Skip to main content
SpringerLink
Log in

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

  • Published:
Psychological Injury and Law Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Adams, J. S. (1965). Inequity in social exchange. In L. Berkowitz (Ed.), Advances in experimental social psychology (Vol. 2). New York: Academic Press.

    Google Scholar 

  • Agency for Healthcare Quality and Research (2015). 2015 National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy. At: http://www.ahrq.gov/research/findings/nhqrdr/nhqdr15/index.html. (Accessed 1 July 2016)

  • Andresen, E. M., Machuga, R., Van Booven, M. E., Egel, J., Chibnall, J. T., & Tait, R. C. (2008). Effects and costs of tracing strategies on nonresponse bias in a survey of workers with low-back injury. Public Opinion Quarterly, 72, 40–54.

    Article  Google Scholar 

  • Atlas, S. J., Chang, Y., Keller, R. B., Singer, D. E., Wu, Y. A., & Deyo, R. A. (2006). The impact of disability compensation on long-term treatment outcomes of patients with sciatica due to a lumbar disc herniation. Spine, 31, 3061–3069.

    Article  PubMed  Google Scholar 

  • Autor, D. H., & Duggan, M. G. (2006). The growth in the Social Security Disability rolls: a fiscal crisis unfolding. Journal of Economic Perspectives, 20, 71–96.

    Article  PubMed  Google Scholar 

  • Bair, M. J., Ang, D., Wu, J., Outcalt, S. D., Sargent, C., Kempf, C., … Kroenke, K. (2015). Evaluation of Stepped Care for Chronic Pain (ESCAPE) in veterans of Iraq and Afghanistan conflicts: a randomized trial. JAMA Internal Medicine, 175, 682–689.

    Article  PubMed  Google Scholar 

  • Barth, P. S. (2003/2004). Compensating workers for permanent partial disabilities. Social Security Bulletin, 65, 16-23

  • Beardwood, B. A., Kirsh, B., & Clark, N. J. (2005). Victims twice over: perceptions and experiences of injured workers. Qualitative Health Research, 15, 30–48.

    Article  PubMed  Google Scholar 

  • Bellamy, R. (1997). Compensation neurosis: financial reward for illness as nocebo. Clinical Orthopedics, 336, 94–106.

    Article  Google Scholar 

  • Board of Trustees of the Federal Old Age and Survivors Insurance and Federal Disability Insurance Trust Funds (2015). The 2015 Annual Report of the Board of Trustees of the Federal Old Age and Survivors Insurance and Federal Disability Insurance Trust Funds. At: http://www.socialsecurity.gov/OACT/tr/2015/tr2015.pdf, TableV.C5, page 137. (Accessed 1 November 2015).

  • Boden, L. I. (1992). The AMA guides in Maryland: an assessment. Cambridge: Workers’ Compensation Research Institute.

    Google Scholar 

  • Buffie, N., & Baker, D. (2015). Rising disability payments: are cuts to Workers’ Compensation part of the story? Preliminary results on the empirical relationship between Workers’ Compensation and disability insurance awards. Center for Economic and Policy Research. http://www.cepr.net/documents/rising-disability-payments-2015-10.pdf (accessed 21 June 2016)

  • Bureau of Labor Statistics. (2015). Nonfatal occupational injuries and illnesses requiring days away from work 2013. Washington, DC: U.S. Department of Labor. Available at: http://www.bls.gov/news.release/pdf/osh2. (accessed 21 June 2016).

    Google Scholar 

  • Cassidy, J. D., Carroll, L. J., Cote, P., Lemstra, M., Berglund, A., & Nygren, A. (2000). Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. New England Journal of Medicine, 342, 1179–1186.

    Article  PubMed  Google Scholar 

  • Cheadle, A., Franklin, G., Wolfhagen, C., Savarino, J., Liu, P. Y., Salley, C., & Weaver, M. (1994). Factors influencing the duration of work-related disability: a population-based study of Washington State workers’ compensation. American Journal of Public Health, 84, 190–196.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chibnall, J. T., Dabney, A., & Tait, R. C. (2000). Internist judgments of chronic low back pain. Pain Medicine, 1, 231–237.

    Article  PubMed  Google Scholar 

  • Chibnall, J. T., & Tait, R. C. (2005). Disparities in occupational low back injuries: predicting pain-related disability from satisfaction with case management in African Americans and Caucasians. Pain Medicine, 6, 39–48.

