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Compensation court.

Explore the source record for details and available documents.

Defense Mechanisms↗

Dupuytren's disease: relation to work and injury.

The present status of adjudication for workers claiming compensation for Dupuytren's disease is inconsistent and, therefore, unfair to both workers and employers. In some Eastern European countries Dupuytren's disease is classified as an industrial disease, whereas in other countries it is considered to have no relation to manual work or hand injury. In jurisdictions that sometimes award compensation, the reasons for acceptance or rejection of a claim vary from case to case and are not necessarily based on our present knowledge of the disease. The purpose of this communication is to highlight the features of Dupuytren's disease that are pertinent to manual work and hand injury and to suggest guidelines that would provide some consistency in the adjudication process. It is hoped that these guidelines would be valuable to the individual surgeon, insurance agencies, and compensation boards.

Dupuytren Contracture↗

Economic miracle for what?: State workers' health in South Korea.

This article is a study of the state's role in workers health in South Korea during the period of the 1950s to 1980s in which South Korea achieved its economic success through a series of economic development plans. The state's role in the protection of workers health will be examined by investigating the historical development of two main welfare state programs, workers' compensation and national health insurance, as the pillars of state policies on workers health. In contrast to the state's direct intervention in economic development, I will argue, the key characteristics of both workers' compensation and national health insurance are the state's minimal organizational and financial costs and the relative autonomy of firm managers. Also, the state first restricted the scope of beneficiaries to the core group of manufacturing and mining workers and then gradually expanded it over a long period of time. I will argue that such features suggest a strong dependence on business by the Korean welfare state programs that contradicts the image of a strong state that the scholars of East Asian states often claim.

Journal Article↗

Heart disease under workmen's compensation.

In expert testimony before the Industrial Accident Commission, all physicians are taken as equally competent. The value of their testimony depends upon the validity of their data and the reasons for the conclusions drawn. In case of conflicting opinion, the referees, who are laymen, must decide on the basis of the testimony. Therefore physicians preparing reports must see that data are complete, that all routine investigative procedures are not only applied but reported, and that the reasons for claiming connection of injury with employment are fully stated. Moreover, other recognized causes of the patient's condition should be considered and ruled out for reasons given. The increasing number of claims for workmen's compensation in heart disease, and the increasing tendency of insurers to settle rather than contest claims, may actually be harmful to the welfare of persons with heart disease, for it deters employers from hiring them and thus risking higher insurance costs. Physicians concerned with compensation claims must develop more widely acceptable standards that properly separate the inherent risk of heart disease from that incurred through employment for which the employer may reasonably be considered liable.

Accidents, Occupational↗

[Medical technical equipment--not so dangerous after all?].

More than a decade has passed since the Ofstad committee presented its report on "Control of medical devices". The committee assumed that the use of medical devices constituted a major safety problem in the Norwegian health care system. The frequency of device-related injuries to patients was expected to be high, especially since the amount of non-recorded injuries was expected to be large. During the period since the publication of the report, several medical device reporting systems have been established, and special injury committees have been formed in some hospitals. Several "ombudsmen" for patients now exist, and both a patients' association and an insurance system for compensation to injured patients have been established. Despite this, we still do not know the total number of medical device-related injuries to patients in Norway. However, the existing records do show that device-related injuries to patients are not as abundant as the Ofstad committee feared.

Equipment Failure↗

The Swedish experience with asbestos: history of use, diseases, legislation, and compensation.

After World War II, large quantities of asbestos were imported to Sweden and used in construction and ship building. In 1976, the use of asbestos was for practical purposes prohibited. Today, the only exposures are environmental, from asbestos in place and when buildings are demolished or rebuilt, and there are very strict rules for such work. Consequently, it is assumed that the asbestos-related diseases will gradually disappear from society, but due to the long latency time, about 100 mesotheliomas still occur every year in Sweden, and so far there is no certain sign of a decrease in incidence. Compensation is from the state via general insurance and consists basically of compensation for lost income and medical costs.

Asbestosis↗

Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury.

BACKGROUND AND METHODS: The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995. RESULTS: Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems. CONCLUSIONS: The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.

Accidents, Traffic↗

Disability certifications in adult workers: a practical approach.

Family physicians are frequently asked to complete disability certification forms for workers. The certification process can be contentious because of the number of stakeholders, the varying definitions of disability and the nature of the administrative systems. Insufficient training on disability during medical school and residency complicates this process. Disability systems discussed include workers' compensation, private disability insurance, the Americans with Disabilities Act and the Family and Medical Leave Act. Strategies that help the physician complete disability certification forms effectively include identification of disability type, ascertainment of the definition of disability being applied, evaluation of workplace demands and essential job functions, assessment of worker capacity, and accurate and timely completion of the forms in their entirety.

Adult↗

Treatment charges, payment sources, and disability from alcohol-related trauma.

We examined treatment charges and who paid them and disability for work, school, household activities, and activities of daily living according to identified use of alcohol before injury among 2,416 patients age 15 years or older from 22 northwestern Vermont communities. Over 90% received emergency department treatment only. Among patients reported to have consumed this drug mean hospital and physician charges, respectively, were $2,482 and $565; 31.7% did not pay any portion of their hospital bills, and 27.8% of their total bills were unpaid. Among patients not known to have consumed alcohol, mean hospital and physician charges were $601 and $158, respectively; 10.7% made no payments and 11.3% of their bills were unpaid. Bills of alcohol users more often were paid by Medicaid and less often by Workmen's Compensation or commercial insurance than were those of patients without alcohol. Users also were less likely than the nonalcohol group to pay physicians' bills for hospital care. Alcohol users experienced longer postinjury disability than did persons not known to have been drinking.

Academic Medical Centers↗

Malpractice liability, patient safety, and the personification of medical injury: opportunities for academic medicine.

The political battle over trial lawyers and "tort reform" centers on whether or not to reduce incentives to sue for medical malpractice by capping damages in malpractice suits and limiting legal fees. But the current struggle mis-states the case for innovation in medical malpractice policy. Rather than focus exclusively on the financial consequences of legal claims, malpractice reform should move closer to the bedside, emphasizing error prevention, open communication, rapid compensation, and efficient insurance of the costs of injury. Academic health centers are well positioned to lead this effort in each of their three recognized missions: patient care, teaching, and research. Academic health centers enjoy greater institutional cohesiveness and research capacity than most other medical practice settings. Perhaps most important, their high visibility ensures that patients who suffer avoidable harm within their walls become salient to the public as individuals, not merely as dollar entries in a litigation ledger.

Academic Medical Centers↗

Medical aspects of motor insurance.

Changes in the law related to, and the administration of, compensation under the Motor Vehicle Insurance Act of 1972 are likely in the near future. This Act makes the treating medical practitioner an obligatory assessor of damage incurred by individuals entitled to compensation under this legislation by completion of an MVA 13 form. The value judgment of a treating practitioner and an independent medical assessor in defining injuries and disabilities subject to legal claims are discussed and 5 cases are used to illustrate the disadvantages of the treating medical practitioner as the definitive source of assessment opinion--these are lack of objectivity, perpetuation of errors of omission and lack of specialized knowledge. The very limited value (if any) of the MVA 13 form is emphasized.

Accidents, Traffic↗

The functional IME: A linkage of expertise across the disability continuum.

Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.

Humans↗