Long-term labour-market performance of whiplash claimants

Abstract

Abstract:A whiplash is a sudden acceleration-deceleration of the neck and head, typically associated with a rear-end car collision that may produce injuries in the soft tissue. Often there are no objective signs or symptoms of injury, and diagnosing lasting whiplash associated disorders (WAD) is difficult, in particular for individuals with mild or moderate injuries. This leaves a scope for compensation-seeking behaviour. The medical literature disagrees on the importance of this explanation. In this paper we trace the long-term earnings of a group of Danish individuals with mild to moderate injuries claiming compensation for having permanently lost earnings capacity and investigate if they return to their full pre-whiplash earnings when the insurance claim has been assessed. We find that about half of the claimants, those not granted compensation, return to an earnings level comparable with their pre-whiplash earnings suggesting that these individuals do not have chronic WAD in the sense that their earnings capacity is reduced. The other half, those granted compensation, experience persistent reductions in earnings relative to the case where they had not been exposed to a whiplash, even when they have a strong financial incentive to not reduce earnings. This suggests that moderate injuries tend to be chronic, and that compensationseeking behaviour is not the main explanation for this group. We find that claimants with chronic WADs used more health care in the year prior to the whiplash than claimants with non-chronic cases. This suggests that lower initial health capital increases the risk that a whiplash causes persistent WAD. JEL-Codes: I12, J29

Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers

“…2 In recent studies, up to 50% of WAD patients 3,4 and 30% to 100% of postsurgical CR patients 4-9 report personal suffering from prolonged symptoms, with persistent pain, disability, and reduced health-related quality of life (HRQoL). Physical function and treatment have been severely understudied both for CR patients scheduled for surgery 9,10 and for chronic WAD patients, 11 particularly for patients with verified neurological and musculoskeletal findings (WAD Grade III).…”

Neck Injury after Whiplash Trauma in a Defined Population in Northern Sweden – Long-Term Sick Leave and Costs of Low Productivity

“…There are also significant costs on a personal level for a large proportion of the injured, LethPetersen et al found that only half of whiplash claimants returned to the same earning level that they had prior to the injury [37]. The mean cost for productivity loss per person found in this study (10,400 Euros) can be compared with a study from Sweden showing that whiplash injuries give rise to an approximate eight days average increase in the number of sick days from the year prior to the whiplash injury to the year after the injury [17].…”

Neck-specific exercise with or without a behavioural approach, or prescription of physical activity in chronic whiplash associated disorders

“…It gives a broad effect on both society and for the individual in terms of suffering, health, productivity, and costs (1). About 50% of those who suffer a whiplash trauma continue to report neck pain one year after their injury (4), and among those with persistent symptoms about 50% experience persistent reductions in earnings relative to the trauma (5). Yet there is no clear evidence for any effective treatments for either acute, subacute or chronic Whiplash Associated Disorders (WAD), mainly due to lack of high quality studies (6,7).…”

“…Although it is commonly believed that claiming compensation leads to worse recovery, the opposite, that poor recovery may lead to compensation claims, is just as possible (21). Longitudinal data on neck pain up to 24 months post injury show that removing the financial incentive to over-report symptoms has no effect on self-reported neck pain in WAD (22), and compensation-seeking behaviour is not the main explanation for this group (5). Furthermore, there is a growing body of evidence of objective findings in people with WAD (23)(24)(25)(26)(27)(28)(29)(30).…”