    Article  PubMed  Google Scholar 

  • Chibnall, J. T., & Tait, R. C. (2009). Long-term adjustment to work-related low back pain: associations with socio-demographics, claim processes, and post-settlement adjustment. Pain Medicine, 10, 1378–1388.

    Article  PubMed  Google Scholar 

  • Chibnall, J. T., & Tait, R. C. (2010). Legal representation and dissatisfaction with Workers’ Compensation: implications for claimant adjustment. Psychological Injury and Law, 3, 230–240.

    Article  Google Scholar 

  • Chibnall, J. T., Tait, R. C., Andresen, E. M., & Hadler, N. M. (2005). Race and socioeconomic differences in post-settlement outcomes for African American and Caucasian Workers’ Compensation claimants with low back injuries. Pain, 114, 462–472.

    Article  PubMed  Google Scholar 

  • Chibnall, J. T., Tait, R. C., Andresen, E. M., & Hadler, N. M. (2006a). Race differences in diagnosis and surgery for occupational low back injuries. Spine, 31, 1272-1275

  • Chibnall, J. T., Tait, R. C., Andresen, E. M., & Hadler, N. M. (2006b). Clinical and social predictors of application for Social Security Disability Insurance by Workers’ Compensation claimants with low back pain. Journal of Occupational and Environmental Medicine, 48, 733-740

  • Chibnall, J. T., Tait, R. C., & Merys, S. C. (2000). Disability management of low back injuries by employer-retained physicians: ratings and costs. American Journal of Industrial Medicine, 38, 529–538.

    Article  PubMed  Google Scholar 

  • Clark, W., & Haldeman, S. (1993). The development of guideline factors for the evaluation of disability in neck and back injuries. Spine, 18, 1736–1745.

    Article  PubMed  Google Scholar 

  • Davis, K., Dunning, K., Jewell, G., & Lockey, J. (2014). Cost and disability trends of work-related musculoskeletal disorders in Ohio. Occupational Medicine, 64, 608–615.

    Article  PubMed  Google Scholar 

  • Dunning, K. K., Davis, K. G., Cook, C., Kotowski, S. E., Hamrick, C., Jewell, G., & Lockey, J. (2010). Costs by industry and diagnosis among musculoskeletal claims in a state workers compensation system: 1999–2004. American Journal of Industrial Medicine, 53, 276–284.

    PubMed  Google Scholar 

  • Franche, R. L., Severin, C. N., Lee, H., Hogg-Johnson, S., Hepburn, C. G., Vidmar, M., & MacEachen, E. (2009). Perceived justice of compensation process for return-to-work: development and validation of a scale. Psychological Injury and Law, 2, 225–237.

    Article  Google Scholar 

  • Frank, J. W., Brooker, A. S., DeMaio, S. E., Kerr, M. S., Maetzel, A., Shannon, H. S., … Wells, R. P. (1996). Disability resulting from occupational low back pain. Part II: what do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine, 21, 2918–2929.

    Article  PubMed  Google Scholar 

  • Franklin, G. M., Wickizer, T. M., Coe, N. B., & Fulton-Kehoe, D. (2015). Workers’ Compensation: poor quality health care and the growing disability problem in the United States. American Journal of Industrial Medicine, 58, 245–251.

    Article  PubMed  Google Scholar 

  • Friedman, L. S., Ruestow, P., & Forst, L. (2012). Analysis of ethnic disparities in Workers’ Compensation claims using data linkage. Journal of Occupational and Environmental Medicine, 54, 1246–1252.

    Article  PubMed  Google Scholar 

  • Green, C. R., Anderson, K. O., Baker, T. A., Campbell, L. C., Decker, S., Fillingim, R. B., … Vallerand, A. H. (2003). The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain Medicine, 4, 277–294.

    Article  PubMed  Google Scholar 

  • Greenwood, J. G. (1985). Low-back impairment-rating practices of orthopaedic surgeons and neurosurgeons in West Virginia. Spine, 10, 773–776.

    Article  PubMed  Google Scholar 

  • Guo, X., & Burton, J. F. (2012). The growth in applications for Social Security Disability Insurance: a spillover effect from Workers’ Compensation. Social Security Bulletin, 72(3). https://www.ssa.gov/policy/docs/ssb/v72n3/v72n3p69.html (accessed 1 November 2015).

