Handbook of Complex Occupational Disability Claims: Early Risk Identification, Intervention, and Prevention

559 Pages·2005·4.667 MB·English

by  J. Mark Melhorn M.D., Jacob Lazarovic M.D., Wanda K. Roehl C.S.P. (auth.), Izabela Z. Schultz, Robert J. Gatchel (eds.)

Handbook of
Complex Occupational
Disability Claims
Early Risk Identification,
Intervention, and Prevention
Handbook of
Complex Occupational
Disability Claims
Early Risk Identification,
Intervention, and Prevention
Edited by
Izabela Z. Schultz
TheUniversityofBritishColumbia
Vancouver,BritishColumbia,Canada
and
Robert J. Gatchel
TheUniversityofTexasatArlington
Arlington,Texas
123
Editors
Izabela Z. Schultz Robert J. Gatchel
University of British Columbia University of Texas
Department of Education, Counselling Southwestern Medical Center
Psychology & Special Education 5323 Harry Hines Blvd.
2125 Main Hall Dallas, TX 75235
Vancouver, BC V6T 1Z4 USA
Canada [email protected]
[email protected]
ISBN:978-0-387-50167-3 e-ISBN:978-0-387-28919-9
DOI: 10.1007/978-0-387-28919-9
LibraryofCongressControlNumber:2005926893
(cid:1)C 2005 SpringerScience+BusinessMedia,LLC, First softcover printing 2008
Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthe
writtenpermissionofthepublisher(SpringerScience+BusinessMedia,LLC,233SpringStreet,
NewYork,NY10013,USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarly
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adaptation,computersoftware,orbysimilarordissimilarmethodologynowknownorhereafter
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Theuseinthispublicationoftradenames,trademarks,servicemarksandsimilarterms,even
iftheyarenotidentifiedassuch,isnottobetakenasanexpressionofopinionastowhether
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Printedonacid-freepaper
springer.com
Contributors
JonathanBorkum,Ph.D. Rene´e-LouiseFranche,Ph.D.
HealthPsychMaine InstituteforWorkandHealth
Waterville,Maine PublicHealthSciences
UniversityofToronto
Toronto,Ontario,Canada
MarilynL.Bowman,Ph.D.
DepartmentofPsychology
JohnFrank,M.D.,CCFP,M.Sc.,
SimonFraserUniversity
FRCP(C)
Vancouver/Burnaby,Canada
InstituteforWorkandHealth
PublicHealthSciences
NancyCanning,Psy.D.
UniversityofToronto
AltaBates/Summit
Toronto,Canada
MedicalCenter–Henrick
CampusBerkeley,California GaryM.Franklin,M.D.,M.P.H.
SchoolofPublicHealthand
JoanCrook,Ph.D. CommunityMedicine
SchoolofNursing UniversityofWashington
FacultyofHealthScience Seattle,Washington
McMasterUniversity UniversityofBritishColumbia
Hamilton,Ontario,Canada Vancouver,BritishColumbia,Canada
NiklasKrause,M.D.M.P.H.Ph.D.
JeffreyDersh,Ph.D.
DivisionofOccupationaland
ProductiveRehabilitationInstituteof
EnvironmentalMedicine
DallasforErgonomics(PRIDE)
OccupationalEpidemiologyProgram
Dallas,Texas
UniversityofCalifornia
atSanFrancisco
Marie-Jose´ Durand,Ph.D. SanFrancisco,California
DisabilityResearchand
TrainingCenter JacobLazarovic,M.D.
DepartmentofCommunityHealth VicePresidentandChiefMedical
Sciences Officer
Universite´ deSherbrooke BroadspireServices,Inc.
Quebec,Ontario,Canada Plantation,Florida
v
vi Contributors
GordonLeeman,M.S. ThomasM.Pendergrass,RN,Ph.D.
ProductiveRehabilitationInstituteof UnumProvident
DallasforErgonomics(PRIDE) Chattanooga,Tennessee
Dallas,Texas
CeriJ.Phillips,Ph.D.
StevenJamesLinton,Ph.D. CentreforHealthEconomicsandPolicy
DepartmentofOccupationaland Studies
EnvironmentalMedicine SchoolofHealthSciences
O¨rebroUniversityHospitaland UniversityofWalesSwansea
DepartmentofBehavioral, Wales,UnitedKingdom
SocialandLegal
Sciences—Psychology
PeterPolatin,M.D.
