The Experts below are selected from a list of 31650 Experts worldwide ranked by ideXlab platform
Jason W Busse - One of the best experts on this subject based on the ideXlab platform.
-
smoking obesity and Disability Benefits or litigation are not associated with clinically important reductions in physical functioning after intramedullary nailing of tibial shaft fractures a retrospective cohort study
Clinical Orthopaedics and Related Research, 2021Co-Authors: Fawaz Findakli, Jason W Busse, Emil H Schemitsch, Eva Lonn, Forough Farrokhyar, Mohit BhandariAbstract:BACKGROUND Forty percent of long bone fractures involve the tibia. These fractures are associated with prolonged recovery and may adversely affect patients' long-term physical functioning; however, there is limited evidence to inform what factors influence functional recovery in this patient population. QUESTION/PURPOSE In a secondary analysis of a previous randomized trial, we asked: What fracture-related, demographic, social, or rehabilitative factors were associated with physical function 1 year after reamed intramedullary nailing of open or closed tibial shaft fractures? METHODS This is a secondary (retrospective) analysis of a prior randomized trial (Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures; TRUST trial). In the TRUST trial, 501 patients with unilateral open or closed tibial shaft fractures were randomized to self-administer daily low-intensity pulsed ultrasound or use a sham device, of which 15% (73 of 501) were not followed for 1 year due to early study termination as a result of futility (no difference between active and sham interventions). Of the remaining patients, 70% (299 of 428) provided full data. All fractures were fixed using reamed (298 of 299) or unreamed (1 of 299) intramedullary nailing. Thus, we excluded the sole fracture fixed using unreamed intramedullary nailing. The co-primary study outcomes of the TRUST trial were time to radiographic healing and SF-36 physical component summary (SF-36 PCS) scores at 1-year. SF-36 PCS scores range from 0 to 100, with higher scores being better, and the minimum clinically important difference (MCID) is 5 points. In this secondary analysis, based on clinical and biological rationale, we selected factors that may be associated with physical functioning as measured by SF-36 PCS scores. All selected factors were inserted simultaneously into a multivariate linear regression analysis. RESULTS After adjusting for potentially confounding factors, such as age, gender, and injury severity, we found that no factor showed an association that exceeded the MCID for physical functioning 1 year after intramedullary nailing for tibial shaft fractures. The independent variables associated with lower physical functioning were current smoking status (mean difference -3.0 [95% confidence interval -5 to -0.5]; p = 0.02), BMI > 30 kg/m2 (mean difference -3.0 [95% CI -5.0 to -0.3]; p = 0.03), and receipt of Disability Benefits or involvement in litigation, or plans to be (mean difference -3.0 [95% CI -5.0 to -1]; p = 0.007). Patients who were employed (mean difference 4.6 [95% CI 2.0 to 7]; p < 0.001) and those who were advised by their surgeon to partially or fully bear weight postoperatively (mean difference 2.0 [95% CI 0.1 to 4.0]; p = 0.04) were associated with higher physical functioning. Age, gender, fracture severity, and receipt of early physical therapy were not associated with physical functioning at 1-year following surgical fixation. CONCLUSION Among patients with tibial fractures, none of the factors we analyzed, including smoking status, receipt of Disability Benefits or involvement in litigation, or BMI, showed an association with physical functioning that exceeded the MCID. LEVEL OF EVIDENCE Level III, therapeutic study.
-
association of Disability Benefits and or litigation with time to return to work after tibia shaft fracture fixation
Journal of Occupational and Environmental Medicine, 2020Co-Authors: Yasir Rehman, Aaron Jones, Kim Madden, Diane Heelsansdell, Jason W Busse, Trust InvestigatorsAbstract:OBJECTIVES We explored the association of compensation status with return to work (RTW) after tibial fracture. METHODS Eligible patients were adults with tibial shaft fractures enrolled in the Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures. We explored the association between Disability Benefits and/or litigation and RTW using multivariable discrete interval hazard analysis, adjusting for sex, age, country of residence, smoking status, body mass index, polytrauma, fracture severity, fracture gap, pain severity, and physical functioning. RESULTS Of 330 eligible patients, 111 (34%) had not returned to full-time work 1-year after surgery. In our adjusted model, receipt of Disability Benefits and/or involvement in litigation was associated with delayed RTW (HR = 0.71, 95% CI 0.52-0.96). DISCUSSION Tibial shaft fracture patients receiving Disability Benefits and/or involved in litigation are less likely to RTW.
