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Chronic pain and depression: what treatment does work comp cover?

Chronic pain is tough enough in its own right. Many people experience it after getting hurt at work and it's difficult to deal with, day after day after day.

When the pain leads to depression, that condition takes the problem to an even more difficult level.

What happens when a worker suffers a job-related injury involving chronic pain, develops depression, and is denied the medical treatment that he or she seeks? In this post, we will use a recent California case to discuss the role of work comp in paying for medical treatment for chronic pain and depression.

Tragic California case

A news report in the Bay Area recently called attention to a tragic case involved a nurse in Fresno who helped women with at-risk pregnancies. On a house call for her job with the county health department, she suffered a bad fall and hurt her lower back and legs.

Despite having surgery, the woman kept suffering from chronic pain and eventually developed depression.

The guidelines that California work comp authorities use for medical care recognize that chronic pain often leads to depression. The woman in the Fresno case was prescribed anti-depressants, but they seemed to alter her personality negatively.

So the woman's doctor sought a procedure known as transcanial magnetic stimulation (TMS). This procedure seemed to be working, but the workers' compensation insurance company denied the application.

The woman appealed, seeking an independent medical review (IMR) from the for-profit company hired by the state to conduct those reviews. The company denied the appeal, and the woman tragically took her own life.

Huge number of people affected

Chronic pain is different than acute pain. This is because unrelenting pain - sometimes defined as pain that lasts more than 12 weeks -- can distort the nervous system.

It affects vast numbers of people, perhaps as many as 100 million nationwide. Last year it finally got some attention from movie makers, when the actress Jennifer Anniston played someone trying to cope with chronic pain. But more often the media tends to ignore the subject, unless it's in the context of stories about addiction to opioid painkillers.

Chronic pain is difficult to treat and it's hard to cope with for both the person suffering and his or her family. People's personalities can change, not only because of neurological alternations, but because of not being able to participate in once-enjoyable activities. This, in turn, can lead to self-isolating behavior that is harmful to mental health and well-being.

Small wonder, then, that chronic pain can lead to depression. And depression -- called by one author "The Noonday Demon" - can of course have devastating consequences. These consequences can include, in some cases, suicide.

Independent medical review

Given the link between chronic pain and depression, it is vitally important that Californians who suffer this pain from a work injury get a chance to get the treatment they need.

The problem, however, is that if the work comp insurer denies that treatment, the process for appealing that denial has recently changed in ways that seem to stack the deck against injured workers.

Injured workers in California do have a right to an independent medical review when a treatment request is denied. But under a law that took effect in 2013, these reviews are now conducted by unknown doctors who work for companies hired by the state, companies that may be out to make a profit - not help injured workers get the treatment they need.

Asserting your rights

If you have been injured at work and are concerned that you aren't getting the medical treatment you need, you don't have to go it alone. You can assert your rights with help from a proven work comp attorney.

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