Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries

Abstract

BackgroundCompensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma. The study was conducted in New South Wales (NSW), Australia, in motor vehicle crash and workers’ compensation schemes.MethodsParticipants were patients admitted with upper or lower extremity factures following a motor vehicle crash to two trauma hospitals. Data were collected at baseline within two weeks of injury. Participants were followed up at six months. Analysis involved: descriptive statistics for baseline characteristics; comparison of compensable and non-compensable participants with Analysis of Variance (ANOVA) and chi-squared tests; and logistic regression for predictor models.ResultsThe cohort consisted of 452 participants with a mean age 40 years; 75% male; 74% working pre-injury; 30% in excellent pre-injury health; 56% sustained serious injuries with an Injury Severity Score (ISS) 9-15; 61% had a low-middle range household income; and 35% self-reported at fault in the crash. There was no significant difference in pre-injury/baseline health between compensable and non-compensable participants. Follow up data was available for 301 (67%) participants.The significant predictor of claiming compensation in the adjusted analysis was higher body mass index (BMI) (overweight Odds Ratio [OR] 3.05, 95% Confidence Interval [CI] 1.63-5.68; obese OR 1.63, 95% CI 0.83-3.20). Participants less likely to claim were: involved in a motorcycle crash (OR 0.47, 95% CI 0.28-0.82); socioeconomically less disadvantaged (OR 0.37, 95% CI 0.17-0.82) or least disadvantaged (OR 0.39, 95% CI 0.17-0.90); at risk for short term harm (injury) due to alcohol consumption (OR 0.56, 95% CI 0.32-0.97); and with fair-poor pre-injury health (OR 0.30, 95% CI 0.09-0.94). The predictors for seeking legal representation were speaking a language other than English at home (OR 2.80, 95% CI 1.2-6.52) and lower household income (OR 3.63, 95% CI 1.22-10.72). Participants less likely to seek legal representation were least socioeconomically disadvantaged (OR 0.15, 95% CI 0.04-0.50).ConclusionsSeeking financial compensation was associated with a higher pre-injury BMI rather than injury-related factors. Seeking legal representation was solely related to socio-economic factors.

Beyond symptom resolution: insurance case manager’s perspective on predicting recovery after motor vehicle crash

“…The CMs perceived greater variation in more subjective, less clinically defined conditions, especially where there appears to be a disconnection between the extent of injury and level of symptoms. In persons with minor injuries following a motor vehicle crash, the literature suggests that socio-economic factors in terms of seeking financial compensation were much more important than injury severity [6,27]. Co-morbidities and preinjury health status were consistently cited as very relevant predictors.…”

“…CMs thought that those who were not focused on compensation eligibility, not involved in litigation, and were compensated for care that was within treatment guidelines was predictive of a better outcome. Being involved in a compensation process has been cited as a negative factor for recovery by most systematic reviews [27,61,62]. Even though the compensation contexts in the USA and Australia are quite different, case managers from both countries spoke about how they perceived that people who were focused on compensation entitlement would not recover well.…”

Factors associated with long term work incapacity following a non-catastrophic road traffic injury: analysis of a two-year prospective cohort study

“…It is difficult to discern whether participants who could not return to work immediately after injury had a higher propensity to claim compensation, or whether compensation scheme factors contributed to delayed RTW. Claiming compensation was shown to be associated with reduced likelihood for RTW at all timepoints after accounting for covariates that include pre-injury health, disability, and psychological status, as people who have poorer outcomes under these domains are shown to be more likely to claim compensation and exhibit long-term work incapacity [ 58 ].…”