Relationship between compensation claims for psychiatric injury and severity of physical injuries from motor vehicle accidents.

Abstract

To examine the relationship between compensation claims for psychiatric injury after motor vehicle accidents and physical injuries sustained. Audit of Compulsory Third Party (CTP) insurance claims. 559 consecutive CTP claims referred by NRMA Insurance Limited to its sole provider of CTP legal services during a three-month period in 1994 after the claimant had engaged legal representation. Claim for psychiatric injury (any psychiatric disorder excluding traumatic brain injury) supported by a medicolegal report from a psychiatrist, other medical practitioner or psychologist; pre-existing psychiatric disorders; Injury Severity Score; initial treatment setting; hospital stay; percentage of accidents involving loss of consciousness or a death. 522 claims were eligible for the study; 19.5% (102/522) included a claim for psychiatric injury. A pre-existing depression or anxiety disorder was documented in 11 claims (2.1% of all claims and 3.9% of those claiming psychiatric injury). Only very severe injuries, particularly those involving loss of consciousness, were associated with an increased rate of claims for psychiatric injury. No association was found between claims for psychiatric injury and severity of physical injuries, except among those most severely injured.