Steps for Workers Comp Insurers to Deal With Pain Psychology

February 7, 2019

The workers compensation insurance industry has an opportunity to treat pain holistically and minimize disability for pain patients, according to hosts of the Out Front Ideas webinar series.

Kimberly George, chief healthcare officer for Sedgwick, and Mark Walls, vice president for communications and strategic analysis with Safety National, included the topic in their first installment of the Out Front Ideas webinar series for the year 2019, outlining “20 Issues to Watch in 2019.”

“Understanding a patient’s response to pain earlier in the claim offers an opportunity to proactively create a meaningful, holistic treatment plan,” George said. “If the initial pain assessment reveals the patient has a high level of subjective pain complaints with limited objective findings, there is a likelihood the patient will end up in a chronic pain state in the future.”

George outlined their suggestions for steps that carrier claims teams can take as they work to improve patient outcomes:

  1. Create a pain philosophy for the claims program. Engage the whole cross-functional claims team to develop the program, including claims, clinical, legal, employer, and occupational and orthopedic providers. Make the pain philosophy and associated documents part of the client services instructions.
  2. Implement pain assessment tools. These will help to identify patient challenges.
  3. Outline care pathways for a holistic pain treatment plan.
  4. Communicate clearly and often with the injured worker. Transparency and empathy by the provider, the employer and the claims team are extremely important for patient-centered care.
  5. Consult. Identify a pain psychologist or pain expert to consult, as needed, on pain cases and help guide the more complex cases.
  6. Create a feedback loop approach to bring stakeholders together on a regular basis and assess the pain philosophy, outcomes and opportunities for improvement.