  • Guthrie, R., & Jansz, J. (2006). Women’s experience in the workers’ compensation system. Journal of Occupational Rehabilitation, 16, 474–488.

    Article  Google Scholar 

  • Guyton, G. P. (1999). A brief history of Workers’ Compensation. Iowa Orthopaedic Journal, 19, 106–110. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888620/ (accessed 21 June 2016).

    PubMed  PubMed Central  Google Scholar 

  • Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., … Coyne-Beasley, T. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. American Journal of Public Health, 105, e60–e76.

    Article  PubMed  Google Scholar 

  • Harris, I., Mulford, J., Solomon, M., van Gelder, J. M., & Young, J. (2005). Association between compensation status and outcome after surgery. Journal of the American Medical Association, 293, 1644–1652.

    Article  PubMed  Google Scholar 

  • Healthlink (2005). Changes in Missouri Workers’ Compensation law. http://www.healthlink.com/documents/mo_compensation_law.pdf. (accessed 14 June 2016).

  • Hepburn, C. G., Kelloway, E. K., & Franche, R.-L. (2010). Early employer response to workplace injury: what injured workers perceive as fair and why these perceptions matter. Journal of Occupational Health Psychology, 15, 409–420.

    Article  PubMed  Google Scholar 

  • Hinderer, S. R., Rondinelli, R. D., & Katz, R. T. (2000). Measurement issues in impairment rating and disability evaluation. In R. D. Rondinelli & R. T. Katz (Eds.), Impairment rating and disability evaluation (pp. 35–52). Philadelphia: W.B. Saunders.

    Google Scholar 

  • Institute of Medicine Committee on Advancing Pain Research, Care, and Education (2011). Washington, DC: The National Academies Press. At: http://www.nap.edu/catalog.php?record_id=13172. (Accessed 29 June 2016)

  • Interagency Pain Research Coordinating Council. National Institutes of Health (2015). National Pain Strategy. At: https://iprcc.nih.gov/National_Pain_Strategy/NPS_Main.htm. (Accessed 1 July 2016)

  • Jensen, M. P., Turner, L. R., Turner, J. A., & Romano, J. M. (1996). The use of multiple-item scales for pain intensity measurement in chronic pain patients. Pain, 67, 35–40.

    Article  PubMed  Google Scholar 

  • Kiselica, D., Sibson, B., & Green-McKenzie, J. (2004). Workers’ compensation: a historical review and description of a legal and social insurance system. Clinics in Occupational and Environmental Medicine, 2004, 237–247.

    Article  Google Scholar 

  • Lippel, K. (2007). Workers describe the effect of the workers’ compensation process on their health: a Quebec study. International Journal of Law & Psychiatry, 30, 427–443.

    Article  Google Scholar 

  • MacEachen, E., Kosny, A., & Ferrier, S. (2007). Unexpected barriers in return to work: lessons learned from injured worker peer support groups. Work, 29, 155–164.

    PubMed  Google Scholar 

  • Main, C. J., Keefe, F. J., Jensen, M. P., Vlaeyen, J. W. S., & Vowles, K. E. (Eds.). (2015). Fordyce’s behavioral methods for chronic pain and illness: republished with invited commentaries. Philadelphia: Wolters Kluwer.

    Google Scholar 

  • Mallon, T. M., Grizzell, T. L., Nelson, C. L., & Hodgson, M. (2015). Federal Workers’ Compensation program basics. Journal of Occupational and Environmental Medicine, 57, S4–S11.

    Article  PubMed  Google Scholar 

  • Mayberry, R. M., Mili, F., & Ofili, E. (2000). Racial and ethnic differences in access to medical care. Medical Care and Research Review, 57(Suppl. 1), 108–145.

    Article  Google Scholar 

  • Meghani, S. H., Polomano, R. C., Tait, R. C., Vallerand, A. H., Anderson, K. O., & Gallagher, R. M. (2012). Advancing a national agenda to eliminate disparities in pain care: directions for health policy, education, practice, and research. Pain Medicine, 13, 5–28.

    Article  PubMed  Google Scholar 

  • Mendelson, G. (1995). “Compensation neurosis” revisited: outcome studies of the effects of litigation. Journal of Psychosomatic Research, 39, 695–706.

    Article  PubMed  Google Scholar 

  • Merskey, H., & Teasell, R. W. (2000). The disparagement of pain: social influences on medical thinking. Pain Research and Management, 5, 259–270.

