The Great Trade-off in Workers’ Compensation: Perceptions of Injustice by Those Experiencing Persistent Pain

Abstract

Introduction Some claimants harbor perceptions of injustice about the way they have been treated. In particular, those with ongoing and disabling pain have been generally dissatisfied by the way they have been managed by the systems designed to offer them financial compensation. Aim To explore possible factors that may contribute to their dissatisfaction. Method We review the historical development of the various systems in which monetary compensation was awarded for personal injury. Findings In the latter years of the 19th century, a significant trade-off occurred in the German workers’ compensation systems. On the one hand employers accepted the principle of no-fault insurance and agreed to provide injured workers with monetary compensation and medical treatment. On the other hand, employees agreed to relinquish the right to sue their employer for negligence. However, awards under this legal system did not include assessments for ongoing pain, humiliation, or loss of social status as were incorporated in previous systems. Conclusion Although the Prussian and German approach provided a utilitarian model for similar systems around the world, its failure to include some long-established benefits of a moral nature may have contributed to the current perceptions of injustice expressed by many injured workers experiencing persistent pain.

Appraisal of Washington State workers' compensation‐based return‐to‐work programs and suggested system improvements: A survey of workers with permanent impairments

“…This suggestion resonates with a recent paper describing the historical origins of excluding pain from compensation, and concluding that the resulting WC systems fail to address certain harms and may contribute to perceptions of injustice and adverse health outcomes. 45 The findings of this study suggest that, although the majority of workers appraised WC-based RTW programs favorably, there is also substantial room for improvement in workers' experience with the WC system. In addition, injured workers' feedback may reflect opportunities to reduce administrative burden and to improve health and RTW outcomes.…”

“…The Washington State Department of Labor and Industries (L&I) administers the WC system, which includes the State Fund (covering about 70% of workers specified by Washington's Industrial Insurance Act 45 ), and self-insured employers (covering the remaining 30%).…”

Involvement in a Personal Injury Claim Is Associated With More Pain and Delayed Return to Work After Elective Nonsurgical or Surgical Treatment for Hand or Wrist Disorders: A Propensity Score–matched Comparative Study

“…Still, loss of (future) income and general compensatory damages will be relevant issues to patients in both settings. Additionally, feelings of psychological distress [ 7 ] and perceived injustice [ 23 , 28 ] will affect personal injury claim patients irrespective of country, suggesting that the similarities in personal injury claims between countries may outweigh the differences. This is in line with a meta-analysis of surgical treatment outcomes of patients with workers compensation or involved in litigation [ 15 ], where it was shown that the association between compensation and worse treatment outcomes was consistently present in the United States, Canada, Europe, and Australia.…”