Injured Workers Research Articles

Wellbeing after finalisation of a workers’ compensation claim: a cross-sectional survey

ABSTRACT Objective Injured workers can be disadvantaged after a workers’ compensation claims ends. This study investigated the association of a range of variables with wellbeing in injured workers who had finalised a workers’ compensation claim >3 months prior. Methods On-line, cross-sectional survey (n = 129, 55.81% female). Wellbeing was measured using the Psychological Wellbeing 18-item (PWB) and the Personal Wellbeing Score (PWS). Results Multivariable quantile regression analysis controlling for education level demonstrated associations between the PWB and levels of psychological distress -1.53 (95% CI -2.11 to -0.94), p < 0.001 and resilience 6.51 (95% CI 2.65 to 10.37), p = 0.001, and between the PWS and levels of psychological distress -0.04 (95% CI -0.51 to -0.29), p < 0.001 and resilience 1.2 (95% CI 0.47 to 1.93), p = 0.001. Conclusions Contemporaneous variables of resilience and psychological distress were stronger correlates with wellbeing than historic claim-related variables.

Biomechanical Assessment of Exoskeleton Intervention for Injured and Recovering Workers: A Simulation Study of Bending Tasks

Exoskeletons, wearable devices designed to enhance physical activity, show promise in mitigating work-related musculoskeletal disorders and injuries. This study examines exoskeleton efficacy as ergonomic intervention for aiding injured workers with limited trunk mobility in returning to work. Six adult males participated in simulated bending tasks using a trunk mobility restrictor and a passive trunk exoskeleton. Lumbosacral joint loads and moments during bending tasks with and without the exoskeleton were biomechanically assessed using optical motion capture and ground reaction force data as model inputs. Results indicate significant reductions in compressive loads and subject moments at the lumbosacral joint with exoskeleton usage, particularly during full bending. Moreover, the exoskeleton’s supportive impact increases with greater trunk flexion angles. These findings underscore exoskeleton potential in facilitating the return to work for individuals with limited trunk mobility, emphasizing the need for further empirical validation in real-world settings.

Work-Readiness self report lift capacity test short form.

The Multidimensional Task Ability Profile (MTAP) is a measure of self reported physical work capacity developed for injured workers with musculoskeletal disorders (MSDs) to determine readiness to return to work. This study compared the concurrent validity of a new short form MTAP (MTAP-SF) comprised of 16 lifting and/or carrying items with the MTAP 55-item version. The hypothesis addressed is whether the validity of a version that imposes less respondent burden (MTAP-SF) would be comparable to the more burdensome instrument (MTAP-55). MTAP scores were compared with demonstrated lift capacity in 1,252 healthy adults. Parallel regression analyses were conducted to examine the explanatory power of both MTAP versions. Age, gender, body mass and MTAP-SF explained 55% of the variance (p < 0.001) in demonstrated lift capacity, equivalent to MTAP-55. Self reported performance in physical work capacity tasks accounts for significant variance in lifting performance. MTAP-SF diminishes respondent burden while maintaining validity and may be useful for managing MSDs by enhancing understanding of the evaluee's psychophysical component in return-to-work rehabilitation planning.

The Impact of Benefit Generosity on Workers’ Compensation Claims: Evidence and Implications

Leveraging unique administrative data and a sharp increase in benefit generosity in a difference-in-differences research design, we estimate the impact of workers’ compensation wage replacement benefits on individual behavior and program costs. We find that increased benefit generosity leads to longer income benefit durations and increased medical spending. Responses along these two margins are equally important drivers of increased program costs, collectively increasing program costs 1.4 times the mechanical increase in costs. Using these estimates and an estimate of the consumption drop among injured workers, our welfare calibrations suggest that a marginal increase in benefit generosity would not improve welfare. (JEL D91, I11, J28, J31)

Knowledge, attitudes and beliefs on disability and vocational rehabilitation of injured male migrant workers in Singapore

