The workers compensation system that has long served as a safety net for injured or sick workers may actually lead to worse outcomes for some patients, concludes a new Canadian study.
University of Alberta researchers found that people with carpal tunnel syndrome who had claimed compensation were more likely to stop working and lost more income than those not in the compensation system.
The authors speculate that the process of having to battle for redress may delay some patients from returning to work, and say there is evidence of a similar phenomenon with other types of injury.
"Once you make a patient have to prove they're ill, it slows down the recovery process," said Dr. Jeremy Beach, an occupational medicine professor who spearheaded the study.
"If you're having to prove you're ill, there is a vested interest in not going to work.... That, to a certain extent, is inevitable."
The research, just published in the journal Occupational Medicine, also found that the workers compensation patients were much more likely to undergo surgery or other types of treatment than the other patients, despite their poorer results.
It raises questions about whether that treatment is needed or effective, Dr. Beach said.
Robert Lindsay, president of the Canadian Injured Workers Alliance, said the study's findings make sense to him. Often one of the most difficult aspects of being hurt -- especially with carpal tunnel -- is convincing a compensation board that the problem is job-related and deserves compensation, he said.
"You have someone who can't move their wrist, and they're called a liar," Mr. Lindsay said.
"You have a lot of instances where injured workers don't return to work because of the fact they're worn down, they're depressed, they're stressed."
Cynthia Hoy, a spokeswoman for the Alberta compensation board, said the agency has developed clear medical guidelines to more effectively handle such cases since the period covered by the study. That and other changes have meant cases are being resolved in less time than ever, she said.
Carpal tunnel syndrome involves compression of a nerve linking the arm to the hand, resulting sometimes in feelings of numbness or paralysis. It can be caused by repetitive movements.
One recent study estimated the average cost of such injuries to workers compensation boards at about $13,700 each.
The U of A researchers looked at two groups of about 50 patients each who saw an Alberta doctor for carpal tunnel between 1994 and 2000. One group was made up of people whose cases were work-related and covered by the Alberta Workers Compensation Board, which pays for lost wages, treatment and other costs stemming from on-the-job injuries. Those in the other group were not eligible for aid from the board.
Although the severity of injury was about the same for both groups, those on WCB were more than five times more likely to stop working or change jobs, the researchers found.
As well, their average loss of income was much higher -- $22,872 versus $5,313 for non-WCB patients.
The reasons for the differences are not obvious, but Dr. Beach said he suspects that the WCB patients were off the job more often because of their fight to be compensated.
tblackwell@nationalpost.com