CHRONIC WIDESPREAD PAIN

Should Disability Attributed to Chronic Widespread Pain be Financially Compensated?

SUMMARY Compensation for chronic widespread pain is a matter for legal and social consideration, and medicine has little to contribute beyond compassion. Physical medicine specialists are currently being asked to advise the courts on conditions that are better addressed by experts in mental conditions. Even psychiatrists' and psychologists' expertise is in more accurate diagnosis rather than assessment of disability.

Compensation for chronic widespread pain is a matter for legal and social consideration, and medicine has little to contribute beyond compassion. The factors that determine the severity and impact of FMS are either inappropriate as criteria (education level, litigation status), or entirely subjective ¹.

There is no medical means of independently confirming the claim to be disabled because of chronic widespread pain. The tender points of FMS are no more objective than the complaints of widespread pain, so a physician can add little to the "diagnosis" than indicate whether s/he believes the claimant.

Physical medicine specialists are currently being asked to advise the courts on conditions that are better addressed by experts in mental conditions. In medical jargon, the differential diagnosis is usually between somatoform disorder ² and malingering ³. Because these conditions lie in the expertise of psychiatrists and psychologists, those specialists have more to contribute than orthopedic surgeons, rheumatologists and physiatrists. This is particularly true if major psychiatric disorders have been insufficiently considered.

Even psychiatrists' and psychologists' expertise is in more accurate diagnosis rather than assessment of disability. Since in the legal arena the court claims the prerogative to determine veracity, a physician can otherwise give no more help than offer a personal opinion about the claimant's sincerity, based on clinical experience.

Thus, the physician or psychologist merely expresses beliefs that are either congruent with or dissimilar to those of the claimant. This takes the form of an expert report or testimony that is either advocative or descriptive ⁴, but provides no expert medical evidence of any substance.

Does Trauma Cause Chronic Widespread Pain?
Does Chronic Widespread Pain Cause Disability?
Can Disability from Chronic Widespread Pain be measured?

Referenced Articles

Medical Litigation News Volume 3 Issue 5 Somatoform
Medical Litigation News Volume 1 Issue 5 Malingering 1994

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