Predicting Prolonged Disability with LBP
Reference:Steenstra IA et al Predicting time on prolonged benefits for injured workers with acute back pain.J Occup Rehabil.2015Jun;25:267-78.
This study analyzed the data of over 6600 workers with LBP over a 2-year period across Ontario and came up with the following.
Top 5 predictors of a LONGER time on disability benefits:
1) Older age (we can’t change that)
2) Greater physical demands in the workplace (consider modified or lighter duties)
3) Employer doubt regarding the work-relatedness of the back injury (…causes the employee to have anger & perceived injustice)
4) Receiving a prescription for opioids (MD can control that)
5) Reimbursed by the WSIB during the first 4 weeks of the claim
Top 5 predictors of a SHORTER time on disability benefits:
1) Union membership (we can’t change that)
2) Availability of an early RTW program (we can promote it and ask for it)
3) Positive recovery expectations on the part of health-care providers (we can certainly change our attitudes about LBP)
4) Being entered in a work rehabilitation program (Usually the MD determines if PT is required)
5) Communication of functional ability to RTW by the health care provider (The MD & the PT can certainly address that)
Clinical Relevance: Patients with work-related LBP should ideally start rehab early, the PT should be optimistic about recovery and clearly discuss with the patient and the case adjudicator options for returning to modified duties.
Posted on: October 11, 2015
Categories: Lumbar Spine