PurposeThere are over 300,000 male migrant workers in Singapore. Around 600 major workplace injuries are reported in Singapore each year, mainly in the manufacturing and construction injuries. Migrant workers who are affected by workplace injuries often face many challenges, including not being able to work and thus may be repatriated to their home countries, which affects their financial status and that of their families, whom they support. This research aims to explore the knowledge, attitudes and beliefs of injured migrant workers in Singapore, towards disability and vocational rehabilitation.Design/methodology/approachFifteen male migrant workers, from Bangladesh, China and India, who had acquired disabling injuries in their workplaces in Singapore, were identified through purposive sampling. They were interviewed by a male interviewer, either in Mandarin Chinese or with the assistance of interpreters for Bengali-English and Tamil-English. Interviews were recorded, transcribed, translated to English, then analysed thematically.FindingsThe interviewees generally had a pessimistic outlook on their disability, which often impacted negatively on their self-worth and familial relationships. Many of them also had little knowledge of vocational rehabilitation and had not yet seriously considered future job prospects.Originality/valueTo the best of the authors’ knowledge, there are no similar studies exploring the knowledge, attitudes and beliefs of injured migrant workers in Singapore towards disability and vocational rehabilitation.

Research on Predicting the Status of Returning to Work for Injured Workers Based on the ICF Upper Limb Vocational Ability Assessment System

&amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: To verify the accuracy and effectiveness of the ICF Upper Limb Vocational Ability Assessment System (ULVAAS) in assessing the occupational capacity of patients with upper extremity injuries. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: The ICF-ULVAAS tool was applied to assess the work ability of 119 patients and suggestions for returning to work were given. After discharge, their work status was determined through telephone follow-up for 3 months. The evaluated resumption of work suggestions were compared and analyzed with their actual resumption of work status, in order to verify the predictive accuracy of the ULVAAS. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The K coefficient of consistency between the predicted return to work suggestion based on the assessment of upper limb occupational ability and the actual work status of the patient after discharge was 0.322 (p&amp;lt;0.001), with an overall accuracy of 85.71%. The consistency between the therapist&amp;apos;s advice on resuming work and the patient&amp;apos;s actual resumption of work status is not significantly correlated with their educational background and occupational nature. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: The ULVAAS based on the ICF can effectively assess the vocational ability of patients with hand and upper extremity injuries, and provide appropriate recommendations for returning to work based on the assessment results.

Workplace Injury Compensation and Mental Health and Self-Harm Outcomes: A Systematic Review.

Workers' compensation systems aim to financially support injured workers. However, seeking compensation often leads to poorer physical and mental health outcomes. This review examines previous studies to investigate the relationship between workers' compensation and mental health and self-harm outcomes. A three-tiered search strategy across five databases identified studies that examined workers' compensation claims as an exposure or risk factor, with outcomes related to mental health, self-harm and suicidality. Nine full-text studies were included; however, heterogeneity limited generalizability. Most studies supported an association between pursuing compensation and poorer mental health and self-harm outcomes. Some studies attributed this to specific aspects of the system such as justice perception and navigation of the claims system. Findings suggest an association between workers' compensation and mental health or self-harm outcomes. Inconclusive findings highlight the need for further research. Understanding the psychiatric impacts of pursuing compensation is crucial to help formulate a more accessible compensation system.

Identifying factors associated with physical therapy use versus non-use among injured workers with back pain in Washington State.

