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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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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
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 1-847-275-8236 (24
Hrs).
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To make an appointment, 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: Store: Unique Psychological and Motivational Tools
Go to>Motor Vehicle Accidents, Job Injuries and PTSD
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