title: Workers' compensation: poor quality health care and the growing disability problem in the United States.
abstract: The proportion of working age citizens permanently removed from the workforce has dramatically increased over the past 30 years, straining both Federal and State disability systems designed as a safety net to protect them. Almost one-third of these rapidly emerging disabilities are related to musculoskeletal disorders, and three of the top five diagnoses associated with the longest Years Lived with Disability are back, neck and other musculoskeletal disorders. The failure of Federal and state workers' compensation systems to provide effective health care to treat non-catastrophic injuries has been largely overlooked as a principal source of permanent disablement and corresponding reduced labor force participation. Innovations in workers' compensation health care delivery, and in use of evidence-based coverage methods such as prospective utilization review, are effective secondary prevention efforts that, if more widely adopted, could substantially prevent avoidable disability and provide more financial stability for disability safety net programs.
authors.affiliation: Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health and Community Medicine, Seattle, Washington; Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, Washington; Department of Neurology, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Franklin
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Wickizer
authors.forename: Norma B
authors.initials: NB
authors.lastname: Coe
authors.forename: Deborah
authors.initials: D
authors.lastname: Fulton-Kehoe
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004651:Employment; D006801:Humans; D059408:Pain Management / Q000379:methods; D011322:Primary Prevention; D011787:Quality of Health Care / Q000592:standards*; D055502:Secondary Prevention; D018582:Sick Leave / Q000639:trends*; D014481:United States; D014942:Workers' Compensation / Q000592:standards* / Q000706:statistics & numerical data
keywords: Insurance; chronic; disability; fusion; opioids; pain; spinal; syndrome; thoracic outlet; workers' compensation