Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2017 | Research article

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

Authors: Darnel Murgatroyd, Ian A. Harris, Jian Sheng Chen, Sam Adie, Rajat Mittal, Ian D. Cameron

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Abstract

Background

Compensation 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.

Methods

Participants 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.

Results

The 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).

Conclusions

Seeking 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.

World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization; 2009. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf. Accessed 1 March 2017.

Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. [Erratum appears in Lancet. 2013 Feb 23;381(9867):628 Note: AlMazroa, Mohammad A [added]; Memish, Ziad A [added]]. Lancet. 2012;380(9859):2197–223.CrossRefPubMed

Littleton SM, Cameron ID, Poustie SJ, Hughes DC, Robinson BJ, Neeman T, et al. The association of compensation on longer term health status for people with musculoskeletal injuries following road traffic crashes: emergency department inception cohort study. Injury. 2011;42(9):927–33.CrossRefPubMed

Yang Z, Lowe AJ, de la Harpe DE, Richardson MD. Factors that predict poor outcomes in patients with traumatic vertebral body fractures. Injury. 2010;41(2):226–30.CrossRefPubMed

Clay FJ, Newstead SV, Watson WL, Ozanne-Smith J, Guy J, McClure RJ. Bio-psychosocial determinants of persistent pain 6 months after non-life-threatening acute orthopaedic trauma. J Pain. 2010;11(5):420–30.CrossRefPubMed

Mock C, Mackenzie E, Jurkovich G, Burgess A, Cushing B, deLateur B, et al. Determinants of disability after lower extremity fracture. J Trauma. 2000;49(6):1002–11.CrossRefPubMed

Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, et al. An analysis of outcomes of reconstruction or amputation of leg-threatening injuries. N Engl J Med. 2002;347(24):1924–31.CrossRefPubMed

Harris IA, Young JM, Dalaludin BB, Solomon MJ. The effect of compensation on general health in patients sustaining fractures in motor vehicle trauma. J Orthop Trauma. 2008;22(4):216–20.CrossRefPubMed

Gabbe B, Cameron P, Williamson O, Edwards E, Graves S, Richardson M. The relationship between compensable status and long-term patient outcomes following orthopaedic trauma. Med J Aust. 2007;187(1):14–7.PubMed

10.

Spearing NM, Connelly LB, Gargett S, Sterling M. Does injury compensation lead to worse health after whiplash? A systematic review. [Review]. Pain. 2012;153(6):1274–82.CrossRefPubMed

11.

Spearing NM, Connelly LB. Is compensation “bad for health”? A systematic meta-review. [Review]. Injury. 2011;42(1):15–24.CrossRefPubMed

12.

Grimes DA, Schulz KF. Bias and causal associations in observational research. Lancet. 2002;359(9302):248–52.CrossRefPubMed

13.

Atlas SJ, Tosteson TD, Blood EA, Skinner JS, Pransky GS, Weinstein JN. The impact of workers’ compensation on outcomes of surgical and nonoperative therapy for patients with a lumbar disc herniation: SPORT. Spine (Phila Pa 1976). 2010;35(1):89–97.CrossRef

14.

Elbers NA, Hulst L, Cuijpers P, Akkermans AJ, Bruinvels DJ. Do compensation processes impair mental health? A meta-analysis. [Review]. Injury. 2013;44(5):674–83.CrossRefPubMed

15.

Grant GM, O'Donnell ML, Spittal MJ, Creamer M, Studdert DM. Relationship between stressfulness of claiming for injury compensation and long-term recovery: a prospective cohort study. JAMA Psychiat. 2014;71(4):446–53.CrossRef

16.

Carroll LJ, Connelly LB, Spearing NM, Cote P, Buitenhuis J, Kenardy J. Complexities in understanding the role of compensation-related factors on recovery from whiplash-associated disorders: discussion paper 2. Spine (Phila Pa 1976). 2011;36(25 Suppl):S316–21.CrossRef

17.

Clay F, Berecki-Gisolf J, Collie A. How well do we report on compensation systems in studies of return to work: a systematic review. J Occup Rehabil. 2014;24(1):111–24.CrossRefPubMed

18.

Safe Work Australia. Work-related injuries in Australia: Who did and didn’t receive workers’ compensation in 2009–10. Canberra: Safe Work Australia; 2011. Available from: http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/644/Who%20did%20and%20did%20not%20receive%20workers%20compensation%202009-10.pdf. Accessed 1 March 2017.