-
Association of Disability Benefits and/or Litigation With Time to Return to Work After Tibia Shaft Fracture Fixation.
Journal of occupational and environmental medicine, 2020Co-Authors: Yasir Rehman, Aaron Jones, Kim Madden, Jason W Busse, Diane Heels-ansdell, Trust InvestigatorsAbstract:OBJECTIVES We explored the association of compensation status with return to work (RTW) after tibial fracture. METHODS Eligible patients were adults with tibial shaft fractures enrolled in the Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures. We explored the association between Disability Benefits and/or litigation and RTW using multivariable discrete interval hazard analysis, adjusting for sex, age, country of residence, smoking status, body mass index, polytrauma, fracture severity, fracture gap, pain severity, and physical functioning. RESULTS Of 330 eligible patients, 111 (34%) had not returned to full-time work 1-year after surgery. In our adjusted model, receipt of Disability Benefits and/or involvement in litigation was associated with delayed RTW (HR = 0.71, 95% CI 0.52-0.96). DISCUSSION Tibial shaft fracture patients receiving Disability Benefits and/or involved in litigation are less likely to RTW.
-
factors associated with the duration of Disability Benefits claims among canadian workers a retrospective cohort study
CMAJ Open, 2017Co-Authors: Sohail M Mulla, Diane Heelsansdell, Sun Makossokallyth, Nathalie Sthilaire, Katrena Munsch, Peter B Gove, Gordon H Guyatt, Jason W BusseAbstract:BACKGROUND Disability insurance protects workers from total loss of income in case of a disabling injury or illness by providing wage-replacement Benefits. To better inform early identification of claims at risk of prolonged recovery, we explored predictors of the duration of Disability Benefits claims. METHODS We conducted a retrospective cohort study using claims data provided by SSQ Life Insurance Company Inc., a private Canadian Disability insurer. We examined all claims SSQ approved for short- and long-term Disability Benefits from Jan. 1, 2007, to Mar. 31, 2014, and evaluated the association between 9 variables and duration of short- and long-term Disability Benefits using Cox proportional hazards regression analyses. RESULTS For both short- (n = 70 776) and long-term Disability (n = 22 205) claims, and across all disorders, older age, female sex, heavy job demands, presence of comorbidity, attending an independent medical evaluation, receipt of rehabilitation therapy and longer time to claim approval were associated with longer claim duration. Higher preDisability salary was associated with longer short-term Disability claim duration. Quebec residency was associated with longer short-term Disability claim duration among workers with psychological disorders, but shorter short-term Disability claim duration among those with musculoskeletal complaints and other illnesses. For long-term Disability claims, however, residing in Quebec was associated with shorter claim duration, although the size of the association differed across clinical conditions. INTERPRETATION The factors we found to be associated with the duration of short- and long-term Disability claims may be helpful to identify claims at risk of prolonged recovery. Our study has limitations, however, and well-designed prospective studies are needed to confirm our findings and identify other promising predictors.
-
0161 development of an instrument assessing recovery expectations in patients receiving Disability Benefits secondary to mental health disorders
Occupational and Environmental Medicine, 2014Co-Authors: Sohail M Mulla, Gordon H Guyatt, Shanil Ebrahim, Cindy Malachowski, Mostafa Kamal El Din, Sheena Bance, Luis Montoya, Jason W BusseAbstract:Objectives Of workers approved for long-term Disability Benefits, 31.6% suffer from a primary mental illness. Negative patient recovery expectations are associated with worse outcome in many conditions. Our objectives were: 1) to complete a systematic review to identify measures that assess patient recovery expectations, and 2) using the results from our review, develop an instrument designed to assess recovery expectations in individuals receiving Disability Benefits secondary to a mental health disorder. Method We completed searches of MEDLINE and PSYCInfo from inception of each database to June 2013, to identify primary studies evaluating patient’s recovery expectations across all clinical populations. Teams of reviewers completed title and abstract screening of citations, full text review of potentially eligible articles, data extraction, and quality assessment of eligible studies. Findings from the review and input from content experts informed the development of a comprehensive list of items that captured patient’s recovery expectations. Results We identified 12 599 unique citations; 46 studies were eligible. Studies reported on 20 different instruments assessing patient’s recovery expectations. A minority (20%) of studies included measurement properties of reported instruments; 11% evaluated mental health conditions. No instruments were validated among patients receiving Disability Benefits or explored associations with return to work. Generalizability to disabled patients receiving wage replacement Benefits is therefore unclear. Items that comprise our summary instrument will be presented at EPICOH. Conclusions Our instrument holds promise for identifying claimants holding negative recovery expectations, which may be associated with prolonged recovery. These unhelpful beliefs may be a useful target for early interventional therapies.
