A Longitudinal Study of Compensation-Seeking and Return to Work in a Treated Mild Traumatic Brain Injury Sample

Abstract

The present study design does not allow for determination of the reasons for the strong relationship between financial compensation-seeking soon post-MTBI and a slow return to work. However, the strength of the present findings indicates that the presence or absence of financial compensation-seeking soon post-MTBI should be routinely evaluated when return to work is an issue.

Utility of the Validity-10 scale across the recovery trajectory following traumatic brain injury

“…Despite this statistically significant relationship, and after controlling for other variables, return to duty status only explained 1.9 percent of the variance in the Validity-10 scale. Previous research has shown that external incentives increase rates of invalid responding on neuropsychological tests [11][12][13][14][15]18,[20][21]; however, the current results suggest only a very mild relationship between external incentives and Validity-10 scale. It is likely that the small increase in Validity-10 scale in participants undergoing medical board evaluations and on limited duty (medical hold) is driven by underlying psychological distress.…”

“…Underreporting of TBI and postconcussive symptoms is a particular concern in athletes [6][7][8][9][10]. In contrast, overreporting symptoms is often found in patients who are involved in litigation or otherwise have potential for secondary gain [11][12][13][14][15]. Performance validity test failure rates have previously been shown to be high in Active Duty and Veteran samples, ranging from 11 to 59 percent [16][17][18][19][20][21][22][23][24].…”

Predictors of invalid neuropsychological test performance after traumatic brain injury

“…Whatever the explanation, there is no doubt that the presence or absence of financial compensation seeking is a strong moderating variable with regard to the degree of symptom reporting after TBI and that this cannot be explained by the effect of injury severity [20,34]. This association persists over time and also affects return to work [35,36]. It has been proposed that there may be an interaction with the effect of psychiatric history in this regard, where persons with longstanding emotional difficulties are more likely to pursue financial compensation with an associated increased focus on perceived disability and entitlement [37].…”

Investigation of factors related to employment outcome following traumatic brain injury: a critical review and conceptual model

“…23,33,51,55 Studies by Paniak et al 33 and Reynolds et al 55 found that individuals seeking or receiving compensation took longer to return to work than individuals who were not involved in the litigation process. In contrast, research by Fraser et al 23 and Hanlon et al 51 failed to find a significant difference in the employment outcomes between individuals involved and not involved in litigation.…”