Workers' compensation. A psychiatric follow-up study

In a follow-up survey of 106 settled workers' compensation cases which involved some degree of psychiatric impairment, there was found to be a high prevalence of cases in which the settlement correlated with no improvement in the patient's subjective feelings of well-being, and no improvements in employment status. There was also a large percentage of cases in which the individual continued to operate at a less adaptive level of functioning, as judged by the evaluating clinician.     

论人身死伤损害的定额化赔偿

本文介绍评述了定额化赔偿理论,分析研究了我国人身损害赔偿立法的演变,提出我国民法典应对人身损害施行全部赔偿、定额化赔偿和概括性赔偿的建议。     

Claims of psychiatric injury after alleged false arrest

Litigation has increased rapidly in the United States; those who feel aggrieved sue readily for damages. Police officers and security people may be sued after arrests or detention followed by unsuccessful prosecution or dropping of criminal charges. Claims of psychiatric injury may be made where there are no discernible damages otherwise. Examiners must keep in mind that physical abuse or grossly inappropriate police behavior may be factors in the ultimate results. This paper reviews 13 cases of claimed psychiatric injury after arrest. Almost all were settled, some for significant amounts. Appropriateness of evaluation, the value of nuisance suits in this type of litigation, the role of attorneys' fees, and the effect of Federal suits as opposed to state suits are discussed.     

Knocking at the wrong door: insured workers' inadequate psychiatric care and workers' compensation claims

ObjectiveTo describe the prevalence of inadequately evaluated and treated psychopathology among insured workers making workers' compensation claims for psychiatric disability whose cases were reviewed by one forensic psychiatrist. To assess the relationship of inadequate evaluation and treatment to the outcomes of these workers' compensation claims.MethodsRecords of a series of 185 workers' compensation cases reviewed in 1998 and 1999 by a California forensic psychiatrist were abstracted. Patient factors (gender, Axis II pathology, psychosocial circumstances, substance abuse), case factors (psychiatric injury secondary to physical injury, or secondary to psychological stresses), type of provider (mental health, or other), adequacy of evaluation and treatment, forensic psychiatrist's recommendation, and claim outcome were categorized. The relationships between case characteristics, adequacy of care, and claim outcome were described.Results22% of cases had adequate evaluation, 48% superficial, and 30% had no evaluation. 11% had adequate treatment, 67% superficial, and 22% had no treatment. Compared to claims for psychiatric disability related to a physical injury, claims related to psychosocial stresses more often had superficial diagnostic evaluations and treatments. Those with superficial treatment were less likely to have their claim granted (19.3%) than those with no treatment (47.5%) or those with adequate treatment (36.8%). Success of claim was not related to provider type.ConclusionsThe majority of the studied workers with employer-provided health insurance who sought workers' compensation for disability due to mental illness did so inappropriately, in that the workplace did not cause the psychopathology. Their seeking workers' compensation was plausibly due to the observed inadequate evaluation and treatment available through their employer-provided health insurance. The adequacy of their care influenced the likelihood their claim would be granted. The relations observed here merit further research to establish their generality and to determine their causes.     

The demographic and psychiatric characteristics of 110 personal injury litigants.

One hundred ten litigants who were suing for emotional damages were assessed by the author for medical-legal reasons. Most of the plaintiffs were involved in motor vehicle accidents and suffered from "whiplash" injuries. Semi-structured interviews were used to reach criteria based on DSM-III-R diagnoses. Requests for consultation, on average, came 25 months after the patient's accident. Approximately 70 percent of patients had evidence for continuing physical injuries to account for the physical and emotional symptoms. The most common DSM-III-R diagnoses were psychiatric condition affecting physical illness (N = 56), major depression (N = 27), and somatoform disorder (N = 12). Alternative diagnoses relating the effect of the accident on the patient's life included: emotional reaction to physical condition (N = 29), difficulty coping with developmental tasks (N = 20), severe depression (N = 20), aggravation of normal premorbid personality (N = 18), aggravation of abnormal premorbid personality (N = 14), phobia (N = 7), no permanent effect (N = 12), and independent illness (N = 2). Severe emotional problems and disability are common among litigants. The causes of their suffering are more complex and less poorly understood than is assumed from the pejorative labels that are sometimes applied. Lawyers and the courts need the help of psychiatrists to understand this suffering. Empirical data such as these may lead to better classification systems and improve our understanding and treatment of these patients.     

Modeling eligibility under national systems of compensation for treatment injury

How can different schemes of compensation for treatment injury be evaluated? This article offers an empirical approach to assessment based on the simulation of alternative models of eligibility using real-world data. It draws on information about adverse events generated from a representative survey of public hospital admissions in New Zealand and classifies these under a range of eligibility criteria for different possible compensation systems. These are then evaluated according to a number of policy design considerations, using variables available from the New Zealand study.     

精神病院内伤害事件的法律探讨

某地精神病院发生这样一起事件:某青年男性患者,因兴奋、冲动、自伤及伤人一周,由家属送入医院诊治.在住院治疗期间,患者乘上厕所之机,突然以头猛撞水龙头,工作人员及时发现并制止,其后迅速转至综合医院急诊,诊断为"头颅外伤、颅骨骨折",经抢救后脱险.     

医疗损害限额赔偿原则的理论探讨

有关医疗纠纷处理的问题已有不少作者探讨,在许多文献中已有作者提出适当赔偿的办法,也有作者在总结我国法律制度中限额赔偿的做法后,提出了医疗损害限额赔偿的原则.但是尚没有从理论上、实践上进行论述,本文拟从这一角度对医疗损害限额赔偿原则问题进行讨论.