There is little information about predictors of physical therapy (PT) use among injured workers with back pain. The primary objective of this study is to investigate the associations between PT use and baseline factors not routinely captured in workers' compensation (WC) data. We conducted a secondary analysis using the Washington State Workers' Compensation Disability Risk Identification Study Cohort, which combines self-reported surveys with claims data from the Washington State Department of Labor and Industries State Fund. Workers with an accepted or provisional WC claim for back injury between June 2002 and April 2004 were eligible. Baseline factors for PT use were selected from six domains (socio-demographic, pain and function, psychosocial, clinical, health behaviors, and employment-related). The outcome was a binary measure for PT use within 1 year of injury. Bivariate and multivariable logistic regression models were conducted to evaluate the associations between PT use and baseline factors. Among the 1370 eligible study participants, we identified 673 (49%) who received at least one PT service. Baseline factors from five of the six domains (all but health behaviors) were associated with PT use, including gender, income, pain and function measures, injury severity rating, catastrophizing, recovery expectations, fear avoidance, mental health score, body mass index, first provider seen for injury, previous injury, and several work-related factors. We identify baseline factors that are associated with PT use, which may be useful in addressing disparities in access to care for injured workers with back pain in a WC system.

Injured worker participation in assessment during the acute phase of workers compensation rehabilitation: a scoping review.

Rates of return to work (RTW) are declining in the Australian workers compensation system alongside significant economic and social costs, disputes, and secondary psychological injury. Non-medical assessment of workplace injuries now considers psychosocial and workplace factors, and worker participation in the assessment process is limited. This scoping review examines studies regarding non-medical assessment during the acute phase of rehabilitation in terms of costs, disputes, secondary psychological injury, and worker participation. An electronic and manual search of relevant articles across four databases was conducted using PRISMA guidelines, followed by quality assessment. Of the 1,630 studies retrieved, 12 met the inclusion criteria with most focused on assessment for risk of obstructed or delayed RTW. Non-medical assessment in the acute stage of rehabilitation identifies risk for delayed or complicated RTW, overlooking potential for the process of assessment to contribute to disputes and development of secondary psychological injury. Doubt around the capacity of workers to participate objectively in assessment persists. These are aspects of assessment worthy of further exploration for their impact on RTW outcomes.

"I'm pulling through because of you": injured workers' perspective of workplace factors supporting return to work under the Saskatchewan Workers' Compensation Board scheme.

Research demonstrates sustained return to work (RTW) by individuals on medical leave is influenced by personal and job resources and job demands. Relatively few studies have been conducted in the workers' compensation context that is known to have longer absence durations for RTW. This study sought to illuminate workers' experience as they returned to work following a work injury that was either psychological in nature or involved more than 50 days of disability, with a focus on the co-worker, supervisor, and employer actions that supported their return. Workers in Saskatchewan, Canada, with a work-related psychological or musculoskeletal injury, subsequent disability, and who returned to work in the last three years, were invited to complete an online survey comprising of free-text questions. Thematic analysis was used to explore participants' experiences. Responses from 93 individuals were analysed. These revealed that persistent pain, emotional distress, and loss of normal abilities were present during and beyond returning to work. Almost two-thirds indicated that the supervisors' and co-workers' support was critical to a sustained return to work: their needs were recognized and they received autonomy and support to manage work demands. By contrast, one-third indicated that the support they expected and needed from supervisors and employers was lacking. Workers returning to work lacked personal resources but co-workers' and supervisors' support helped improve confidence in their ability to RTW. Supervisors and employers should acknowledge workers' experiences and offer support and autonomy. Likewise, workers can expect challenges when returning to work and may benefit from cultivating supportive relationships with co-workers and supervisors.

Occupational Medicine, Go Above and Beyond.

The population of people in Japan over 65 years old is expected to exceed 30% by 2025. As the society ages, there are not only healthy workers and employers, but also an increasing number of diseased or injured workers. Falls, the most common occupational hazard, increase in incidence with age. The management of osteoporosis and prevention of bone fractures from falls are emerging in elderly female workers, to reduce the loss of work productivity. Rheumatoid arthritis is a representative musculoskeletal disease that causes functional decline because of joint damage mainly in working women, but appropriate treatment improves disease activity and work productivity in workers with rheumatoid arthritis. It is also important not only to digitize subjective information by converting it into digital form (digitization), but also to digitalize the physiological information related to health, labor and disease (digitalization). In the future, artificial intelligence (AI) will be able to analyze vast amounts of physiological information (big data) obtained from workers and patients via the Internet of things (IoT), which will improve the information value linked to health promotion and optimal treatment practices, and contribute to the Digital transformation (DX).

