroid shots any day. I would not groan about it, but that’s because personally, I just try not to make a lot of noise.

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    5. DramaQ*

      Human beings are programmed to respond to pain noises, it is part of what makes us a social species.

      While I would sympathize eventually it would probably grind me down to hear constant moaning in pain because I know she’s miserable and there isn’t a dang thing I can do about it but sit here and listen to it.

      And yes to an extent that is my problem but if it is starting to interfere with others getting work done because they are moving to get away from it or are distracted then it needs to be addressed in some fashion. While yes people can be jerks most people’s first instinct isn’t to run to the manager it’s to try to deal with it on their own. The fact they are coming to their manager about it makes me think it’s getting to be a situation of where it is starting to drag down morale.

      I think the office suggestion is an excellent idea. I would bet Pam doesn’t like the situation any more than her coworkers do. Having an office would allow her to have a private place to shut the door if the pain gets to be too much and not feel like there are a million eyes on her as she groans.

      Reply ↓
  8. Three Flowers*

    Folks are bringing up a lot of good points about how Pam might have trouble accessing or sustaining care. However…it does occasionally happen that people just won’t get treatment they can access because they, for whatever reason, don’t want to, and that has an impact on their coworkers. It happened in my office and it was very ugly, very demoralizing, created a lot of work for everyone else, and ultimately lost us a staff line.

    Reply ↓
  9. HonorBox*

    You can’t force Pam to get treatment. You also don’t want to ask too many personal, prying questions. But you can speak to her truthfully about what you’re witnessing and hearing and how it is impacting work. There may be any number of reasonable reasons that Pam has stopped with treatments. But if she’s moaning and groaning and that’s impacting others’ ability to get their work done effectively, you do have the ability to weigh in.

    Reply ↓
  10. Clam Condor*

    I have a people pleaser coworker like this with a severe case of “martyr syndrome”. being unwell is how they get their validation. They’re salaried but won’t take a day off no matter how sick they are.

    Reply ↓
    1. LifebeforeCorona*

      Covid took care of a lot of these people because the cost of coming into work while sick became starkly clear. Sadly, some people forgot those lessons and we’re back to the “I’m sick but I can still work” co-workers.

      Reply ↓
      1. LifebeforeCorona*

        When I say “took care” I meant that it became socially unacceptable to expose other people to your illness in the interest of gaining brownie points for working when you should not be. Not that the martyrs came to a bad ending.

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    2. Greta*

      One of my direct reports can be this way too. Or rather they have FOMO, get bored recovering, or feel unproductive while resting. There were out for a procedure and told to expect recovery to take 4-5 weeks. Guess who begged their doctor to give them medical clearance (with a lot of restrictions until the 5th week) at 1.5 weeks. Sick leave was not an issue as they had more than a month available when they came back. They were improving, but a friend who also works with our company mentioned they still looked like they were in pain when they hung out. But with the medical clearance, we had to scramble to get telework tasks for them to do until the lifting restrictions.

      Reply ↓
  11. Rando*

    Not loving that “awarding” a private office is seen as the way to go here. That seems like it could create a whole different set of problems among the coworkers.

    Reply ↓
    1. Caramel & Cheddar*

      Same. I think I’d have to balance my jealousy at not getting my own office when I could definitely use one vs not having to listen to the moaning, I guess.

      Reply ↓
    2. Throwaway Account*

      Just because i need the mental amusement, I’m picturing a scenario in which all the other employees are crowded into a small office to escape moaning myrtle who is left alone in the cubicle farm.

      Reply ↓
    3. Three Flowers*

      When I went through this, if my Pam-coworker had gotten any kind of apparent reward while I was basically doing their job, I would have been LIVID.

      Reply ↓
    4. MigraineMonth*

      I understand the objection, but sometimes it’s better to solve the problem than to be completely fair.

      I once had an Amtrak train canceled due to mudslides across the tracks and was very glad that the company arranged for a charter bus to the destination city. The others were also making the best of it; a couple of people found the free snacks/water bottles and were going down the aisle pretending to be airline stewards.

