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Workers returning to work after an injury can faced various obstacles depending on the nature of their injury and the job, their available benefits and rehabilitation needs, even transportation challenges.

Those who help workers know that behavioral issues also get in the way. More than 40% of employees who have missed workdays due to injury have experienced a psychosocial barrier to recovery, according to workers’ compensation claim data collected by Travelers Insurance.

Ignoring or downplaying this phenomenon can lead to serious consequences, warns healthcare industry consultant Joe Paduda, principal of Health Strategy Associates. He believes a compassionate approach could lead to healthier, more productive workers – and better financial outcomes.

“We have to overtly and actively recognize and embrace and understand that what holds people back from recovery is more mental/emotional than physical,” Paduda said in a recent Insurance Journal interview.

Factors that may impede post-injury recovery or increase medical costs include lack of family or community support systems, low levels of motivation, general fear, pessimism, perceived injustice or poor recovery expectations after an injury. Perception of workplaces as stressful or not supportive can create hurdles, too, as can preexisting mental health symptoms or conditions.

For some, the issue is not whether but how best to address the behavioral issues.

In August, the Workers’ Compensation Research Institute released a 68-page study digging into the effects of behavioral health care in workers’ compensation. Authors Vennela Thumula and Sebastian Negrusa highlighted how early identification of psychosocial factors is key for ensuring such factors do not affect a worker’s recovery.

“Workers’ compensation stakeholders recognize the importance of unaddressed behavioral health issues and how they might delay a worker’s recovery and return to work and increase medical costs,” the study reads. “But many have concerns that the current efforts to address behavioral health care needs of workers may be insufficient.”

The WCRI study reported that work-focused cognitive behavioral therapy – during which a provider listens, teaches and encourages the use of techniques – is the most often recommended treatment by national and state-specific guidelines for various behavioral health conditions.

Because workers’ compensation is concerned with recovery and getting patients back to work, Paduda described any hurdle that complicates or limits a patient’s ability to achieve this goal as a “significant financial problem.”

Earlier this month, Travelers, the country’s largest workers’ compensation insurer, launched a smartphone app designed to promote the mental health of injured employees and facilitate a more holistic recovery. Named Wysa for Return to Work, the app was created in partnership with Wysa, a provider of mental health support solutions driven by artificial intelligence.

“Factors unrelated to an individual’s injury, such as fear, unrealistic expectations, lack of sleep or minimal social support, can hinder the recovery process,” said Dr. Marcos Iglesias, chief medical director at Travelers. “Helping injured employees bounce back requires an approach that addresses an individual’s physical and mental health challenges, and we’re pleased to offer another tool that supports the total well-being of our customers’ employees.”

Wysa for Return to Work is accessible to injured employees who indicate one or more psychosocial barriers to their recovery during conversations with a Travelers nurse or claim professional. Early pilot results show that injured employees using the app have reduced the number of missed workdays by approximately one-third, compared to those not using it.

Paduda said that for “probably the first 90 years that workers’ comp was around, it did everything it possibly could to avoid dealing with one of these behavioral health issues,” he said. “They didn’t want to, quote, ‘own the psych,’ unquote, on a claim.”

But now he maintains that employers are adopting more positive approaches to helping employees return to work.

“You’re going to have healthier, more productive workers,” Paduda said, “who are going to get back to work faster, who are less likely to be reinjured, and you are not going to have to worry about replacing them. And right now, hiring people who are qualified to do jobs is really hard to do. So, from a financial perspective, it makes a ton of sense to do this.”

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Workers’ Compensation

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