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Opiate Abuse and Chronic Pain in Fraudulent Claims

One of the most common causes for fraudulent claims is chronic pain. It’s almost impossible to prove or disprove, and there are almost no visible physical symptoms. What’s worse is that fraudulent chronic pain claims often begin legitimately, but continue because workers develop an addiction or tolerance to the opioid drugs they’re prescribed to handle the pain, becoming “legacy claims” who seek pain prescriptions for many years after their initial injury.

Defining Terms

Opioids include hydrocodone (Vicodin), morphine, oxycodone (OxyCotin), and other natural or synthetic variations and brand names. It’s a powerful pain-numbing drug that blocks the pain receptors in your brain, and opioids have made life bearable for many sufferers of chronic pain.

“Chronic pain” is pain that persists after a worker should have expected to heal from an injury. After musculoskeletal pain moves from the acute stage into the chronic stage, it will often never leave in the patient’s lifetime. Doctors will often treat this pain with opioids, but this can eventually result in addiction, abuse, or overdosing from an increased tolerance. Oftentimes, patients with chronic pain will seek to supplement their legal prescription drugs with street drugs, compounding their danger. In fact, the first death in our nation from prescription opioids was an injured worker and beneficiary of the Washington Department of Labor and Industries.

A Broken Industry

Opioids were extremely common in the 1990s, but around 2005 awareness of the risks associated with these drugs increased. According to a recent report by WorkerCompCentral, there has since been a sharp decline in the prescription of opioids to workers’ compensation claims involving pain as doctors realized that over-prescription was destructive, bad for workers, and bad for employees.

Despite the fact that physicians have been seriously seeking alternative pain techniques for about a decade, there is still huge reliance in the medical community on opioids for pain treatment, which has led to reliance among patients. In Washington State, 42 percent of workers with compensable back injuries received an opioid prescription within the first year of their injury, and 16 percent of them continued receiving opioids one year after injury.

The California Workers’ Compensation Institute reported in 2011 that 3% of the prescribing physicians accounted for 55% of all opioid prescriptions. This means that a disproportionately small number of doctors are responsible for an entire industry of opioid pain medication. And further, 67 percent of primary care doctors even responded in one survey that they were “somewhat likely” or “highly likely” to presecribe opioids even to an active substance abuser. It is not at all difficult for patients to receive opioid prescriptions, even after many years.

What Does This Mean for Injury Claims?

Many opioid-reliant patients and sufferers of chronic pain started with completely legitimate workplace accidents, such as falls or back injuries, but after treatment with opioids they have become addicted. Rather than treating the underlying issue, the patient becomes more focused on continuing or even increasing medication. And as the California Workers’ Compensation Institute report shows us, it is not difficult for workers to find doctors who are extremely likely to prescribe opioid medication. Unfortunately, employers have to keep paying the cost of this treatment.

If you think a false claim of chronic pain has been filed against you by someone suffering from opioid addiction, Stop Claims can help! We can assist in your investigation of the situation and in the process of rectifying the false claim. Call us today!