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Litigating Chronic Pain


DR. Michael Shery, clinical psychology

   2615 Three Oaks Rd. Ste 2A; Cary, IL 60013 847 516 0899 (24 Hrs);



_  __________________________________________________

Doctoral degree: University of Southern California, 1975





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Litigating Chronic Pain



Chronic pain is a frequent subject of litigation, both in personal injury and workers' compensation claims.


Often, pain persists well beyond the expected course and appears to be in excess of physical pathology.


The term Chronic Pain Syndrome has been used to describe this phenomenon which is based on a behavioral, conditioning process.


In essence, patients are said to be so in tune with their pain and with fear of re-injury that they aggravate their healing.


For example, in anticipation of pain, they create a heightened state of physiological arousal which actually increases the pain.


Also, by being overly protective about their pain, they reduce mobility and become weak and de-conditioned.


Finally, by receiving a positive payoff for having pain, through an operant conditioning mechanism, they reinforce it.


Positive payoffs can include attention, sympathy or nurturing from family; avoidance of unpleasant work situations; and financial compensation through damage awards or disability payments.


Because chronic pain is still poorly understood, the diagnosis of Chronic Pain Syndrome has become extremely popular. It allows for vague physical and emotional features of a patients presentation to be grouped under a convenient label.


But, a syndrome is not a disease since it does not have unique pathophysiological elements. Rather, it is an observation of frequently occurring features and behavioral responses that are categorized under a common title.


Unfortunately, this is often on the basis of relative and sometimes arbitrary characteristics.


With the medicalization seen in society today, defining something as a syndrome gives it legitimacy, for example, Battered Wife or Sick Building Syndrome.


More importantly, syndromes are often employed for their political and social utility in which the pathological affliction may be only in the eye of the beholder.


In litigation, of course, the beholder is the plaintiff or claimant who needs definition for the perceived harm that has occurred.


There is no question that many suffering people have entered into a vicious cycle of pain leading to stress, leading to more pain, and so on, as a result of an initial tortuous injury.


For them, identification of the cascading set of circumstances that led to excessive chronic pain is the first step in its treatment and using medical and psychological disciplines in a team approach has offered them new hope for recovery.


Chronic Pain Syndrome does not imply cause and effect, but only defines symptomatic observations.


Another dysfunction within this group, Somatization Disorder, is a long-term condition in which physical symptoms of a wide variety have occurred over several years, and the current pain condition may only be incidental to this psychosomatic predisposition.


Typically, it is said that patients who have suffered with pain for a prolonged period of time are likely to become depressed, and this is often the case.


But, extensive Scandinavian studies have shown that where depression is seen in chronic pain conditions, it frequently precedes injury and pain, and is evident when the life history is thoroughly explored.


In the evaluation of these litigants and claimants, the scope of inquiry should address the course of symptoms following an injury to determine whether it is typical or not of the type of physical harm usually sustained.


Symptom magnification and exaggeration, negative conditioning, avoidance behaviors, physical deterioration, immobility, and investment in the rehabilitation process are all important to assess.


In addition, numerous other psychosocial variables should be considered: the presence of depression and anxiety states, pre- existing pain-prone personality, pre-existing life factors and work adjustment, history of the utilization of medical services, early developmental and family dynamics, and recent and past workplace adjustment.


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Dr. Mike Shery is the director of ACRS and pre-screens injury victims for psychological prevent it from being overlooked in a claim; it’s available nationwide.  He also is a licensed clinical psychologist. He has practiced clinical psychology for approximately 24 years and is affiliated with almost all health plans, including: ValueOptions, Medicare, Cigna, Cigna Behavioral Health, United Health Care, Aetna, First Health, Healthstar, Blue Cross Blue Shield of Illinois, ComPsych, Magellan Health, HFN, Tricare, Humana, most union local plans, most school district plans, Unicare, ChoiceCare, CAPP, Multiplan, Mental Health Network, Managed Health Network, PHCS, PPONext, Humana Military-Tricare, United Behavioral Health and Beech Street.


He is board certified as a specialist in professional counseling by the International Academy of Behavioral Medicine, Counseling and Psychotherapy.  He a member of the American Counseling Association.


The office is located in Cary, IL, near Crystal Lake and Algonquin, northern Kane County and in southern McHenry County. In select cases, phone consultations are available for those who don’t live locally> Telephone Counseling.


To make an appointment>New Patient Registration  or to learn more about the psychological services he provides call him at 1-847-275-8236 (24 Hrs).





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