Guidelines Help Emphasize Value of Psychological Evaluations in Workers’ Compensation Arena.

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A review of several recently published practice guidelines suggests that the use of psychological tests in evaluating workers’ compensation patients is gaining increased support. The American College of Occupational and Environmental Medicine (ACOEM) guidelines recently adopted in California, for example, specifically recommend that patients who are not showing normal recovery within the expected timeframe receive a psychological evaluation. The State of Colorado's Division of Workers' Compensation guidelines and the Official Disability Guidelines also support the use of psychological assessments.

Kathryn Mueller, MD, MPH, associate professor at the University of Colorado Health Sciences Center, has been involved in developing both the ACOEM and Colorado guidelines—and has observed the influential role guidelines can play in raising awareness among practitioners on the benefits of psychological evaluation (see main article above). She also notes the importance of ensuring that practitioners use solidly researched tools, such as the BBHI™ 2 (Brief Battery for Health Improvement 2) test, a brief psychomedical inventory designed for use by medical practitioners.

“The BBHI 2 instrument is well-supported—and it’s well-suited for use with workers’ compensation cases,” Mueller says. “Unlike assessments that measure a single factor such as depression, the BBHI 2 test evaluates a number of additional factors that are particularly relevant in treating workers, such as functionality, level of pain, emotional distress, and defensiveness.” The BBHI 2 test is derived from the widely used BHI™ 2 (Battery for Health Improvement 2) instrument, a comprehensive assessment that can be used for in-depth follow-up evaluations.

Related articles:

Evidence-Based Guidelines Help Create a Solid Foundation for Practice Decisions in Occupational Medicine.

Making the Case for Evidence-Based Medicine

Evidence-Based Medicine Guidelines Create New Opportunities for Heath Psychologists in Occupational Medicine

For more information…

• Official Disability Guidelines (ODG)


• State of Colorado Division of Workers’ Compensation Practice Guidelines



• Occupational Medicine Practice Guidelines published by American College of Occupational and Environmental Medicine (ACOEM)


• An evaluation tool designed by Kathryn Mueller, MD, MPH, to assess how providers are using ACOEM guidelines can be used as a medical record that providers fill out to gather quality improvement feedback; or by case managers to do chart reviews.


• A report on evaluation of users’ responses to ACOEM guidelines

Mueller KL, Harris JS, Low P, Koziol-McLain J, Peplowski B. Acceptance and self-reported use of national occupational practice guidelines. Journal of Occupational and Environmental Medicine, 1999, 42:362–369.

Kathryn Mueller, MD, MPH, is an associate professor at the University of Colorado Health Sciences Center, an attending physician at National Jewish Medical and Research Center, and residency director for the University of Colorado occupational medicine residency program. She is also medical director of the Colorado Division of Workers’ Compensation and secretary/treasurer of the American College of Occupational and Environmental Medicine (ACOEM). Dr. Mueller received her MD from the University of Nebraska Medical School and her Masters in Public Health from the Medical College of Wisconsin. She is board-certified in Occupational Medicine.

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