Robert A. Rosenheck - One of the best experts on this subject based on the ideXlab platform.
-
Incomes and Outcomes: Social Security Disability Benefits in First-Episode Psychosis
The American journal of psychiatry, 2017Co-Authors: Robert A. Rosenheck, Sue E. Estroff, Kyaw Sint, Haiqun Lin, Kim T. Mueser, Delbert Robinson, Nina R. Schooler, Patricia Marcy, John M. KaneAbstract:Objective:Social Security Administration (SSA) Disability Benefits are an important source of income for people with psychoses and confer eligibility for health insurance. The authors examined the impact of coordinated specialty care on receipt of such Benefits in first-episode psychosis, along with the correlates and consequences of receiving them.Method:The Recovery After an Initial Schizophrenia Episode–Early Treatment Program (RAISE-ETP) study, a 34-site cluster-randomized trial, compared NAVIGATE, a coordinated specialty care program, to usual community care over 2 years. Receipt of SSA Benefits and clinical outcomes were assessed at program entry and every 6 months for 2 years. Piecewise regression analysis was used to identify relative change in outcome trajectories after receipt of Disability Benefits.Results:Among 399 RAISE-ETP participants, 36 (9%) were receiving SSA Disability Benefits at baseline; of the remainder, 124 (34.1%) obtained Benefits during the 2-year study period. The NAVIGATE inte...
-
a qualitative study of u s veterans reasons for seeking department of veterans affairs Disability Benefits for posttraumatic stress disorder
Journal of Traumatic Stress, 2011Co-Authors: Nina A. Sayer, Maureen Murdoch, Michele Spoont, Louise E Parker, Samuel Hintz, Robert A. RosenheckAbstract:Posttraumatic stress disorder (PTSD) is the most prevalent compensable mental disorder within the U.S. Department of Veterans Affairs Disability system and the number of veterans with PTSD service-connected Disability has increased steadily over the past decade. An understanding of the reasons veterans apply for PTSD Disability status may inform interpretation of this increase and policies and interventions to assist veterans with military-related PTSD. The authors conducted an exploratory qualitative study to describe the reasons veterans seek PTSD Disability Benefits and explored differences between those who served in different military service eras. They gathered data through in-depth interviews with 44 purposefully selected U.S. veterans, and conducted content analysis of transcribed interviews using inductive and deductive analysis with constant comparison. Participants described 5 interrelated categories of reasons for seeking PTSD Disability Benefits, including 3 internal factors (tangible need, need for problem identification or clarification, beliefs that justify/legitimize PTSD Disability status) and 2 external factors (encouragement from trusted others and professional assistance). There were no major differences by service era. Findings may help policy makers, providers, and researchers understand what veterans hope to achieve through PTSD Disability and the instrumental role of social networks and government systems in promoting the pursuit of PTSD Disability status.
