Nm. Hadler et al., THE INFLUENCE OF INDEMNIFICATION BY WORKERS COMPENSATION INSURANCE ONRECOVERY FROM ACUTE BACKACHE, Spine (Philadelphia, Pa. 1976), 20(24), 1995, pp. 2710-2715
Study Design. A prospective observational cohort was recruited from 20
8 randomly selected North Carolina practices. Objective. To compare th
e course of compensation claimants with gainfully employed patients no
t so insured from the time when they first sought care for acute back
pain. Summary of Background Data. The human and financial cost attribu
table to disabling chronic low back pain indemnified by workers' compe
nsation programs continues to escalate. We explored the antecedents to
this phenomenon. Method. Consecutive patients with acute low back pai
n were interviewed by telephone within 1 week of first seeking care an
d in follow-up calls after 2, 4, 8, 12, and 24 weeks to monitor functi
onal and work status. Results. Of the 1633 patients enrolled, 505 were
insured by workers' compensation. These were compared with 861 who ha
d been employed on any job for pay within 3 months of the onset of the
ir backache but whose care was not so underwritten. Those with compens
able back pain were more likely to categorize their tasks as physicall
y demanding and had taken more time off work in the month before the b
aseline interview (P = 0.02). Recovery of the sense of wellness they e
njoyed before this episode of back pain was delayed (Cox Model:Hazard
Ratio = 0.822; P < 0.001; confidence interval: 0.733, 0.923), but reco
very of function or return to work was not. This delay was independent
of type of health care and perception of task demand and beyond that
which could be ascribed to the quality of back pain. Conclusion. Each
of these associations is a reproach to the fashion in which workers' c
ompensation insurance for regional back pain serves the ethic that is
its raison d'etre.