Ratings don't predict disabilities accurately.

• Position: Worker's compensation - Brief article

A study of settlement decisions in workers' compensation claims for low back pain has found almost no relationship between the rating of the disability's severity when the claim was settled and reported pain and disability 21 months later. Findings were counterintuitive: Claimants with higher disability ratings, which suggest greater severity and less ability to work, fared better than those with lower ratings. The study shows that "administrative decisions made at the end of the workers' compensation claim process about the ability of someone to work after back injury has very little predictive validity," indicates Norton Hadler, professor of medicine and microbiology/immunology at the University of North Carolina, Chapel Hill.

Workers' compensation is a vital part of America's health-care system, accounting for three percent of an employer's gross income, Hadler points out. "Clearly, the rating schemes for workers' compensation are inconsistent, and that fact is stirring enormous pots across the country.... There is a need to reform how...