-
Long-term Outcomes of Disability Benefits in US Veterans With Posttraumatic Stress Disorder
Archives of general psychiatry, 2011Co-Authors: Maureen Murdoch, Robert A. Rosenheck, Nina A. Sayer, Michele Spoont, Siamak Noorbaloochi, Joan M. Griffin, Paul A. Arbisi, Emily HagelAbstract:Context Most studies examining the clinical impact of Disability Benefits have compared aid recipients with people who never applied for Benefits. Such practices may bias findings against recipients because Disability applicants tend to be much sicker than never-applicants. Furthermore, these studies ignore the outcomes of denied claimants. Objective To examine long-term outcomes associated with receiving or not receiving Department of Veterans Affairs (VA) Disability Benefits for posttraumatic stress disorder (PTSD), the most common mental disorder for which veterans seek such Benefits. Design Comparison of outcomes between successful and unsuccessful applicants for VA Disability payments. Because we could not randomize the receipt of Benefits, we used exact matching by propensity scores to control for potential baseline differences. We examined clinical outcomes approximately 10 years later. Setting and Participants Stratified, nationally representative cohort of 3337 veterans who applied for VA PTSD Disability Benefits between January 1, 1994, and December 31, 1998. Main Outcome Measures Assessment on validated survey measures of PTSD; work, role, social, and physical functioning; employment; and poverty. We compared outcomes with earlier scores. Homelessness and mortality were assessed using administrative data. Results Of still-living cohort members, 85.1% returned usable surveys. Symptoms of PTSD were elevated in both groups. After adjustment, awardees had more severe PTSD symptoms than denied claimants but were nonetheless more likely to have had a meaningful symptom reduction since their last assessment (−6.1 vs−4.4; SE, 0.1; P = .01). Both groups had meaningful improvements of similar magnitude in work, role, and social functioning (−0.15 vs−0.19; SE, 0.01; P = .94), but functioning remained poor nonetheless. Comparing awardees with denied claimants after adjustment, 13.2% vs 19.0% were employed (P = .11); 15.2% vs 44.8% reported poverty (P Conclusions Regardless of claim outcome, veterans who apply for PTSD Disability Benefits are highly impaired. However, receiving PTSD Benefits was associated with clinically meaningful reductions in PTSD symptoms and less poverty and homelessness.
-
Disability Benefits and clinical outcomes among homeless veterans with psychiatric and substance abuse problems.
Community mental health journal, 2006Co-Authors: Alvin S. Mares, Robert A. RosenheckAbstract:This study examined the relationship between Disability payment status and clinical outcomes among 305 homeless veterans entering VA treatment. Disability status and clinical outcomes were characterized using self-report data at program entry, and quarterly for 2 years thereafter. Seeking or already receiving Disability Benefits at program entry was not associated with any of the 8 clinical outcomes examined. Those seeking or receiving Disability Benefits during the 2 years that followed showed more serious mental health problems and lower levels of mental health functioning, but no greater risk of substance use or not being employed nor worse housing outcomes than those who remained uninterested in applying for Disability Benefits. This study does not, therefore, support the notion that Disability orientation results in poorer clinical outcomes, at least not among homeless veterans.
-
improving access to Disability Benefits among homeless persons with mental illness an agency specific approach to services integration
American Journal of Public Health, 1999Co-Authors: Robert A. Rosenheck, Linda K Frisman, Wesley J KasprowAbstract:OBJECTIVES: This study evaluated a joint initiative of the Social Security Administration (SSA) and the Department of Veterans Affairs (VA) to improve access to Social Security Disability Benefits among homeless veterans with mental illness. METHODS: Social Security personnel were colocated with VA clinical staff at 4 of the VA's Health Care for Homeless Veterans (HCHV) programs. Intake assessment data were merged with SSA administrative data to determine the proportion of veterans who filed applications and who received Disability awards at the 4 SSA-VA Joint Outreach Initiative sites (n = 6709) and at 34 comparison HCHV sites (n = 27 722) during the 2 years before and after implementation of the program. RESULTS: During the 2 years after the initiative began, higher proportions of veterans applied for Disability (18.9% vs 11.1%; P < .001) and were awarded Benefits (11.4% vs 7.2%, P < .001) at SSA-VA Joint Initiative sites. CONCLUSION: A colocation approach to service system integration can improve acces...
Maureen Murdoch - One of the best experts on this subject based on the ideXlab platform.
