Workmen's Compensation Research Articles

Predicting treatment response in depressed and non-depressed chronic pain patients

Although it has often been observed that chronic pain and depression are associated, there have been few systematic comparisons of chronic pain patients with and without depression. In the study reported in this article, depressed and non-depressed chronic pain patients were found to be quite similar with respect to demographic, pain-related, and treatment response variables. The primary aim of the study, however, was to examine the hypothesis that treatment response in these two groups of patients would be predicted by different patterns of variables. In non-depressed patients, beneficial response to treatment was related to a greater number of treatment visits, not receiving workmen's compensation, fewer previous types of treatment, and low back pain. As predicted, a different pattern of predictors of treatment response was found for the depressed patients, who were more likely to benefit when they were employed at the beginning of treatment and when their pain was of shorter duration. These results suggest that activity and active involvement in treatment are particularly important with chronic pain patients who are depressed. In addition, they suggest that the best prediction of treatment response in future research on chronic pain patients may be achieved by dividing patients into groups based on psychological characteristics.

CANADA

International Social Security ReviewVolume 39, Issue 1 p. 68-69 CANADA Amendment of the Quebec Workmen's Compensation Act First published: January 1986 https://doi.org/10.1111/j.1468-246X.1986.tb00609.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume39, Issue1January 1986Pages 68-69 RelatedInformation

Beveridge, Workmen's Compensation and the Alternative Remedy

ABSTRACTThe passing of the Workmen's Compensation Act 1897 did not affect an injured worker's rights to sue for damages at common law or under the Employers' Liability Act 1880. However, the evidence suggests that these alternative remedies declined in importance until the 1930s when certain court decisions and acts of Parliament gave them renewed significance. For several reasons Beveridge was antipathetic towards unmodified retention of the alternative remedy, but he proposed the establishment of an official committee for the purpose of making a full inquiry. As a result, the Home Secretary, Herbert Morrison, appointed the Monckton Committee on Alternative Remedies. The Committee's majority report largely endorsed the TUC's viewpoint in recommending maintenance of the alternative remedy. Subsequent legislation, the Law Reform (Personal Injuries) Act, permitted reduction of damages where industrial injuries benefit was secured; otherwise injured workers' rights to sue were perpetuated, albeit with questionable results. Down to the present day the costly alternative remedy survives, despite lack of evidence that it achieves either of its supposed objectives, namely, the compensation of personal injury victims or the deterrence of carelessness.

Unraveling the effects of compensation, litigation, and employment on treatment response in chronic pain

Although it has often been suggested that chronic pain patients who are receiving workmen's compensation or who have litigation pending are less likely to benefit from treatment, the results of outcome studies of this question conducted by various pain clinics have been inconsistent. We hypothesized that poorer outcome in such patients may be related to the fact that they are less likely to be working and that the inconsistent results in the literature may therefore be explained by variability among studies in the percentages of patients who are receiving compensation (or who have litigation pending) who are also working. We examined the relationships among compensation, litigation, employment, and short- and long-term treatment response in a series of 454 chronic pain patients. Compensation benefits and employment status both predicted poorer short-term outcome in univariate analyses; however, when employment and compensation were jointly used to predict outcome in multiple regression analyses, only employment was significant. In additional analyses, only employment significantly predicted long-term outcome, whereas compensation and litigation did not. Our results suggest that it would be valuable to redirect attention away from the deleterious effects of the ‘compensation neurosis’ and toward the roles of activity and employment in the treatment and rehabilitation of chronic pain patients.

State Courts and Protective Legislation during the Progressive Era: A Reevaluation

For a number of years, courts during the Progressive Era have been characterized as enemies of reform. Judges, according to that view, read their own conservative biases into law in order to nullify child labor legislation, efforts to establish maximum hours, minimum wages, and workmen's compensation, and revisions of traditional rules governing employer liability in job-related accidents. Theodore Roosevelt, Gilbert Roe, Roscoe Pound, and others were only a few voices in the chorus that condemned courts for their allegedly reactionary attitudes toward social legislation. Louis D. Brandeis, for example, on the eve of his nomination to the United States Supreme Court, charged judges with being blind to the great social and economic changes of the past halfcentury and with erecting their own prejudices into legal barriers to reform. ' Recent studies of the United States Supreme Court have led to a revision of that institution's image as a thoroughgoing enemy of reform. Despite its decisions in such cases as Lochner v. New York, Adair v. United States, and Coppage v. Kansas, which have often been portrayed as epitomizing its opposition to protective legislation, the Court in fact upheld the vast majority of protective statutes it reviewed.2 A similar analysis needs to be done for state courts,

