Article Figures & Data
Figures
- Figure 1.
Conceptual understanding of how compensation neurosis fits into the spectrum of symptom exaggeration.
Tables
- Table 1
Various Names for the Concept of Compensation Neurosis That Have Been Used Over Time
Accident neurosis Aftermath neurosis Cogniform disorder Compensation hysteria Compensation neurosis Entitlement neurosis (Ethnic or national group) neurosis/injury Fright neurosis Greenback neurosis Injury neurosis Justice neurosis Litigation neurosis Postaccident syndrome Posttraumatic syndrome Profit neurosis Railway spine Secondary gain neurosis Social iatrogenesis for disease production by well-intended social programs Syndrome of disproportionate disability Traumatic hysteria Traumatic neurasthenia Traumatic neurosis Triggered neurosis Unconscious malingering Various work groups (usually manual labor) neurosis Whiplash neurosis Workman's compensation neurosis Occurs in a situation in which someone else is at fault or is perceived to be at fault. Occurs in a situation in which an award of damages is possible. Has an inverse relationship with degree of injury if any physical injury at all. The more severe the injury, the less likelihood of accident neurosis. Is more likely to occur in those with lower socioeconomic status. Is characterized by failure to improve until after compensation litigation is settled, with ensuing improvement from significant to complete. - Table 3
Reasons That Someone Correctly Diagnosed With Compensation Neurosis Would Not Return to a Comparable Level of Work or Appear to Improve After Injury
Concern about review and possible loss of benefits causes continued stress and symptoms. Concern about being accused of fraud or malingering. Is attempting to receive additional benefits or is involved in additional lawsuits. Does not want to return to (comparable) work. Waiting for retirement. Low initial job satisfaction; does not need to return to work because of the settlement. Concern over return of symptoms that have resolved. Unable to get a job because of disability or a known pre-existing condition. Does not have to work because of a change in family role or dynamics (e.g., partner is now the primary breadwinner or is working more). Obtaining a job will cause loss of disability payments and benefits. Family likes the change in dynamics and is encouraging a continuation of the status quo. Freedom to take a lower-paying, lower-stress job after the settlement. Cases may involve additional time (depositions, paperwork, different regulations, and insurance procedures). Uncomfortable taking letters of protection (LOPs) from attorneys. Questions patient's desire to recover. Likelihood that the patient will demand or require complicated medications (narcotics). Concern that the patient may attempt to compromise physician's medical integrity. Frustration about patient's lack of improvement. Conscious or unconscious conflict about wanting improvement, because it could hurt compensation case for the patient. Damage to one's ego if the patient does not improve. Concern about loss of objectivity or reputation in the community. Need to become an advocate and give justification for why patient's case is difficult and the patient is not improving. Concern about being held responsible for failure of patient to receive benefits. Concern that failure of claim will interfere with patient-physician relationship. Concern about being seen as uncaring if notes are not strong enough to support the claim. Concern about receiving low grades from various entities (maintenance of certifications, health maintenance organization panels, Internet evaluation websites). Concern that the patient will start seeing the doctor more or less often because he knows the doctor's records will be used in court.
