Ohio comp could pay for behavioral tests for injured workers

The Ohio Bureau of Workers’ Compensation’s Joint Committee of Agency Rule Review is now weighing a proposed rule that would set up reimbursements for the bureau to pay for counseling and coaching sessions that help injured workers overcome issues like negative thinking, poor coping skills, lack of motivation and other behavioral barriers to recovery, a spokeswoman told Business Insurance on Friday.

“An injured worker would be eligible for consideration of health and behavior assessment and intervention services if several criteria are met, including that the injured worker's physician of record determines (he or she) is not progressing with their injury after the initial course of treatment and that (his or her) healing appears to be delayed due to behavioral barriers,” according to a draft of the rule. The injured worker would also have to demonstrate “the capacity to understand and respond meaningfully during the face-to-face encounter,” according to the proposal.

“We’re not talking about mental illness and psychological disorders but normal emotional responses that many people experience following a serious injury,” a spokeswoman told BI in an e-mail. “The goal is to make sure injured workers get the coaching or guidance they need before those behaviors spiral into something more serious, such as depression and opioid abuse.”

The rule would cover one health and behavioral assessment and up to six hours of intervention sessions per 12-month period. Any one of a number of licensed health professionals may provide the treatment, including physicians, chiropractors, psychologists, social workers and counselors, according to the spokeswoman.

The bureau expects the rule, which was approved by the Board of Directors, to go into effect sometime this summer, she wrote.