Motor Vehicle Accidents and Chronic Pain
We are regularly asked if chronic pain can be a result of a motor vehicle accident. The short answer is yes. We represent many clients who suffer from chronic pain syndrome and Fibromyalgia (which is a chronic disorder having symptoms including widespread tenderness and pain, sleep problems, fatigue, emotional and mental distress) because of a motor vehicle accident. Insurers may be quick to dismiss pain as soft tissue injury but pain, long after its cause is gone is called “chronic pain.”
Chronic pain is a complex problem as pain is subjective. The American Medical Association’s guides[1] (The “AMA Guides”) defines pain as a “complex experience embracing physical, mental, social and behavioral processes.” These are the aspects of life that define someone’s quality of life. The guides also characterize chronic pain as a persistent pain that “is not a symptom of an underlying acute somatic injury, but rather a destructive illness in its own right.”
According to the AMA Guides, there are six (6) diagnostic criteria for a chronic pain syndrome, of which at least three (3) must be met. They are as follows:
Use of prescription drugs beyond the recommended duration and/or abuse of or dependence on prescription drugs or other substances.
Excessive dependence on health care providers, spouse, or family.
Secondary physical deconditioning due to disuse and or fear-avoidance of physical activity due to pain.
Withdrawal from social milieu, including work, recreation, or other social contacts.
Failure to restore pre-injury function after a period of disability, such that the physical capacity is insufficient to pursue work, family or recreational needs.
Development of psychosocial sequelae after the initial incident, including anxiety, fear-avoidance, depression, or nonorganic illness behaviors[2].
Medical studies have shown that involvement in a motor vehicle accident, specifically, may increase the risk of chronic widespread pain onset[3]. Chronic pain/fibromyalgia are serious health conditions which can manifest anywhere in the body and often leads to complications beyond physical symptoms. Insurers tend to downplay the seriousness of the condition and determine the symptomology and injuries to be minor. Recent License Appeal Tribunal decisions favouring insurers on disputes concerning if injuries meet the AMA Guides for chronic pain are only some of the challenges facing claimants with respect to persuading insurers and the Tribunal otherwise[4].
[1] American Medical Association, Guides to the Evaluation of Permanent Impairment, 6th Edition, 2008
[2] M.A. vs. Aviva Insurance Canada, 2019 CanLII 101601 (ON LAT) & 17-007825 v Aviva Insurance Canada, 2018 CanLII 98282 (ON LAT)
[3] http://www.ncbi.nlm.nih.gov/pubmed/21425478
[4] M.A. vs. Aviva Insurance Canada, 2019 CanLII 101601 (ON LAT)
