As previously reported, meta-analysis indicates that involvement in litigation increases the occurrence and severity of deficits following Mild Traumatic Brain Injury.

A similar study showed a highly significant adverse effect on severity and prognosis of chronic pain.

A recent paper¹ reported the outcome of 27 claimants/litigants undergoing elective discectomy for degenerative disc disease. The results were independently judged good in only 29%, compared with 81% in matched patients not legally involved.

The magnitude of the adverse effect of the litigation process on healing goes far beyond malingering or even somatoform disorder. By the most liberal definitions, these two factors could affect at most a quarter to a third of litigants.

What evidence there is, suggests that resolution of the litigation makes no material difference to the medical outcome of the injury².

Chronic pain specialists and physiatrists have long exhorted lawyers to expedite settlement so that their therapy can proceed unhampered by secondary gain. This advice is based on optimism rather than empirical evidence: with the best intentions, it might not be possible to speed the compensation process sufficiently to prevent the arrested healing. The scant research to date is equally compatible with the theory that the initiation of litigation is sufficient to inhibit recovery.

Not only may recovery be blocked, but the very occurrence of some common chronic conditions may be contingent on the existence of institutionalised tort. Thus, late whiplash is essentially unknown in Lithuania, where most drivers have no accident insurance³. 1-3 years after soft tissue neck injury following rear-end collision, the prevalence of symptoms was not significantly different from that in the normal community.

Copyright © 2008 Electronic Handbook of Legal Medicine