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PAIN

Pain is "an unpleasant feeling often caused by intense or damaging stimuli....Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or disease." Wikipedia

"Chronic pain" means any pain that persists beyond the anticipated time of healing: MTUS

Ironically, while "pain is the most common reason for physician consultation in the United States (Wikipedia)" and a major cost in the workers' compensation system, California doctors cannot assign more than a 3% add-on for pain, no matter how severe (see Permanent Disability Rating). But pain may still be relevant when assessing ability to return to work or when vocational experts are assessing loss of earning capacity. The description of pain in the California system relies on technical terms defined in 8 CCR §9727.

"While the person who claims to have been injured is ordinarily the first person who should testify as to whether he is suffering pain (citations omitted) it should be borne in mind that the law does not award compensation for mere pain unless it is of such a character as to raise a presumption of incapacity to earn."  West v. IAC (1947) 79 Cal. App. 2d 711

To control abuse and expense, the DWC issued special guidelines for pain treatment and opioid use, effective July 28, 2016.

Label Item Links Comments
Labor Code The Labor Code refers to "serious pain" in two statutes (§4610.6(d)) and §4616.4) in relation to independent medical review but the term is not defined in the statute or regulations for IMR.    
Health & Safety Code Pain Patient's Bill of Rights Health & Safety §124960 et seq.
Business & Professions Code "Intractable Pain Law" B&P §2241.5
Regulations/Rules Not defined for IMR but "chronic pain" is defined in the Medical Treatment Utilization Schedule—Definitions

Pain is also defined in §9727. Subjective Disability.
MTUS


8 CCR §9727.
 
Chronic Pain Medical Treatment Guidelines

8 CCR §9792.24.2

& Guidelines replacing ACOEM

MTUS guidelines for pain treatment and opioid use, effective July 28, 2016.

  (b) For all conditions or injuries not addressed in the MTUS, the authorized treatment and diagnostic services in the initial management and subsequent treatment for presenting complaints shall be in accordance with other scientifically and evidence-based medical treatment guidelines that are nationally recognized by the medical community pursuant to section 9792.25(b).
     (1) In providing treatment using other guidelines pursuant to subdivision (b) above and in the absence of any cure for the patient who continues to have pain that persists beyond the anticipated time of healing, the chronic pain medical treatment guidelines in section 9792.24.2 shall apply and supersede any applicable chronic pain guideline in accordance with section 9792.23(b).
8 CCR §9792.23

 
Forms American Chronic Pain Association's pain Log ACPA Pain Log  
Websites The American Chronic Pain Association

Index of conditions

PainMed.org:  American Academy of Pain Medicine (AAPM)
ACPA

ACPA Conditions Index

PainMed
 

Definitions and links
Practice Tips 

 
Publications ACPA Resource Guide to Chronic Pain Medication & Treatment: 2013 Edition ACPA Guide 2013 Indispensable free guide to pain treatment
Articles
While pain gets at most a 3% add-on under the 2005 rating schedule, it does interfere with Activities of Daily Living (ADL) and return to work. See article PD Pain. Also consider Side Effects & Sequelae

Are Chronic Pain Syndromes and Drug Dependency Ratable Under the AMA Guides? If So, How? by Robert G. Rassp, Esq.

PD Pain

 

 

Rassp on rating chronic pain

Magazine Articles SB 863 and the Opioid/Chronic Pain Dilemma by Steven D. Feinberg. M.D.

Pain & the Brain – New Imaging Methods to Objectify Experience by Gilewski, Michael, Ph.D.

Pain Management: Dr. Lawrence Weil, M.D.

Pain, PD Under SB 899: Part I by Marjory Harris, Esq.

Pain, PD Under SB 899: Part II by Marjory Harris, Esq.

SB 863 & Chronic Pain


Pain & The Brain



Pain Management

PD Pain: Part I

PD Pain: Part II

 
Roundtable New Pain Publications by Steven D. Feinberg, M.D. Feinberg 4-13  
Miscellaneous      

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