Since 2019 the World Health Organization has recognized chronic pain as a disease, but insurance companies have not kept up with the times. This is important knowledge for personal injury lawyers who have many plaintiff clients involved in MVA and disability cases who suffer long-term pain.Pain is chronic when it lasts more than three months. Chronic pain affects women slightly more than men, is associated with other diseases such as arthritis and cancer and can also occur for no obvious reason (known as idiopathic). Chronic pain affects about 25 per cent of Canadians, and this rate is expected to rise as the population ages and cancer rates increase. It can lead to severe limitations at work and in daily life, and result in complete disability.A plaintiff with low back pain who has previously had chronic pain is more likely to develop it again. A large proportion of cancer survivors experience chronic pain due to treatment or surgery — chemotherapy can lead to neuropathy, a form of nerve damage that can be difficult to treat.One problem is that chronic pain is hard to measure. Doctors are not always able to demonstrate permanent physical damage in patients who feel pain. However, there are measurement tools in daily use in pain clinics that could be more widely used.Currently, chronic pain care involves a series of complementary therapies, treatments, medication, diet, exercise, and psychology. There is no pill or injection available to ease patients’ suffering; scientists have been working on chronic pain for years but have not yet found a solution.Insurance companies should recognize the risk factors for developing chronic pain after an acute event. They readily issue payment or reimbursement for treatments like physiotherapy, but disability arising from chronic pain is disputed. Because insurers don’t consider pain to be a disease, but a sign or symptom of another condition, health professionals are asked to prove the source of the pain. The case gets more complicated with extended disability insurance.Insurance Portal interviewed Dr. Anne-Marie Pinard, an anesthesiologist who heads the chronic pain clinic at the CHU de Québec and is one of Canada’s leading clinical experts in pain, holding the Medisca Leadership Chair in Chronic Pain Education at Université Laval.“It’s normal to explain to insurers what has been tried, what works and what doesn’t,” she says. “Where I have a problem is when we have a patient whose only symptom is pain, and they tell you the MRI is normal, so they don’t recognize their condition. That’s where it gets extremely complex to justify. Chronic pain is a disease in and of itself, and it’s high time that insurance companies recognize that.”Dr. Pinard would like training in chronic pain for people in the insurance industry. “If insurers acted on the evidence stemming from large numbers of studies to initiate early multidisciplinary team treatment for patients with risk factors, perhaps fewer people would be on disability or more individuals would still be able to work part time.”Personal injury lawyers need to stay abreast of the medical developments in chronic pain, to be able to develop a case for their client based on current scientific knowledge.NOTE: This article was written in January 2023 and is based on information available at that time.
