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the compensation provider, in particular, its primary
point of contact, the case managers. Clients reported
perceived lack of capacity by the case managers to
advise on what type of services and when those can
be accessed. While some clients (7) reported being
confident in navigating the health and compensation
process, others (16) stated a preference of having more
structured information and guidance at the beginning
and throughout the recovery journey.
I keep asking them I want a job [at the compensation
insurer] because nobody seems to know anything there and
I don’t know anything so I’ll be very good at it and I’ll be
quite nice on the phone and will be nice to people and say
I don’t know anything and don’t even ring next week cause
the people above me don’t know anything either. (Female, 55
years old, soft tissue-contusion)
e) Lack of single point of contact and lack of trust in
case managers’ decisions. Case managers were iden-
tified by clients as playing an important and enduring
role in the coordination of services they receive during
their rehabilitation process. It was perceived that case
managers were challenged by time and resource restric-
tions in the management of a large number of clients
in need. Clients were aware of the challenges faced
by case managers. However, they complained about
poor handover of information, constantly repeating
their story when trying to get in touch, dealing with
administrative people who do not understand medical
terminology and the recovery process and a lack of
response from the compensation provider when they
were contacted. This consequently led to lack of trust
in the system in general and even giving up on their
claim as some clients expressed they could not have
been “bothered” with the provider.
If there was anything that was required I had to have a huge
fight. You cannot get this and cannot get that. What can I get!?
I was dealing with administrative people who perhaps have
no understanding of the real level of capacity after injury and
recovery. (Female, 50 years old, soft tissue – neck and back)
f) Lack of understanding the system, its policies and
procedures and lack of guidelines. Approximately 60%
of clients reported there was no introduction to the com-
pensation processes, no structure about what to expect
and what services they can use and who to report back
when recovery is not progressing as expected. Clients
found the guidance in navigating the compensation
system to be disappointing and a source of ongoing
frustration.
No … no one explained … no one introduced me to the
system or how it works … There was very minimal information
provided unless we asked the direct question. The amount of
time to get to the same person you can count of one hand …
they asked about the medications stuff but even filling that
form was a nightmare. Sorry … It was a real nightmare.
(Female, 53 years old, soft tissue – neck and back)
www.medicaljournals.se/jrm
g) Financial impacts. Clients also reported financial
consequences from inadequate reimbursement of costs
for treatment received and from an inability to undertake
paid employment to the same extent as they were under-
taking pre-accident. Reduced working hours following
the accident was in most cases the result of physical
injury. Some clients reported that it was very difficult
for them to find a new job after the injury due to their
disabilities, while other reported being out of pocket due
to the misunderstandings on their entitlement under the
compensation system.
For the first 3 months I was paying all out of my pockets
because they said they need like 12 weeks or something before
they can step in. And then after that $600 … yes that’s right
I had to pay $600 and after that they started paying for my
GP. And then they said it was too much and even though my
GP and physio said I need these services they said it’s too
much and they won’t pay for it anymore. (Female, 45 years
old, soft tissue – neck and shoulder)
DISCUSSION
This research highlighted that recovery is a complex
phenomenon, regardless of the severity of injury at-
tained. Specifically, it demonstrated some advantages
of using the compensation benefits, but highlighted
numerous challenges in navigating the system and
using compensated services.
The findings highlighted numerous complexities in-
volved in compensation service delivery, especially for
clients dealing with chronic pain and psychopathology,
which often present as vague conditions problematic
to definitively diagnose and adequately treat. It has
been acknowledged that there are multiple challen-
ges when dealing with people with chronic pain and
mental health conditions (23, 24), which are common
comorbidities after any road trauma. Previous studies
have shown that these challenges commonly lead to
trust issues between clients and other professionals and
impact the quality of care received (25, 26).
Unfortunately, there is still scarcity of qualitative
studies on people with minor injuries and protracted
recovery, but few studies that have explored this in-
depth have described similar results to this study. A
recent study led by Ritchie et al. (27) which focused on
patients suffering whiplash associated disorder (WAD)
stated that many participants described complexities
in navigating and understanding recovery processes
incurred by interactions with compensation and fun-
ding systems (27). Another qualitative study carried out
in Sweden found that medically classified minor and
moderate injuries have a long-lasting and detrimental
impact on patients’ quality of life (28).
Therefore, it seems that certain complexities are
expected during recovery, but the question is how to