Legal Representation and Dissatisfaction with Workers’ Compensation: Implications for Claimant Adjustment

摘要

This study examined relationships between attorney retention and adjustment outcomes for Workers’ Compensation low back claimants at post-settlement (N = 1,464; 21 months post-claim settlement) and long-term follow-up (N = 371; 72 months post-claim settlement). Claimants were classified into three groups: those who had not retained an attorney (no attorney group, 15%); those who had retained an attorney, but for reasons other than dissatisfaction with Workers’ Compensation medical treatment (attorney group, 31%); and those who had retained an attorney specifically because of dissatisfaction with Workers’ Compensation medical treatment (dissatisfied/attorney group, 54%). Groups were compared on demographic characteristics, Workers’ Compensation variables, and adjustment indicators of pain intensity, pain-related disability, general physical and mental health status, and pain catastrophizing. Relative to the no attorney and attorney groups, claimants in the dissatisfied/attorney group were younger, had longer time to settlement, and reported greater post-settlement socioeconomic stress and catastrophizing. At long-term follow-up, the dissatisfied/attorney group reported higher levels of disability and catastrophizing, as well as lower levels of mental health status, relative to the other groups. The results suggest that attorney retention that is motivated by dissatisfaction with Workers’ Compensation medical care is a significant risk factor for poor adjustment, not only in the intermediate time frame following claim settlement, but also over the long term. Findings are discussed in the context of “perceived injustice” in the Workers’ Compensation system and the mechanisms by which dissatisfaction and attorney retention may impact adjustment.