    Article  Google Scholar 

  • Montgomery, A. S., Cunningham, J. E., & Robertson, P. A. (2015). The influence of no fault compensation on functional outcomes after lumbar spine fusion. Spine, 40, 1140–1147.

    Article  PubMed  Google Scholar 

  • Reville, R. T., Seabury, S. A., Neuhauser, F. W., Burton, J. F., & Greenberg, M. D. (2005). An evaluation of California’s permanent disability rating system (p. MG-258). Santa Monica: RAND Corporation.

    Google Scholar 

  • Riedel, N., Muller, A., & Ebener, M. (2015). Applying strategies of selection, optimization, and compensation to maintain work ability—a psychosocial resources complementing the job demand-control model? Journal of Occupational and Environmental Medicine, 57, 552–561.

    Article  PubMed  Google Scholar 

  • Roberts, K., & Markel, K. S. (2001). Claiming in the name of fairness: organizational justice and the decision to file for workplace injury compensation. Journal of Occupational Health Psychology, 6, 332–347.

    Article  PubMed  Google Scholar 

  • Roberts-Yates, C. (2003). The concerns and issues of injured workers in relation to claims/injury management and rehabilitation: the need for new operational frameworks. Disability & Rehabilitation, 25, 898–907.

    Article  Google Scholar 

  • Robinson, J. P., Turk, D. C., & Loeser, J. D. (2004). Pain, impairment, and disability in the AMA guides. Journal of Law, Medicine & Ethics, 32, 315–326.

    Article  Google Scholar 

  • Rohling, M. L., Binder, L. M., & Langhinrichsen-Rohling, J. (1995). Money matters: a meta-analytic review of the association between financial compensation and the experience and treatment of chronic pain. Health Psychology, 14, 537–547.

    Article  PubMed  Google Scholar 

  • Rondinelli, R. D. (2007). AMA guides to the evaluation of permanent impairment (6th ed.). Chicago: American Medical Association.

    Google Scholar 

  • Scott, W., Trost, Z., Milioto, M., & Sullivan, M. J. L. (2013). Further validation of a measure of injury-related injustice perceptions to identify risk for occupational disability: a prospective study of individuals with whiplash injury. Journal of Occupational Rehabilitation, 23, 557–565.

    Article  PubMed  Google Scholar 

  • Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Unequal treatment: confronting racial and ethnic disparities in health care. Washington, D.C.: National Academies Press.

    Google Scholar 

  • Strunin, L., & Boden, L. I. (2004). The workers’ compensation system: worker friend or foe? American Journal of Industrial Medicine, 45, 338–345.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., Adams, H., Horan, S., Maher, D., Boland, D., & Gross, R. (2008). The role of perceived injustice in the experience of chronic pain and disability: scale development and validation. Journal of Occupational Rehabilitation, 18, 249–261.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: development and validation. Psychological Assessment, 7, 524–532.

    Article  Google Scholar 

  • Sullivan, M. J. L., Yakobov, E., Scott, W., & Tait, R. (2014). Perceived injustice and adverse recovery outcomes. Psychological Injury and Law, 7, 325–334.

    Article  Google Scholar 

  • Tait, R. C. (2004). Compensation claims for chronic pain: effects on evaluation and treatment. In R. H. Dworkin & W. S. Breitbart (Eds.), Psychosocial aspects of pain: a handbook for health care providers (pp. 547–569). Seattle: IASP Press.

    Google Scholar 

  • Tait, R. C., & Chibnall, J. T. (2001). Work injury management of refractory low back pain: relations with ethnicity, legal representation, and diagnosis. Pain, 91, 47–56.

    Article  PubMed  Google Scholar 

  • Tait, R. C., & Chibnall, J. T. (2011). Legal sequelae of occupational back injuries: a longitudinal analysis of Missouri judicial records. Spine, 36, 1402–1409.

    Article  PubMed  Google Scholar 

  • Tait, R. C., & Chibnall, J. T. (2016). Workers’ Compensation claimants with low back pain: the role of dissatisfaction in the transition to disability. Psychological Injury and Law, 9, 16–22.

    Article  Google Scholar 

  • Tait, R. C., Chibnall, J. T., Andresen, E. M., & Hadler, N. M. (2004). Management of occupational back injuries: differences among African Americans and Caucasians. Pain, 112, 389–396.

