M M Large1. 1. Department of Psychiatry, Royal Prince Alfred Hospital, Sydney, NSW. mlarge@ozemail.com.au
Abstract
OBJECTIVE: To examine the relationship between compensation claims for psychiatric injury after motor vehicle accidents and physical injuries sustained. DESIGN: Audit of Compulsory Third Party (CTP) insurance claims. SUBJECTS AND SETTING: 559 consecutive CTP claims referred by NRMA Insurance Limited to its sole provider of CTP legal services during a three-month period in 1994 after the claimant had engaged legal representation. MAIN OUTCOME MEASURES: Claim for psychiatric injury (any psychiatric disorder excluding traumatic brain injury) supported by a medicolegal report from a psychiatrist, other medical practitioner or psychologist; pre-existing psychiatric disorders; Injury Severity Score; initial treatment setting; hospital stay; percentage of accidents involving loss of consciousness or a death. RESULTS: 522 claims were eligible for the study; 19.5% (102/522) included a claim for psychiatric injury. A pre-existing depression or anxiety disorder was documented in 11 claims (2.1% of all claims and 3.9% of those claiming psychiatric injury). Only very severe injuries, particularly those involving loss of consciousness, were associated with an increased rate of claims for psychiatric injury. CONCLUSIONS: No association was found between claims for psychiatric injury and severity of physical injuries, except among those most severely injured.
OBJECTIVE: To examine the relationship between compensation claims for psychiatric injury after motor vehicle accidents and physical injuries sustained. DESIGN: Audit of Compulsory Third Party (CTP) insurance claims. SUBJECTS AND SETTING: 559 consecutive CTP claims referred by NRMA Insurance Limited to its sole provider of CTP legal services during a three-month period in 1994 after the claimant had engaged legal representation. MAIN OUTCOME MEASURES: Claim for psychiatric injury (any psychiatric disorder excluding traumatic brain injury) supported by a medicolegal report from a psychiatrist, other medical practitioner or psychologist; pre-existing psychiatric disorders; Injury Severity Score; initial treatment setting; hospital stay; percentage of accidents involving loss of consciousness or a death. RESULTS: 522 claims were eligible for the study; 19.5% (102/522) included a claim for psychiatric injury. A pre-existing depression or anxiety disorder was documented in 11 claims (2.1% of all claims and 3.9% of those claiming psychiatric injury). Only very severe injuries, particularly those involving loss of consciousness, were associated with an increased rate of claims for psychiatric injury. CONCLUSIONS: No association was found between claims for psychiatric injury and severity of physical injuries, except among those most severely injured.