Litigating Chronic
Pain
Affiliated COUNSELING AND REFERRAL SERVICES (ACRS)
DR. Michael Shery, clinical psychology
2615 Three Oaks Rd. Ste
2A;
Cary, IL 60013
www.carypsychology.com 847 516 0899 (24 Hrs); drmike@carypsychology.com
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StressScreen: “Boosting profits for
lawyers…restoring quality of life to victims”
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FREE Taped
Messages: Call 847 516 0899 (24 Hrs). To hear: How to Select
a Counselor-Push 1; Emotional Stress Caused by an Accident or Injury-Press 2
Litigating Chronic Pain
Chronic pain is a frequent subject of litigation, both in personal injury and
workers' compensation claims.
Often, pain persists well beyond the expected course and appears to be in excess of
physical pathology.
The term Chronic Pain Syndrome has been used to describe this phenomenon which is
based on a behavioral, conditioning process.
In essence, patients are said to be so in tune with their pain and with fear of
re-injury that they aggravate their healing.
For example, in anticipation of pain, they create a heightened state of physiological
arousal which actually increases the pain.
Also, by being overly protective about their pain, they reduce mobility and become
weak and de-conditioned.
Finally, by receiving a positive payoff for having pain, through an operant
conditioning mechanism, they reinforce it.
Positive payoffs can include attention, sympathy or nurturing from family; avoidance
of unpleasant work situations; and financial compensation through damage awards or disability payments.
Because chronic pain is still poorly understood, the diagnosis of Chronic Pain
Syndrome has become extremely popular. It allows for vague physical and emotional features of a
patients presentation to be grouped under a convenient label.
But, a syndrome is not a disease since it does not have unique pathophysiological
elements. Rather, it is an observation of frequently occurring features and behavioral responses
that are categorized under a common title.
Unfortunately, this is often on the basis of relative and sometimes arbitrary
characteristics.
With the medicalization seen in society today, defining something as a syndrome gives
it legitimacy, for example, Battered Wife or Sick Building Syndrome.
More importantly, syndromes are often employed for their political and social utility
in which the pathological affliction may be only in the eye of the beholder.
In litigation, of course, the beholder is the plaintiff or claimant who needs
definition for the perceived harm that has occurred.
There is no question that many suffering people have entered into a vicious cycle of
pain leading to stress, leading to more pain, and so on, as a result of an initial tortuous injury.
For them, identification of the cascading set of circumstances that led to excessive
chronic pain is the first step in its treatment and using medical and psychological disciplines in a team approach has offered them new hope
for recovery.
Chronic Pain Syndrome does not imply cause and effect, but only defines symptomatic
observations.
Another dysfunction within this group, Somatization Disorder, is a long-term
condition in which physical symptoms of a wide variety have occurred over several years, and the current pain condition may only be incidental
to this psychosomatic predisposition.
Typically, it is said that patients who have suffered with pain for a prolonged
period of time are likely to become depressed, and this is often the case.
But, extensive Scandinavian studies have shown that where depression is seen in
chronic pain conditions, it frequently precedes injury and pain, and is evident when the life history is thoroughly explored.
In the evaluation of these litigants and
claimants, the scope of inquiry should address the course of symptoms following an injury to determine whether it is typical or not of the
type of physical harm usually sustained.
Symptom magnification and exaggeration, negative conditioning, avoidance behaviors,
physical deterioration, immobility, and investment in the rehabilitation process are all important to assess.
In addition, numerous other psychosocial variables should be considered: the presence
of depression and anxiety states, pre- existing pain-prone personality, pre-existing life factors and work adjustment, history of the
utilization of medical services, early developmental and family dynamics, and recent and past workplace adjustment.
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Presented by:
Dr. Mike Shery is the
director of ACRS and originator of StressScreen, the next generation tool for personal injury law
practices. It pre-screens injury victims for psychological trauma.to
prevent it from being overlooked in a claim; it’s available nationwide. He also is a licensed clinical
psychologist. He has practiced clinical psychology for approximately 24 years and is affiliated with almost all health plans, including: ValueOptions, Medicare, Cigna, Cigna Behavioral Health, United Health Care, Aetna, First
Health, Healthstar, Blue Cross Blue Shield of Illinois, ComPsych, Magellan Health, HFN, Tricare, Humana, most union local
plans, most school district plans, Unicare, ChoiceCare, CAPP, Multiplan, Mental Health Network, Managed Health Network, PHCS,
PPONext, Humana Military-Tricare, United Behavioral Health and Beech Street.
He is board certified
as a specialist in professional counseling by the International Academy of Behavioral Medicine, Counseling and Psychotherapy. He a member of the American Counseling Association.
The office is located
in Cary, IL, near Crystal Lake and Algonquin, northern Kane County and in southern McHenry County. In select cases, phone consultations are available for those who don’t live
locally> Telephone
Counseling.
To make an
appointment>New Patient
Registration or to learn more about the psychological services he provides call
him at 1-847-516-0899 (24 Hrs).
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To make a free phone appointment to discuss StressScreen,
call 1-847-516-0899, or schedule yourself in our online appointment book now;
Click:
Make appointment for Cary Office: Therapy and Counseling
Go to>StressScreen: Report
Outline
Go to>StressScreenRegistration
to>Articles about Motor Vehicle Accidents (MVAs), Work Injuries and Mental Health
to>A PI Law Miracle: StressScreen
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