Purpose: Recovering from compensable injuries can be influenced by a variety of factors including the claimant's experience of distress during the claims process. In order to develop cross-scheme, nation-wide strategies to improve claimants' interactions with the compensation system, reduce claimant distress, and improve claimant outcomes, it is important to understand sources of claims-related distress from the perspective of both claimants and clinicians.
Methods: An exploratory qualitative design was undertaken using semi-structured interviews with 13 claimants and 26 clinicians from four injury compensation schemes in five Australian states. A collaborative and reflexive thematic analysis was undertaken with an inductive approach to coding, and themes were constructed for claimants and clinicians across compensation schemes.
Results: Claimants and clinicians interviews revealed four main sources of distress, including (1) complexity and delays in administrative processes, (2) interruptions to recovery caused by treatment delays, (3) non-individualised approaches to care, and (4) a lack of support for navigating the claims process.
Conclusion: Sources of claims-related distress identified by claimants and clinicians in the present study point to the urgent need for nationwide systems level changes to reduce claimant distress in the pursuit of better claimant outcomes.
Keywords: Workers’ compensation; distress; insurer; motor-vehicle collision; qualitative; rehabilitation access.
People who have a compensable insurance claim experience often experience interactions with the insurer and claims process as stressful.Providing information about the claims process to people with a compensable injury may help to reduce claim-related distress during recovery.Finding opportunities to provide social support and reassurance to people with a compensable injury may help them feel supported and reduce distress.Reducing distress for people who are recovering from a compensable injury may lead to better recovery outcomes.