      My seatmate was less thrilled; she had a full-on meltdown was literally sobbing into her phone about how she had bought a business class ticket but was now being forced onto a *bus* to sit with “these people”. (Note, this was *not* the inner city; it was a charter bus filled with middle class white people.)

      When it turned out there was a free seat in the town car Amtrak had also chartered, I could have tried to claim it for myself. After all, I had also paid an entire $10 for business-class on the train, and why reward her behavior? Instead, the bus unanimously nominated Crying Lady for the upgrade and we were all much happier for it.

      Reply ↓
      1. Three Flowers*

        I think you’re right in principle, but “get the asshole off this bus we are all stuck in for the next x hours” and “give this person, whom we know is disturbing us constantly when she could solve her problem, a permanent perk we don’t have access to” are two different things.

        Reply ↓
        1. axc241*

          Framing a chronic illness as a “solvable problem” is quite generous. I don’t think anyone really knows for certain if it is solvable. (I think LW thinks they do, but may not have full picture)

          Reply ↓
    5. axc241*

      You can’t have your cake and eat it too. Unfortunately, this may seem like an award, but LW can’t just demand that her worker stop moaning in pain. Given that it (reasonably) bothers the other employees, it’s a fix within legal boundaries. Who gets an office in a workplace isn’t always fair, and thats unfortunate but unavoidable.

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    6. Annika Hansen*

      I worked with a guy who had his own private office despite having title that did not “merit” it. He had an eye condition where he had to basically work in the dark. I decided that even though I would have also liked a private office, I was thankful that I didn’t have that eye condition that necessitated his own office. I think most people felt that way I did.

      Reply ↓
      1. JanetM*

        Some years ago, I ended up in the ER when an innocuous bump on my face suddenly blew up into a draining abscess. A few days later, I got a phone call.

        It was a survey of my ER experience.

        The last question was, “We know a visit to the ER is never pleasant, but is there anything we could have done to make it better?”

        I thought for a moment and said, “Well, in a perfect universe where everything revolved around me, the ER would have been less busy, and I’d have gotten out in two hours rather than six. But I know you triage on the basis of severity, and there is something to be said for NOT being at the top of the list.”

        The surveyor thought for a moment, and said, “That is a very … enlightened … attitude.”

        So, yeah. I get the, “I’m glad I don’t have that need.”

        Reply ↓
  12. I should really pick a name*

    There are already a lot of posts speculating as to why Pam isn’t getting treatment.

    That’s really a red herring.

    The LW has to deal with the current situation which is Pam being loudly in pain. The LW can’t force Pam into treatment.

    Reply ↓
    1. Throwaway Account*

      Exactly. Plus, we believe letter writers (and this OP says it is fully covered and cannot really change the medical plan provided by the employer).

      Reply ↓
    2. MigraineMonth*

      Very good point.

      Consider the case of Mary, who is in pain from her leg and groans all the time. She’s on a bunch of painkillers, doing PT and acupuncture, but it’s still incredibly painful. I understand why Mary is far more sympathetic than Pam. It seems like she’s being proactive and working hard to solve the issue, while Pam just complains. Mary seems like she *deserves* sympathy, while Pam wants more than her share of sympathy, as if compassion is a limited resource that must be earned.

      However, Pam and Mary are both causing the same work problem and should be treated the same. How Pam manages what sounds like a chronic degenerative condition in is her business, and until we’ve groaned a mile in her shoes I don’t think we can say we’d do better.

      Reply ↓
  13. Not The Earliest Bird*

    This could have been written about my Mother. She had a degenerative hip issue, and complained (loudly) for years about it, while only half-assing PT. Finally she gave in and got her hip replaced. At about 4 weeks post surgery, she says “Well, that was easier than I thought, I should have done this five years ago.” No kidding.

    Reply ↓
  14. Melon Merengue*

    I remember when one of my discs herniated and I was in constant excruciating pain for over six weeks. My doctor would only give me muscle relaxants and prednisone, which did nothing to ease the pain. I would come into work and sit on the floor. My boss made it clear I could absolutely work at home but I would have been in just as much pain at home, alone. I wanted the distractions of the office. But I also know that my pain caused a lot of disturbance. In my case my steriod shot appt finally came and my pain lessened. That’s got to be a hard situation, though, when the condition doesn’t resolve. I can see both sides here.

