The Intelligent Insurance Solution

Beyond the Injury: Treating the Whole Person

There is much discussion these days among those in the workers’ compensation industry that we need to start looking beyond the myopic view of just dealing with the injured worker’s torn rotator cuff, back strain, or carpal tunnel syndrome, and begin looking at how their injury may be impacting them overall. According to a number of recent studies that speak to what drives good patient outcomes in workers’ compensation claims, it seems that taking a greater holistic health approach and going beyond just focusing on the specific injury complaint boosts an injured worker’s sense of purpose and strengthens their community and social relationships; even their financial health which leads to better recovery outcomes.

Professionals that help injured workers address what is commonly referred to as biopsychosocial issues agree with what the data is suggesting. Most biopsychological approaches take into account that factors such as emotions, behaviors, social environments and culture all of which have a tendency to impact human medical conditions and performance. These types of services, usually performed by highly trained psychologists, and referred to as cognitive behavioral therapy (CBT), are being applied more often when claims professionals identify that medical treatment alone fails to mend injured workers. CBT can help with issues such as depression, pain perception, pain medication misuse and obesity which can often delay or even thwart a patient’s quick recovery and successful return to work.

The Trust has recognized for some time now the benefits of CBT in certain cases when it appears that an injured worker may be a greater risk of becoming an outlier in their recovery.
In a recent case, a food service worker in her mid-twenties suffered a serious back injury as a result of a slip/fall injury. She initially sought conservative care which ultimately failed and eventually led to back surgery. As time went on after the surgery, she continued to complain that the pain was increasing over time and not getting any better. This resulted in the worker becoming more and more disillusioned that she would ever get back to a normal life again. The provider suggested more exploratory back surgery to find the pain source, but the assigned nurse case manager and claims adjuster identified some things in the file that just weren’t adding up and didn’t think a second surgery was going to be the answer. So the Trust communicated with the provider and the injured worker and suggested that a CBT program may be beneficial. She responded very well to the CBT program, and it became apparent that a second surgery was not necessary. She had gained a better understanding of the expectations of her recovery and the CBT program allowed her to significantly improve her coping skills with the injury.