In 1982 the Workers'' Compensation Board of New York State authorized payment of $42,084,999 for closed cases of spinal injuries; 30 states paid a combined $1.9 billion for medical treatment and/or compensation for back injuries. The other states did not have the requested information available. Analysis of 2932 spinal injury cases evaluated for disability in a 7-year period showed a mean of 23.4 months of medical treatment in 1706 cases concluded with no disability. Also, 91% of the claimants represented by counsel were not working, whereas 77% not so represented were working. Most of the consultative medical reports, insurance carriers'' and claimants'', veered on the adversarial and favored the respective interested party. The cost of workers'' compensation back injury claims is very high. The conclusion is inescapable that iatrogenic and jurisgenic factors have a direct effect (in the cohort of cases analyzed) on the prolongation of medical care, and delay in returning to gainful employment, and, consequently, contributing to the high cost.