Background and Methods The incidence and prognosis of whiplashinjury from motor vehicle collisions may be related to eligibilityfor compensation for pain and suffering. On January 1, 1995,the tort-compensation system for traffic injuries, which includedpayments for pain and suffering, in Saskatchewan, Canada, waschanged to a no-fault system, which did not include such payments.To determine whether this change was associated with a decreasein claims and improved recovery after whiplash injury, we studieda population-based cohort of persons who filed insurance claimsfor traffic injuries between July 1, 1994, and December 31,1995.
Results Of 9006 potentially eligible claimants, 7462 (83 percent)met our criteria for whiplash injury. The six-month cumulativeincidence of claims was 417 per 100,000 persons in the lastsix months of the tort system, as compared with 302 and 296per 100,000, respectively, in the first and second six-monthperiods of the no-fault system. The incidence of claims washigher for women than for men in each period; the incidencedecreased by 43 percent for men and by 15 percent for womenbetween the tort period and the two no-fault periods combined.The median time from the date of injury to the closure of aclaim decreased from 433 days (95 percent confidence interval,409 to 457) to 194 days (95 percent confidence interval, 182to 206) and 203 days (95 percent confidence interval, 193 to213), respectively. The intensity of neck pain, the level ofphysical functioning, and the presence or absence of depressivesymptoms were strongly associated with the time to claim closurein both systems.
Conclusions The elimination of compensation for pain and sufferingis associated with a decreased incidence and improved prognosisof whiplash injury.
Source Information
From the Alberta Centre for Injury Control and Research, Department of Public Health Sciences, University of Alberta, Edmonton, Canada (J.D.C., L.J.C.); the Institute for Work and Health and the Department of Public Health Sciences, University of Toronto, Toronto (P.C.); the Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Canada (M.L.); and the Section of Personal Injury Prevention, Department of Clinical Neurosciences, Karolinska Institute, Stockholm, Sweden (A.B., Å.N.).
Address reprint requests to Dr. Cassidy at the Alberta Centre for Injury Control and Research, University of Alberta, 4075 EDC, 8308–114 St., Edmonton, AB T6G 2V2, Canada, or at dcassidy{at}ualberta.ca.
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