title: The role of health care providers in long term and complicated workers' compensation claims.
abstract: BACKGROUND
  Health care providers (HCPs) play a central role in workers' compensation systems. In most systems, they are involved in the legitimization of work-related injury, are required to provide information to workers' compensation boards about the nature and extent of the injury, give recommendations about return-to-work capability and provide treatment for injury or illness. This study identifies problems that occur at the interface between the health care system, injured workers, and workers' compensation boards (WCBs) that may complicate and extend workers' compensation claims and the mechanisms that underlie the development of these problems.
  
  
  METHODS
  Interviews were sought with injured workers, peer helpers and service providers from a variety of geographic locations in order to get a broad picture of return to work problems and concerns. This analysis includes data from total of 34 interviews with injured workers who had long term and complicated claims. Interviews were also conducted with 14 peer helpers and 21 service providers.
  
  
  RESULTS
  We identified four domains related to injured workers' interface with the health care system that played a key role in complicating and prolonging compensation claims. These problems, related to health care access, conflicting or imperfect medical knowledge, limited understanding of compensation system requirements and confusion about decision-making authority, resulted in frustration, financial difficulties and mental health problems for injured workers.
  
  
  CONCLUSIONS
  Recommendations are made about how compensation system parties can find better ways to serve injured worker health care needs and facilitate a smooth relationship between the compensation board and HCPs.
authors.affiliation: Institute for Work and Health, 481 University Avenue, Toronto, Ontario, Canada. akosny@iwh.on.ca
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kosny
authors.forename: Ellen
authors.initials: E
authors.lastname: MacEachen
authors.forename: Sue
authors.initials: S
authors.lastname: Ferrier
authors.forename: Lori
authors.initials: L
authors.lastname: Chambers
mesh_terms: D000328:Adult; D003657:Decision Making; D034462:Dissent and Disputes; D005260:Female; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000534:rehabilitation*; D060051:Occupational Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D009864:Ontario; D010819:Physician's Role; D024382:Professional Role; D013997:Time Factors; D014942:Workers' Compensation / Q000191:economics / Q000458:organization & administration