Volume 48 | Number 4 | August 2013

Abstract List

Lenore S. Azaroff Sc.D., Letitia K. Davis Sc.D., M.Ed., Robert Naparstek M.D., F.A.C.O.E.M., Dean Hashimoto M.D., James R. Laing B.S., David H. Wegman M.D., M.S.O.H.


To examine barriers community health centers (s) face in using workers' compensation insurance ().

Data Sources/Study Setting

Leadership of s in assachusetts.

Study Design

We used purposeful snowball sampling of leaders for in‐depth exploration of reimbursement policies and practices, experiences with , and decisions about using . We quantified the prevalence of perceived barriers to using through a mail survey of all s in Massachusetts.

Data Collection/Extraction Methods

Emergent coding was used to elaborate themes and processes related to use of . Numbers and percentages of survey responses were calculated.

Principal Findings

Few s formally discourage use of , but underutilization emerged as a major issue: “We see an awful lot of work‐related injury, and I would say that most of it doesn't go through workers' comp.” Barriers include lack of familiarity with , uncertainty about work‐relatedness, and reliance on patients to identify work‐relatedness of their conditions. Reimbursement delays and denials lead patients and s to absorb costs of services.


Follow‐up studies should fully characterize barriers to use of and experiences in other states to guide system changes in s and agencies. Education should target staff and workers about .