    Reply ↓
  15. Thin Mints didn't make me thin*

    Is it at all doable for Pam to work from home? For that matter, is that an arrangement that can be offered to the whole team?

    Reply ↓
  16. Busy Middle Manager*

    The management answer is: go out to lunch somewhere nice, let her talk. Gently steer her towards some type of solution. She probably has decision paralysis since there is too much information out there and the medical system is hard to navigate.

    Reply ↓
    1. MigraineMonth*

      If you mean a workplace solution, such as a private office or WFH, sure.

      If you mean medical solution, NO. You are not a medical professional or her family. You have no business steering your employees towards any medical treatments. (Getting too involved in an employee’s medical issues is also an ADA suit waiting to happen if you start changing how you manage them based on what you know about their condition.)

      Reply ↓
    2. axc241*

      I thought about this too! As someone with a complex chronic illness, I’ve definitely gone through periods where I just “gutted it out” with no treatment because balancing all the providers + payment plans + insurance + scheduling + side effects on top of being, obviously, ill(!) was just way too much.

      Reply ↓
  17. Tradd*

    I have to say I’m surprised that WFH was not mentioned as an option for the employee, if the job could be done from home. If everyone is in office, which would the coworkers object to more – employee having a private office or WFH?

    Reply ↓
  18. H.Regalis*

    It’s Pam’s choice how she wants to handle her condition, but requiring her coworkers to put up with constant moaning and groaning isn’t a reasonable solution. I think even the most empathetic person would lose it at her after months of that. It’d probably be best to look at getting Pam her own office, letting her work from home, or putting her somewhere in the building away from other people.

    Reply ↓
  20. AngryOwl*

    As a chronically ill/in pain person, I sympathize with Pam. But walking around moaning and groaning to the point that it’s affecting other people’s ability to exist peacefully is just too much. This would drive me bananas.

    Reply ↓
  21. YetAnotherAnalyst*

    Why wouldn’t you just handle this like any other involuntary-but-annoying noise? Is it really loud enough to not be covered by headphones or a white noise machine? Sure, in Pam’s case potentially she could improve her situation with treatment, maybe – but what would you do if treatment no longer worked, instead?

    Reply ↓
    1. A. Lab Rabbit*

      Making others wear headphones because Pam is moaning like a ghost ina haunted house is not fair and possibly not doable. This is about what Pam is doing, not what others are not doing.

      If the treatment no longer worked, and Pam really was giving it her all, then it is seriously time to consider disability. You cannot constantly distract your coworkers eight hours a day.

      Reply ↓
  22. Anon in Midwest*

    I worked with a wonderful & talented middle aged woman who had the most horrendously annoying workplace health problem – a hacking, gurgling, wheezing cough that happened anywhere from 5-20 times per hour.

    It sounded gross, it was super loud and distracting, and she didn’t really cover it because she knew it wasn’t contagious, it was some kind of asthma or COPD.

    I have mild misophonia already and this was horrible for me every day, though I’m privileged to be healthy and I never wanted to come across negatively towards her, so I never said anything.

    It’s really hard when the health issues of one employee that impact everyone around them like this becomes . Alison’s suggestion of a private office does seem like a good potential option.

    Reply ↓
  23. cz*

    It’s not for you to decide her treatment or make the judgment that it is easily manageable. Medical issues are different for everyone. What is your business is her performance, and possible FMLA chronic condition coverage.

    Reply ↓
  24. Dancing Otter*

    Physical therapy for one issue can cause or worsen something else.

    When I did PT for my rotator cuff (shoulder), the therapist kept grabbing my wrist to “help” with range of motion. Yeah, the PT fixed my shoulder. I have permanent damage to my wrist now.

    Pam said she didn’t enjoy the physical therapy. That could mean so many different things.

    Reply ↓

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