Legal issues associated with the handling of cytotoxic drugs

Legal issues associated with the handling of cytotoxic drugs are discussed. The essential legal elements of negligence and proof requirements are briefly reviewed as they relate to the liability of various parties for injury caused or aggravated by the handling of cytotoxic drugs. Legal remedies in these cases--such as workmen's compensation claims, claims against independent contractors, and claims against product manufacturers--are outlined, and common defenses to product-liability cases are presented. The legal basis for determining liability for injury associated with the handling of cytotoxic drugs and the remedies available for such injury should be familiar to hospital administrators, drug manufacturers, and all personnel dealing with these drugs.

Surgical Treatment of Plantar Fasciitis

Ten patients were operated on for plantar fasciitis (12 heels) by stripping the plantar fascia and superficial plantar muscles from the calcaneus. All patients were refractory to conservative treatment for an average of 12.4 months prior to operation and were followed up for a minimum of 24 months after operation. Complete symptomatic relief was obtained in all patients despite the presence of massive obesity in six. Hypoesthesia of the heel, which was present in five feet after operation, may have enhanced pain relief. Three patients who were receiving workmen's compensation returned to work within 16 weeks of surgery. One deep wound infection occurred and required surgical debridement before healing could occur. Surgical treatment is efficacious in selected cases of plantar fasciitis that are refractory to conservative measures.

Isometric Strength Test Consistency over Time

Workmen's Compensation costs have become a major financial burden on industry. A significant part of these costs are the result of musculoskeletal injuries. One method of controlling these injuries is matching employees to jobs based on strength. Isometric strength testing has been shown to be an effective method of matching employee strength capability to job strength requirements. The use of screening test raises the question of test-retest consistency. This study was designed to determine the consistency of isometric strength test results over time. Thirteen student volunteer subjects (10m, 3F) participated in a testing protocol consisting of five strength tests performed a minimum of two times each at two week intervals. Four test sessions were held. An analysis of variance was used to identify week to week strength differences in the test population. Each of the five tests was analyzed separately and no significant week to week strength differences were found. This result further supports the validity of using isometric strength testing as a selection tool.

Back School

The Canadian Back Education Units (CBEU) in a review of 6418 participants found a significant subjective improvement in 69% of the participants. This figure improved to 80% when only patients who experienced back pain for six months or less were considered. Ninety-seven percent of the participants considered the back education program helpful. Patients who had completed their high school education, who believed that they understood the mechanism of the pain, and who recognized an emotional component to the problem had the best results. Functional improvement was most pronounced in the activities most often performed. Patients with pain persistently radiating below the knee and patients receiving workmen's compensation did not fare as well. Using a computer analysis of the variation in test scores from pretest to the review class, a statistically valid positive correlation was established between the patient's subjective improvement and the amount of information retained. The CBEU are an efficient, effective, well received, and cost-effective therapeutic modality in the conservative treatment of chronic low back pain.

The Effort of Labor Force Age Distribution on Worker's Compensation Costs

Workers' compensation insurance is funded by premium payments from employers. The premium is determined by legislated coverage and benefits, industry category, and in some cases, employer accident record. Researchers have concentrated on the cost effect of changes in legislation. In this study, attention is focused on the age distribution of the insured individuals. Workers' compensation cost per unit of exposure varies by age group. Changes in the age distribution of the workforce induce changes in the cost of workers' compensation. Workers' compensation (WC) premiums are based on the location of the firm, the industry classification of the enterprise, and in some cases the accident record of the firm. Firm location is important since it determines the WC system and, therefore, the set of benefit provisions to which the firm is subject. Industry classification affects premium size because WC insurers track injury experience by industry group. However, the demographic characteristics of the pool of insured individuals (workers) do not directly enter the calculation of expected WC costs, although such characteristics directly affect insurance premiums in programs such as life and auto insurance. This unique trait of WC insurance has influenced the focus of WC studies, especially those conducted since the early 1970's. Liberalization of benefits and the increased rate of inflation drove WC costs up rapidly after 1970.1 In response a series of commissions and task forces has analyzed WC costs emphasizing factors that influence total dollar compensation for a given injury or number of injuries.2 In this study of WC costs the emphasis is on determinants of the number and severity of injuries. Specifically, the two-fold purpose of the study is to Alan E. Dillingham, Illinois State University. This research was funded by Illinois State University and, through the Workers' Compensation Project of the University of Connecticut, the Employment Standards Administration of the U.S. Department of Labor. An expanded version of this paper will appear in Safety and the Workplace: Incentives and Disincentives in Workers' Compensation, edited by John Worrall (New York: ILR Press, 1983). 1 Price [141 calculates the 1970-76 increase in employer costs for WC at 126 percent. Elson and Burton [61 estimate that their adjusted manual rate for WC coverage almost doubled between 1972 and 1978. 2 The two major efforts were: (a) the National Commission on State Workmen's Compensation Laws and (b) the Interdepartmental Workers' Compensation Task Force.

