Canada Research Chair in Occupational Health and Safety Law, University of Ottawa, Faculty of Law, Civil Law Section, Ontario, Canada.
Am J Ind Med. 2012 Jun;55(6):519-36. doi: 10.1002/ajim.22022. Epub 2012 Feb 21.
Workers' compensation systems are among the most generous disability insurance systems in North America, although they are also known to be potentially adversarial and may have iatrogenic effects on claimants. This article examines issues to be considered to ensure fair compensation provided in a way that respects the dignity of workers.
An overview of the literature on characteristics and effects of workers' compensation systems is followed by an analysis based on classic legal methods, including those of comparative law, complemented with interview data to examine three models of disability compensation.
The first part of the article identifies cross cutting issues to be considered in the examination of the equity of compensation systems and the protection of the dignity of claimants. These include three underpinnings of workers' compensation: the links between a "no-fault" system and the adversarial process, the appropriate use of medical and scientific evidence in the determination of compensability and the application of appropriate measures for promoting return to work. The second part looks at accident compensation in New Zealand, where compensation is available regardless of the cause of the accident, and disability insurance in the Netherlands, where compensation is available regardless of the cause of the disability. It then describes a composite of characteristics favorable to equity drawn from the thirteen workers' compensation systems in Canada.
Systems that succeed in reducing opportunities for adversarial interactions and that provide substantive protection could better promote the dignity of claimants.
工人赔偿制度是北美最慷慨的残疾保险制度之一，但也以潜在的对抗性和可能对索赔人产生医源性影响而闻名。本文探讨了确保以尊重工人尊严的方式提供公平赔偿时需要考虑的问题。
本文首先对工人赔偿制度的特点和影响进行了文献综述，然后基于经典法律方法进行了分析，包括比较法，并辅以访谈数据，以考察三种残疾赔偿模式。
文章的第一部分确定了审查赔偿制度的公平性和保护索赔人尊严时需要考虑的交叉问题。这些问题包括工人赔偿的三个基础：“无过错”制度与对抗性程序之间的联系、在确定可赔偿性时适当使用医学和科学证据以及适用适当的促进重返工作岗位的措施。第二部分研究了新西兰的事故赔偿，无论事故原因如何都可以获得赔偿，以及荷兰的残疾保险，无论残疾原因如何都可以获得赔偿。然后，它描述了从加拿大的十三个工人赔偿制度中提取的有利于公平的综合特征。
成功减少对抗性互动机会并提供实质性保护的制度，可以更好地促进索赔人的尊严。
