Can chronic pain, often the lingering result of a workplace injury, be predicted? The Travelers Companies, Inc. believes the answer is yes. The company has developed what it describes as the first predictive model designed to reverse a sharp rise in chronic pain caused by workplace injuries.
The Travelers Early Severity Predictor (patent pending) identifies the likelihood of an injured employee developing chronic pain so that they can avoid it in recovery and reduce the need to use opioids or other painkillers.
“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 the initiative was announced in April.
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.
“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.”
The 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 precisely sequenced to aid and accelerate their recovery, the company explained.
Injured employees who participated in the program in the past year have, on average, recovered and returned to work more quickly, the company said. 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.
In 2014, there were 107.1 cases of nonfatal occupational injuries or illnesses requiring an employee to miss work for every 100,000 full-time American workers, according to the U.S. Bureau of Labor Statistics (BLS), the website IPWatchdog reported. Although this represented a decline from 2013’s workplace injury numbers, it still resulted in 1,157,410 days away from work among private, state government and local government employees. BLS statistics show that workplace injury incidence rates were highest in the industries of transportation and warehousing as well as health care and social assistance, according to the website.
The Centers for Disease Control issued a guideline earlier this year, the Insurance Journal reported, 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.
According to research into physician dispensing of opioids, the Workers Compensation Research Institute (WCRI) noted that three out of four injured workers with pain are prescribed opiods, with the amount per claim varying by state, the Insurance Journal reported. 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.
“Helping employees avoid chronic pain and the slippery slope to possible opioid dependency is critical to reversing this disturbing and costly health crisis,” Seidner emphasized.
The Travelers Companies, Inc. is a leading provider of property casualty insurance for auto, home and business. The company’s main offices are in New York, Hartford and St. Paul. A component of the Dow Jones Industrial Average, Travelers has approximately 30,000 employees and generated revenues of approximately $27 billion in 2015.