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Journal of Occupational Rehabilitation

Erschienen in:

01.09.2015

Development and Validation of a Clinical Prediction Rule of the Return-to-Work Status of Injured Employees in Minnesota

verfasst von: A. Bentley Hankins, Christine A. Reid

Erschienen in: Journal of Occupational Rehabilitation | Ausgabe 3/2015

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Abstract

Purpose Vocational rehabilitation services can be a valuable resource to injured employees at risk for sustaining permanent disability. The aim of this study was to develop and validate a predictive model of return-to-work (RTW) status at workers’ compensation claim closure that may assist rehabilitation counselors tasked with determining how to allocate such services. Methods A cross-sectional, retrospective study was conducted using data obtained from 15,372 workers’ compensation claims in Minnesota’s administrative claims database. The association between a set of 15 predictor variables representing medical and contextual factors and the RTW status as of claim closure of the accessible population was assessed using backward stepwise logistic regression. The most parsimonious set of variables that reliably predicted the outcome was selected as the optimal RTW model. This model was then internally validated via a split-dataset approach. Results Risk factors for failure to RTW by claim closure include the following: (1) attorney involvement; (2) higher level of permanent impairment (PI); (3) shorter job tenure; (4) lower pre-injury average weekly wage (AWW); (5) injury affecting the head and neck or the back; and (6) lower level of educational attainment. The optimal RTW model included four main effects (attorney involvement; severity of PI; age; job tenure) and three first-order interaction effects (pre-injury AWW × pre-injury industry; attorney involvement × severity of PI; attorney involvement × job tenure). When applied to the full dataset, the overall classification rate was 74.7 %. Conclusions This study’s optimal RTW model offers further support for evaluating disability from a biopsychosocial perspective. Given the model’s performance, it may be of value to those assessing rehabilitation potential within Minnesota’s, and possibly other, workers’ compensation system(s).

This is no longer the case due to an amendment to the Minnesota Workers’ Compensation Act which went into effect on September 30, 2013.

Suitable gainful employment is defined as “employment which is reasonably attainable and which offers an opportunity to restore the injured employee as soon as possible and as nearly as possible to employment which produces an economic status as close as possible to that which the employee would have enjoyed without disability” [26].

This included the following three types of injured employee claims: (1) claims in which a PPD benefit was paid and stipulated to by the employee and employer; (2) claims in which a PPD benefit was paid but was not stipulated to by either the employee or employer; and (3) claims in which no PPD benefit was technically paid but that involved a claim settlement payment of more than $20,000 that likely included consideration of a compromised PPD award (Zaidman B, brian.zaidman@state.mn.us, 2013 March 13 and 19).

The one exception to this eligibility criterion was with respect to the severity of PI predictor as the workers’ compensation claims database did not include a PI rating assigned by a treating or evaluating physician for claims in which no PPD benefit was paid (despite there likely being a compromised PPD award). Claims without data regarding the severity of PI but that met all other eligibility criteria and in which the injured employee received a compromised PPD award were thus also included in this study.

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Titel: Development and Validation of a Clinical Prediction Rule of the Return-to-Work Status of Injured Employees in Minnesota
verfasst von: A. Bentley Hankins
Christine A. Reid
Publikationsdatum: 01.09.2015
Verlag: Springer US
Erschienen in: Journal of Occupational Rehabilitation / Ausgabe 3/2015
Print ISSN: 1053-0487
Elektronische ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-015-9568-3

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