A computer data bank system for otolaryngologic and audiologic data.

A data bank system has been in routine clinical operation for more than two years in our department. It is used to record histories, physical findings, and audiometric data; to produce reports that are sent with short covering letters to referring physicians, and to establish a data bank for research. Although originally created for noise-induced hearing loss claimants referred by the Workmen's Compensation Board, the system was designed, from the start, to be applicable to a wide range of clinical conditions. This report describes the conceptual approach to the data bank and certain practical details involved. The system is quick and effective to use, and it can be run on a relatively small microcomputer.

Failure and fulfillment: Agitation for employers’ liability legislation and the origins of workmen's compensation in New York state, 1876–1910

Failure and fulfillment: Agitation for employers’ liability legislation and the origins of workmen's compensation in New York state, 1876–1910

Factors Influencing Mine Location: An Iron Ore Example

When a mine is threatened with closure, ensuing publicity generally focuses on the burden of mineral taxes, environmental regulations, and labor's excessive fringe benefits as decisive factors behind the shutdown.1 But despite this emphasis, such factors are usually only secondary locational determinants for mining operations. Ore quality and transportation costs have proven to be considerably more important in other case studies (Tull 1979), as they do in this analysis of iron ore mining. Still, there is a very practical reason why public debate consistently neglects these primary determinants; public policy decision makers can change taxes, pollution standards, and workmen's compensation rates, but there is no way a vote can alter ore quality or the geographic location of a deposit. This tends to be the case not only for minerals but for many other natural resource products as well. Unfortunately, if the politically influenced but less important locational factors are given too much attention, inequities can arise. The apparent benefits of reduced state taxes, for example, can be exaggerated if such reductions are not put into the proper perspective of their true share of full mining costs and compared to those of competing mines in other states. PRESENT CASE

Mortality among miners receiving workmen's compensation for silicosis in Ontario: 1940-1975.

We investigated mortality among 1,190 Ontario miners who received Workmen's Compensation awards for silicosis from 1940 through 1975. In comparison with the general population of Ontario these men had elevated all-cause mortality rates, with deaths attributed to nonmalignant respiratory diseases and tuberculosis being primarily responsible. The group of miners receiving their compensation awards between 1940 and 1959 has experienced more than twice as many lung cancer deaths as expected while men receiving compensation awards after 1959 have had lung cancer rates similar to the general population. It is concluded that silicosis is not a benign disease and that efforts must be continued to prevent its occurrence.

Implementing Workmen's Compensation Programs in the States

This article investigates the implementation of state workmen's compensation programs using a two-stage approach. Initially the agency that delivers workmen's compensation benefits and services is examined to determine what factors are important in explaining the agency's performance. Next the organization's performance is used as an independent variable along with other socioeconomic and political indicators to examine policy impact. The findings suggest that organizational characteristics are important determinants of organizational performance but organizational performance is not a significant factor in explaining policy impact.

Should Social Insurance Pay Compensation for Pain and Suffering?

origins in ancient Roman Law and which regulated civil liability in this field. In the process of its historical evolution, this system found concrete legislative expression in Continental Law in the French Code Civile of 1804', and later, in many laws in most States. Then, about a century ago, a second system emerged, designed, inter alia, for the same purpose. This was the system of social insurance, 2 and since that time, there are two parallel - albeit totally different - legal systems for ensuring conpensation for personal injury. The first milestone in the above-mentioned evolution was the German Workmen's Compensation Act 1884. This revolutionary Law, the passage of which constituted an event of utmost importance in the history of law, ushered in a new era in the field of compensation for personal injuries. Its importance was fourfold: first, it extricated, for the first time, a most important and defined segment of compensation (i.e. for work injuries) from the sphere of tort law, relocating it in another, totally new field. Secondly, it introduced, for the first time, liability insurance (concerning the liability of employers) of significant dimensions, in the novel form of compulsory insurance. Thirdly, it implemented, for the first time, a comprehensive system of No-Fault liability and insurance in the form of absolute liability; and fourthly, it embodied the archetype of social insurance in our time for the injured, and symbolised the birth of such insurance. In all these aspects, the said Law possesses the birthright on a world-wide level. In recent years, there has been an increasing trend for certain provisions in the field of tort law to be brought closer to the field of social insurance: consequently, it is possible to talk of the birth of a new category of legal provisions designed to compensate the victims of personal injury, represented by quasi-social provisions which have departed significantly from the classical forms of tort law.

