Work comp litigation and chronic pain Discussion

Worker's compensation litigation and chronic pain: Unfortunately, when persistent pain is labelled work-related, a complicated scenario often develops which promotes dissatisfaction and hinders recovery. This is particularly evident when the primary problem is persistent pain and not simply the early result of a cut or break. Obviously, any chronic health problem can have profound effects on a person's life. However, the influences of compensation and litigation can be so overwhelming to a patient that medical treatment becomes irrelevant or even counterproductive to recovery. This is an entirely different issue than malingering, personality disorder, or laziness, for it seems to develop as a result of a particular set of circumstances. The following elements are present early in the course of most patients who go on to develop chronic compensation related medical problems:

Blame the job/boss...
Fear of additional injury
Loss of personal responsibility to recover
Anger at being injured
Job dissatisfaction
Advice from lawyers and from other chronic comp patients...
To stop working
Focus on symptoms and suffering
Assign all blame and responsibility to others
Foster the role as a victim: dependent and angry
Promise of lotto-type windfall for disability and lost wages
Emotional stress...
Reduces pain tolerance
Undermines normal coping mechanism
Depression fueled by anger
Symptom magnification...
Focus on any and all lingering or possibly related symptoms
Focus on the injury, not on recovery
Prolonged time to recover
Increase treatment requirements beyond what would be expected...
More doctor's visits
More therapy
More medications
More surgery
More complications
More dissatisfaction with the situation
Disability time off work...
Financial upset
Pressure from the job site
Justify time off work by focusing on disability
Comp pay for not working
In time, lifestyle change to no-work

Individually, these are all completely normal issues. However, together they fit like pieces of a puzzle, providing strong and invisible disincentive for recovery. Any patient may be sucked into this downward spiral, and if not recognized, both the patient and surgeon will be suprised and disappointed by a slow, painful and remarkably unsatisfying recovery following surgery.

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