-
persistent serious mental illness among former applicants for va ptsd Disability Benefits and long term outcomes symptoms functioning and employment
Journal of Traumatic Stress, 2017Co-Authors: Maureen Murdoch, Nina A. Sayer, Michele Spoont, Shannon M Kehleforbes, Eileen M Harwood, Barbara Clothier, Ann BangerterAbstract:Millions of U.S. veterans have returned from military service with posttraumatic stress disorder (PTSD), for which a substantial number receive U.S. Department of Veterans Affairs (VA) Disability Benefits. Although PTSD is treatable, comorbid serious mental illness (defined here as schizophrenia, schizoaffective disorder, and bipolar spectrum disorders) could complicate these veterans’ recovery. Using VA administrative data, we examined the burden of persistent serious mental illness in a nationally representative cohort of 1,067 men and 1,513 women who applied for VA PTSD Disability Benefits between 1994 and 1998 and served during or after the Vietnam conflict. Self-reported outcomes were restricted to the 713 men and 1,015 women who returned surveys at each of 3 collection points. More than 10.0% of men and 20.0% of women had persistent serious mental illness; of these, more than 80.0% also had persistent PTSD. On repeated measures modeling, those with persistent serious mental illness consistently reported more severe PTSD symptoms and poorer functioning in comparison to other participants (ps < .001); their employment rate did not exceed 21.0%. Interactions between persistent serious mental illness and PTSD were significant only for employment (p = .002). Persistent serious mental illness in this population was almost 2 to 19 times higher than in the general U.S. population. The implications of these findings are discussed.
-
sexual assault during the time of gulf war i a cross sectional survey of u s service men who later applied for department of veterans affairs ptsd Disability Benefits
Military Medicine, 2014Co-Authors: Maureen Murdoch, Melissa A Polusny, Siamak Noorbaloochi, Ann Bangerter, Amy E Street, Alisha Baines Simon, Joseph Grill, Emily VollerAbstract:ABSTRACT Objectives: To estimate the cumulative incidence of sexual assault during the time of Gulf War I among male Gulf War I Veterans who later applied for Department of Veterans Affairs (VA) post-traumatic stress disorder Disability Benefits and to identify potential risk and protective factors for sexual assault within the population. Method: Mailed, national, cross-sectional survey supplemented with VA administrative and clinical data. Results: Of 2,415 Veterans sampled, 1,700 (70%) responded. After adjusting for nonignorable missing data, the cumulative incidence of sexual assault during Gulf War I in this population ranged from 18% [95% confidence intervals (CI): 5.0%–51.9%] to 21% (95% CI: 20.0–22.0). Deployment was not associated with sexual assault [Odds Ratio (OR), 0.96; 95% CI: 0.75–1.23], but combat exposure was (OR, 1.80; 95% CI: 1.52–2.10). Other correlates of sexual assault within the population included working in a unit with greater tolerance of sexual harassment (OR, 1.80; 95% CI: 1.52...
-
a qualitative study of u s veterans reasons for seeking department of veterans affairs Disability Benefits for posttraumatic stress disorder
Journal of Traumatic Stress, 2011Co-Authors: Nina A. Sayer, Maureen Murdoch, Michele Spoont, Louise E Parker, Samuel Hintz, Robert A. RosenheckAbstract:Posttraumatic stress disorder (PTSD) is the most prevalent compensable mental disorder within the U.S. Department of Veterans Affairs Disability system and the number of veterans with PTSD service-connected Disability has increased steadily over the past decade. An understanding of the reasons veterans apply for PTSD Disability status may inform interpretation of this increase and policies and interventions to assist veterans with military-related PTSD. The authors conducted an exploratory qualitative study to describe the reasons veterans seek PTSD Disability Benefits and explored differences between those who served in different military service eras. They gathered data through in-depth interviews with 44 purposefully selected U.S. veterans, and conducted content analysis of transcribed interviews using inductive and deductive analysis with constant comparison. Participants described 5 interrelated categories of reasons for seeking PTSD Disability Benefits, including 3 internal factors (tangible need, need for problem identification or clarification, beliefs that justify/legitimize PTSD Disability status) and 2 external factors (encouragement from trusted others and professional assistance). There were no major differences by service era. Findings may help policy makers, providers, and researchers understand what veterans hope to achieve through PTSD Disability and the instrumental role of social networks and government systems in promoting the pursuit of PTSD Disability status.