19.

Australian Bureau of Statistics. 6324.0 - Work-Related Injuries, Australia, Jul 2013 to Jun 2014. Canberra: Australian Bureau of Statistics; 2014. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/6324.0. Accessed 1 March 2017.

20.

Sterling M, Hendrikz J, Kenardy J. Compensation claim lodgement and health outcome developmental trajectories following whiplash injury: a prospective study. Pain. 2010;150(1):22–8.CrossRefPubMed

21.

Kilgour E, Kosny A, McKenzie D, Collie A. Interactions between injured workers and insurers in workers’ compensation systems: a systematic review of qualitative research literature. J Occup Rehabil. 2015;25(1):160–81.CrossRefPubMed

22.

Kilgour E, Kosny A, McKenzie D, Collie A. Healing or harming? Healthcare provider interactions with injured workers and insurers in workers’ compensation systems. J Occup Rehabil. 2015;25(1):220–39.CrossRefPubMed

23.

Murgatroyd DF, Cameron ID, Harris IA. Understanding the effect of compensation on recovery from severe motor vehicle crash injuries: a qualitative study. Inj Prev. 2011;17(4):222–7.CrossRefPubMed

24.

Gabbe BJ, Sleney JS, Gosling CM, Wilson K, Sutherland A, Hart M, et al. Financial and employment impacts of serious injury: a qualitative study. Injury. 2014;45(9):1445–51.CrossRefPubMed

25.

Bagley S, White H, Golomb B. Logistic regression in the medical literature: standards for use and reporting, with particular attention to one medical domain. J Clin Epidemiol. 2001;54:979–85.CrossRefPubMed

26.

Harris IA, Young JM, Rae H, Jalaludin BB, Solomon MJ. Predictors of general health after major trauma. J Trauma Inj Infect Crit Care. 2008;64(4):969–74.CrossRef

27.

Murgatroyd DF, Harris IA, Tran Y, Cameron ID. The association between seeking financial compensation and injury recovery following motor vehicle related orthopaedic trauma. BMC Musculoskelet Disord. 2016;17:282.CrossRefPubMedPubMedCentral

28.

Murgatroyd DF, Harris IA, Tran Y, Cameron ID. Predictors of return to work following motor vehicle related orthopaedic trauma. BMC Musculoskelet Disord. 2016;17(1):1–13.CrossRef

29.

MacKenzie EJ, Bosse MJ, Pollak AN, Webb LX, Swiontkowski MF, Kellam JF, et al. Long-term persistence of disability following severe lower-limb trauma. Results of a seven-year follow-up. J Bone Joint Surg Am. 2005;87(8):1801–9.PubMed

30.

Holbrook TL, Hoyt DB, Stein MB, Sieber WJ. Perceived threat to life predicts posttraumatic stress disorder after major trauma: risk factors and functional outcome. J Trauma Inj Infect Crit Care. 2001;51(2):287–92. discussion 92-3.CrossRef

31.

State Insurance Regulatory Authority, NSW. Guide for people injured in a motor vehicle accident. Available from: http://www.sira.nsw.gov.au/resources-library/motor-accident-resources/publications/injury-advice-centre/guide-for-people-injured-in-a-motor-vehicle-accident/_nocache. Accessed 1 March 2017.

32.

State Insurance Regulatory Authority, NSW. Workers Compensation. Available from: http://www.sira.nsw.gov.au/workers-compensation. Accessed 1 March 2017.

33.

Association for the Advancement of Automotive Medicine. The Abbreviated Injury Scale, 1990 Revision, Update 98. Barrington, Illinois: Association for the Advancement of Automotive Medicine; 1998.

34.

Baker SP, O'Neill B, Haddon Jr W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187–96.CrossRefPubMed

35.

Stevenson M, Segui-Gomez M, Lescohier I, Di Scala C, McDonald-Smith G. An overview of the injury severity score and the new injury severity score. Inj Prev. 2001;7(1):10–3.CrossRefPubMedPubMedCentral

36.

Australian Bureau of Statistics. Australian Standard Classification of Occupations (ASCO), Cat.no. 1220.0: Australian Bureau of Statistics; 1997. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/66f306f503e529a5ca25697e0017661f/5c244fd9d252cfc8ca25697e00184d35!OpenDocument. Accessed 1 March 2017.

