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Understanding and Managing the Increase in Chronic Claims and Newly Classified Disabilities

Understanding and Managing the Increase in Chronic Claims and Newly Classified Disabilities

By Richard Bogoroch and Leanne Goldstein

October 22, 2003

Introduction

In 1924, Emily Dickinson1 wrote the following of pain:

PAIN has an element of blank;
It cannot recollect
When it began, or if there were
A day when it was not.It has no future but itself,
Its infinite realms contain
Its past, enlightened to perceive
New periods of pain.

For both medical science and the legal profession, the subject of pain remains an elusive and controversial 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 with tissue 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 and emotional components. What complicates things further, is that the perception of pain remains largely a subjective experience. This poses a difficulty for the medical profession when faced with the prospect of measuring pain and determining its etiology. This, in turn, poses a difficulty for those in the legal profession who rely upon these medical assessments in order to determine causation and quantify damages.

Despite these difficulties and although there remains significant controversy, there have been numerous developments, both in medical science and in our law, in the form of recognizing pain associated conditions and disorders and their effects on an individual's ability to function in the work place and to perform his or her activities of normal life. Some of the pain associated conditions and disorders that the medical and legal profession have grappled with in recent years are Chronic Pain Syndrome, Fibromyalgia and Chronic Fatigue Syndrome.

Notes:
1Dickinson, Emily. The Complete Poems of Emily Dickinson. Boston: Little, Brown, 1924; Bartleby.com, 2000.
2The IASP is an international, multidisciplinary, non-profit professional association dedicated to furthering research on pain and improving the care of patients with pain. It is a Non-Governmental Organization (NGO)and an affiliate of the World Health Organization (WHO).
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Understanding and Managing the Increase in Chronic Claims and Newly Classified Disabilities

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