title: Associations with legal representation in a compensation setting 12 months after injury.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Inception cohort study.
  
  
  METHODS
  246 people with WAD compensation claim.
  
  
  METHODS
  Legal involvement and Functional Rating Index at 12 months post injury.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Rehabilitation Studies Unit, Kolling Institute, University of Sydney, NSW 2065, Australia. Electronic address: pcas0573@uni.sydney.edu.au.
authors.forename: Petrina P
authors.initials: PP
authors.lastname: Casey
authors.affiliation: 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.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Feyer
authors.affiliation: Rehabilitation Studies Unit, Kolling Institute, University of Sydney, NSW 2065, Australia.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000063:Accidents, Traffic / Q000191:economics / Q000523:psychology*; D000328:Adult; D001315:Australia / Q000453:epidemiology; D058443:Catastrophization / Q000523:psychology*; D035881:Compensation and Redress; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D004608:Eligibility Determination; D006801:Humans; D007345:Insurance Claim Review; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology*; D020127:Recovery of Function; D014911:Whiplash Injuries / Q000191:economics / Q000503:physiopathology / Q000523:psychology*
keywords: Compensation; Health Outcome; Insurance; Lawyer/Legal representation; Prospective design; Recovery; WAD; Whiplash