Affiliations: Division of Occupational & Environmental
Medicine, Duke University, Durham, NC, USA | Safety and Health Assessment and Research Program
(SHARP), Department of Labor and Industries, Olympia, WA, USA
Note: [] Address for correspondence: Kristen L Kucera, PhD, ATC, Division
of Occupational and Environmental Medicine, Duke University, 2200 W Main St,
Suite 400, Durham, NC 27705, USA. Tel.: +1 919 684 8374; Fax: +1 919 286 1620;
E-mail: kristen.kucera@duke.edu
Abstract: Objective: We describe medical care received through workers'
compensation (WC) and union-provided insurance surrounding work-related back
injuries and examine relationships between care provided and time off work
among a large cohort of carpenters. Methods and Participants: Union
records identified a cohort of 20,642 carpenters working in Washington State
from 1989–2003 and their private health insurance claims. These data were
linked to workers' compensation files from this state-run program including records of medical care. Results: Over 74,000 WC medical encounters
resulted from 2959 work-related back injuries. Eleven percent received private
care for musculoskeletal back pain within 90 days of work-related injury; this
proportion increased with increasing lost days. Delay to physical therapy was
more prevalent among those out of work longest. The proportion of claimants
with care from both systems and from private utilization only increased after
the first 90 days and, for the subset with at least one paid lost work day,
after return to work. Conclusions: Examination of medical care through
both systems versus solely in workers' compensation provides a more complete
understanding of back injury care while also demonstrating complexity.
Differences in outcomes based upon treatment shortly after injury are worthy of
further exploration.
Keywords: Private insurance, workers compensation, return to work, delays to care