Alcohol, drugs and safety: An updated perspective on problems and their management in the workplace

The relationship between alcohol, drugs and accidents in the workplace is explored in the context of available evidence, the balance of which suggests that the contribution of substance abuse and misuse to personal injury and property damage losses has been underestimated. Recommendations are made which require that a more complete data base be developed in this area. Necessary steps are seen as: (1) conducting independent prevalence surveys of alcohol and drug use in specific work organizations; (2) relating this information to safety-related behaviour as monitored through, (a) observation and interviews and (b) searches of official records, in particular, Workmen's Compensation files. Collaboration from the outset with key interest groups such as Safety Associations, Unions, concerned health and safety agencies as well as management is recommended as the prerequisite to the effective implementation of such a research programme and its results. In the interim, it is recommended that all interested parties take a close informal look at their own areas of responsibility in order to determine the probability of losses to life, limb and property caused by alcohol and drugs. Also, it is suggested that the relationships between the management of alcohol and drug related problems and the management of safety be more closely coordinated. The emphasis, however, should be as much on heavy drinking as on alcoholism, and as much on inappropriate prescription use of drugs as on illicit drug abuse.

Occupational hearing loss: an Ontario perspective.

In the past 11 years over 6,500 patients referred by the Workmen's Compensation Board for evaluation of hearing loss of possible industrial etiology have been evaluated at Mount Sinai Hospital. Various groups of workers have been studied from the audiological, otological, and epidemiological standpoint. Problems of assessment include the accurate quantification of hearing loss which may be difficult for a number of reasons including lack of understanding of the test and lack of willingness to cooperate. An accurate diagnosis may be difficult to achieve because of lack of previous history, poor memory, etc. The method of use in Ontario for quantifying hearing loss will be reviewed and its relationship to handicap discussed. The success of rehabilitation by means of hearing aid use will be analysed. This is surprisingly good.

Adequacy of current industrial hygiene and occupational safety professional manpower

Heated current political discussions of proper staffing and conduct of industrial hygiene and safety programs raise the questions of the numbers and adequacy of available professional manpower. Data from several studies of such professional manpower in the U.S. during the past decade were critically reviewed and compared. Their projected growth rates for industrial hygiene were far short of the actual recent 15%/year growth rate of AIHA membership and of ABIH diplomates, and 27%/year for ABIH trainees. From these studies and census data, it was calculated that in 1977 the ratio of employees to IH professionals was 17 100, and to safety professionals 2200. Also the ratio of professional costs to the value of lost workdays plus workmen's compensation was 1.4% for industrial hygiene and 10.6% for safety. It appears likely that more 1H professionals would be cost effective. Data on outputs of university training programs indicate that the majority of individuals on current staffs were not specifically trained as IH or safety professionals. Although employment demands may be affected by the outcome of ongoing political discussions, there are obvious unsatisfied needs for services. These require professional training of greater numbers than current capacities of university programs permit.

Adequacy of current industrial hygiene and occupational safety professional manpower.

Heated current political discussions of proper staffing and conduct of industrial hygiene and safety programs raise the questions of the numbers and adequacy of available professional manpower. Data from several studies of such professional manpower in the U.S. during the past decade were critically reviewed and compared. Their projected growth rates for industrial hygiene were far short of the actual recent 15%/year growth rate of AIHA membership and of ABIH diplomates, and 27% year for ABIH trainees. From these studies and census data, it was calculated that in 1977 the ratio of employees to IH professionals was 17 100, and to safety professionals 2200. Also the ratio of professional costs to the value of lost workdays plus workmen's compensation was 1.4% for industrial hygiene and 10.6% for safety. It appears likely that more IH professionals would be cost effective. Data on outputs of university training programs indicate that the majority of individuals on current staffs were not specifically trained as IH or safety professionals. Although employment demands may be affected by the outcome of ongoing political discussions, there are obvious unsatisfied needs for services. These require professional training of greater numbers than current capacities of university programs permit.