Had a claimant with low back pain away from work more than seven weeks?

As evidence-based professionals, it is worth looking at the recent research from Michael Di Donato and colleagues at Monash University. The Insurance Work and Health Group compared the incidence, duration and patterns of working time loss in compensated Australian workers with either low back pain; limb fracture or non-specific limb conditions.

Their results included:

1. The risk of a claim for low back pain is higher than limb fracture and non-specific limb condition
2. Low back pain and limb fracture had similar median time loss (from work) - at 9.39 weeks and 9.21 weeks respectively.
3. Claims for low back pain are more likely to resolve in the early phase than limb fracture or non-specific limb conditions, but if a worker with low back pain is away from work for more than seven weeks the claims is likely to be of a long duration.

The findings suggest that long tail claims in low back pain cases continue to be an issue for workers, employers and insurers. We know in many of these cases there is a complex interplay of factors involved, which pose barriers to a person's successful return to work.

What is it about the seven week mark?

We asked Dr Sid O’Toole, Occupational and Environmental Physician, about whether the seven week mark was particularly relevant point in time in the rehabilitation process?

“In my experience it's often between the four to six week mark in the recovery phase where we notice a worker’s progress might be slowing. We usually see this in hindsight when we are looking back over a case when the worker is at the point of having an Independent Medical Examination.”

An Independent Medical Examination gives our specialists the opportunity to look at the causation, preceding factors and interventions in a case to date. Yet, could this ‘second set of eyes’ be brought in sooner? 

Right treatment, right time

Dr O'Toole explained that it is critical that individual gets the right treatment at the right time for their condition.

“OEP’s often get pretty frustrated for the worker and the workplace – everyone involved really – as it is often the case that we could have stepped in to intervene if we had the opportunity earlier in the process. It could have been an issue with the treatment or even that the provisional diagnosis needed revising – I can’t tell you how many times I’ve seen someone being treated for a pain in one body part– say the neck - when the diagnosis is actually pathology affecting the shoulder.”

" I can’t tell you how many times I’ve seen someone being treated for a pain in one body part– say the neck - when the diagnosis is actually pathology affecting the shoulder.” Dr Sid O'Toole

Pre-IME options for insurers and employers

So what options do insurers and workplaces have available to intervene earlier?

LIME’s sister organisation - Phoenix Occupational Medicine - began with the goal of offering the right treatment at the right time to worker who were injured or ill – ironically so they may not need an IME in the future. The On The Right Track® service was especially designed to help in those cases where rehabilitation or recovery has slowed – especially at the four to six weeks point in time after onset of the condition/injury.

For more information, about On The Right Track® please contact Phoenix Occupational Medicine on 07 3333 2222.

‍Reference:

Di Donato, M., Buchbinder,R., Iles, R. et al. Comparison of Compensated Low Back Pain Claims Experience in Australia with Limb Fracture and Non-Specific Limb Condition Claims: A Retrospective Cohort Study. J Occup Rehabil (2020). https://doi.org/10.1007/s10926-020-09906-x