Is compensation "bad for health"? A systematic meta-review
ABSTRACT There is a common perception that injury compensation has a negative impact on health status, and systematic reviews supporting this thesis have been used to influence policy and practice decisions. This study evaluates the quality of the empirical evidence of a negative correlation between injury compensation and health outcomes, based on systematic reviews involving both verifiable and non-verifiable injuries.
Systematic meta-review (a "review of reviews").
PubMED, CINAHL, EMBASE, PEDro, PsycInfo, EconLit, Lexis, ABI/INFORM, The Cochrane Library, and the AHRQ EPC were searched from the date of their inception to August 2008, and hand searches were conducted.
Selection criteria were established a priori. Included systematic reviews examined the impact of compensation on health, involved adults, were published in English and used a range of outcome measures. Two investigators independently applied standard instruments to evaluate the methodological quality of the included reviews. Data on compensation scheme design (i.e., the intervention) and outcome measures were also extracted.
Eleven systematic reviews involving verifiable and non-verifiable injuries met the inclusion criteria. Nine reviews reported an association between compensation and poor health outcomes. All of them were affected by the generally low quality of the primary (observational) research in this field, the heterogeneous nature of compensation laws (schemes) and legal processes for seeking compensation, and the difficulties in measuring compensation in relation to health.
Notwithstanding the limitations of the research in this field, one higher quality review examining a single compensation process and relying on primary studies using health outcome (rather than proxy) measures found strong evidence of no association between litigation and poor health following whiplash, challenging the general belief that legal processes have a negative impact on health status. Moves to alter scheme design and limit access to compensation on the basis that it is "bad for health" are therefore premature, as evidence of such an association is unclear.
Full-textDOI: · Available from: Luke Connelly, Aug 28, 2015
- SourceAvailable from: Katherine Lippel
[Show abstract] [Hide abstract]
- "This approach is built on the premise of ''moral hazard''[Dembe and Boden, 2000; Campolieti, 2002], that access to benefits will prolong duration of disability, implicitly, or explicitly suggesting malingering , and as such contributes to the stigmatization of workers' compensation claimants. Recent research warns against the use of such studies in the redesign of compensation systems [Spearing and Connelly, 2011]. Evidence-Based Decision Making: Is Science Used Appropriately in Workers' Compensation Systems Practice of evidence-based occupational medicine exploitation of scientific uncertainty, and co-opting of physicians [Bohme and Egilman, 2008; Guidotti, 2008] and science by industry, and to some extent by governments has been well documented in the contexts of both the regulatory and liability agendas [Michaels, 2008]. "
ABSTRACT: Workers' 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. An 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. The 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. Systems that succeed in reducing opportunities for adversarial interactions and that provide substantive protection could better promote the dignity of claimants.American Journal of Industrial Medicine 06/2012; 55(6):519-36. DOI:10.1002/ajim.22022 · 1.59 Impact Factor
[Show abstract] [Hide abstract]
- "In the Netherlands, each year about 50.000 people file a PI liability claim. Research has shown that the current claims settlement process has a negative impact on personal injury (PI) victims' health and well-being . Most of the studies that investigated the influence of litigation or compensation on health show that PI victims who are involved in litigation are less likely to return to work , have more disability, worse health outcomes [3,4], increased pain intensity and decreased physical functioning [5-8], and more symptoms of depression, anxiety and distress [9-14] than non-litigating PI victims. "
ABSTRACT: Research has shown that current claims settlement process can have a negative impact on psychological and physical recovery of personal injury (PI) victims. One of the explanations for the negative impact on health is that the claims settlement process is a stressful experience and victims suffer from renewed victimization caused by the claims settlement process. PI victims can experience a lack of information, lack of involvement, lack of 'voice', and poor communication. We present the first study that aims to empower PI victims with respect to the negative impact of the claims settlement process by means of an internet intervention. The study is a two armed, randomized controlled trial (RCT), in which 170 PI victims are randomized to either the intervention or control group. The intervention group will get access to a website providing 1) an information module, so participants learn what is happening and what to expect during the claims settlement process, and 2) an e-coach module, so participants learn to cope with problems they experience during the claims settlement process. The control group will get access to a website with hyperlinks to commonly available information only. Participants will be recruited via a PI claims settlement office. Participants are included if they have been involved in a traffic accident which happened less than two years ago, and are at least 18 years old.The main study parameter is the increase of empowerment within the intervention group compared to the control group. Empowerment will be measured by the mastery scale and a self-efficacy scale. The secondary outcomes are perceived justice, burden, well being, work ability, knowledge, amount of damages, and lawyer-client communication. Data are collected at baseline (T0 measurement before randomization), at three months, six months, and twelve months after baseline. Analyses will be conducted according to the intention-to-treat principle. This study evaluates the effectiveness of an internet intervention aimed at empowerment of PI victims. The results will give more insight into the impact of compensation proceedings on health over time, and they can have important consequences for legal claims settlement. Strengths and limitations of this study are discussed. Netherlands Trial Register NTR2360.Trials 02/2011; 12:29. DOI:10.1186/1745-6215-12-29 · 2.12 Impact Factor
[Show abstract] [Hide abstract]
- "Added to the concept that compensation neurosis represents malingering is the belief that claimants experience a " magical cure " immediately following the settlement of their claims, although this has been established as generally inaccurate (Mayou 1995; Mendelson 1995; Merskey 1986; Scholten-Peeters et al. 2003). Accordingly, the legitimacy of the concept of compensation neurosis has been heavily criticized (e.g., Allaz et al. 1998; Mendelson 1988, 1991; Sears et al. 2008), with numerous empirical investigations and reviews (e.g., Burns et al. 1995; Melzack et al. 1985; Spearing and Connelly 2010; Swartzman et al. 1996; Tait et al. 1990) suggesting its very questionable validity. Nevertheless, litigation/compensation neurosis continues to be too frequently asserted within the medicolegal system (Batchelder v. "
ABSTRACT: Approximately half of the state legislatures in the USA have enacted tort reform, generally focused on reducing noneconomic damages such as those awarded for pain and suffering of traumatically injured parties. Traumatic injury has been empirically associated with the development of chronic pain, which in turn has been associated with the concept of human suffering. This analysis examines the meaning of suffering within the context of traumatically induced chronic pain, recognizing that this population is at heightened risk of experiencing long-term emotional as well as physical pain. Factors contributing to profound suffering include the potential development of post-traumatic stress disorder, depression and anxiety, role/identity loss, maltreatment by a medical system generally inept in its management of chronic pain, and the negative manner in which personal injury victims are often treated by the legal system. While the American medical system struggles to identify suffering, the legal system—through tort reform—has chosen to simply ignore it, demonstrating little concern for the integrity of the vulnerable chronic pain sufferer. In doing so, the “destructed” chronic painient is further “deconstructed”. We argue that by limiting the size of settlements and jury awards, tort reform serves to potentially deny personal injury victims of a critical vehicle for finding meaning in their suffering, and accordingly limits their likelihood of achieving relief. KeywordsTraumatic injury chronic pain-Suffering-Tort reform-PTSD-Depression-AnxietyPsychological Injury and Law 09/2010; 3(3):182-202. DOI:10.1007/s12207-010-9083-y