Many studies have been done comparing results of injury for treatment of Worker Compensation patients compared with non-compensation employees. Until recently, the number one reason workers were out was always low back pain. Now, the number of claims from leg and arm injuries has increased dramatically. And shoulder injuries (e.g., rotator cuff tears) can keep a worker off the job twice as long as a back injury.
We do know that results after upper extremity (shoulder or arm) surgery for worker compensation patients are worse than for non-worker compensation patients. Worker compensation patients take longer to recover after shoulder/arm surgery compared with non-worker compensation patients treated for the same thing.
Worker compensation patients are sl oftenower to return to their jobs at a preinjury level compared with non-worker compensation patients. And more worker compensation patients change jobs because of continued pain after surgery compared with non-worker compensation patients. In fact, fewer worker compensation patients return to employment at all compared with non-worker compensation patients.
Recovery from work-related injuries can be complicated by the fact that workers are financially compensated for bodily injury in the work place. It is tempting to assume that financial gain is the reason for unfavorable outcomes and worse prognoses for these workers.
But from a review of studies done in this area, several factors have come to light that might help explain the differences in results. First, worker compensation patients tend to be younger and expected to be more physically active on-the-job compared with non-worker compensation patients with the same injuries.
Returning to preinjury levels of activity may differ between these two groups. Workers must get back to their preinjury level of work activities (e.g., pushing, pulling, or lifting heavy objects, operating heavy equipment). Non-worker compensation patients may be having trouble performing less difficult tasks (e.g., brushing teeth, caring for a child, dressing).
The type of surgery performed may vary from study to study. Results from arthroscopic shoulder surgery are not always the same compared with other surgical techniques (e.g., open surgery or mini-open approaches). The use of alcohol and/or tobacco (known to delay wound healing and recovery) are additional factors to be considered. It is possible that ongoing pain, shoulder stiffness, and lower function after surgery may be worse in some
patients as a direct result of these lifestyle factors.
Sometimes pinpointing results after surgery can be difficult. For example, some worker compensation patients do return-to-work but are unable to meet the higher work demands or end up at a lower functional level than before their injury.
And sometimes the type of injury and surgery required affect outcomes (e.g., results after elbow surgery are usually worse than after rotator cuff (shoulder) surgery). Worker compensation patients are also more likely to need a second surgery but whether or not this is to regain a higher level of physical function was not reported.
So, you can see the issues around work-related injuries and Worker Compensation are complex and varied and not easily understood. Hopefully, this quick review will broaden your understanding of these issues. Putting into place and enforcing safety measures in the workplace is the number one way to decrease occupational injuries. As a manager, this is something you can pay particular attention to.