INDUSTRIAL REHABILITATION-MEDICINE .1. WHY IS INDUSTRIAL REHABILITATION-MEDICINE UNIQUE

This self-directed learning module is part of the chapter on industria l rehabilitation medicine in the Self-Directed Physiatric Education Pr ogram for practitioners and trainees in physical medicine and rehabili tation, Industrial rehabilitation medicine encompasses injuries and il lnesses that occur in the workplace and are covered under workers' com pensation, The central thesis of this article is that industrial rehab ilitation medicine is a unique area because the workers' compensation system influences the behavior of injured workers, The article is divi ded into three sections, The first briefly reviews the history of work ers' compensation in the United States, and describes eight key featur es of compensation systems, The second explores several hypotheses to explain why injured workers frequently have less favorable outcomes th an noncompensation patients with similar medical conditions, Some expl anations focus on dysfunctional psychologic reactions such as ''compen sation neurosis'' and ''disability syndrome.'' Others focus on context ual factors, including return to work policies by employers and financ ial incentives or disincentives for return to work, The third section outlines reasons why the physiatrist is often the ''preferred provider '' in industrial rehabilitation medicine, One crucial consideration is that many of the most important disabling work injuries are those wit h which physiatrists are familiar, Also, physiatric training and philo sophy prepare the physician to focus on function, to work with a rehab ilitation team, and to be sensitive to psychologic factors that might impede an injured worker's recovery, All of these skills are important in the treatment of injured workers. (C) 1997 by the American Academy of Physical Medicine and Rehabilitation.