Are you familiar with the SIMP program? SIMP is an abbreviation for Structured Intensive Multidisciplinary Program. More simply, it’s a chronic pain management program. L&I regularly refers work injury claimants to SIMP during L&I claims. In fact, L&I recommends SIMP for chronic pain when workers don’t respond to conservative care.
What is the SIMP program in L&I claims?
SIMP can be helpful when chronic pain interferes with your ability to work. Furthermore, SIMP is useful when work injury claimants develop dependency on pain medication. However, the program is a somewhat complex and expensive way to treat chronic pain.
The SIMP program is “structured”. That’s because workers receive care in a consistent manner. The care is regular and steady. It has a schedule for modules of assessment. In addition, it includes education, treatment, and follow up evaluations. During the program, caregivers custom-tailor plans to address specific treatment needs for workers.
Key parts of the L&I claim SIMP program for chronic pain
SIMP is also “intensive” because it requires 6-8 hours of daily treatment. The routine continues 5 days a week for up to 4 weeks. The program is also “multidisciplinary”: A team of providers with different yet complementary expertise provide the care. Moreover, providers address pain management in multiple ways. That includes traditional medicine, psychology, physical therapy, and occupational therapy.
Sometimes, the program also includes vocational services and nursing services. Finally, the “program” portion focuses on outcomes. To get there, the program offers coordination and goal-oriented processes. In fact, caregivers regularly measure and document the workers’ progress. Consequently, failure to make progress can result in discharge from the program.
Phases in the SIMP pain management program
If L&I approves a SIMP program, then 3 essential phases follow. The first phase is evaluation. The second phase is treatment. Then, the third is the follow up. Usually, Evaluation is a lengthy process. Program providers conduct a history review and physical exams. They evaluate the likelihood that the work injury claimant will benefit from the program. Plus, they develop a treatment plan during the evaluation. Upon completion, SIMP caregivers submit a report with their findings and recommendations.
After L&I approves the program, the work injury claimant enters the treatment phase. Treatment comprises several important components, which include:
- Cognitive behavioral therapy
- Coordination of services
- Education and skill development
- Pain and function tracking
- Ongoing assessment of unrelated conditions
- Doing real or simulated work or daily functional tasks
- Establishing return to work goals
- Developing a discharge care plan.
When the plan completes, providers provide workers with a discharge report.
Finally, the Follow Up can last up to 6 months after treatment concludes. The goal of the follow-up phase is to reinforce pain management gains. On top, the follow-up supports return to work goals. Additionally, it helps identify setbacks or issues that require intervention.
Takeaways and conclusions
Work injury claimants must give good faith efforts to comply with SIMP treatment plans. After all, in theory, SIMP is ideal for treating complex chronic pain in L&I claims. However, there are ongoing debates as to whether such programs deliver on their promise.
Personally, as an attorney representing injured workers that regularly participate in SIMP, I see too few results. From my perspective, optimal outcomes on paper don’t match reality. I would like to see more attention and legitimacy to how workers feel about their own progress and symptoms. That said, SIMP is one of the only L&I-approved treatments for pain. That’s because pain is subjective. For that, I am grateful even if I don’t always agree with SIMP outcomes.