-
Long-term Outcomes of Disability Benefits in US Veterans With Posttraumatic Stress Disorder
Archives of general psychiatry, 2011Co-Authors: Maureen Murdoch, Robert A. Rosenheck, Nina A. Sayer, Michele Spoont, Siamak Noorbaloochi, Joan M. Griffin, Paul A. Arbisi, Emily HagelAbstract:Context Most studies examining the clinical impact of Disability Benefits have compared aid recipients with people who never applied for Benefits. Such practices may bias findings against recipients because Disability applicants tend to be much sicker than never-applicants. Furthermore, these studies ignore the outcomes of denied claimants. Objective To examine long-term outcomes associated with receiving or not receiving Department of Veterans Affairs (VA) Disability Benefits for posttraumatic stress disorder (PTSD), the most common mental disorder for which veterans seek such Benefits. Design Comparison of outcomes between successful and unsuccessful applicants for VA Disability payments. Because we could not randomize the receipt of Benefits, we used exact matching by propensity scores to control for potential baseline differences. We examined clinical outcomes approximately 10 years later. Setting and Participants Stratified, nationally representative cohort of 3337 veterans who applied for VA PTSD Disability Benefits between January 1, 1994, and December 31, 1998. Main Outcome Measures Assessment on validated survey measures of PTSD; work, role, social, and physical functioning; employment; and poverty. We compared outcomes with earlier scores. Homelessness and mortality were assessed using administrative data. Results Of still-living cohort members, 85.1% returned usable surveys. Symptoms of PTSD were elevated in both groups. After adjustment, awardees had more severe PTSD symptoms than denied claimants but were nonetheless more likely to have had a meaningful symptom reduction since their last assessment (−6.1 vs−4.4; SE, 0.1; P = .01). Both groups had meaningful improvements of similar magnitude in work, role, and social functioning (−0.15 vs−0.19; SE, 0.01; P = .94), but functioning remained poor nonetheless. Comparing awardees with denied claimants after adjustment, 13.2% vs 19.0% were employed (P = .11); 15.2% vs 44.8% reported poverty (P Conclusions Regardless of claim outcome, veterans who apply for PTSD Disability Benefits are highly impaired. However, receiving PTSD Benefits was associated with clinically meaningful reductions in PTSD symptoms and less poverty and homelessness.
-
Mitigating effect of Department of Veterans Affairs Disability Benefits for post-traumatic stress disorder on low income.
Military medicine, 2005Co-Authors: Maureen Murdoch, James S Hodges, Michelle Van Ryn, Diane C. CowperAbstract:OBJECTIVE The goal was to assess the impact of Veterans Affairs (VA) Disability Benefits for post-traumatic stress disorder (PTSD) on veterans' odds of poverty. Women and African American veterans were of special interest, because they are less likely than other groups to receive PTSD Disability Benefits. METHODS A cross-sectional survey of 4,918 veterans who applied for VA Disability Benefits for PTSD between 1994 and 1998 was performed. Responses were linked to administrative data. RESULTS Overall, 42% reported low income (defined as household income less than or equal to 20,000 dollars per year). Men's and women's odds of reporting poverty were similar, but receipt of PTSD Disability Benefits mediated African American veterans' odds of poverty. Veterans' odds of impoverishment were reduced considerably if they received VA PTSD Disability Benefits and identified themselves as disabled. CONCLUSIONS VA Disability Benefits for PTSD reduced odds of impoverishment for psychiatrically ill veterans. This effect appeared to be especially important for African American veterans and for veterans self-identifying as disabled.
Trust Investigators - One of the best experts on this subject based on the ideXlab platform.
-
association of Disability Benefits and or litigation with time to return to work after tibia shaft fracture fixation
Journal of Occupational and Environmental Medicine, 2020Co-Authors: Yasir Rehman, Aaron Jones, Kim Madden, Diane Heelsansdell, Jason W Busse, Trust InvestigatorsAbstract:OBJECTIVES We explored the association of compensation status with return to work (RTW) after tibial fracture. METHODS Eligible patients were adults with tibial shaft fractures enrolled in the Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures. We explored the association between Disability Benefits and/or litigation and RTW using multivariable discrete interval hazard analysis, adjusting for sex, age, country of residence, smoking status, body mass index, polytrauma, fracture severity, fracture gap, pain severity, and physical functioning. RESULTS Of 330 eligible patients, 111 (34%) had not returned to full-time work 1-year after surgery. In our adjusted model, receipt of Disability Benefits and/or involvement in litigation was associated with delayed RTW (HR = 0.71, 95% CI 0.52-0.96). DISCUSSION Tibial shaft fracture patients receiving Disability Benefits and/or involved in litigation are less likely to RTW.
