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Legal Sequelae of Occupational Back Injuries: A Longitudinal Analysis of Missouri Judicial Records

Tait, Raymond C. PhD; Chibnall, John T. PhD

doi: 10.1097/BRS.0b013e3181ebacab
Health Services Research

Study Design. Telephone survey and longitudinal analysis of judicial database for cohort of worker's compensation (WC) claimants in Missouri.

Objective. To compare legal difficulties experienced by African American and white WC claimants presettlement versus postsettlement.

Summary of Background Data. Retrospective studies suggest that workers with occupational back injuries experience financial and personal duress after claim settlement. This study examined these issues by comparing financial and domestic court actions for the 5-year presettlement against 5-year postsettlement. Sociodemographic differences also were examined.

Methods. Missouri judicial records were reviewed for African American (n = 580) and non-Hispanic white (n = 892) WC claimants to determine the frequency with which four types of cases occurred: general financial, domestic financial, residence financial, and domestic behavior. Average annual level of judicial activity during the 5 years before claim settlement was compared to activity for each of five postsettlement years; significance of change was evaluated with univariate and multivariate repeated measures analyses.

Results. Statistically significant (P < 0.001) postsettlement increases in legal cases were noted for each of the four categories of cases. There were significant interactions between race and time for general financial and domestic financial cases. A significant interaction between age and time occurred for general financial cases. Significant three-way interactions (race × income change × time) emerged for general and domestic financial cases.

Conclusion. The results confirm that workers with occupational back injuries, especially African American and younger adults, encounter long-term financial and domestic duress that appears to escalate with each passing year after claim settlement. This pattern suggests that short-term studies underestimate postsettlement difficulties, particularly among selected demographic cohorts.

This longitudinal study showed that workers with occupational back injuries, especially African American and younger adults, encountered increased court actions reflecting financial/domestic duress after claim settlement. Postsettlement, finance-related court actions increased yearly. These data suggest that short-term studies underestimate postsettlement difficulties, particularly for selected demographic cohorts.

Department of Neurology & Psychiatry, Saint Louis University, MO

Address correspondence and reprint requests to Raymond C. Tait, PhD, Department of Neurology & Psychiatry, Saint Louis University School of Medicine, 1438 South Grand Blvd, St Louis, MO 63104; E-mail:

Acknowledgement date: March 5, 2010. Revision date: May 12, 2010. Acceptance date: May 24, 2010.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Federal funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

This study was reviewed and approved by the institutional review board of Saint Louis University and the Battelle Centers for Public Health Research and Evaluation.

Supported in part by funding from the Agency for Healthcare Research and Quality, grants R01 HS13087 and R01 HS14007.

© 2011 Lippincott Williams & Wilkins, Inc.