Predictive Psychosocial Triggers For Workers’ Compensation Claims

There are a number of factors, which, if present, provide accurate prediction of who will benefit from early psychological evaluation. Current research is conclusive that the two most predictive psychological factors regarding who will file a non-traumatic occupational injury claim are:

  • Job task dissatisfaction; and,
  • Distress as reported on Scale 3 of the Minnesota Multiphasic Personality Inventory (MMPI). The MMPI Scale 3 was created using patients who exhibited some physical complaint for which no general medical explanation could be established.

However, employers rarely sense job dissatisfaction in one of their workers and claims adjusters don’t administer the MMPI to claimants before or even after they file claims.

So, when we attend claims association meetings in New Jersey, we are often asked what psychosocial factors, if present in a claim, should prompt a speedy referral for an Initial Psychological Evaluation. With that in mind, and drawing on the best evidence-based scientific research available, we’ve put together a list of specific Predictive Triggers for workers’ comp claims, Triggers which, if three or more are present, indicate early referral for an Initial Psychological Evaluation  is important. Keep in mind that our Initial Psychological Evaluation, although not technically an IME, is done at the IME level.

In no particular order, here are the Triggers:

  • History of abuse, sexual and/or physical
  • Excessive alcohol consumption
  • History of narcotics abuse
  • Depression, or a history of it
  • Coping inadequacy
  • Two or more prescriptions for narcotics
  • Perception of poor health in general
  • Passive attitude
  • Widowed or divorced
  • Tendency to catastrophize and make a referral
  • Blue collar, physically demanding job
  • Complaints of headaches, with no head injury
  • PTSD complaint, without traumatic experience
  • Age over 40
  • Low non-work activity levels
  • History of Somatization (Somatization is the conversion of anxiety to physical symptoms)
  • Driving distance from home to work greater than  30 miles
  • History of filing workers’ comp claims, or other legal claims
  • Poor performance in high school

If you’re a claims adjuster, a nurse case manager or an attorney handling workers’ comp claims, you’ve seen many claims where a number of these Predictive Triggers are present. And you’ve probably been frustrated because the claims have not closed when they should have; they drag on; MMI seems elusive. Workers Compensation Psychological Network can help. Give us a chance. Create an account and login at www.wcpn.net to Make a ReferralSooner – Faster – Smarter.