Unraveling the effects of compensation, litigation, and employment on treatment response in chronic pain. 1985

Robert H Dworkin, and David S Handlin, and David M Richlin, and Leonard Brand, and Charlene Vannucci
Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY 10032 U.S.A. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032 U.S.A. Department of Anesthesiology, Monmouth Medical Center, Long Branch, NJ 07740 U.S.A. Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY 10029 U.S.A.

Although it has often been suggested that chronic pain patients who are receiving workmen's compensation or who have litigation pending are less likely to benefit from treatment, the results of outcome studies of this question conducted by various pain clinics have been inconsistent. We hypothesized that poorer outcome in such patients may be related to the fact that they are less likely to be working and that the inconsistent results in the literature may therefore be explained by variability among studies in the percentages of patients who are receiving compensation (or who have litigation pending) who are also working. We examined the relationships among compensation, litigation, employment, and short- and long-term treatment response in a series of 454 chronic pain patients. Compensation benefits and employment status both predicted poorer short-term outcome in univariate analyses; however, when employment and compensation were jointly used to predict outcome in multiple regression analyses, only employment was significant. In additional analyses, only employment significantly predicted long-term outcome, whereas compensation and litigation did not. Our results suggest that it would be valuable to redirect attention away from the deleterious effects of the 'compensation neurosis' and toward the roles of activity and employment in the treatment and rehabilitation of chronic pain patients.

UI MeSH Term Description Entries
D007603 Jurisprudence The science or philosophy of law. Also, the application of the principles of law and justice to health and medicine. Litigation,Medical Jurisprudence,Constitutional Law,Court Decision,Law,Legal Aspects,Legal Obligations,Legal Status,State Interest,Aspect, Legal,Aspects, Legal,Constitutional Laws,Court Decisions,Decision, Court,Decisions, Court,Interest, State,Interests, State,Jurisprudence, Medical,Law, Constitutional,Laws,Laws, Constitutional,Legal Aspect,Legal Obligation,Litigations,Obligation, Legal,Obligations, Legal,State Interests,Status, Legal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D004651 Employment The state of being engaged in an activity or service for wages or salary. Employment Termination,Employment Status,Labor Force,Occupational Status,Status, Occupational,Underemployment,Labor Forces,Status, Employment,Termination, Employment
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014942 Workers' Compensation Insurance coverage providing compensation and medical benefits to individuals because of work-connected injuries or disease. Workmen's Compensation,Worker's Compensation,Workman's Compensation,Compensation, Worker's,Compensation, Workers',Compensation, Workman's,Compensation, Workmen's,Compensations, Worker's,Compensations, Workers',Compensations, Workman's,Compensations, Workmen's,Worker Compensation,Worker's Compensations,Workers Compensation,Workers' Compensations,Workman Compensation,Workman's Compensations,Workmans Compensation,Workmen Compensation,Workmen's Compensations,Workmens Compensation

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