Management of Occupational Low Back Pain: a Case Study of the Missouri Workers’ Compensation System

Abstract

This manuscript examines the management of low back injury claims in the Missouri Workers’ Compensation (WC) program. It is based on research published over the past decade, although it is the first manuscript to integrate findings across studies. It links these findings with other WC-related research to identify broad themes: (1) evidence of treatment-related racial/ethnic disparities; (2) evidence of poorer outcomes for African Americans relative to Caucasians; (3) evidence that legal representation, when secondary to dissatisfaction, is associated with poorer outcomes; (4) little evidence supporting the validity of disability ratings as predictors of post-settlement adjustment; and (5) substantial evidence for negative long-term quality-of-life effects, particularly for African Americans and younger workers. Results are discussed with particular attention to the need for psychology involvement to improve WC processes.