SAN DIEGO — One of the biggest predicters of mental issues arising in a workers compensation claim is pain, according to several experts who say claims handlers must deploy strategies to help injured workers with how they are feeling.

A topic Tuesday at Riskworld, the Risk & Insurance Management Society Inc.’s annual conference, experts said that data is helping the industry better understand that tackling the issue early results in fewer costs overall, and that the link between pain and the mind is clear.

Optum Inc.’s 2023 workers comp claims data showed that 10.1% of drugs prescribed to injured workers addressed behavioral health conditions — and such conditions often run alongside pain, said Tron Emptage, Westerville, Ohio chief clinical officer for Optum.

“We know that chronic pain can lead to many mental health conditions; it can impact the activities of daily living,” Mr. Emptage said. 

And pain “interferes with their recovery process pretty early,” said Jean Feldman, Oldsmar, Florida-based senior director of managed care for Sentry Insurance, which has developed models that guide claims handlers on when to intervene, all based on data collected that showed injured workers do better when mental health is addressed.

The interventions, she said, have been “unusual,” such as providing several mental counseling sessions for injured workers early in the claim or using virtual reality technology to help the injured worker with anxiety or depression — two issues Sentry found have crept into claims as early as 45 days post-injury.

On counseling, Ms. Feldman said industry skeptics have seen the approach as dangerously too close to “creating a psych claim,” referring to the complications that arise in workers comp claims with a mental injury, but that at least one group of stakeholders have endorsed the idea: defense attorneys.

“They said, you are really tackling this head-on,” she said of a group that often sees complicated claims creep into litigation, often as the result of unaddressed psychosocial issues.

Panelist Dale Schultz, director of risk management for the hospital system Valleywise Health in Phoenix, said resistance to addressing psychosocial issues early in a claim is common, but that seeing better financial outcomes has been beneficial in driving change, he said.

“We were investing more in administering the claims and we ended up with better outcomes,” he said.