Profile of litigators with chronic limb pain in a predominantly Hispanic workers'-compensation population

Abstract

Litigators have characteristics that are identifiable with psychosocial testing in the outpatient setting. We conducted a secondary analysis of retrospective data in a subset of patients who were treated for neuropathic pain in a specialty clinic and sought litigation. We reviewed medical records that included reports from the first author, a hand surgeon, and a psychologist. Analysis consisted of descriptive statistics and correlations and Chi Square using SPSS statistical program. Thirty of the 91 patients in the original sample (33%) sought litigation. Litigators tended to be females with an average age of 40 who had moderate difficulty in social and occupational functioning (i.e. few friends and conflicts with peers/co-workers). About 27% had prior history of psychological dysfunction and 16% had a family history of emotional problems. When compared with the larger sample, litigators experienced more thoughts of harm including suicidal ideation and attempt (47% vs. 32%), had longer duration of pain measured at last follow-up treatment visit (6.5 years vs. 3.5 years), and were more likely to consume tobacco and alcohol. Of interest, two of the three patients with a past history of alcohol abuse were in the litigation group and there were more non-Hispanics in the litigation group than in the total group (23% vs. 19%). Seventy percent of litigators (n=30) returned to work as compared to 87% of total sample. With psychosocial testing litigators in this population have identifiable characteristics in the outpatient setting. They tend to have more psychosocial stressors and consume tobacco and alcohol in greater amounts than non-litigators. Of greatest concern is the high rate of thoughts of harm, including suicidal ideation and attempt.