Low back pain is currently the leading cause of disability worldwide and the most common reason for workers’ compensation claims.

A new study from the Workers Compensation Research Institute (WCRI) finds that workers’ compensation patients with low back pain reported lower improvements in functional status score following physical therapy than patients covered by other payment systems, such as private insurance, auto insurance, and Medicaid among others.

The study, Patient-Reported Functional Outcomes after Low Back Pain – A Comparison of Workers’ Compensation and Other Payors, examined the difference in the functional recoveries reported by workers’ compensation patients with low back pain, compared with non-workers’ compensation patients.

The study was based on a patient-reported outcome measure that assesses the patient’s functional status during the episode of physical therapy.

The study results are not unexpected. There have been decades of similar reports in the medical literature. Studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions.

For example, on June 7, 2021, the International Journal of Environmental Research and Public Health published its study “Does Workers’ Compensation Status Affect Outcomes after Lumbar Spine Surgery? A Systematic Review and Meta-Analysis” (Int J Environ Res Public Health. 2021 Jun; 18(11): 6165. )

In their study, a systematic search was performed on Medline, Scopus, CINAHL, EMBASE and CENTRAL databases. The review included studies of patients undergoing lumbar spine surgery in which compensation status was reported. A total of 26 studies with a total of 2668 patients were included in the analysis.

WC patients had higher post-operative pain and disability, as well as lower satisfaction after surgery when compared to those without WC. Furthermore, WC patients demonstrated to have a delayed return to work.

“According to our results, compensation status is associated with poor outcomes after lumbar spine surgery. Contextualizing post-operative outcomes in clinical and work-related domains helps understand the multifactorial nature of the phenomenon.”

Indeed, the authors say that several studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions.

Moreover, they claim that interactions of claimants with compensation authorities are often referred to by workers as stressful experiences that might induce poor mental health.

On the other hand, the authors say several procedural and bureaucratic features (e.g., delays in the claim processing times, strict and rigid procedures, lack of communication between workers and authorities) of the WC administrative process can increase the disability duration, thus delaying the reintegration of people into the workforce