Validity and Determinants of Clinicians’ Return to Work Judgments for Individuals Following Whiplash Injury

Abstract

Rehabilitation clinicians routinely make judgments about the capacity of individuals to return to work following whiplash injury, which can have serious implications for individuals' continued access to salary indemnity benefits. The present study examined the validity and determinants of these judgments. During a standardized rehabilitation intervention, data regarding demographic factors, crash characteristics, pain severity, range of motion, pain-related psychological functioning, as well as change in the latter three factors over the course of treatment were collected for 104 whiplash-injured individuals (73 women, 31 men). Upon completion of the intervention, clinicians rated the number of hours each individual was capable of working per day. Follow-up data regarding the actual number of hours worked were collected 1 year later. Hierarchical regression analyses revealed that clinicians' judgments added significant unique variance to the return to work prediction beyond other predictive factors, and that clinicians were particularly influenced by patients' pain severity and treatment-related change in pain severity in making these judgments. Although clinicians were significantly able to predict return to work, the limited variance accounted for by their judgments (12%) warrants caution in the use of these judgments in decisions related to access to services or indemnity. Factors predictive of clinician judgment and actual return to work are compared, and recommendations to enhance the utility of these judgments are made.

The Mediating Role of Recovery Expectancies on the Relation Between Depression and Return-to-Work

“…The distribution of depression scores is comparable to that which has been reported in previous research with participants with WRMDs [47][48][49]. t tests revealed no significant differences between men and women on measures of pain severity, t(107) = 1.176, p = .242, and RTW status at follow-up, v 2 = 1.548, p = .213.…”

Clinically Meaningful Scores on Pain Catastrophizing Before and After Multidisciplinary Rehabilitation

“…20 The current study is a secondary analysis of those data. Assessments of catastrophizing were completed after admission to and during the final week of the rehabilitation program.…”

Changes in Pain Catastrophizing Following Physical Therapy for Musculoskeletal Injury: The Influence of Depressive and Post-traumatic Stress Symptoms

“…Clinicians chose from one of the following options ''0 h per day'', ''1 h per day'', ''2 h per day'', ''3 h per day'', ''4 h per day'', ''5 or more hours per day''. Clinician's judgments have been shown to significantly predict return-to-work [29].…”