Predictors of returning to work.

P. Ash and S. I. Goldstein,
Bull. Amer. Acad. Psychiatry & the Law 23(2): 205-10, 1995.
An investigation of predictors of returning to work in a sample of physically injured persons who are receiving workers' compensation benefits and vocational rehabilitation is presented. One hundred fourteen injured subjects (86 with back injury; 28, other injury) undergoing vocational rehabilitation and receiving workers' compensation benefits were assessed on demographic, emotional, cognitive, financial incentive, and miscellaneous variables. Predictors for returning to work were identified using stepwise logistic regression. Patients with moderate or severe depression, defined as a score greater than 16 on the Beck Depression Inventory (BDI), were significantly less likely to return to work following vocational rehabilitation efforts than patients with less severe depression (for back-injured patients, odds ratio (OR) = 31, 95% CI [8.8, 108]). BDI scores correctly classified 84 percent of the back-injury and 86% of the other-injury groups with respect to their return to work. The level of workers' compensation benefit was the only variable that added (marginally) to the predictive power of the BDI. In a physically injured population receiving workers' compensation benefits, who are judged to be not clearly permanently disabled, level of depressive symptoms is a strong predictor of returning to work. Caution is warranted in using the BDI as the sole determinant in a forensic situation for making a real-world prediction, as BDI responses are easy to fake. Treatment of concurrent depression is an important component of helping physically injured workers resume gainful employment.