O¨rebroUniversity,O¨rebro,Sweden
DepartmentsofPsychiatryand
AnesthesiologyandPain
PatrickLoisel,M.D. Management
DisabilityResearchandTrainingCenter TheUniversityofTexasSouthwestern
DepartmentofSurgery(Divisionof MedicalCenteratDallas
Orthopaedics Dallas,Texas
Universite´ deSherbrooke
Quebec,Ontario,Canada
RichardC.Robinson,Ph.D.
DepartmentsofPsychiatryand
ChrisJ.Main,Ph.D.
AnesthesiologyandPainManagement
DepartmentofBehaviouralMedicine
TheUniversityofTexasSouthwestern
HopeHospital,SalfordRoyal
MedicalCenteratDallas
HospitalsNHSTrustand
Dallas,Texas
HonoraryProfessor(Facultyof
Medicine)
WandaK.Roehl,C.S.P.
UniversityofManchester
ManagerofWorkforcePlacement
UnitedKingdom
RaytheonAircraftCompany
Wichita,Kansas
DonaldD.McGeary,Ph.D.
ClinicalHealthPsychology
RonaldM.Ruff,Ph.D.
WilfordHallMedicalCenter
St.Mary’sHospitalandMedicalCenter
59thMDOS/MMCPH
DepartmentofNeurosurgery
SanEntario,Texas
UniversityofCalifornia,SanFrancisco
SanFranciscoClinicalNeurosciences
J.MarkMelhornM.D.
SanFrancisco,California
SectionofOrthopaedics,Departmentof
Surgery
UniversityofKansasSchoolofMedicine JotiSamra,Ph.D.
Wichita,Kansas PrivatePractice
Vancouver,BritishColumbia,Canada
AkikoOkifuji,Ph.D.
PainResearchandManagementCenter RobertJ.Sbordone,Ph.D.,A.B.P.P
DepartmentofAnesthesiology PrivatePractice
UniversityofUtah LagunaHills,California
Contributors vii
JeromeA.Schofferman,M.D. PaulWatson,Ph.D.,M.Sc.,Bask
TheSanFranciscoSpineInstitute (Hones),MCSP
SpineCareMedicalGroup DepartmentofAnesthesia,CriticalCare
SanFrancisco,California andPainManagement
Leicester-WarwickMedicalSchool
IzabelaZ.Schultz,Ph.D.,ABPP, Leicester,UnitedKingdom
ABVE
DepartmentofEducationaland TravisWhitfill,B.A.
CounselingPsychologyandSpecial DepartmentofAnesthesiologyandPain
Education Management
TheUniversityofBritishColumbia TheUniversityofTexasSouthwestern
Vancouver,BritishColumbia, MedicalCenteratDallas
Canada Dallas,Texas
AlannaWinter,M.A.
AlanM.Strizak,M.D.
DepartmentofEducationaland
CollegeofMedicine
CounselingPsychologyandSpecial
UniversityofCalifornia
Education
Irvine,California
UniversityofBritishColumbia
Vancouver,BritishColumbiaCanada
DennisC.Turk,Ph.D.
DepartmentofAnesthesiology
LarryK.WilkinsonM.D.
UniversityofWashington
Pro-MedPhysicianServices
SchoolofMedicine
Wichita,Kansas
Seattle,Washington
AnnaWrightStowell,Ph.D.
JudithA.Turner,Ph.D. DepartmentofPsychiatryand
DepartmentofPsychiatryand AnesthesiologyandPainManagement
BehavioralSciences TheUniversityofTexasSouthwestern
UniversityofWashington MedicalCenteratDallas
Seattle,Washington Dallas,Texas
Preface
The health care, compensation, insurance and legal systems, together with employ-
ers, in the Western world are challenged by a “new generation” of complex and
multifaceted, yet still inadequately understood, clinical conditions with major oc-
cupational impact. These conditions include chronic pain (such as headache, back
pain,neckpainandfibromyalgia),repetitivestraininjuries,mildtraumaticbrainin-
juries, depression, anxiety and specific posttraumatic stress disorders. The resulting
wave of occupational disabilities brought on by these conditions defies traditional
but outdated biomedical reductionistic models of identification, rehabilitation and
management. These occupational disabilities, which we conceptualize and term in
thisHandbookas“biopsychosocial,”havebeenexpandingmorerapidlythanmedi-
callybaseddisabilities.Theyhavenowreachedtheverytoprankingsinthehierarchy
ofoccupationaldisabilitiesinindustrializedcountries,andareaccompaniedbyspi-
ralingcostsfromassociatedhealthcare,compensation,rehabilitation,litigation,and
productivitylosses.
