Poisoned Chalice? A Critical Analysis of the Evidence Linking Personal Injury Compensation Processes with Adverse Health Outcomes

Preserving workers' dignity in workers' compensation systems: An international perspective

“…Workers' experience of workers' compensation systems vary considerably, depending on many variables [Grant and Studdert, 2009]. Those with visible, physical injuries that occur as a result of acute trauma are less likely to have a confrontational relationship with a compensation system than those who suffer from soft tissue injury, neurological damage, mental health problems, or from controversial illnesses [Lippel, 2008].…”

“…For example, epidemiologists sometimes include the ''compensation issue'' as a variable in predicting duration of disability, and sometimes conclude that those subjects who are involved in the compensation process will take longer to heal than the other subjects, an approach that is the subject of scrutiny and that can be problematic [Grant and Studdert, 2009;Spearing and Connelly, 2011]. Studies may confuse receiving benefits with being a claimant, or equate having contacted a lawyer with being in the compensation system; they do not necessarily distinguish between the tort system and workers' compensation and are then cited to show that workers' compensation increases duration of disability.…”

Associations with legal representation in a compensation setting 12 months after injury

“…A recent review by Elbers et al [27] suggests that there are significant stressors in the compensation process, among them; numerous assessments, situations where claimants are confronted with the traumatic history of the injury event, delayed funds and financial risks. It has been suggested that claimants with lower general health, particularly mental health at baseline may be more vulnerable to the effects of these stressors [14,26]. These stressful processes have been associated with increased claim duration [27], increased lawyer involvement [17], and increased health care utilisation [28].…”

“…Legal involvement in the compensation process has been associated with negative outcomes [11][12][13], with suggested reasons for the association generally referred to as the effects of prolonged exposure to the compensation system, in particular the adversarial nature of the system when lawyers become involved in a claim [14]. Some authors are critical of the research to date suggesting that there is insufficient evidence to draw a causal relationship between legal involvement and negative outcomesdo people with lawyer involvement have worse health as a consequence?…”

“…[15]. In addition, the research to date largely ignores what Grant et al refer to as 'the realities in the legal services markets' where prospective lawyers select cases according to their economic viability (from the perspective of the lawyer), with cases assessed based on the permanence of an injury and the associated impairment [14].…”