ReedGroup, Ltd. (Ms. Wizner and Dr. Gaspar); Boston Medical Center and Boston University School of Medicine, MA (Dr. Berenji); Webility Corporation, Wayland, MA (Dr. Christian). Dr. Harrell is an independent researcher, San Diego, CA. kerri.wizner@mdguidelines.com
Ms. Wizner and Dr. Gaspar are employees of ReedGroup, Ltd., which publishes disability duration guidelines and the American College of Occupational and Environmental Medicine evidence-based medical treatment guidelines.
Drs. Harrell, Berenji, and Christian reported no potential conflict of interest relevant to this article.
Employer programs, such as modified duty, transitional duty, or early return to work programs, have been found to resolve claims faster and improve recovery outcomes.10,12 Such programs might also reduce occupational stress and improve productivity when an employee realizes that their functional abilities are matched to realistic job expectations during recovery.16 You can play an important role in empowering your patients to seek out these support programs.
What’s ahead for managing disability durations?
Work disability duration is influenced by the complex mix of biological, psychosocial, and economic variables that we have touched on here. All stakeholders involved in the recovery process should support the patient’s ability to live life with as few restrictions as possible; you play a key role in their recovery by focusing on ability, highlighting remaining capabilities, emphasizing activities that are safe to perform, and encouraging acceptance of, and adaptation to, any irrevocable losses.
This is a holistic approach that might help patients overcome the stress and anxiety associated with major life events arising from illness or injury that trigger disability benefits. Open communication and establishing a shared goal, among all involved, of the best possible outcome increases the likelihood that working patients will return to their familiar life or find another positive path forward.
Keep the patient’s attention on the positive process of recovery, and document evidence of functional progress.
Using EBM and disability duration guidelines can help decrease the length of life–work disruption by ensuring that patients are given a diagnosis, treated, and managed appropriately.32,33 Although these practices have been adopted by some physicians, health care systems, and insurers, they are not being implemented systematically and are unlikely to become ubiquitous unless they are mandated by payers or by law.
Family physicians are front-line providers for America’s workforce. They are distinctly situated to help patients achieve their best life at home and work. Improving the timeliness and quality of work guidance provided by the physician is an important way to minimize the impact of health problems on working people’s lives and livelihoods—and to help them stay employed.