The last two decades have seen a proliferation of basic science and clinically
basedresearchontheseconditions.Despitetheseefforts,theknowledgegeneratedby
thisresearchhasnotyetbeenintegratedandtranslatedintoclinicalandcasemanage-
mentpractice,policyandnewparadigmsofservicedelivery.Thereisnooverarching
conceptualframeworkfordiagnosis,riskidentification,earlyintervention,returnto
work and prevention. Rehabilitation and compensation systems, and professionals
workingwithinthem,togetherwithemployers,arechallengedbythepressingneed
to develop effective clinical and occupational interventions, as well as management
and prevention approaches for these complex yet still elusive disabilities. Unfortu-
nately, these professionals still have no access to a systematic and integrated body
of knowledge that would provide them with conceptual and research support for
evidence-based effective practices and policies in this expanding field. This urgent
needstimulatedthedevelopmentofthepresentHandbook.
Likewise,themanagedcaresystems,insuranceindustry,workers’compensation
systems,healthcareandrehabilitationsystems,aswellasourlegalsystem,continue
to struggle with the onslaught of these complex, chronic, labor-intensive, poorly
understood and costly claims. The absence of evidence-informed paradigms, guide-
lines and strategies for early identification, intervention and management of these
claims(foruseincompensation,occupationalandclinicalsettings)resultsinmulti-
billiondollardisability-relatedeconomiclossesacrossindustrializedcountries.These
ix
x Preface
lossesarealreadyestimatedatseveralpercentofthegrossnationalproductinthose
countries, and they are continuing to rise. Moreover, for more than a decade, the
system “stakeholders” delineated above have not been able to effectively deal with
secondary prevention of occupational disabilities that require a biopsychosocial di-
agnostic and intervention framework. Their mandate to facilitate the recovery and
return to work of persons with biopsychosocial disabilities (and thereby reducing
disabilitycosts)hasthereforebeenseriouslycompromised.
The problem continues to escalate despite the proliferation of thousands of
studiesonpredictorsandearlyinterventionprogramsforindividualsathighriskfor
chronicoccupationaldisability.Theroleofpsychosocialfactorsinthedevelopment
ormaintenanceofoccupationaldisabilityisfrequentlyraised,thoughstillpoorlyun-
derstood. Explanations of disability as solely, or primarily, motivated by secondary
gainorpreexistingpsychologyaboundinthemedico-legalcontext.Yet,nosystem-
atic and legally defensible ways of identifying those at risk for disability and then
interveningwiththemearlybeforedisabilitysetsin,havebeenimplementedinsuch
contexts.Thisisthecurrentstatusinthefield,inspiteoftheconsistentlypromising
outcomedataontheuseofaninterdisciplinarymodelofearlyintervention,coupled
withtheeffectivenessofcognitive-behavioralapproaches.
Amismatchandachasmbetweenthetraditionalbiomedicalmodel,uponwhich
healthcare,compensationandlegalsystemshavebeenhistoricallyconstructed,and
thenewparadigmrequiredfortheeffectivemanagementofbiopsychosocialdisabil-
ities, have been largely responsible for the escalation of this problem. At the same
time, the current clinical literature has few examples of attempts at the integration
ofresearchevidenceontheseeminglydisparateclinicalconditions(e.g.,non-specific
chronicpain,repetitivestraininjuryandposttraumaticpsychologicalandneuropsy-
chologicalconditions)forwhichthebiomedicalmodelhasfailedinbothresearchand
practice. The major aim of this interdisciplinary Handbook, therefore, is to bridge
thegapbetweennewdevelopmentsinthescienceofbiopsychosocialdisabilities,with
particularemphasisonmedicineandpsychology,andtheclinical,occupational,or-
ganizational,compensation,andcasemanagementpracticesinwhatiswidelyunder-
stood as the “disability industry”. This has been accomplished using an integrative
biopsychosocialparadigm,asopposedtothetraditionalbutoutdatedunidisciplinary
biomedicalmodelfollowingtheanachronisticCartesianmind-bodydistinction.The
Handbookfocusesonthetranslationofthescienceofpredictionofworkdisability
fromearlymarkerstonewresearchandclinicalpracticemodelsincludingtheclinical,
rehabilitation,occupational,casemanagementandcompensationapproachesinthe
area of high risk, costly and complex disabilities. Being cognizant of the evidence
thatonlyaminorityofindividualswithbiopsychosocialdisabilitygoontodevelop
chronicity and fail to return to work, identification of these individuals who are at
highestriskforsuchdisabilitybecomescriticallyimportant.
