A large percentage (I would venture an estimate of 2/3 or more) of injured workers are the victims of past trauma. That includes all forms of physical and emotional abuse; often beyond our comprehension. Many of these adults were also abandoned as children, grew up with abusive relatives or in foster homes.
Many have harbored emotional problems for years and self-medicated with substance abuse and/or chaotic relationships; never fully accepting the source of their problems.
It is also true that should some psychologist get involved in these past problems, the patient will remain in care indefinitely (most often with little or no improvement). Then the psychologist labels them as emotionally disabled from ever working again and attributes this to the recent injury rather than realizing that the patient was never functional, and his keeping the patient in open-ended care has merely made the injured worker worse.
However, there are quite a few injured workers who are quite aware of the their own traumatic past. They know, and will readily state, that many of their problems have long existed and are not related to a recent injury. They simply want assistance in dealing with that injury and can be concurrently (or subsequently) directed to private or community mental health care for past problems.
I have found that there are some injured workers for whom their past trauma serves as a conviction that they have _gotten through it_ before, and that they can do so again.
It always comes down to accurate assessment of the patient and revealing/understanding the role of past trauma in today_s complaints.