Productivity outcomes from chronic pain management interventions in the working age population; a systematic review.

Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults might be expected to achieve enhanced productivity in terms of reduced costs of workers' compensation insurance, reduced disability support, and improved rates of return to work for injured workers. This would require the use of measures of productivity in the evaluation of chronic pain management interventions. The aim of this review was to identify and interpret the productivity outcomes of randomised controlled trials reported by studies that conducted economic evaluations (eg, cost-effectiveness and cost-utility) of chronic pain management interventions in the working age population published from database inception to March 2023. Econlit, Embase, and Pubmed electronic databases were searched, yielding 12 studies that met the selection criteria. All 12 studies used absenteeism to measure productivity, translating return to work measures into indirect costs. Only one study included return to work as a primary outcome. Ten studies found no statistically significant improvements in productivity-related costs. Despite evidence for reduced pain-related disability after pain management interventions, this review suggests that the use of measures for assessing productivity gains is lacking. Including such measures would greatly assist administrators and payers when considering the broader societal benefits of such interventions.

Evaluating Effectiveness of Telerehabilitation Services Among Injured Workers Treated in a Canadian Workers' Compensation System: A Population-Based Study.

To evaluate the effectiveness of telerehabilitation for promoting return-to-work (RTW) among injured workers. We conducted a pragmatic, quasi-experimental study comparing telerehabilitation, in-person, or hybrid services. Descriptive statistics analyzed demographics, occupational factors, and patient-reported outcome measures (PROMs). Kruskal-Wallis tests investigated differences between mode of delivery and changes in PROM scores. Logistic and Cox-proportional hazard regression examined associations between mode of delivery and RTW status or days receiving wage replacement benefits in the first-year post-discharge, respectively, while controlling for potential confounders. A slightly higher percentage of the 3,708 worker sample were male (52.8%). Mean (standard deviation (SD)) age across all delivery formats was 45.5 (12.5) years. Edmonton zone had the highest amount of telerehabilitation delivery (53.5%). The majority of workers had their program delivered in a hybrid format (54.1%) and returned to work (74.4%) at discharge. All PROMs showed improvement although differences across delivery formats were not clinically meaningful. Delivery via telerehabilitation had significantly lower odds of RTW at discharge (Odds Ratio: 0.82, 95% Confidence Interval: 0.70-0.97) and a significantly lower risk of experiencing suspension of wage replacement benefits in the first year following discharge (Hazard Ratio: 0.92, 95% Confidence Interval: 0.84-0.99). Associations were no longer significant when confounders were controlled for. RTW outcomes were not statistically different across delivery formats, suggesting that telerehabilitation is a novel strategy that may improve equitable access and earlier engagement in occupational rehabilitation. Factors such as gender and geographic location should be considered when deciding on service delivery format.

Is Arthroscopic Meniscectomy Associated With an Increased Risk of Total Knee Arthroplasty for Claimants in the Workers' Compensation System? A 10-Year Study of Workers' Compensation Claims From a Large Nationwide Workers' Compensation Insurance Carrier.

Total knee arthroplasty (TKA) is a commonly performed knee surgery and prior arthroscopic meniscectomy (AM) has been linked to an increased risk of TKA in the general population. To study the relationship between AM and TKA among injured workers whose medical care is paid for under workers' compensation (WC). A total of 17,247 lost-time claims depicting all arthroscopic knee surgical procedures performed from 2007 to 2017 were followed to the end of 2022 and analyzed. The odds ratio of undergoing a TKA for those with a preceding AM is 2.20, controlling for age, sex, and attorney involvement. Undergoing an AM is associated with an increased risk of TKA in WC claimants.

