Screening Injured Workers for Risk of Extended Work Absence and Work Disability: Understanding the Evidence.

Abstract

Most individuals with work-related musculoskeletal disorders return to work in a medically predictable timeframe. For some, psychosocial and work factors influence work loss. Clinicians often lack knowledge and skills to identify and manage risks. This paper explores evidence regarding multidimensional tools (Orebro Musculoskeletal Pain Questionnaire, STarT Back Screening Tool) and ancillary assessments to identify at-risk patients. A multidisciplinary ACOEM member group composed a narrative review regarding feasibility and validity of screening injured workers. Select measures appear feasible for administration and show reasonable validity to detect risks for extended work absence (limited strength of evidence). Potential screening adverse effects include misclassification. Multidimensional and ancillary screening tools can help obtain a better understanding of injured workers and improve work outcomes. A future guidance will provide recommendations regarding tool adoption, use, and operational issues.