Patients involved in litigation regarding claims of injury seem different in several respects from those who were not involved in litigation. Their symptoms seem unusually severe and persistent considering the type of injury that they experienced; in addition, their response to treatment is often very discouraging. A detailed prospective study of 249 patients with litigated claims of injury was performed to determine how they differ from other patients.
Inconsistent nongenuine abnormalities were found on examination in 88.7% of the patients in the study group and in 5.4% of the control group. In both groups, the most common nongenuine abnormalities were false weakness, nonanatomic sensory disturbances, and inconsistencies of straight leg raising and forward bending. Complaints related by the patients to the litigated events often consisted of an accumulation of pre-existing symptoms, magnified discomforts of life, and the effects of aging. Treatment was frequently poorly effective even though given over long periods of time.
Patients involved in litigation frequently differ from those not involved with the legal system. Physicians and other health-care providers should be aware of this. These persons should be carefully examined to be sure that they receive medically indicated treatment and disability compensation that is appropriate and fair to all concerned parties.
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