Understanding and Managing the Increase in Chronic Claims and ...

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In 1924, Emily Dickinson 1 wrote the following of pain:PAIN has an element of blank;It cannot recollectWhen it began, or if there wereA day when it was not.It has no future but itself,Its infinite realms containIts past, enlightened to perceiveNew periods of pain.For both medical science and the legal profession, the subject of pain remains an elusive andcontroversial one. Pain has been defined by the International Association for the Study of Pain(“IASP”) 2 as “an unpleasant sensory and emotional experience which is primarily associated withtissue damage or described in terms of tissue damage, or both”.What can be extrapolated from this definition is that pain is comprised of both physical andemotional components. What complicates things further, is that the perception of pain remainslargely a subjective experience. This poses a difficulty for the medical profession when faced withthe prospect of measuring pain and determining its etiology. This, in turn, poses a difficulty for thosein the legal profession who rely upon these medical assessments in order to determine causation andquantify damages.12Dickinson, Emily. The Complete Poems of Emily Dickinson. Boston: Little, Brown, 1924;Bartleby.com, 2000.The IASP is an international, multidisciplinary, non-profit professional association dedicated tofurthering research on pain and improving the care of patients with pain. It is a Non-GovernmentalOrganization (NGO)and an affiliate of the World Health Organization (WHO).
−3−Despite these difficulties and although there remains significant controversy, there have beennumerous developments, both in medical science and in our law, in the form of recognizing painassociated conditions and disorders and their effects on an individual’s ability to function in the workplace and to perform his or her activities of normal life. Some of the pain associated conditions anddisorders that the medical and legal profession have grappled with in recent years are Chronic PainSyndrome, Fibromyalgia and Chronic Fatigue Syndrome.2. Chronic Pain or Chronic Pain SyndromeAcute pain, which is generally regarded as pain that begins suddenly and arises directly from aninjury or disease, can be distinguished from chronic pain.The International Association for the Study of Pain describes chronic pain as any pain in any areaof the body that lasts for over a month beyond the reasonable or expected recovery time for an injuryor disease. Other medical professionals have designated a time line of three or six months after theexpected recovery time, in classifying whether pain has developed into chronic pain.Dr. David Corey, in his article entitled “Chronic Pain Syndrome: Identification and Management” 3defines chronic pain as “pain persisting for more than six months from its onset. He further expandshis definition as follows 4 :34Corey, David: Chronic Pain Syndrome: Identification and Management 1988 9 The Advocates’Quarterly, 223Ibid.
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