37.

Australian Bureau of Statistics. 4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13. Canberra: Australian Bureau of Statistics. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4363.0.55.001Glossary12011-13?OpenDocument. Accessed 1 March 2017.

38.

Australian Bureau of Statistics. Technical Paper Census of Population and Housing: Socio-Economic Indexes for Area’s (SEIFA), Cat no. 2039.0.55.001: Australian Bureau of Statistics; 2001. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2039.0.55.0012001?OpenDocument. Accessed 1 March 2017.

39.

Australian Bureau of Statistics. National Health Survey: Users’ Guide – Electronic Publication, Cat.no. 4363.0.55.001: Australian Bureau of Statistics; 2004-05. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/ProductsbyReleaseDate/E88508137A2912FECA25762E0017C550?OpenDocument. Accessed 1 March 2017.

40.

Australian Institute of Health and Welfare. National Health Priority Areas. Available from: http://www.aihw.gov.au/national-health-priority-areas/. Accessed 1 March 2017.

41.

Australian Bureau of Statistics. National Health Survey: Summary of Results, Cat. No. 4364.0: Australian Bureau of Statistics; 2004-05. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.02004-05?OpenDocument. Accessed 1 March 2017.

42.

Foreman P, Murphy G, Swerissen H. Barriers and facilitators to return to work: A literature review. Melbourne: Australian Institute for Primary Care, La Trobe University; 2006. Available from: http://www.tavrp.com/wp-content/uploads/2014/07/LaTrobeRTWReview0706.pdf. Accessed 1 March 2017.

43.

Cole DC, Mondloch MV, Hogg-Johnson S, Early Claimant Cohort Prognostic Modelling G. Listening to injured workers: how recovery expectations predict outcomes--a prospective study. Can Med Assoc J. 2002;166(6):749–54.

44.

Mondloch MV, Cole DC, Frank JW. Does how you do depend on how you think you’ll do? A systematic review of the evidence for a relation between patients’ recovery expectations and health outcomes.[erratum appears in CMAJ 2001 Nov 13;165(10):1303]. Can Med Assoc J. 2001;165(2):174–9.

45.

Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The Alcohol Use Disorders Identification Test, Guidelines Use in Primary Care, Second Edition: Department of Mental Health and Substance Dependence, World Health Organization; 2001. Available from: http://apps.who.int/iris/bitstream/10665/67205/1/WHO_MSD_MSB_01.6a.pdf. Accessed 1 March 2017.

46.

Bush K, Kivlahan D, McDonell M, Fihn S, Bradley K. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol use disorders identification test. Arch Intern Med. 1998;158(16):1789–95.CrossRefPubMed

47.

National Health and Medical Research Council. Australian Alcohol Guidelines, Health Risks and Benefits: National Health and Medical Research Council, Commonwealth of Australia. 2001. Available from: https://www.nhmrc.gov.au/guidelines-publications/ds9. Accessed 1 March 2017.

48.

University of Sydney. The Drink-less program, Alcohol Use Disorders Identification Test (AUDIT): University of Sydney. Available from: http://sydney.edu.au/medicine/addiction/drinkless/resources.php. Accessed 1 March 2017.

49.

Making a claim, Information you need to know when making a claim if you have been injured in a car crash. State Insurance Regulatory Authority, NSW; 2017. Available from: http://www.sira.nsw.gov.au/motor-accidents/making-a-claim. Accessed 1 March 2017.

50.

Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. New York: John Wiley & Sons; 2000.CrossRef

51.

Cameron AJ, Magliano DJ, Dunstan DW, Zimmet PZ, Hesketh K, Peeters A, et al. A bi-directional relationship between obesity and health-related quality of life: evidence from the longitudinal AusDiab study. Int J Obes. 2012;36(2):295–303.CrossRef

52.

Wong E, Stevenson C, Backholer K, Mannan H, Pasupathi K, Hodge A, et al. Adiposity measures as predictors of long-term physical disability. Ann Epidemiol. 2012;22(10):710–6.CrossRefPubMed

53.

Wright LJ, Schur E, Noonan C, Ahumada S, Buchwald D, Afari N. Chronic pain, overweight, and obesity: findings from a community-based twin registry. J Pain. 2010;11(7):628–35.CrossRefPubMedPubMedCentral

54.

