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April 13, 1994

Work Disability and Workers' Compensation

Author Affiliations

Texarkana, Tex

JAMA. 1994;271(14):1079. doi:10.1001/jama.1994.03510380035024

To the Editor.  —In the article1 describing a decrease in the prevalence of work disability in the United States, the author of the Centers for Disease Control and Prevention editorial note offered several potential explanations for the desirable declining trend in work disability. Not among them was the possibility that meaningful numbers of patients are opting out of the workers' compensation program.Demoralized by the seeming impossibility of achieving reasonably similar return-to-work outcomes between my workers' compensation patients and those with no apparent secondary gain, I closed my neurosurgical practice to elective workers' compensation patients a few years ago. Although my workload and income diminished slightly, my attitude and that of my remaining patient population improved dramatically, as I expected. The surprise was the emergence of a group of patients who indicated that they had originally filed workers' compensation claims for their problems. However, after discovering that I no

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