-
Association of Disability Benefits and/or Litigation With Time to Return to Work After Tibia Shaft Fracture Fixation.
Journal of occupational and environmental medicine, 2020Co-Authors: Yasir Rehman, Aaron Jones, Kim Madden, Jason W Busse, Diane Heels-ansdell, Trust InvestigatorsAbstract:OBJECTIVES We explored the association of compensation status with return to work (RTW) after tibial fracture. METHODS Eligible patients were adults with tibial shaft fractures enrolled in the Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures. We explored the association between Disability Benefits and/or litigation and RTW using multivariable discrete interval hazard analysis, adjusting for sex, age, country of residence, smoking status, body mass index, polytrauma, fracture severity, fracture gap, pain severity, and physical functioning. RESULTS Of 330 eligible patients, 111 (34%) had not returned to full-time work 1-year after surgery. In our adjusted model, receipt of Disability Benefits and/or involvement in litigation was associated with delayed RTW (HR = 0.71, 95% CI 0.52-0.96). DISCUSSION Tibial shaft fracture patients receiving Disability Benefits and/or involved in litigation are less likely to RTW.
Nina A. Sayer - One of the best experts on this subject based on the ideXlab platform.
-
persistent serious mental illness among former applicants for va ptsd Disability Benefits and long term outcomes symptoms functioning and employment
Journal of Traumatic Stress, 2017Co-Authors: Maureen Murdoch, Nina A. Sayer, Michele Spoont, Shannon M Kehleforbes, Eileen M Harwood, Barbara Clothier, Ann BangerterAbstract:Millions of U.S. veterans have returned from military service with posttraumatic stress disorder (PTSD), for which a substantial number receive U.S. Department of Veterans Affairs (VA) Disability Benefits. Although PTSD is treatable, comorbid serious mental illness (defined here as schizophrenia, schizoaffective disorder, and bipolar spectrum disorders) could complicate these veterans’ recovery. Using VA administrative data, we examined the burden of persistent serious mental illness in a nationally representative cohort of 1,067 men and 1,513 women who applied for VA PTSD Disability Benefits between 1994 and 1998 and served during or after the Vietnam conflict. Self-reported outcomes were restricted to the 713 men and 1,015 women who returned surveys at each of 3 collection points. More than 10.0% of men and 20.0% of women had persistent serious mental illness; of these, more than 80.0% also had persistent PTSD. On repeated measures modeling, those with persistent serious mental illness consistently reported more severe PTSD symptoms and poorer functioning in comparison to other participants (ps < .001); their employment rate did not exceed 21.0%. Interactions between persistent serious mental illness and PTSD were significant only for employment (p = .002). Persistent serious mental illness in this population was almost 2 to 19 times higher than in the general U.S. population. The implications of these findings are discussed.
-
a qualitative study of u s veterans reasons for seeking department of veterans affairs Disability Benefits for posttraumatic stress disorder
Journal of Traumatic Stress, 2011Co-Authors: Nina A. Sayer, Maureen Murdoch, Michele Spoont, Louise E Parker, Samuel Hintz, Robert A. RosenheckAbstract:Posttraumatic stress disorder (PTSD) is the most prevalent compensable mental disorder within the U.S. Department of Veterans Affairs Disability system and the number of veterans with PTSD service-connected Disability has increased steadily over the past decade. An understanding of the reasons veterans apply for PTSD Disability status may inform interpretation of this increase and policies and interventions to assist veterans with military-related PTSD. The authors conducted an exploratory qualitative study to describe the reasons veterans seek PTSD Disability Benefits and explored differences between those who served in different military service eras. They gathered data through in-depth interviews with 44 purposefully selected U.S. veterans, and conducted content analysis of transcribed interviews using inductive and deductive analysis with constant comparison. Participants described 5 interrelated categories of reasons for seeking PTSD Disability Benefits, including 3 internal factors (tangible need, need for problem identification or clarification, beliefs that justify/legitimize PTSD Disability status) and 2 external factors (encouragement from trusted others and professional assistance). There were no major differences by service era. Findings may help policy makers, providers, and researchers understand what veterans hope to achieve through PTSD Disability and the instrumental role of social networks and government systems in promoting the pursuit of PTSD Disability status.