Our Handbook has been envisioned as a “transfer of knowledge” project that
contributes an integration of the best, state-of-the-art research on the identification
of high risk for disability, prediction of occupational disability, and early interven-
tion with those who are at risk of failing to return to work following trauma and
injury.Thoseindividualsaremostlikelytobecometheinsuranceandrehabilitation
industry’s “complex claims”: poorly understood, traditionally treatment-resistant,
contentious,litigiousandexpensive.Theyarealsolikelytobecomeemployers’most
significant human resource, productivity and “bottom line” economic challenges
Preface xi
withrespecttoprevention,disabilitymanagementandjobaccommodation.Thein-
curringdisabilitycostsmaypotentiallythreatentheircompany’seconomicviability.
And,lastbutnotleast,theyaremostlikelytobecomeanobjectoflitigationinvolving
employment law, personal injury, workers’ compensation, and long-term disability
entitlement.
Theseadversescenariosarenotyetfullypreventableinthecurrentsocial,politi-
cal,legal,policyandeconomiccontexts.However,majorchangesinsystems,policies
andpracticesappliedwiththesedisabilitiescanbeeffectedifnewintegratedevidence-
based approaches to prediction, risk identification, early clinical, case management
and occupational interventions are applied. Our Handbook constitutes a state-of-
the-art, integrated research-based resource to facilitate the transfer of knowledge
and the development of new clinical and occupational practices in healthcare, re-
habilitation, insurance and workers’ compensation industries. This Handbook also
synthesizesandcriticallyreviewsthecurrentresearchonbiopsychosocialconditions,
andprovidesanetiologicalandepidemiologicalsynopsiswithimplicationsforearly
diagnosis, risk identification, intervention, case management and disability preven-
tion. It focuses on the functional and occupational impact of these conditions, as
well as the most effective intervention approaches in clinical, workplace and com-
pensation environments. The conceptual and methodological issues and controver-
sies, together with directions for future research and practice, are also highlighted.
Not only will the reader be provided with knowledge of concepts and the empiri-
cal evidence gathered to date, in order to guide their practice, but also the neces-
sarykeycomponentsofa“how-to”toolboxfortheireverydayworkandforfuture
advances.
ACKNOWLEDGMENTS
Wewouldliketothankalloftheauthorsfortheirvaluablestate-of-the-artcontribu-
tions,andformakingthisfirstintegrativeHandbookonabiopsychosocialapproach
to early detection and intervention with occupational disabilities come to fruition.
We would also like to acknowledge the support and assistance of many colleagues
onboththeresearchandclinicalsidesofoccupationaldisabilitythroughdiscussion,
exchangeofinformationandsuggestions.Inaddition,wewouldliketothankSharon
Panulla, Malcolm Crystal, and Herman Makler of Springer, who supported the vi-
sionofthisHandbookandencourageditstimelycompletion.Wearealsoindebtedto
AlannaWinter,ResearchCoordinatorattheUniversityofBritishColumbia,forher
technicalandresearchcontributionstothedevelopmentofthisbook.Wealsothank
the numerous consultants who helped with different aspects of this multifaceted
project,includingphysicians,psychologists,vocationalrehabilitationexperts,occu-
pationalhealthnurses,researchers,andcompensation/insurancespecialistsspanning
theNorthAmericancontinent.
IZABELAZ.SCHULTZ
ROBERTJ.GATCHEL