An employee who suffers a work injury may be left with chronic, debilitating pain, even after the injury has been treated. Unfortunately, the causes of chronic pain are not completely understood. While workers’ compensation is supposed to provide coverage for all reasonable and necessary treatment, many employers and insurers will argue that treatment for chronic pain does not meet this standard. Then they deny workers’ compensation claims for chronic pain treatment that could provide relief.
When you are suffering from chronic pain caused by a work-related injury or illness, you deserve workers’ compensation benefits for treatment. At Joye Law Firm, our South Carolina workers’ compensation attorneys will fight for the full benefits and treatment you deserve. For more than 50 years, our firm has advocated on behalf of injured workers, even when employers and insurers try to deny coverage. We have successfully helped thousands of injured workers recover the compensation they need to get back to a normal life after a debilitating injury.
Contact our firm today for a free evaluation of your chronic pain workers’ compensation case. We will explain your options and get started on your case with no upfront fees. You only pay us if we recover compensation for you. With offices in Charleston, Myrtle Beach, Columbia, and Clinton, we serve injured workers across South Carolina.
Understanding Chronic Pain
After a work-related injury, some people may continue to suffer from chronic pain even after they have reached maximum medical improvement (MMI). MMI is the point at which no further treatment is expected to improve a patient’s condition.
Chronic pain is often defined as pain that lasts at least three months from the initial onset of symptoms and cannot be resolved by multiple forms of treatment or palliative care. Chronic pain may be attributed to a condition called Complex Regional Pain Syndrome (CRPS). This condition can cause chronic, often debilitating pain in a person’s neck, back, and/or extremities that can last for months, years, or even a lifetime.
CRPS comes in one of two forms:
- CRPS-1, also known as Reflect Sympathetic Dystrophy, arises from injuries and damage to soft tissues such as skin, tendons, ligaments, and muscles. CRPS-1 can be caused by injuries like burns, strains, and tears, leading to chronic conditions like bursitis, arthritis, or tendonitis.
- CRPS-2, also called causalgia, is caused by an injury to a major nerve grouping, usually from a traumatic force such as blunt force trauma or a penetrating wound. The condition can begin immediately after an injury occurs or may not manifest until months later, even after a wound or other tissue damage has healed.
Another form of chronic pain is caused by a condition called fibromyalgia, which typically involves hypersensitivity and intense pain from even minor touching, muscle spasms, and weakness in the extremities.
How Do You Deal with Chronic Pain from a Work Injury?
Unfortunately, many work injury victims have difficulty dealing with symptoms of chronic pain. For starters, work injury victims suffering from chronic pain often face skepticism from their treating providers, employers, and workers’ compensation insurers. A worker suffering from chronic pain may be accused of malingering, or exaggerating complaints of pain to continue receiving workers’ compensation benefits. Treating medical providers may also attribute chronic pain symptoms to psychological or psychiatric causes, telling a patient, in essence, “It’s all in your head.”
Injured workers suffering from chronic pain may need to push to have their condition diagnosed so that they can get the treatment they deserve from workers’ compensation. Doctors can run many different tests, most of which are aimed at excluding other possible causes of pain, such as:
- X-rays, which can reveal microfractures or bone density loss
- MRIs, which can show damage or irregularities in soft-tissue
- Blood tests, which can exclude infection or inflammation as a cause of pain
- Ultrasound scans, which can rule out blood clots
- Electrodiagnostic testing, which measures the electrical activity of body parts to determine whether nerves or pain receptors are being stimulated
How Does One Get Treatment for Chronic Pain within the Workers’ Compensation System?
Treatment of chronic pain is usually provided by a particular type of physician known as a pain management specialist. Pain management specialists usually come from the medical discipline of anesthesiology. Treatments for chronic pain can include:
- Physical and occupational therapy
- Nerve block, trigger point, and epidural injections
- Spinal cord stimulation
Workers’ compensation is required to provide all reasonable and necessary treatment for a work-related injury. This can include treatment to provide relief from the effects of the injury, such as chronic pain.
However, many employers and workers’ compensation insurers deny coverage for treatment for chronic pain because the conditions are so poorly understood. As a result, a worker suffering from chronic pain may need to get an official diagnosis of their pain and link it to the work-related injury. With such a concrete link, treatment to help relieve pain can be considered reasonable and necessary so that an employer may be obligated to cover it.
When chronic pain is found to be severe enough, an injured worker may even be determined to suffer from a whole-body impairment. This finding may entitle a worker to permanent partial or permanent total disability benefits when chronic pain does not respond to treatments or other palliative care.
What Are the Problems with Chronic Pain?
Chronic pain can leave an injured worker unable to perform the requirements of the job or even tasks of daily living. It can result in loss of mobility, impaired range of motion, or reduced strength when a person tries to guard from movements that trigger sharp pain.
People suffering from chronic pain may also turn to narcotic medications to get relief. However, the side effects of narcotics may make it unsafe for users to drive vehicles or operate machinery, potentially rendering them unable to get to work or to perform job tasks.
Finally, chronic pain can cause significant emotional and mental distress. Chronic pain can interfere with concentration. In addition, the loss of quality of life due to chronic pain can trigger anxiety and depression that can affect a person’s ability to work or perform tasks of daily living.
Why Workers’ Comp Claims Involving Chronic Pain Are So Complex
Unfortunately, many employers and workers’ compensation insurers resist paying claims for treatment of chronic pain. Treatment of chronic pain can last for years or potentially for an injured worker’s entire life, resulting in significant costs for the employer and its workers’ comp insurer.
In addition, many physicians remain suspicious of claims of chronic pain, especially when the physician cannot attribute the pain to a healing injury or to an infection or other disease. Chronic pain that continues even after a patient has reached MMI may simply be dismissed as psychological. Chronic pain can also be seen as an attempt by an injured worker to remain on workers’ comp even after healing enough to return to work.
Even when an employer or workers’ compensation insurer is willing to cover treatment for chronic pain after a work injury has healed, they may push to ensure that treatment will be reasonably related to and necessary for the work injury. Treatment for chronic pain may be more likely to be approved for workers’ compensation when:
- Treating providers have a defined plan to relieve chronic pain.
- Long-term treatment plans will provide treatments on an as-needed basis rather than on a set schedule without reevaluating the need for treatment.
- Treatments have low costs, or if expensive, only require a few sessions.
- Treatment does not duplicate other efforts that might provide relief, such as physical therapy.
Because employers often resist approving treatment for chronic pain, you should speak to a knowledgeable workers’ compensation lawyer about your legal rights.
Contact a Workers’ Compensation Lawyer for Help
If you are suffering from chronic pain due to a work injury or an occupational illness, you may be entitled to additional benefits from workers’ compensation to cover treatments that can help relieve or mitigate your pain. Reach out to Joye Law Firm online or give us a call at 888-324-3100 today for a free, no-obligation consultation. One of our South Carolina workers’ compensation lawyers can explain more about your rights and options.