In the realm of workers’ compensation, the impact of psychosocial factors on claim outcomes has been a topic of considerable interest and debate. At the WCRI Conference in Boston, MA, a presentation titled “Psychological Risk Factors and Functional Recovery” shed light on this issue. The presenters, Vennela Thumula, a Policy Analyst with WCRI, and Dr. Randy Lea, a Senior Research Fellow at WCRI, provided a comprehensive analysis of the prevalence and impact of psychosocial factors on the functional recovery of workers’ compensation patients.
It was, in my ever so humble opinion, one of the most important topics addressed by WCRI in recent years. The idea of psychosocial barriers is not a new one for workers’ comp, but it is one that rarely seems to wind its way into the zeitgeist of our system.
The study presented at the conference was unique in its focus on workers’ compensation patients, a group often underrepresented in previous research on psychosocial factors. The research aimed to fill the gaps in understanding the prevalence of these factors among workers’ compensation patients, their impact on recovery, and the potential for psychosocial factors to explain differences in physical therapy outcomes between workers’ compensation and non-workers’ compensation patients.
The study utilized data from Focus on Therapeutic Outcomes (FOTO), which included information from over half a million patients who completed psychosocial screening tools. The findings revealed that psychosocial factors are indeed prevalent among workers’ compensation patients, with one in three falling into the high-risk category for persistent disability. This prevalence was higher compared to non-workers’ compensation populations, such as private insurance patients.
The impact of psychosocial factors on functional recovery was significant. Workers’ compensation patients with high psychological risk factors experienced functional recoveries that were 40% smaller than those in the lowest risk group. This trend was consistent across different measures of functional recovery, including the patient-reported outcome of functional recovery (FS4 change) and the proportion of patients achieving a minimal clinically important improvement in function.
The study also explored whether psychosocial factors could explain the differences in physical therapy outcomes between workers’ compensation and non-workers’ compensation patients. It was found that these differences became more pronounced with an increase in the level of psychosocial risk factors. For example, the regression-adjusted differences in functional recovery between workers’ compensation and private insurance patients increased with higher levels of psychosocial risk.
And lest I remind you, last time I checked, impaired outcomes are a bad thing. They lead to extended durations, increased medical costs, and potential litigation. Often because we fail to recognize that, as my business partner Mark Pew likes to say, “what goes on between the ears of the injured worker is as important as the physical injury they suffered.”
The findings have profound implications for workers’ compensation stakeholders. Early identification and intervention for psychosocial risk factors could lead to improved functional recovery and potentially lower costs. The study underscores the need for further research on effective interventions and the appropriate timing for these interventions.
I sincerely hope that WCRI pursues this path.
The WCRI Conference presentation by Thumula and Dr. Lea provided valuable insights into the role of psychosocial factors in the recovery of workers’ compensation patients. The study’s findings highlight the high prevalence of these factors and their negative impact on functional recovery, as well as their contribution to differences in physical therapy outcomes between different patient groups. For stakeholders in the workers’ compensation system, these insights emphasize the importance of addressing psychosocial factors as part of a comprehensive approach to treatment and recovery.
The research suggests that addressing psychosocial factors could be key to improving functional recovery and reducing the overall burden of workers’ compensation claims. Dr. Lea emphasized the point that medical providers could be more effective if they adopted early identification techniques. He was absolutely correct, but we should expand on his point.
Anyone and everyone who touches the life of an injured worker should understand the importance of this topic and be trained to look for signs of psychosocial factors that could negatively influence the outcome for an injured worker. This doesn’t mean that you’ll always need a psychologist, or even make every claim a “psych” claim. What it does mean is that we must understand the psychology of what is “behind the claim,” in the injured workers’ mind, that may be leading to negative thoughts and results. Sometimes its as simple as truly communicating with that worker, and understanding the impact the injury is really having in their lives.
Understanding psychology doesn’t have to be rocket science. And to continually to ignore it is, well, just crazy.
Artificial intelligence assisted in the development of this article