    Article  PubMed  Google Scholar 

  • Tait, R. C., Chibnall, J. T., Andresen, E. M., & Hadler, N. M. (2006). Disability determination: validity with occupational low back pain. Journal of Pain, 7, 951–957.

    Article  PubMed  Google Scholar 

  • Tait, R. C., Chibnall, J. T., & Krause, S. J. (1990). The Pain Disability Index: psychometric properties. Pain, 40, 171–182.

    Article  PubMed  Google Scholar 

  • Tait, R. C., Chibnall, J. T., & Richardson, W. D. (1990). Litigation and employment status: effects on patients with chronic pain. Pain, 43, 37–46.

    Article  PubMed  Google Scholar 

  • Texas Department of Insurance Workers’ Compensation Research Group (2005). Comparison of State Workers’ Compensation Systems. (accessed 21 June 2016). www.senate.state.tx.us/75r/senate/commit/c780/Downloads/testimony/032504/comprswcompn.pdf

  • Trujillo, A. J., Heins, S. E., Anderson, G. F., & Castillo, R. C. (2014). Geographic variability of adherence to occupational injury treatment guidelines. Journal of Occupational and Environmental Medicine, 56, 1308–1312.

    Article  PubMed  Google Scholar 

  • Turner, J. A., Franklin, G., Fulton-Kehoe, D., Sheppard, L., Stover, B., Wu, R., … Wickizer, T. M. (2008). ISSLS prize winner: early predictors of chronic work disability: a prospective, population-based study of workers with back injuries. Spine, 33, 2809–2818.

    Article  PubMed  Google Scholar 

  • Waddell, G. (1987). A new clinical model for the treatment of low-back pain. Spine, 12, 632–644.

    Article  PubMed  Google Scholar 

  • Ware, J. E., Jr., Kosinski, M., & Keller, S. D. (1995). SF-12: How to score the SF-12 physical and mental health summary scales (2nd ed.). Boston: Health Institute.

    Google Scholar 

  • Webster, B. S., & Snook, S. H. (1994). The cost of 1989 workers’ compensation low back pain claims. Spine, 19, 1111–1115.

    Article  PubMed  Google Scholar 

  • White, J. A., Tao, X., Talreja, M., Tower, J., & Bernacki, E. (2012). The effect of opioid use on Workers’ Compensation claim cost in the State of Michigan. Journal of Occupational and Environmental Medicine, 54, 948–953.

    Article  PubMed  Google Scholar 

  • Wickizer, T. M., Franklin, G., Fulton-Kehoe, D., Gluck, J., Mootz, R., Smith-Weller, T., & Plaeger-Brockway, R. (2011). Improving quality, preventing disability and reducing costs in Workers’ Compensation healthcare: a population-based intervention study. Medical Care, 49, 1105–1111.

    Article  PubMed  Google Scholar 

  • Wickizer, T. M., Franklin, G., Fulton-Kehoe, D., Turner, J. A., Mootz, R., & Smith-Weller, T. (2004b). Patient satisfaction, treatment experience, and disability outcomes in a population-based cohort of injured workers in Washington State: implications for quality improvement. Health Services Research, 39, 727-748

  • Wickizer, T. M., Franklin, G., Plaeger-Brockway, R., & Mootz, R. D. (2001). Improving the quality of workers’ compensation health care delivery: the Washington State Occupational Health Services Project. Milbank Quarterly, 79, 5–33.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wickizer, T. M., Franklin, G., Turner, J., Fulton-Kehoe, D., Mootz, R., & Smith-Weller, T. (2004a). Use of attorneys and appeal filing in the Washington State Workers’ Compensation program: does patient satisfaction matter? Journal of Occupational and Environmental Medicine, 46, 331–339

Download references

Acknowledgments

This research was supported by grants from the Agency for Healthcare Research and Quality (AHRQ RO1 HS13087 and R01 HS14007), Rockville, MD.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Saint Louis University School of Medicine, 1438 South Grand Boulevard, St. Louis, MO, 63104, USA

    Raymond C. Tait & John T. Chibnall

Authors
  1. Raymond C. Tait
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John T. Chibnall
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raymond C. Tait.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tait, R.C., Chibnall, J.T. Management of Occupational Low Back Pain: a Case Study of the Missouri Workers’ Compensation System. Psychol. Inj. and Law 9, 298–312 (2016). https://doi.org/10.1007/s12207-016-9272-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12207-016-9272-4

Keywords

Search

Navigation