ChiroView Presents - FYI Article

Reviewed a bunch of articles this morning and posted them to the 
ChiroView Presents web site. Just thought you would like to view 
this one ASAP!

Let me know what ya¼ think!

Sig
http://www.ChiroViewPresents.com

Whiplash Incidence & Prognosis Depend On Medical- Legal 
Environmentä

Westport ‚ Reuters Health
April 20,, 2000

Eliminating compensation for pain and suffering, as part of a no-
fault compensation system for traffic injuries, results in a lower 
incidence and improved prognosis of whiplash injury, according to a 
report in the April 20th issue of the New England Journal of 
Medicine. 

Dr. J. David Cassidy, of the University of Alberta, Edmonton, Canada, 
and colleagues examined the number and duration of claims for 
whiplash injury in Saskatchewan, Canada, before and after the 
province switched to a no-fault system that did not allow payment 
for pain and suffering. 

The incidence of whiplash claims fell by 28% after the change, the 
authors report, with a greater decrease among men (43%) than among 
women (15%). These decreases occurred in the setting of rising 
vehicle-damage claims and increasing distances driven. 

Time to closure of a claim decreased 54%. Resolution under both 
systems was much more likely to be delayed if the claimant had a 
lawyer, the researchers observe. "The intensity of neck pain [and] the 
level of physical functioning...were strongly associated with the 
time to claim closure in both systems," they note. 

"The type of insurance system has a profound effect on the frequency 
and duration of whiplash claims and...claimants recover faster if 
compensation for pain and suffering is not available," the authors 
conclude. "Legislators may wish to consider the advantages of 
removing payments for pain and suffering from compensation 
systems." 

"The vast majority of claimants undoubtedly have real symptoms, 
but how these symptoms are labeled, evaluated and treated may have 
important effects on their perceived severity and duration," writes 
Dr. Richard A. Deyo, of the University of Washington, in Seattle, in a 
related editorial. 

The April issue of Archives of Neurology also features the 
controversy surrounding whiplash injury. Citing international 
medical literature describing whiplash injury, Dr. Robert Teasell, of 
the University of Western Ontario, London Health Sciences Center, 
London, Ontario, Canada, and associates write, "It is hard to accept 
that the symptoms of whiplash are the result of an international, 
translingual conspiracy among malingerers." 

Instead, these authors assert, "those who experience chronic 
symptoms...are likely to have a substantive injury." They urge 
thorough assessment and treatment with such proven interventions 
as radiofrequency neurotomy. 

In a response, Dr. Henry Berry, of St. Michael's Hospital, in Toronto, 
Ontario, Canada, argues that "an adequate physical explanation for 
the multiplicity of symptoms and disability of chronic whiplash 
syndrome has not been established." 

Citing his own study of Demolition Derby drivers, which identified 
no chronic whiplash syndrome among drivers who averaged some 
1,900 collisions in their careers, Dr. Berry concludes that "the 
context of the injury will be the chief determinant of whether the 
symptom is brought to medical and legal attention." 

N Engl J Med 2000;342:1179-1186,1211-1213. 
Arch Neurol 2000;57:590-593.