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However, prior studies have not comprehensively adjusted for potential confounders and few studies have focused on work\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population\u2010based prospective cohort study analyzed data from workers' compensation claimants with a work\u2010related back injury who initiated care with either a chiropractor or a primary care physician. We evaluated the association of seeing a chiropractor first, compared to seeing a primary care physician first, with receipt of wage replacement benefits for temporary total disability (time loss) at 1 year after claim initiation. Association was estimated using logistic regression adjusting for potential confounders including patient sociodemographic characteristics, employment details, self\u2010reported pain and physical function, injury severity, healthcare factors, and psychological factors. The E\u2010value was used to assess unmeasured confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1219 participants (mean age\u2009=\u200939, 67.5% male, 72.1% non\u2010Hispanic White), 541 (44.4%) initiated care with a chiropractor. Participants who saw a chiropractor first, compared to a primary care physician first, were less likely to be on time\u2010loss at 1 year as estimated by adjusted multivariate logistic regression (4.8% vs. 11.8%; adjusted odds ratio [OR]: 0.45, 95% CI: 0.24\u20130.86; E\u2010value: 3.8).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with work\u2010related back injury who initiated care with a chiropractor were less likely to be receiving time loss compensation at 1 year compared to those who saw a primary care physician. Comprehensive adjustment for patient characteristics did not account for the differential outcome by provider type.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajim.70097","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:56:48Z","timestamp":1779782208000},"page":"645-656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association of First Provider Seen With Time Loss From Work Among Workers With Back Injury: A Cohort Study"],"prefix":"10.1002","volume":"69","author":[{"given":"Morgan","family":"Young","sequence":"first","affiliation":[{"name":"Washington State Department of Labor and Industries Tumwater Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6214-3166","authenticated-orcid":false,"given":"Andrea","family":"Elmore","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3240-6756","authenticated-orcid":false,"given":"Eric J.","family":"Roseen","sequence":"additional","affiliation":[{"name":"Section of General Internal Medicine, Department of Medicine Boston University Chobanian &amp; Avedisian School of Medicine and Boston Medical Center Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6663-6904","authenticated-orcid":false,"given":"Deborah","family":"Fulton\u2010Kehoe","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-4091","authenticated-orcid":false,"given":"Gary","family":"Franklin","sequence":"additional","affiliation":[{"name":"Washington State Department of Labor and Industries Tumwater Washington USA"},{"name":"Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA"},{"name":"Department of Health Systems and Population Health University of Washington School of Public Health Seattle Washington USA"},{"name":"Department of Neurology University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2665-9913(23)00098-x"},{"key":"e_1_2_13_3_1","unstructured":"Bureau of Labor Statistics U.S. Department of Labor 2024 Back Injuries Prominent in Work\u2010Related Musculoskeletal Disorder Cases in 2016"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.84.2.190"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318266187d"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4151-3"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0734"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00043764-199710000-00005"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199405001-00001"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199811010-00016"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2012.0096"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzac150"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-4754(01)77689-0"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzad067"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182814ed5"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318269e0b2"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-028633"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnz219"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-016-9667-9"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2010.08.018"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12998-024-00533-4"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny212"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2016.01.006"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050251"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3171\/2023.2.Spine221341"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.F.00260"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12998-016-0113-z"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2012.02.011"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2014.05.001"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4539-y"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7395.911"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31817df7a7"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-5-14"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e318058a9e7"},{"key":"e_1_2_13_35_1","unstructured":"Guidelines for Using Rural\u2010Urban Classification Systems for Community Health Assessment. 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