Business man with shoulder pain in office at deskThe country’s largest workers’ compensation insurer said it has developed a model to predict the likelihood of an injured worker developing chronic pain. The model can them help the workers take steps to avoid chronic pain in recovery and reduce their need for opioids or other painkillers that can be addictive.

The Travelers Companies said its Travelers Early Severity Predictor has been applied in more than 20,000 cases since early 2015. Of those, more than 9,000 injured employees were identified as being at risk of developing chronic pain. These employees received a customized, sports medicine-like regimen of treatment to aid and accelerate their recovery, according to the insurer.

Travelers sees its patent-pending model helping to reverse a sharp rise in chronic pain caused by workplace injuries.

“Millions of American workers are injured on the job each year, and the number of cases in which chronic pain interferes with an employee’s recovery has risen from less than 10 percent a decade ago to more than half of all serious injuries today,” said Dr. Adam Seidner, the National Medical Director at Travelers. “When someone develops chronic pain, they are prescribed opioids or other painkillers more than 90 percent of the time. Our goal is to work with injured employees and their doctors to eliminate or substantially reduce the need for painkillers that can slow their recovery or lead to devastating long-term addiction.”

travelersInjured employees who participated in the program in the past year have, on average, recovered and returned to work more quickly. They were also far less likely to receive a prescription for opioids, and when they did, it was typically a lower dosage or only for short-term use. At the same time, medical expenses, which cost American employers an average of nearly $40,000 per injury, were reduced by as much as 50 percent.

“Helping employees avoid chronic pain and the slippery slope to possible opioid dependency is critical to reversing this disturbing and costly health crisis,”said Seidner.

According to A.M. Best, Travelers is the largest workers compensation carrier in the United States. The company manages more than 250,000 workplace injury claims and 3.5 billion medical treatments per year.

A growing body of research has questioned the increased dispensing of opioids and other painkillers overall and for workers’ compensation injuries in particular. State legislatures, the federal government and insurance carriers and drug benefit managers have been taking steps to limit or monitor opioid prescriptions and improve medical training.

The industry’s National Council on Compensation Insurance (NCCI) has reported that narcotics account for nearly one quarter of all workers compensation prescription drug costs. In workers compensation, narcotics are used mostly for back injuries.

According to research into physician dispensing of opioids, the Workers Compensation Research Institute (WCRI) reported that three out of four injured workers with pain are prescribed opiods, with the amount per claim varying by state.

Also, nearly 1 in 12 injured workers given narcotics are still on them 3 to 6 months later as few doctors appear to be following recommended treatment guidelines to prevent abuse, according to WCRI research in 2012.

A 2012 study in the Journal of Occupational & Environmental Medicine found that when long-acting opioid painkillers are prescribed, workers’ compensation claims are nearly four times more likely to turn into catastrophic claims with costs tallying more than $100,000.

The National Safety Council reports that drug overdoses have surpassed car crashes as the leading cause of preventable death for American adults, with prescription opioids contributing to more deaths than heroin and cocaine combined. The rise in overdoses has paralleled an increase in prescribing. Doctors prescribe enough opioids to give every American a bottle of pills, according to the NSC.

The White House has called opioid abuse an epidemic and proposed new initiatives and increased funding to fight it, including improved training for federal health professionals who prescribe opioids. Also, more than 40 health care provider groups have committed to improved training on appropriate opioid prescribing in the next two years.

The centers for Disease Control last month issued a guideline for primary care physicians for treating chronic pain. The new CDC guideline aims to lessen opioid use disorder and overdose. When opioids are used, doctors should prescribe lowest possible effective dosage, according to the guideline. The CDC guideline also suggests increasing the use of other effective treatments available for chronic pain, such as non-opioid medications or non-pharmacologic therapies.

*This story ran previously in our sister publication Insurance Journal.

Topics Workers' Compensation Training Development