OBJECTIVES

We documented barriers to workers' compensation and injury-related medical care faced by homecare or Personal Assistance Services (PAS) workers. We explored differences between independent providers and agency-employed workers.

METHODS

We conducted in-depth, semi-structured interviews with a diverse sample of 38 injured workers. Participants were primarily female and racial-ethnic minorities.

RESULTS

Most participants (82%) were independent providers. Common barriers to reporting injury included commitments to clients and financial pressure. Unlike agency employees, many independent providers knew little about workers' compensation eligibility and injury reporting procedures, and frequently were given "the runaround" by the social service bureaucracy when they attempted to report injury and access injury-related medical care. Among independent providers, delays in filing a claim and receiving timely medical attention were common.

CONCLUSIONS

The lack of a traditional employment infrastructure has important implications for vulnerable workers' health and the sustainability of consumer-directed PAS programs. We provide recommendations for improving workers' access to workers' compensation and injury-related medical care.