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Index May 20, 2008
World Congress on Pain Submission Blasts Workers Compensation Board" Campbell-Taylor takes issue with the definition of chronic pain used by the Nova Scotia Worker’s Compensation Board, saying it’s not used anywhere else in the world . . . “The bit that they have added themselves is the part that is used most often to deny claims for chronic pain,” she said. “When you find that more than 70 per cent of claims are denied, well, that’s statistically impossible. . . . They started about a year ago by randomly selecting 1,500 compensation appeals tribunal decisions . . . they . . . found medical data was often misinterpreted. . . . There seems to be universal assumption that those complaining of chronic pain are cheating, Campbell-Taylor said, although literature shows that is a small number.""Poster abstract by medical advisor and injured worker selected for presentation at World Congress on PainNANCY KINGThe Cape Breton Post SYDNEY — Work carried out by the medical advisor to the Cape Breton Injured Workers Association and a local injured worker has been selected for presentation at the World Congress on Pain this summer. The poster abstract submitted by Dr. Irene Campbell-Taylor and Sharon MacIntyre was one of only 180 accepted out of more than 1,900 submissions for the congress, which will take place in Glasgow, Scotland in August. The congress, which attracts experts from around the globe, is held every four years. Their presentation focuses on the importance of an accurate definition of chronic pain, noted Campbell-Taylor, a clinical neuroscientist. The association noted they don’t know of any other abstract from Nova Scotia selected for the conference. The submission was sponsored by Dr. Harry Pollett of North Sydney, who is a member of the International Association on the Study of Pain. There is ongoing debate about in the medical community about what the definition of chronic pain should be, said Campbell-Taylor, adding it’s generally pain that persists beyond the normal recovery time — usually six months. But there’s a growing school of thought — to which Campbell-Taylor subscribes — that chronic pain is a disease in itself. “Even if an injury does heal, the severe pain over a long period of time actually changes the brain chemistry to the point where the brain perceives pain even though the injury has healed,” she said. “You have to start with a definition — what is it?” Campbell-Taylor takes issue with the definition of chronic pain used by the Nova Scotia Worker’s Compensation Board, saying it’s not used anywhere else in the world, that they won’t compensate pain for someone where there’s a significant object finding that the injury has not healed. “The bit that they have added themselves is the part that is used most often to deny claims for chronic pain,” she said. “When you find that more than 70 per cent of claims are denied, well, that’s statistically impossible. You can’t say that over 70 per cent of people who are putting in claims for chronic pain after injuries don’t have it, that doesn’t make any sense, particularly in an area like this where the major industries were coal mining, steelworking, construction, in which you’re likely to get very serious injuries with consequent long term chronic pain.” She cited one condition, called arachnoiditis, which occurs as a result of healing. When someone has surgery for a back injury, she noted as an example, scar tissue can form within the spine, entrapping a nerve. “Scar tissue is, by definition, healed tissue, so it’s that healing, that scar formation, unfortunately around a nerve, that causes excruciating untreatable pain,” Campbell-Taylor said. “When you’re faced with a decision that says you do have arachnoiditis, you have been in serious pain for 18 years, but it’s not chronic pain according to our definition, so too bad, it’s most unbelievable.” They started about a year ago by randomly selecting 1,500 compensation appeals tribunal decisions — 30 per cent of decisions over a three-year period — from before and after a Supreme Court of Canada ruling on chronic pain compensation. They eliminated those that weren’t considered applicable. Of the remaining 758, there was only one case where a decision was reversed on appeal said Campbell-Taylor, and that was in favour of the employer. “That was the most startling of all,” she said, adding they also found medical data was often misinterpreted. There seems to be universal assumption that those complaining of chronic pain are cheating, Campbell-Taylor said, although literature shows that is a small number. There are ways for experienced personnel to determine whether someone might be faking, she added. “Pain is subjective, by definition,” she said. Taking part in a poster session at the congress will allow Campbell-Taylor and MacIntyre to discuss issues with experts in pain and use their feedback to help the process. Campbell-Taylor noted she came to Cape Breton four years ago to live in semi-retirement after working for many years in Toronto. She works on a volunteer basis with the injured workers association. 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