title: The workers' compensation system: worker friend or foe?
abstract: BACKGROUND
  The workers' compensation system was designed to help injured workers who have substantial medical expenses and perhaps have lost a great deal of income. This study determines both similarities and differences in how workers experience their interactions with the workers' compensation systems in Florida and Wisconsin.
  
  
  METHODS
  Ethnographic open-ended interviews with 204 workers from Florida and 198 workers in Wisconsin were conducted. All the workers had back injuries in 1990 and were either paid workers' compensation temporary disability benefits for at least 4 weeks or received permanent disability benefits or compromise settlements.
  
  
  RESULTS
  Some interactions with the workers' compensation system were positive. However, the majority of respondents in both states experienced their encounters with the workers' compensation system as cumbersome, frustrating, and demeaning.
  
  
  CONCLUSIONS
  Mistrust, stigmatization, payment delays, and refusal of insurer personnel to pay benefits contribute to workers' negative experiences with the workers' compensation system. These insurer behaviors raise the costs to injured workers of workers' compensation benefits and thus may reduce the propensity of eligible workers to apply for benefits.
authors.affiliation: Social and Behavioral Sciences Department, Boston University School of Public Health, Boston, Massachusetts 02118-2394, USA. lstrunin@bu.edu
authors.forename: Lee
authors.initials: L
authors.lastname: Strunin
authors.forename: Leslie I
authors.initials: LI
authors.lastname: Boden
mesh_terms: D000062:Accidents, Occupational / Q000191:economics*; D001294:Attitude to Health; D019567:Back Injuries / Q000191:economics*; D005431:Florida; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D009784:Occupational Diseases / Q000191:economics*; D011369:Professional-Patient Relations; D011897:Random Allocation; D012647:Self-Assessment; D014922:Wisconsin; D014942:Workers' Compensation / Q000458:organization & administration*