A multidisciplinary approach to the prevention, evaluation, and management of work disability.

Occupational musculoskeletal disorders represent a major challenge to the injured worker, his or her family, the various health care, health and safety, and human resource professionals that work in this area as well as employers and the workers' compensation system. The epidemiology of the occupational musculoskeletal disorders and work disability indicate the problem is growing. Given the multiple factors that contribute to work disability and the complexity in the return to work process, the need to address the varied factors that contribute to work disability has become increasingly clear. Following a review of the magnitude of the problem, a conceptual framework that considers the multivariate nature of work disability is proposed as a heuristic for research and practice. Such an integrated approach argues for a broader consideration of work disability from a biomedical, biomechanical, and psychosocial framework. Last, this paper summarizes efforts to date in the areas of prevention, evaluation, and rehabilitation. The paper suggests that a number of factors have converged over the past 5-10 years that point to the need for a new approach to the problem of work disability, one that truly attempts to integrate the diverse groups and approaches of the past and seeks to develop new knowledge and strategies. It is expected that the Journal of Occupational Rehabilitation will facilitate such an integration.