Workers' Compensation

What is pain management?

Wikipedia gives as good a definition as any: Pain management is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of live of those living with pain. That’s well and good but what does it mean in the context of workers’ compensation?

We usually see pain management coming when a surgeon is done with you but you still have problems functioning and with pain. The surgeon may see his role as ending after the operation. It is up to a different specialty to handle the long-term results and recovery from this. While that could seem like the surgeon is just handing you off to someone else it’s not that simple and it’s not that callous.

In a deposition we took a prominent pain management doctor testifies that 80% of patients with chronic pain (that is defined as pain which last for six months or more) will develop clinical depression. Our bodies are not designed to put up with pain for that long. As much as we all want to see people get 100% better sometimes that doesn’t happen. People learn to live with pain. They do this sometimes with medications, sometimes with therapy and exercise, sometimes with counseling, and often with a combination of all that. Truthfully, managing all this is a skill set completely different than performing surgery.

Clients shouldn’t feel neglected or abandoned when their surgeons refer them to pain management. What we do see happen, though, is that pain management specialists can seem to exhibit a certain sense of prejudice. A lot of injured workers have reported that their pain doctors view them skeptically. It’s almost as if it’s ok to be in pain management if you have cancer but if you are there after a failed back surgery you should buck up and stop your whining and nothing cures like some tough love or a kick in the butt. If true such an approach is reprehensible in our minds.

Our best advice to clients in this predicament is to avoid playing into stereotypes and prejudices. As we’ve said repeatedly it is important to retain your credibility with your doctor. That means you’re complaints and self-assessments should be accurate, clear, and not exaggerated. It’s important to note that we’ve seen plenty of medical records with references to “non-organic pain” or “non-physiological pain” and “symptom magnification.” Many of these doctors are clued in for evidence that you are not being accurate or honest. When it comes to an issue like pain, which cannot be measured with a thermometer or an MRI, you word has to be 100% solid.