Does access to compensation have an impact on recovery outcomes after injury?

Belinda J Gabbe, Ian A Harris, Alex Collie and Peter A Cameron
Med J Aust 2010; 193 (3): . || doi: 10.5694/j.1326-5377.2010.tb03852.x
Published online: 2 August 2010

To the Editor: A recent article by O’Donnell and colleagues1 claimed contradictory results to a previous study which found that compensation was associated with worse health and return-to-work outcomes after injury.2 Their findings were similar to those of the previous study until they excluded a group of non-compensable patients because they had accessed private health insurance. The authors argued that “private health insurance was similar to other compensation agencies in that patients in this group had their health care costs met”. Using this argument, all patients would be compensable, as Australia has a universal health care system in which all Australians have their health care costs met. There is no precedent in the literature for such an exclusion. Compensation bodies provide additional payments beyond health costs, including payment for pain and suffering and income replacement. They also involve patients in a complex process with many features thought to influence outcomes (eg, the adversarial nature of making compensation claims and delays in receiving payments). We believe that the exclusion of private patients from the non-compensable group in the study by O’Donnell et al was incorrect and reduced the already small study sample, limiting the capacity to identify differences across groups.

  • Belinda J Gabbe1
  • Ian A Harris2
  • Alex Collie3,0
  • Peter A Cameron1

  • 1 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC.
  • 2 South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Sydney, NSW.
  • 3 Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC.



Acknowledgement: Belinda Gabbe is a recipient of a National Health and Medical Research Council (NHMRC) Career Development Award.

Competing interests:

Alex Collie was previously employed by the Transport Accident Commission (TAC) of Victoria, and in his current position receives research funding from the TAC. He is also a board member of the Victorian Neurotrauma Initiative Pty Ltd, a subsidiary of the TAC.


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