Factors for Delayed Recovery

Identifying and Managing Factors for Delayed Recovery 

According to MTUS, pp 5-6: Patients not responding to initial or subacute management or those thought to be at risk for delayed recovery should be identified as early as possible….. Those at risk should be aggressively managed to avoid ineffective therapeutic efforts and needless disability. Per ACOEM, pp. 86: If personal or psychosocial factors are contributing to delayed recovery, psychological, psychiatric, or other behavioral health intervention is more appropriate than continuing medication, physical therapy, or surgery; continuing such treatment in the face of treatment failure simply creates the expectation of disability.

The Unique Interdisciplinary Approach of IOH

The GPI medical and behavioral health team is uniquely positioned to intervene clinically at all phases of a claim.  We offer early recognition of the critical factors that delay recovery, together with optimally timed intervention, to coordinate treatment with claims management and maximize the likelihood of returning workers to their highest possible level of function.

Historical Risk Factors for Delayed Recovery

  • Prolonged absence from work
  • Delayed reporting of injury
  • Job dissatisfaction
  • Workplace conflict [especially with supervisor(s)]
  • Difficulties at Work [e.g. perception of excessive job demands]
  • No modified work available
  • Chronic (DOI > 6 months ago?)
  • Pain distribution is non-anatomic or described in a bizarre or atypical manner
  • Pain or dysfunction becomes widespread involving other areas of the body
  • Severity of their medical symptoms and pain
  • Experiences increased pain, or at the very least, pain does not decrease over time.
  • Fails to benefit from any, or all, rational therapeutic Interventions
  • Multiple pre-existing and coexisting medical conditions
  • Previous negative experiences with medical care and work-related injuries
  • History of delayed healing
  • Family history of disability
  • Family dysfunction
  • Involvement in financial / disability dispute
  • Smoking
  • Alcoholism
  • Substance abuse
  • Victim of past abuse / emotional trauma
  • History of depression, anxiety
  • Fear of aggravation or re-injury
  • Legal representation or pending litigation