Association of Case Duration with Late vs. Early Physical Therapy Initiation in Treatment of Work-Related Musculoskeletal Injuries: A Retrospective Analysis

Background:Occupational medicine providers treat patients who are injured while working. Conservative management with over-the-counter anti-inflammatory medicines, physical modalities (ice/heat), and activity restrictions are first-line treatment strategies. Physical therapy (PT) is often added to assist with patients’ return to baseline through symptom reduction and restoration of function. PT efficacy on outcomes and healthcare costs has been described in other patient populations but less described in injured worker populations. This study focused on associations between PT timing and case duration for treating musculoskeletal injuries in a regional injured workerpopulation.&#x0D; Methods:A retrospective chart review of 795 patients receiving care at Parkview Occupational Health (POH) for musculoskeletal injuries from 2017-2023 was conducted to determine if early PT was associated with case duration. Patients employed in Indiana and referred to PT within Parkview were included in the study. Age, BMI, and case duration were compared between early vs. late PT groups using two-sampled t-test. Race, sex, smoking status, and injury type were compared using chi-squared tests.&#x0D; Results:The mean case duration (73.41 days) when PT was initiated early (≤ 30 days after date of injury, DOI) was significantly shorter compared to the mean case duration (104.21 days) when PT was initiated late (p&lt;0.0001). Case duration was even shorter (67.61 days) when early PT was defined as ≤14 days after injury (p=0.001). There was no significant difference in case duration (mean difference=9.5 days) between patients initiating PT within 14 days and within 15-30 days (p=0.15). Injury type (back vs. other musculoskeletal injuries) was significantly associated with PT timing (p=0.002).&#x0D; Conclusion/Implications:Future analysis should compare case duration, days of restricted work, advanced imaging utilization, and specialist referral rate between patients with early and late PT initiation. This comparison will aid in development of best practice guidance for treatment of work-related musculoskeletal injuries at POH.

DESENVOLVIMENTO DE SOFTWARE PARA A ASSISTÊNCIA AO TRABALHADOR APÓS-ACIDENTE COM MATERIAL BIOLÓGICO

ABSTRACT Objective: to develop a prototype web-based software program for managing the assistance to be provided to workers after accidents involving exposure to biological material. Method: a research study on technological production involving the development of web-based software using the Agile Scrum method. It was conceived based on data produced in convergent care research with professionals involved in welcoming and decision-making regarding injured workers. The web-based software prototype underwent evaluation by participant that use the tool and was documented. Results: the web-based software assists in recording diverse information about accidents involving biological material and provides access to information, easing prompt actions and ensuring safety in procedures, which favors decision-making and the assistance provided to the workers. Conclusion: workers' health requires technological and managerial investments, with a focus on qualified welcoming and educational management to prevent accidents.

산재근로자 특성별 직업복귀와 재활서비스 간의 연관 패턴 분석: 2018-2020년 행정데이터를 중심으로

This study investigated the association between injured workers’ RTW and occupational rehabilitation in South Korea. Two hundred and ninety individuals with occupational injuries from 2018 to 2020 were analyzed using the cluster analysis and pattern analysis&#x0D; methods to identify their characteristics and significant correlations regarding the combination of rehabilitation services contributing to injured workers’ RTW within each cluster. The study unveiled crucial findings. Firstly, rehabilitation services significantly enhanced successful RTW across all clusters. Particularly, for workers under unstable and precarious employment, these services facilitated their transition into a stable institutional framework, resulting in positive labor market reintegration. Secondly, differences in rehabilitation service patterns were found to be contingent on the types of accident-related and illness-related injuries. Thirdly, rehabilitation services for occupational injuries were categorized into three groups based on usage frequency and identified association patterns. Finally, the provision of occupational injury rehabilitation services tended to lean heavily towards a one-dimensional model, primarily involving singular relationships between operating institutions or individual professionals and workers. This structure emphasized a more limited scope, lacking broader systemic involvement or multidimensional approaches.

