Do injured persons whose injuries are potentially eligible for compensation under social insurance schemes experience worse health outcomes and slower recoveries in the medium-to long-term than persons with similar injuries that are not covered by compensation schemes? Epidemiologists and health services researchers have probed that question since the 1970s, but interest in it has accelerated sharply in the last decade. A substantial empirical literature now exists to support the existence of a link between compensation status and health outcomes. A strand of that literature specifically implicates the role of compensation processes, lawyers and adversarialism in producing or perpetuating ill health among claimants.
This article critically reviews research into the compensation-health relationship. Systematic methodological weaknesses are identified – in particular, an inability to come to grips with the legal contours and realities of compensation processes. We conclude that, although there are important gaps in the evidence, profound questions about the impact of compensation processes on claimants’ health have been placed on the table. Legal professionals and policymakers must take these questions seriously. The involvement of legal scholars in multidisciplinary research may improve the quality of the evidence base and facilitate appropriate policy interventions.