title: Return to Work After Traumatic Injury: Increased Work-Related Disability in Injured Persons Receiving Financial Compensation is Mediated by Perceived Injustice.
abstract: Purpose Traumatic injury is a leading cause of work disability. Receiving compensation post-injury has been consistently found to be associated with poorer return to work. This study investigated whether the relationship between receiving compensation and return to work was associated with elevated symptoms of psychological distress (i.e., anxiety, depression, and posttraumatic stress disorder) and perceived injustice. Methods Injured persons, who were employed at the time of injury (n = 364), were recruited from the Victorian State Trauma Registry, and Victorian Orthopaedic Trauma Outcomes Registry. Participants completed the Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Checklist, Injustice Experience Questionnaire, and appraisals of pain and work status 12-months following traumatic injury. Results Greater financial worry and indicators of actual/perceived injustice (e.g., consulting a lawyer, attributing fault to another, perceived injustice, sustaining compensable injury), trauma severity (e.g., days in hospital and intensive care, discharge to rehabilitation), and distress symptoms (i.e., anxiety, depression, PTSD) led to a twofold to sevenfold increase in the risk of failing to return to work. Anxiety, post-traumatic stress and perceived injustice were elevated following compensable injury compared with non-compensable injury. Perceived injustice uniquely mediated the association between compensation and return to work after adjusting for age at injury, trauma severity (length of hospital, admission to intensive, and discharge location) and pain severity. Conclusions Given  that perceived injustice is associated with poor return to work after compensable injury, we recommend greater attention be given to appropriately addressing psychological distress and perceived injustice in injured workers to facilitate a smoother transition of return to work.
authors.affiliation: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia. melita.giummarra@monash.edu.|Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia. melita.giummarra@monash.edu.|School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3000, Australia. melita.giummarra@monash.edu.
authors.forename: Melita J
authors.identifier: 0000-0001-7839-6058
authors.initials: MJ
authors.lastname: Giummarra
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3000, Australia.|Emergency Department, Hamad General Hospital, Doha, Qatar.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.affiliation: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia.|Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, VIC, Australia.
authors.forename: Jennie
authors.initials: J
authors.lastname: Ponsford
authors.affiliation: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia.
authors.forename: Liane
authors.initials: L
authors.lastname: Ioannou
authors.affiliation: Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.|National Ageing Research Institute, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gibson
authors.affiliation: Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia.|College of Health and Biomedicine, Victoria University, Footscray, VIC, Australia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Jennings
authors.affiliation: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia.
authors.forename: Nellie
authors.initials: N
authors.lastname: Georgiou-Karistianis
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D035881:Compensation and Redress; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010465:Perception; D062707:Return to Work / Q000523:psychology* / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology*; D055815:Young Adult
keywords: Compensation; Embitterment; Injury; Recovery; Trauma; Work