A comparison of pain management outcomes for disability compensation and non-compensation patients

Abstract

In this study. SO men in an in-patient comprehensive rehabilitation program receiving disability compensation were compared with 25 non-recipients with respect to prc-and post-program measures of personality functioning. physical functioning and reported pain. On the pre-program measures. the only significant difference cmerging hetwecn the two groups was found on the Mfscale o f the MMPI, with the compensation group showing a slightly lower mean score. The two groups respondcd cqually well on virtually all outcome measures. One interesting exception was found on the subjective measure of pain. which showed the compensation group reporting ii higher level of subjective pain, and the non-compensation group a lower level than would be predicted o n the basis of pre-program scores. Overall. and contrary to popular belief. the results suggest that compensation recipients can derive considerable benefit from pain managcment interventions despite the ostcnsible rcinforccmcnt provided by disability payments.

Perception of traumatic onset, compensation status, and physical findings: Impact on pain severity, emotional distress, and disability in chronic pain patients

“…Other investigations found no difference in psychological distress, pain severity, or disability (Gallagher et al, 1995;Leavitt, 1990;Mendelson, 1984;Talo et al, 1989;Trabin et aL, 1987), response to treatment (Talo et aL, 1989;Tollison, 1993;Trabin et aL, 1987), or return to work (Dworkin et al, 1985;Gallagher et aL, 1989), between chronic pain patients receiving worker's compensation and those who did not. Dworkin et al (1985) identified employment status as having a moderating role on return to work.…”

Causality of Psychological Injury

“…It was suggested that a likely explanation for this was that this technique is essentially a measure of psychiatric difficulties and would not be appropriate for the identification of malingering in pain. On review of the literature, it was noted that some MMPI/MMPI-2 studies involving a differential prevalence design had found that those who are litigating or involved in a compensation claim have higher clinical and/or validity scale elevations (e.g., Dush et al, 1994;Harness & Chase, 1994), whereas others have not found such differences (e.g., Melzack et al, 1985;Trabin, Rader, & Cummings, 1987). suggested that compensation patients are clinically similar to noncompensation patients in the relative frequency of cases of psychological disturbance or in which there has been potentiation of psychophysiological reactivity.…”