Behavioral Health Barriers Are Slowing Recovery for Injured Workers with Knee and Shoulder Claims

A recent study from the Workers Compensation Research Institute (WCRI) reveals that psychosocial risk factors are playing a major role in delayed recovery for workers with knee and shoulder injuries. The research, which analyzed more than 65,000 physical therapy episodes between 2021 and 2024, found that many patients exhibit behavioral health barriers—such as fear of re-injury, poor coping skills, and symptoms of depression—that significantly reduce therapy effectiveness and slow return-to-work outcomes.

In workers compensation cases specifically, the prevalence of these risk factors was notable. Nearly half of injured workers demonstrated poor coping skills, while a third feared re-injury and 8 percent reported signs of depression. When all three factors were present, physical therapy improvement dropped by 40%. The study also observed that functional limitations persisted in 10% of shoulder injury cases and 5% of knee cases under workers comp.

Interestingly, while psychosocial risks affected all patient types, the impact was more severe in workers comp knee cases compared to those covered by private insurance. This suggests that the comp environment may exacerbate certain behavioral health challenges, emphasizing the need for early intervention strategies.

The WCRI suggests that insurers and claims professionals can improve outcomes by integrating behavioral screenings early in the treatment process. Enhancing communication and educating injured workers about their recovery journey may also mitigate the influence of these risk factors, potentially shortening indemnity periods and reducing medical costs.