Telling a disabled worker that WCB won’t acknowledge their pain is never a pleasant experience.
But the fact remains that WCB doesn’t compensate on the basis of pain and suffering per se. Of course this is rarely a problem for workers with bone fractures, dislocations, and other clear-cut and detectable skeletal injuries; after all, medical imaging will probably prove their pain is real. But what happens when there’s crippling pain without hard proof? What then?
A brief glance at WCB’s policy sheds light on the question above. To qualify for permanent compensation, a claimant must have a “permanent clinical impairment (PCI) and/or work restrictions that cause wage loss.” The PCI benefit is meant to recognize a) the loss of a body part, b) impaired use of a body part, system or function, or c) a measurable change or disfigurement to any body part, system or function.
When a worker reaches maximum recovery — also known as a ‘medical plateau‘ — a medical evaluation will determine the degree of permanent impairment. A WCB medical consultant will then review the results.
Now, notice that pain is conspicuously absent from the PCI qualifiers listed above (i.e. loss of, impaired use, measurable). A doctor can count extremities, quantify a reduced range of motion, and can certainly measure a change in shape or structure — but there’s no way to objectively measure pain. And what can’t be measured can’t be compensated, so says the WCB.
Measuring the grey
Welcome to the land of the grey. Pain is a complicated phenomenon that encompasses the physical, emotional and existential dimensions of being, a measure of suffering we each experience differently. The stress of a marriage annulment, say, or perhaps the loss of a loved one, very often triggers body inflammation, muscular tension, autoimmune flare-ups—the list goes on. And likewise, the effects of debilitating physical pain eventually wear away and erode even the toughest psyche.
So what’s a worker to do when non-specific pain and intense suffering preclude a return to work and a return to life?
There’s no easy answers when it comes to subjective injuries. But it would behoove you to take the following suggestions under advisement:
Take charge of your recovery: Treat it like a mission. During rehab, remember that pain isn’t necessarily doing you harm. Ask your medical practitioners about how to discern good pain from bad. Indefinite bed rest and idleness will only make you weaker. Move your body. There’s no other way.
Get a second opinion: MRI’s, CT’s and X-rays are effective, but errors and discrepancies in radiology practice are uncomfortably common. Leonard Berlin has published extensively on this issue, and cites a real-time day-to-day radiologist error rate averaging 3–5%, and a retrospective error rate among radiologic studies averaging 30%. Applying a 4% error rate to the worldwide one billion annual radiologic studies equates to about 40 million radiologist errors per annum. Insist on another (IME) if you suspect something’s been overlooked or misinterpreted. Or, if it’s important enough to you, consider seeking out a private clinic for further imaging. WCB will reimburse you if the findings reveal new information.
Assert yourself: Only you know your body, so never agree to any form of therapy you deem potentially harmful. That said, WCB expects you to cooperate to a certain extent. Become too militant and the benefit spigot may close altogether. But it’s important to do your research. Case in point: perhaps WCB’s consultant is of the opinion that your debilitating pain is imaginary. But is said consultant up-to-date on the latest medical research, say, in respect of temporomandibular joints? Is the consultant aware of the latest studies that link unexplained neck, shoulder pain or even back pain to a TMJ disorder? With all due respect to WCB’s medical consultants and independent examiners, don’t assume every practitioner is equally fastidious.
Seek a professional opinion
There’s obviously much more to this. If you, or someone you know, is looking for help with a complex compensation claim, we’re always available.