Introduction Although subjects with whiplash associated disorders lack demonstrable physical injury, many exhibit prolonged disability. Disability appears unrelated to the severity of the collision. A prospective study was carried out to identify factors predictive of prolonged disability.

Methods One hundred and forty-seven subjects with recent whiplash injury were interviewed for putative disability risk factors. One hundred and thirty-five were re-interviewed 12 months later to assess the degree and duration of disability. Bi-variate and multi-variate analyses were undertaken to measure the association between putative risk factors and measures of outcome.

Results The bodily pain score and role emotional scores of the SF-36 health questionnaire showed a consistent significant positive association with better outcomes. After adjustment for bodily pain score and role emotional scores, consulting a lawyer was associated with less improvement in NPOS (p< 0.05), but there was no association with change in VAPS. Consulting a lawyer was associated with a lesser chance of claim settlement (p< 0.01) and a greater chance of still having treatment (p< 0.01) after one year, but there was no significant association with rate of return to work. The degree of damage to the vehicle was not a predictor of outcome.

Conclusions SF-36 scores for bodily pain and role emotional are useful means of identifying subjects at risk of prolonged disability. The findings support the implementation of an insurance system designed to minimise litigation.

In relation to the conduct of this study, one or more of the authors is in receipt of a research grant from a non-commercial source.