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The Association Between Fault Attribution and Work Participation After Road Traffic Injury: A Registry-Based Observational Study

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Abstract

Purpose To characterise associations between fault attribution and work participation and capacity after road traffic injury. Methods People aged 15–65 years, working pre-injury, without serious brain injury, who survived to 12 months after road traffic injury were included from two Victorian trauma registries (n = 2942). Fault profiles from linked compensation claims were defined as no other at fault, another at fault, denied another at fault, claimed another at fault, and unknown. Claimant reports in the denied and claimed another at fault groups contradicted police reports. Patients reported work capacity (Glasgow outcome scale-extended) and return to work (RTW) at 6, 12 and 24 months post-injury (early and sustained RTW, delayed RTW (≥ 12 months), failed RTW attempts, no RTW attempts). Analyses adjusted for demographic, clinical and injury covariates. Results The risk of not returning to work was higher if another was at fault [adjusted relative risk ratio (aRRR) = 1.67, 95% confidence interval (CI) 1.29, 2.17] or was claimed to be at fault (aRRR = 1.58, 95% CI 1.04, 2.41), and lower for those who denied that another was at fault (aRRR = 0.51, 95% CI 0.29, 0.91), compared to cases with no other at fault. Similarly, people had higher odds of work capacity limitations if another was at fault (12m: AOR = 1.49, 95% CI 1.24, 1.80; 24m: 1.63, 95% CI 1.35, 1.97) or was claimed to be at fault (12m: AOR = 1.54, 95% CI 1.16, 2.05; 24m: AOR = 1.80, 95% CI 1.34, 2.41), and lower odds if they denied another was at fault (6m: AOR = 0.67, 95% CI 0.48, 0.95), compared to cases with no other at fault. Conclusion Targeted interventions are needed to support work participation in people at risk of poor RTW post-injury. While interventions targeting fault and justice-related attributions are currently lacking, these may be beneficial for people who believe that another caused their injury.

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Funding

This Project was funded by an Australian Research Council Discovery Early Career Research Award (DE170100726) awarded to MJG, and Future Fellowship awarded to BJG (FT170100048). The Victorian State Trauma Registry is funded by the Transport Accident Commission (TAC) and the Department of Health and Human Services (State Government of Victoria). The Victorian Orthopaedic Trauma Outcomes Registry is a TAC funded project.

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Authors and Affiliations

  1. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia

    Georgina Lau, Belinda J. Gabbe, Alex Collie, Peter A. Cameron & Melita J. Giummarra

  2. Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, Swansea, Wales, SA2 8PP, UK

    Belinda J. Gabbe

  3. School of Psychological Sciences, Monash University, Clayton, VIC, Australia

    Jennie Ponsford

  4. Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, VIC, Australia

    Jennie Ponsford

  5. School of Population Health, University of Auckland, Auckland, New Zealand

    Shanthi Ameratunga

  6. Research Centre for Injury Studies, Flinders University, Adelaide, SA, Australia

    James E. Harrison

  7. Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia

    Melita J. Giummarra

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  1. Georgina Lau
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Correspondence to Melita J. Giummarra.

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Lau, G., Gabbe, B.J., Collie, A. et al. The Association Between Fault Attribution and Work Participation After Road Traffic Injury: A Registry-Based Observational Study. J Occup Rehabil 30, 235–254 (2020). https://doi.org/10.1007/s10926-019-09867-w

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