-
Long-term Outcomes of Disability Benefits in US Veterans With Posttraumatic Stress Disorder
Archives of general psychiatry, 2011Co-Authors: Maureen Murdoch, Robert A. Rosenheck, Nina A. Sayer, Michele Spoont, Siamak Noorbaloochi, Joan M. Griffin, Paul A. Arbisi, Emily HagelAbstract:Context Most studies examining the clinical impact of Disability Benefits have compared aid recipients with people who never applied for Benefits. Such practices may bias findings against recipients because Disability applicants tend to be much sicker than never-applicants. Furthermore, these studies ignore the outcomes of denied claimants. Objective To examine long-term outcomes associated with receiving or not receiving Department of Veterans Affairs (VA) Disability Benefits for posttraumatic stress disorder (PTSD), the most common mental disorder for which veterans seek such Benefits. Design Comparison of outcomes between successful and unsuccessful applicants for VA Disability payments. Because we could not randomize the receipt of Benefits, we used exact matching by propensity scores to control for potential baseline differences. We examined clinical outcomes approximately 10 years later. Setting and Participants Stratified, nationally representative cohort of 3337 veterans who applied for VA PTSD Disability Benefits between January 1, 1994, and December 31, 1998. Main Outcome Measures Assessment on validated survey measures of PTSD; work, role, social, and physical functioning; employment; and poverty. We compared outcomes with earlier scores. Homelessness and mortality were assessed using administrative data. Results Of still-living cohort members, 85.1% returned usable surveys. Symptoms of PTSD were elevated in both groups. After adjustment, awardees had more severe PTSD symptoms than denied claimants but were nonetheless more likely to have had a meaningful symptom reduction since their last assessment (−6.1 vs−4.4; SE, 0.1; P = .01). Both groups had meaningful improvements of similar magnitude in work, role, and social functioning (−0.15 vs−0.19; SE, 0.01; P = .94), but functioning remained poor nonetheless. Comparing awardees with denied claimants after adjustment, 13.2% vs 19.0% were employed (P = .11); 15.2% vs 44.8% reported poverty (P Conclusions Regardless of claim outcome, veterans who apply for PTSD Disability Benefits are highly impaired. However, receiving PTSD Benefits was associated with clinically meaningful reductions in PTSD symptoms and less poverty and homelessness.
-
veterans seeking Disability Benefits for post traumatic stress disorder who applies and the self reported meaning of Disability compensation
Social Science & Medicine, 2004Co-Authors: Nina A. Sayer, Michele Spoont, David B NelsonAbstract:Assumptions about the characteristics and motivations of individuals pursuing Disability status are well known. However, policy, programming and interventions need to be based on information about the actual sociodemographic characteristics of disabled individuals, as well as their goals in seeking Disability status. In this study, we focus on veterans seeking Disability compensation for post-traumatic stress disorder (PTSD) from the United States Department of Veterans Affairs. We present information on their life circumstances and their self-reported reasons for valuing the obtainment of veterans' Disability status on the basis of PTSD. There was considerable variability in the background of veterans seeking Disability status on the basis of PTSD. Of concern, only about half of these individuals were receiving any mental health treatment at the time of application. Most claimants reported seeking Disability compensation for symbolic reasons, especially for acknowledgement, validation and relief from self-blame. Reasons having to do with improved finances were less frequently endorsed, although the importance of obtaining improved solvency through Disability status decreased as income increased. The sense of investment in obtaining a sense of self-acceptance and acceptance from others through Disability status varied by sociodemographic variables. Overall, findings suggest that individuals seeking Disability Benefits may have unmet mental health care needs, and that policy makers, investigators and providers should consider material benefit as one of many possible reasons for engaging in a Disability compensation system.