Casey Petrina P, Feyer Anne Marie, Cameron Ian D
Rehabilitation Studies Unit, Kolling Institute, University of Sydney, NSW 2065, Australia.
Lead, Occupational Health and Safety Research Program, Institute of Safety, Compensation, Rehabilitation and Recovery Research, Level 11, 499 St Kilda Road, Melbourne, VIC 3004, Australia.
Injury. 2015 May;46(5):918-25. doi: 10.1016/j.injury.2015.01.003. Epub 2015 Jan 12.
Many people with Whiplash Associated Disorder (WAD) seek treatment though a compensation system where factors such as legal involvement have been reported as having a negative impact on recovery outcomes.
To compare those with and without legal involvement in their compensation claim, and identify associations with legal involvement at 12 months post injury; and longer term disability.
Inception cohort study.
246 people with WAD compensation claim.
Legal involvement and Functional Rating Index at 12 months post injury.
Participants were recruited from an insurance database. Baseline health (Functional Rating Index, Pain Catastrophising Scale and SF-36), socio-economic, work capacity, and claims data were collected within three months of injury and 12 months. Logistic regression models were used to identify associations with legal involvement at 12 months; and disability (FRI) at 12 months.
At baseline 246 participants were enrolled into the study in a median 72 days post injury. At 12 months post injury 52 (25%) had engaged a lawyer. The significant independent associations with legal involvement at 12 months were higher levels of initial disability, work disability, speaking a language other than English at home and lower levels of mental health. Specifically, the odds of lawyer involvement at 12 months post injury was 4.9 times greater for those with work disability; 2.3 times greater for those who spoke a language other than English at home. In terms of health, they had poorer mental health and for every 10 unit increase in the baseline FRI score the odds of having lawyer involvement increased by 38%. DISABILITY: at 12 months (FRI) was significantly independently associated with, PCS-helplessness (p<0.001), age (p<0.001) and prior claim (p=0.001).
This study suggests the people with lawyer involvement in their claim 12 months after injury have socio-economic disadvantage, have had a prior claim and a worse baseline health profile compared to those without a lawyer. Understanding this profile could allow for improved claims processes and targeted interventions to assist this group through any perceived complexities in the system and address the underlying reasons for lawyer participation within compensation schemes.
许多患有挥鞭样损伤相关疾病（WAD）的人通过赔偿系统寻求治疗，据报道，诸如法律介入等因素会对康复结果产生负面影响。
比较赔偿申请中有法律介入和无法律介入的人群，并确定受伤后12个月时与法律介入的关联；以及长期残疾情况。
队列起始研究。
246名提出WAD赔偿申请的人。
受伤后12个月时的法律介入情况和功能评定指数。
从一个保险数据库招募参与者。在受伤后三个月内和12个月时收集基线健康状况（功能评定指数、疼痛灾难化量表和SF-36）、社会经济状况、工作能力和索赔数据。使用逻辑回归模型确定受伤后12个月时与法律介入的关联；以及12个月时的残疾情况（功能评定指数）。
基线时，246名参与者在受伤后中位72天被纳入研究。受伤后12个月时，52人（25%）聘请了律师。受伤后12个月时与法律介入显著独立相关的因素包括初始残疾程度较高、工作残疾、在家说英语以外的语言以及心理健康水平较低。具体而言，受伤后12个月聘请律师的几率，工作残疾者是其他人的4.9倍；在家说英语以外语言者是其他人的2.3倍。在健康方面，他们的心理健康较差，基线功能评定指数（FRI）评分每增加10分，聘请律师的几率就增加38%。残疾情况：12个月时的功能评定指数（FRI）与疼痛灾难化量表无助感（p<0.001）、年龄（p<0.001）和既往索赔（p=0.001）显著独立相关。
本研究表明，与未聘请律师的人相比，受伤后12个月索赔中有律师介入的人存在社会经济劣势，有既往索赔且基线健康状况较差。了解这一情况有助于改进索赔流程，并进行有针对性的干预，以帮助这一群体应对系统中任何明显的复杂情况，并解决赔偿计划中律师参与的潜在原因。
