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businessman with injured wrist working on computer

Workers’ compensation is an issue that commonly arises in primary care practices, and is something that physicians are often asked to comment on; specifically, return-to-work. Return-to-work is an approach that involves partnerships between injured workers, employers, union representatives, and health care providers in an effort to return the worker back to health. Although workers’ compensation is a common part of medical care, it can be confusing to providers and medical practices. To better understand workers’ comp, It’s helpful to review expectations of treatment and how to manage the various return-to-work issues.

Workers’ compensation is perceived to be more complex than it actually is. This, coupled with legalities surrounding these cases, has created a reluctance to care for patients who have been injured on the job. However, treating workman’s compensation patients for their physical ailments is no different than any other part of medicine. These cases are sometimes made more complicated due to the related psychosocial issues.

When treating individuals with workers’ compensation injuries, the return-to-work aspect of their treatment should be addressed almost immediately, possibly on the first evaluation. Goals should be stated clearly, which are to heal the injury and return the patient to the healthiest state possible. Part of returning to health is returning to normal activities.

It is known that when you take an individual out of work, it leads to other psychological and financial stresses. In addition, people who become disabled/are placed on disability actually deteriorate in their overall health status. When dealing with workers’ compensation injured individuals, the return-to-work is the part of their healing process where they return to normal activities. Promoting a return to normal activities, which includes work, is very beneficial to the patient.

Numerous scientific studies have shown benefits of returning an individual to work activities. In addition, physician organizations have made statements supporting return-to-work. These organizations include the American Academy of Orthopaedic Surgeons, the American Medical Association, the Canadian Medical Association, and the American College of Occupational and Environmental Medicine.

Most individuals can return to some form of work activity, within restrictions, as soon as their medical condition becomes stable. However, also needed is the cooperation of employers to accept individuals back to work with modifications. As physicians, we are asked to place restrictions on individuals, which can be confusing. It is important physicians know:

  • What an individual’s work involves
  • All possible restrictions available
  • Specific functions of their work
  • Can the individual get to work?

 

As physicians, our primary concerns with returning an individual to any activity will be:

  1. What is their capacity or what are their abilities to do activities?
  2. Will returning the individual to work put them at increased risk of re-injury?
  3. Will the individual be able to tolerate that type of work activity?

 

The injured individual, however, has different priorities:

  1. Will they be able to tolerate return to work?
  2. Will there be a risk of re-injury?
  3. Do they have the capacity to return to work?

 

As you can see, the focus and concern with return-to-work are very different for the patient and for the physician. The treating physician needs to make it known to the injured worker that they have their best interests, including those that are psychological, in mind when returning an individual to work.

Using the return-to-work approach and clearly stating its goals initially can reduce stress for all parties when treating individuals with workers’ compensation injuries. More importantly, it’s often an effective and efficient way to return the patient to pre-injury status.