Should older adults who have been injured at work be encouraged to return to work?: A study on life satisfaction of older adults with experience in industrial accidents

Work is generally defined as a positive factor in the lives of older adults. However, older adults who have experienced a industrial accidents need to also consider whether they want to work, as they face the double burden of disability and aging. Current rehabilitation services for injured workers focus on return to work without considering the life cycle. The purpose of the study was to determine whether returning to work affects life satisfaction in older adults and to discuss appropriate service directions. The data used to examine this are from the third year of the second cohort of the Panel Study of Workers’ Compensation Insurance. Participants were divided into three groups: Group 1 (under 55, 1,176 participants), Group 2 (from 55 to 64, 1,036 participants), and Group 3 (65 or older, 611 participants). Multiple regression analysis was conducted to examine the impacts of demographic variables (sex, marriage), care and health variables (treatment duration, self-rated health status, disability grade), economic variables (earned income, unearned income, employment status), rehabilitation service (vocational and psychosocial rehabilitation services), and psychosocial variables (self-esteem, social relationship) on life satisfaction. Returning to work and income were found to have no positive impacts on older adults’ life satisfaction. Better self-rated health, higher self-esteem, and good social relationships all had positive effects on life satisfaction among older adults. For the under-65 cohort, a number of factors contributed to life satisfaction, including income, employment, high self-esteem, etc. Indiscriminately encouraging injured older adults to return to work does not always make sense. There is a need to focus on sustainable health and psychosocial services in the community. This study demonstrates the importance of taking a non-work approach with injured older adults who have the dual characteristics of being both old and disabled.

Choice and outcomes in worker injury rehabilitation: A mixed methods study

BACKGROUND: Although workplace injury rehabilitation is a significant economic and social burden for injured workers and the community, it remains inconclusive whether the worker’s choice of provider and treatment type influences these costs or the outcome of rehabilitation. OBJECTIVE: This study explored what choices injured workers could access during rehabilitation in terms of their provider and treatment, what hindered or helped their choice, and whether workers perceived that choice influenced the outcome of their rehabilitation. METHODS: A mixed methods study was employed, utilising an online survey and semi-structured telephone interviews. RESULTS: Injured workers reported that being able to choose their provider and treatment was not straightforward. Obstacles included systemic rigidity, poor relationships between stakeholders, and unfamiliarity with the system. Most survey respondents perceived that the degree of choice they had in their treatment influenced the outcome of their rehabilitation and sometimes also their occupational bond, career, and finances. CONCLUSION: The study found that choice of provider and treatment type does matter for workers undergoing rehabilitation, impacting on outcomes including occupational bond, income, and disputes. In balancing the need for cost containment with social responsibility, both financial and psychosocial outcomes are relevant for those engaged in rehabilitation of injured workers.

Retirement pension poverty among injured workers with long-term workers’ compensation claims

AbstractAchieving adequate incomes to sustain people in their retirement years is a challenge. This paper addresses poverty among injured workers of retirement age when they have been receiving workers’ compensation benefits. Guided by governmental management theory, we address procedures that have operated without media or scholarly attention, in order to highlight details in workers’ compensation retirement pension policy that contribute to injured worker poverty in older age in Ontario, Canada. We used a mixed methods approach, applying critical discourse analysis to explain (a) policies related to retirement income; (b) rationales that supported a legislative change that reduced retirement pensions; and (c) workers’ experiences of living with a workers’ compensation pension. Although workers’ compensation board retirement income policy was intended to make up for loss of contributions to the Canadian federal pension fund, the Ontario injured workers’ retirement pension now pays less than half of the amount workers would have received in the federal pension,a trend that is observable across Canadian provincial workers’ compensation boards. Legislative debates about the 1998 bill that halved the Ontario injured workers’ retirement pension centred on neoliberal logic of fiscal responsibility. Injured workers and key informants in this study expressed trepidation about injured workers’ financial futures.