The impact of psychological distress on compensation outcomes

Rebecca Guest, Yvonne Tran, Ashley Craig

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


It is important to determine whether psychological distress associated with
musculoskeletal injuries sustained in a motor vehicle crash (MVC), regardless of time of onset, has an impact on compensation outcomes such as claim settlement times and costs. It is equally important to identify factors routinely collected by insurance companies that may contribute to psychological distress during the compensation process. Accordingly a state-wide retrospective study was conducted aimed at analysing the New South Wales state-wide (Australia) injury register for MVC survivors who lodged and completed a compensation claim between 2011 to 2013. Participant records of 6,341 adults who
sustained a musculoskeletal injury, and who settled a claim for injury after a MVC were analysed, and of these, 607 were diagnosed with elevated psychological distress versus 5,734 who had not. Time to settlement and total costs of claims, as well as socio-demographic and injury characteristics that may contribute to elevated psychological distress, such as socioeconomic disadvantage and injury severity were analysed. The analysis revealed that psychological distress in those with a musculoskeletal injury was associated with significantly longer settlement times (an additional 17 weeks) and considerably higher costs (an additional A$41, 575.00, or 4.3 times more expensive).
Multivariate logistic regression analysis identified risk factors for psychological distress including being female, social disadvantage, unemployment prior to the claim, not being at fault in the MVC, requiring ambulance transportation and rehabilitation as part of recovery. Results provide compelling evidence that psychological distress has an adverse impact on people with musculoskeletal injury as they progress through compensation. Findings suggest additional resources should be directed toward claimants who are at risk (e.g., the socially disadvantaged or those unemployed prior to the claim), the major aim being to reduce risk of psychological distress (e.g., post-traumatic stress disorder or depression), and associated risk of increased settlement times and claim costs.
Prospective studies are now required that investigate treatment strategies for those at risk of psychological distress associated with a MVC.
Original languageEnglish
Title of host publicationAdversity after the crash
Subtitle of host publicationthe physical, psychological and social burden of motor vehicle crashes
EditorsAshley Craig, Rebecca Guest
Place of PublicationNew York
PublisherNova Science Publishers
Number of pages18
ISBN (Electronic)9781536145649
ISBN (Print)9781536145632
Publication statusPublished - 2019


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