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Consequences
The effect of financial compensation on rehabilitation

At a glance:
Compensation systems support workers by providing for medical costs and lost wages. This study shows that those who receive compensation are less likely to return to work after an injury.
Perspectives:
Employee
Compensation systems give injured workers vital support by providing for medical treatment and lost wages. Many workers could not survive without this support.

Problems often arise a year or two after an injury. People's lives have been disrupted, they are not in the habit of work, and they have reduced job prospects. This means that a return to work is less likely. However, continued absence from the workforce is associated with reduced income, social isolation, and depression.

The key message in this article is that receiving compensation reduces your chances of returning to work. This is not an argument against compensation, but it is important information for you to consider.

If you have injuries that affect your ability to work it is important to be clear about the broader impacts and dangers of long term sickness absence, and to participate actively in your rehabilitation.
Employer
Many people with a work injury report significant problems with their wages and compensation payments. Most common are delays in payment and a lack of understanding that payments are reduced or discontinued over time.

Avoiding misunderstandings or problems with payments can reduce the person's concentration on compensation, allowing them to focus on rehabilitation. This improves their return to work prospects.

It is also important for employers to give workers a clear understanding of what is expected of them, what they are due, and what is likely in their situation. Employees need this information before they can make sensible decisions.
Treater
A number of studies have found that people receiving compensation are less likely to return to work, a hypothesis that is supported by this study.

This may be because the individual is focused on compensation rather than rehabilitation. Those associated with the injured person (including treating practitioners) sometimes feel incapable of altering the situation, or improving the outcome. This may compound the situation.

The consequences of remaining out of work are profound, both for the individual and for their family.

Treating practitioners can influence return to work outcomes, and it is crucial that the treating practitioner
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
 recognises these issues and openly discusses the impact of compensation with patients. Providing clear advice on these issues gives people the information they need to make decisions about their return to work.
Insurer
Many people with a work injury report significant problems with their wages and compensation payments. Common issues are delays in payments and a lack of understanding that payments are reduced or discontinued over time. Giving people a clear understanding of what is expected, what they are due, and what is likely in their situation helps them to make sensible decisions.

Employers can support return to work by providing people with adequate information and a clear picture of what is likely to happen. This reduces the person's concentration on their compensation, and frees them up to focus on rehabilitation. It is important to make sure payments are made on time and delays are avoided.
Original Article, Authors & Publication Details:
Anne Pernille Lysgaard,1,3 Kirsten Fonager2 and Claus V. Nielsen1

Effect of financial compensation on vocational
vocational
Related to work or career. Vocational rehabilitation focuses on the process of returning to the workforce.
 rehabilitation
. Journal of Rehabilitation Medicine 2005;37(6):388 - 391.

1Unit of Social Medicine, Department of Public Health, Aarhus County, Aarhus,
2Department of Social Medicine, Aalborg Hospital, Aalborg and
3Center for Substance Abuse, Aarhus County, Aarhus, Denmark
Background, Study Objectives, How It Was Done:
Some studies have suggested that receiving compensation payments reduces the likelihood of successful rehabilitation
rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 and return to work.

Financial compensation is thought to occupy the recipient's attention at the expense of attention on rehabilitation. In other studies, financial compensation has been associated with poor recovery outcomes and longer sickness absence.

This study was undertaken over an 18 month period in Denmark. Return to work results were measured against a number of factors, including:

Whether the person was receiving financial compensation
Age
Level of education
Marital status
Time taken off work so far

All participants in a five month rehabilitation program were included in the study. The researchers measured the return to work outcomes one year after the program was completed.
Study Findings:
Approximately 1400 people were included in the study, of whom about 30% were receiving compensation. Of those receiving compensation, approximately half the group received it for a work injury, a quarter for a non work-related injury, and a quarter had applied for a disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 pension.

The study found that people receiving financial compensation were less likely to return to work. This result was not affected by factors such as education level, duration of time off work, nature of the condition, or the type of compensation received.
Conclusions:
These results are consistent with previous studies. The authors of this paper suggest that poorer return to work outcomes may be due to a shift of attention away from rehabilitation and onto compensation. The authors also suggest that outcomes are influenced by other people such as family members, treating practitioners, and case managers. These people may add to the transfer of attention if they contribute to delays, feel they are unable to alter the situation, or have beliefs that support a focus on compensation.

Similar studies have not found an association between level of disability and likelihood of return to work.

This study was undertaken in Denmark, but the results obtained are consistent with research done in Australia, Canada, and other European countries. The size of the group evaluated in this study (1400 people) is large, meaning that the conclusions are quite reliable.
References:
PubMed Abstract
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