Published 6/1/2014
J. Mark Melhorn, MD

Improving Outcomes for Worker’s Comp Patients

Appropriate return to work can help workers who are injured on the job, their employers, and society at large. The length of time off work (disability duration) depends on many factors, including the following:

  • type and severity of injury
  • job task requirements
  • employer’s ability to provide accommodated work such as part-time or limited duties
  • individual risk factors such as age, gender, comorbidities, and pain tolerance

Preventing unnecessary disability duration (inappropriate time off work) must involve the employer, the employee, and the physician, who may be able to act as a facilitator if the employer offers accommodated work and the employee accepts. In handling work-related injuries, the orthopaedist’s patient care role expands beyond clinical treatment to incorporate legal, administrative, ethical, and insurance issues.

President Obama’s 2015 budget includes $400 million to support a variety of experiments and demonstration projects aimed at slowing the entry of workers onto the Social Security Disability Insurance (SSDI) rolls. Studies have shown that once people begin receiving SSDI, they rarely return to work. Therefore, the current system becomes a one-way street leading to a lifetime of unemployment, economic dependency, and poverty.

The AAOS supports safe, early return-to-work programs that help injured workers improve their performance, regain functionality, and enhance their quality of life. As patient advocates, orthopaedists realize that early return to work may help prevent the psychological sequelae of prolonged time off.

Orthopaedists are trained in diagnosing and treating musculoskeletal conditions, but may have little formal training in techniques to limit unnecessary disability durations. Continuing education to develop those skills and fill the knowledge gap is key to improving occupational orthopaedics and the associated benefits to the injured worker and society.

For this reason, the AAOS annually sponsors a continuing education course on workers’ compensation issues. This course is designed to provide fresh perspectives on treatment options, patient care management, and strategies for handling both nonmedical and medical issues associated with treating workers’ compensation patients.

This year’s course, “Workers’ Compensation and Musculoskeletal Injuries: Improving Outcomes with Back-to-Work, Legal, and Administrative Strategies,” will be held Nov. 7–9, in Las Vegas. For more information, visit www.aaos.org/courses

J. Mark Melhorn, MD, is the course director for “Workers’ Compensation and Musculoskeletal Injuries: Improving Outcomes with Back-to-Work, Legal, and Administrative Strategies.”