Journal of Rehabilitation Medicine 51-2 | Page 48

Person-centred care after minor transport-related injuries quality of life scores. These clients reported that they did not recover or were only partially recovered at the time of the COS survey. The “good recovery” group (LBoT 7–10) consisted of clients aged between 27 and 70 years of age, living in the metropolitan area, with a claim duration of ap- proximately 25–36 months. In the COS survey, these clients reported moderate to mild level of pain and to have nearly or partially recovered. Themes captured in social domain and relevant to this paper are shown in the Table II. General overview of the themes During interviews, few clients (5) mentioned some benefits in using compensation services, but most (17) have raised numerous issues with the compensation system and claiming processes. Some included limits on amount payable or limits on compensated services and others described compensation insurance as a “forced insurance” (considering Victorians must pay for registration and extras), which did not provide adequate social and financial support. The system was also described as limited in scheme rules with certain services that cannot be approved (e.g. plasma therapy). Clients found the guidance in navigating the compensation system to be disappointing and a source of ongoing frustration. Hence, some clients decided not to “bother” with the compensation regulations and paid for services themselves, while others still reported that they had services under review or were using their pri- vate health insurance. Surprisingly, 9 of the 11 clients identified as being in “good recovery”, according to the LBoT, reported that they had not recovered and did not believe they were in good health during the subsequent interview conducted by the researcher as part of this project. Consequently, it was not possible to conduct a comparison between the poor health and good health groups due to the small number of people reporting to be in “good recovery”. Table II. Emerging themes of the access and delivery of compensation services Theme and Sub-theme 1. Benefits of the compensation system a) Right to use home assistance b) Provision of equipment and/or tools needed 2. Limitations of the compensation system c) Scheme limitations d) Lack of information and guidance e) Lack of a single point of contact and lack of trust in case managers’ decisions f) Lack of understanding of the compensation system, its policies and procedures and lack of guidelines g) Financial impacts 123 1. Benefits of the compensation system a) Right to use home assistance. Clients (n = 4) felt grateful for assistance provided by the compensation provider following physical incapacitation and stressed how crucial this was in facilitating their recovery. Most clients discussed feeling lost and shocked after the ac- cident, some also experiencing excruciating pain days after the accident. For that reason, timely and early intervention and support with daily duties was crucial for them. Although not everyone experienced this level of support, clients who were supported in their homes or work found this to be vital for their recovery. The occupational therapist has been here to see me because of assessing for the household things that they are doing. They provided some support with home assistance as I could not do much at the time. This was obviously very important for my recovery. (Female, 48 years old, soft tissue – neck and back) b) Provision of equipment and/or tools needed to improve daily functioning. Injuries left some clients with ongoing physical disabilities, which consequently led to them needing to make significant adjustments to their home and work environment. This included adjusting steps to aid access and providing chairs/new equipment. This was particularly important for people who were self-employed and still wor- king, so that they could go back to work as early as possible, with adjustments that helped them in dealing with functional limitations they were left with after the accident. They gave me a new chair that I can lift up and down be- cause if I look down I get dizzy. They also got me a new trolley which is about 6 inches higher than the old trolleys that I had which was really good as well. They sort of did that for me. (Female, 55 years old, soft tissue-contusion) 2. Limitations of the compensation system c) Scheme limitations. Some issues with the compensa- tion system included limits on the amount payable or limits on compensated services and access to certain services. The compensation insurance system was de- scribed as a “forced insurance”, which did not provide adequate social and financial support and was limited by scheme rules which prohibited certain services. “Forced insurance” was a term that clients commonly used in describing how they must pay for car regist- rations and TAC access fees, but when they needed financial support and help, they have not received what they felt they were entitled to. Because I wanted to do the alternative treatment and [the compensation provider] said no, so then I had to go back and forth to get things approved. It is a limited service that we are forced to pay but don’t get anything back. (Female, 45 years old, soft tissue- neck and shoulder) d) Lack of information and guidance. Issues com- monly reported by clients involved complexities in the recovery journey with no guidance provided by J Rehabil Med 51, 2019