Ostbye T, Dement JM, Krause KM. Obesity and workers’ compensation: results from the Duke Health and Safety Surveillance System. Arch Intern Med. 2007;167(8):766–73.CrossRefPubMed

55.

Finkelstein EA, DiBonaventura M, Burgess SM, Hale BC. The costs of obesity in the workplace. J Occup Environ Med. 2010;52(10):971–6.CrossRefPubMed

56.

Trogdon JG, Finkelstein EA, Hylands T, Dellea PS, Kamal-Bahl SJ. Indirect costs of obesity: a review of the current literature. Obes Rev. 2008;9(5):489–500.CrossRefPubMed

57.

Johnston P, Brooks C, Savage H. Fatal and serious road crashes involving motorcyclists Canberra: Road Safety, Infrastructure and Surface Transport Policy, Department of Infrastructure, Transport, Regional Development and Local Government. 2008. Available from: https://infrastructure.gov.au/roads/safety/publications/2008/pdf/mono20.pdf. Accessed 1 March 2017.

58.

Wilson SJ, Begg DJ, Samaranayaka A. Validity of using linked hospital and police traffic crash records to analyse motorcycle injury crash characteristics. Accid Anal Prev. 2012;49:30–5.CrossRefPubMed

59.

Lujic S, Finch C, Boufous S, Hayen A, Dunsmuir W. How comparable are road traffic crash cases in hospital admissions data and police records? An examination of data linkage rates. Aust N Z J Public Health. 2008;32(1):28–33.CrossRefPubMed

60.

Australian guidelines to reduce health risks from drinking alcohol. Canberra: National Health and Medical Research Council; 2009. Available from: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/ds10-alcohol.pdf. Accessed 1 March 2017.

61.

National Preventative Health Taskforce. Technical Report No 3: Preventing alcohol-related harm in Australia: a window of opportunity. Prepared for the National Preventative Health Taskforce by the Alcohol Working Group. 2008. Available from: http://www.health.gov.au/internet/preventativehealth/publishing.nsf/Content/tech-alcohol-toc. Accessed 1 March 2017.

62.

Australian Institute of Health and Welfare 2010. Australia’s health 2010. Australia’s health series no. 12. Cat. no. AUS 122. Canberra: Australian Institute of Health and Welfare; 2010. Available from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442452962. Accessed 1 March 2017.

63.

Australian Bureau of Statistics. 4228.0 - Adult Literacy and Life Skills Survey, Summary Results, Australia, 2006 (Reissue). Canberra: Australian Bureau of Statistics; 2008. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Previousproducts/4228.0Main%20Features22006%20%28Reissue%29?opendocument&tabname=Summary&prodno=4228.0&issue=2006%20%28Reissue%29&num=&view. Accessed 1 March 2017.

64.

Sullivan M, Adams H, Horan S, Maher D, Boland D, Gross R. The role of perceived injustice in the experience of chronic pain and disability: scale development and validation. J Occup Rehabil. 2008;18(2):249–61.CrossRefPubMed

65.

Thompson J, O'Donnell M, Stafford L, Nordfjaern T, Berk M. Association between attributions of responsibility for motor vehicle crashes, depressive symptoms, and return to work. Rehabil Psychol. 2014;59(4):376–85.CrossRefPubMed

66.

Prang K-H, Newnam S, Berecki-Gisolf J. The impact of family and work-related social support on musculoskeletal injury outcomes: a systematic review. J Occup Rehabil. 2015;25(1):207–19.CrossRefPubMed

67.

Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998;3(4):322–55.CrossRefPubMed

68.

Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631–7.CrossRefPubMed

Title: Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries
Authors: Darnel Murgatroyd
Ian A. Harris
Jian Sheng Chen
Sam Adie
Rajat Mittal
Ian D. Cameron
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-017-1535-z

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Increased fragility fracture risk in Korean women who snore: a 10-year population-based prospective cohort study

Single versus double row suture anchor fixation for greater tuberosity fractures – a biomechanical study

Use of a decision aid did not decrease decisional conflict in patients with carpal tunnel syndrome

Quantifying bone marrow inflammatory edema in the spine and sacroiliac joints with thresholding

Correlation of blood bone turnover biomarkers and Wnt signaling antagonists with AS, DISH, OPLL, and OYL

Risk factors for joint replacement in knee osteoarthritis; a 15-year follow-up study