title: Associations with duration of compensation following whiplash sustained in a motor vehicle crash.
abstract: BACKGROUND
  Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system.
  
  
  OBJECTIVE
  To identify the associations of extended time receiving compensation benefits with the aim of developing a prognostic model that predicts time to claim closure.
  
  
  METHODS
  Prospective cohort study in people with whiplash associated disorder.
  
  
  METHODS
  Time to claim closure, in a privately underwritten fault based third party traffic crash insurance scheme in New South Wales, Australia.
  
  
  METHODS
  Cox proportional hazard regression modelling.
  
  
  RESULTS
  Of the 246 participants, 25% remained in the compensation system longer than 24 months with 15% remaining longer than three years. Higher initial disability (Functional Rating Index≥25 at baseline) (HRR: 95% CI, 1.916: 1.324-2.774, p<0.001); and lower initial mental health as measured by SF-36 Mental Component Score (HRR: 95% CI, 0.973: 0.960-0.987, p<0.001) were significantly and independently associated with an increased time-to-claim closure. Shorter time to claim closure was associated with having no legal involvement (HRR: 95% CI, 1.911: 1.169-3.123, p=0.009); and, not having a prior claim for compensation (HRR: 95% CI, 1.523: 1.062-2.198, p=0.022).
  
  
  CONCLUSIONS
  Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.
authors.affiliation: John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia. Electronic address: pcas0573@uni.sydney.edu.au.
authors.forename: Petrina P
authors.initials: PP
authors.lastname: Casey
authors.affiliation: Transport and Road Safety Research (TARS), University of NSW, Sydney, NSW, Australia.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Feyer
authors.affiliation: Rehabilitation Medicine, John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000063:Accidents, Traffic / Q000191:economics / Q000523:psychology*; D001315:Australia / Q000453:epidemiology; D058443:Catastrophization / Q000523:psychology*; D035881:Compensation and Redress / Q000331:legislation & jurisprudence*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004608:Eligibility Determination / Q000331:legislation & jurisprudence* / Q000379:methods; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D014911:Whiplash Injuries / Q000175:diagnosis* / Q000191:economics / Q000503:physiopathology / Q000523:psychology
keywords: Compensation; Cox regression; Disability: lawyer/legal representation; Insurance; Time-to-claim closure; Traffic accident; WAD; Whiplash