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

Abstract

BackgroundWorkers' compensation systems are among the most generous disability insurance systems in North America, although they are also known to be potentially adversarial and may have iatrogenic effects on claimants. This article examines issues to be considered to ensure fair compensation provided in a way that respects the dignity of workers.MethodsAn overview of the literature on characteristics and effects of workers' compensation systems is followed by an analysis based on classic legal methods, including those of comparative law, complemented with interview data to examine three models of disability compensation.ResultsThe first part of the article identifies cross cutting issues to be considered in the examination of the equity of compensation systems and the protection of the dignity of claimants. These include three underpinnings of workers' compensation: the links between a “no‐fault” system and the adversarial process, the appropriate use of medical and scientific evidence in the determination of compensability and the application of appropriate measures for promoting return to work. The second part looks at accident compensation in New Zealand, where compensation is available regardless of the cause of the accident, and disability insurance in the Netherlands, where compensation is available regardless of the cause of the disability. It then describes a composite of characteristics favorable to equity drawn from the thirteen workers' compensation systems in Canada.ConclusionSystems that succeed in reducing opportunities for adversarial interactions and that provide substantive protection could better promote the dignity of claimants. Am. J. Ind. Med. 55:519–536, 2012. © 2012 Wiley Periodicals, Inc.

Introduction

“…Its regulation is based on broadly common models in most countries, where employers assume the cost of premiums to ensure some form of access to health care and economic support for their employees in case of work-related injury or disease (Ison, 1998;Lippel, 2012). There are some universal characteristics to these systems: coverage is provided regardless of the fault of the worker or the employer, benefits are generally lower than those that could be obtained through lawsuits in the civil courts, and claims are adjudicated outside the traditional judicial forum.…”

“…Leurs modes de fonctionnement sont largement communs aux différents pays : les employeurs assument le coût des cotisations qui fournissent à leurs salariés un certain type d'accès aux soins de santé et un soutien économique en cas d'accident ou de maladie liés au travail (Ison, 1998 ;Lippel, 2012). Ces systèmes présentent quelques caractéristiques universelles : la couverture est assurée sans égard à la faute du travailleur ou de l'employeur; les prestations sont généralement plus faibles que celles qu'une action en justice pourrait accorder; les litiges sont réglés hors des tribunaux de droit commun.…”

Ethical Perspectives in Work Disability Prevention and Return to Work: Toward a Common Vocabulary for Analyzing Stakeholders’ Actions and Interactions

“…Employer responsibilities will influence what decisions managers need to take in order to comply with regulations, which will in turn influence how workers are treated. Similarly, systems that provide substantive protection and that successfully reduce adversarial interactions have been identified as being better at promoting claimants' dignity (Lippel 2012). Different compensation systems also have different perspectives regarding who is the "client".…”

Reexamining workers' compensation: A human rights perspective

“…Further, experiences attempting to obtain workers' compensation benefits and the stigma attached to applying for them are often so negative that they are themselves barriers to filing. These issues are discussed in this issue by Lippel [2012] and Hilgert [2012].…”

“…Although McCluskey looks to the financing of insurance in the U.S. as a source of change, Lippel [2012] takes us abroad to examine how other countries handle compensation of occupational injuries and illnesses, with an eye toward the goals of equity and the dignity of injured workers. Lippel focuses on several dimensions that she sees as necessary to protect the human rights of injured workers.…”