Injured workers with low back pain whose injuries are covered by workers’ compensation insurance and employers reported the lowest improvements in function after physical therapy than patients covered by all other payment systems, according to a study released Tuesday by the Workers Compensation Research Institute.
Data used in the study were collected at admission and discharge from low back pain patients who received outpatient physical or occupational therapy in the United States from 2017 to 2021 and included a total of 1.3 million patients, covered by workers’ compensation, private insurance, Medicare, Medicaid, auto insurance, other insurance or self-paid.
Of those, workers as compliant patients reported the smallest improvements in function.
WCRI noted in its analysis that features unique to the comp system, such as no copays and instances where providers are called to determine maximum medical improvement status for workers, “potentially explain differences between worker and nonworker patients.”;
Another explanation, WCRI said, may be the presence of biopsychosocial factors “that may have disproportionate prevalence and impact on workers comparing patients.” The report said that “work-related disability in low back pain tends to be significantly influenced by non-clinical factors such as poor expectations of recovery after an injury, fear of pain due to movement, catastrophizing, perceived injustice, job dissatisfaction, pessimism, fear. In general, with low motivation” and a “lack of family or community support systems.”