Opinion
How is the PI compensation process affecting your client’s recovery?
12th Jan 2017
The experience of a long, complex and at times adversarial legal process pursuing personal injury (PI) compensation with the need for multiple health assessments and delays in receiving funds has been shown to increase stress and recovery time for injured people. There is a growing body of evidence that people who seek compensation can experience worse symptoms and longer recovery times than people who do not, with people six years post-injury still reporting significantly higher levels of disability, anxiety, depression and lower quality of life.
The impact of being ‘in limbo’– the asylum seeker analogy
With over a decade of experience in supporting and advocating for people who are waiting long periods for a migration decision, I wondered if my experience would translate to working with people seeking personal injury compensation. Interestingly, the literature shows striking similarities between recovery for people with a personal injury and people seeking asylum. Both groups are in limbo: their trauma is exacerbated by the lengthy nature of the legal process and they cannot begin to recover fully from their trauma until their legal matters are finalised.
Asylum seekers are in limbo until they obtain permanent resettlement in a safe country. Similarly, people seeking PI compensation are in limbo, waiting extended periods for a final legal decision. People seeking asylum cannot commence recovery until it is physically and psychologically safe to do so and until the ongoing stress of possible return to the country of their persecution is over. The need to prove their refugee status by repeatedly having to describe the extent of their physical and psychological injuries resulting from persecution keeps their persecution and injury at the forefront of their minds. The person seeking PI compensation has the stress of not knowing if their claim will be successful and the need to repeatedly prove the extent of their trauma (injury) over many years. This keeps their focus on their disability rather than on their recovery.
How do I support clients during the personal injury compensation process?
As a case manager for people seeking asylum, my focus was on helping people feel safe by providing consistent practical and emotional support and building a network of social connections. On reflection, I realised the underlying practice issues were the same for my PI clients: “How do I build their strength when they do not have the closure of a legal decision, and future support is predicated on the ongoing and full expression of their injuries?” Working with PI clients, I provide regular emotional debriefing and help build resilience by identifying their personal strengths, with a focus on what gives them joy in life. I build a network of practical and social connections around them and their families, which includes finding them a suitable GP and access to other appropriate healthcare and rehabilitation providers.
How lawyers can support clients’ recovery– 5 steps you can take today
PI lawyers already support their clients’ recovery by taking their injury claims seriously, by fighting to overcome any injustice that has occurred and by negotiating appropriate compensation for their injury. Clients consider support to be fundamental to their wellbeing. To improve longer-term recovery, it is important to help clients to find a balance between expressing the extent of their injury to ensure appropriate financial compensation, and focusing on recovery to improve their chances of long-term wellbeing.
As a lawyer, you can support your clients’ recovery by encouraging them to:
- find a supportive GP who understands traumatic injuries and build a long-term relationship;
- establish positive relationships with people who will be key to supporting their mental health and wellbeing – family, friends, carers, support workers, local community groups, including injury-specific peer support organisations such as government brain injury units or disability advocacy peak bodies;
- employ (or contract) a social worker at your firm to work confidentially and independently with clients who experience high-stress levels associated with a claim;[1]
- suggest the client see a mental health professional to talk about the impact of the injury, to reframe their thinking to accept and incorporate their injury into their life;[2] and
- get financial advice early from a financial adviser with experience in the PI field to assist with lifetime planning.
Sarah Grealy is the Wellbeing Advocate with Lyndhurst Family Advisory and a member of the ALA. She worked with refugees and asylum seekers for many years and has a comprehensive knowledge of psychological and physical trauma recovery. Sarah’s role at Lyndhurst was created by Director Charlie Fraser who, in over 10 years in PI financial management, saw that client’s psychosocial needs were not best addressed by lawyers or financial managers.
The views and opinions expressed in these articles are the authors' and do not necessarily represent the views and opinions of the Australian Lawyers Alliance (ALA).
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Notes:
[1] Two Australian PI law firms currently employ social workers to support clients with managing their stress and other psychosocial issues. Clients are referred internally by lawyers and the social worker works independently with the clients. They develop a discharge plan for clients to ensure they are linked to community-based support if they have ongoing needs once their matter is settled.
[2] This can be via a government funded (Access to Allied Psychological Services) ATAPS program, sourced via their Primary Health Network.
References:
Gabbe BJ, Harris IA, Collie A and Cameron PA, 'Does access to compensation have an impact on recovery outcomes after injury?' Medical Journal of Australia, 193(3), 2010, pp188.
American Trauma Society, 'Mental and Emotional Recovery Post-Injury', Trauma Survivors Network website.
Grant GM, O’Donnell ML, Spittal MJ, Creamer M & Studdert DM, 'Relationship Between Stressfulness of Claiming for Injury Compensation and Long-term Recovery', JAMA Psychiatry 71(4), 2014, pp446-53.
Koehler R, Wilhelm EE and Shoulson I (eds) 'Methods' in Cognitive Rehabilitation Therapy for Traumatic Brain Injury. Evaluating the evidence (The National Academies Press, 2011), 115.
Thomas C, 'Psychological consequences of traumatic injury', British Journal of Pscychiatry, 180(5), 2002, pp392-3.
Motor Accident Insurance Commission, The University of Queensland and Griffith University, 'Mental Health', Recover Injury Research Centre website.
Queensland Government (Queensland Health), 'Acquired Brain Injury: Support for Families', Acquired Brain Injury Outreach Service (ABIOS) website.
Newman, L and Harris A, 'Refugees and asylum seekers: supporting recovery from trauma', 2016, TheTrauma and Grief Network.
Manitoba Trauma Information & Education Centre, 'Phases of Trauma Recovery', Trauma Recovery website.
Rothschild B, 'Applying the brakes: In Trauma Treatment, Safety is Essential', 2014, Psychotherapy Networker website.
Murray KE, Davidson GR, Schweitzer RD, 'Psychological Wellbeing of Refugees Resettling in Australia', August 2008, Australian Psychological Society.
Mind Tools Editorial Team, 'Developing Resilience: Overcoming and Growing From Setbacks', Mind Tools website.
Du Plooy L, Outreach social work service making a difference to law firm clients, Summer 2013, Australian Association of Social Workers National Bulletin, pp26-7.
Myles S, ‘Understanding and Treating Loss of Sense of Self Following Brain Injury: A Behavior Analytic Approach’, International Journal of Psychology and Psychological Therapy, Vol 4(3), 2004, pp87-504.
Lyndhurst Family Advisory, Private communications, 2016.
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