Employment and litigation: improved by work, assisted by verdict.

Previous research exploring the relationship between litigation status and the symptoms of the plaintiff has been inconsistent and limited by methodological difficulties. This longitudinal study addressed many of the methodological shortcomings of previous research and examined the relationship between litigation status, employment, depression, pain and disability over the duration of the compensation process. Two hundred chronic back pain participants were selected from patients who attended an initial assessment interview at a pain centre. According to their litigation and employment status these patients were divided into four groups, namely a non-litigating non-working group, a non-litigating working group, a litigating non-working group and a litigating working group. All participants completed three questionnaires, one at intake, one at a minimum of 2 years later (for litigants during the litigation process), with the final questionnaire completed at a minimum of 15 months thereafter (for litigants after they had settled their claim). Questionnaires contained measures of pain (Visual Analogue Scale, Short Form McGill Pain Questionnaire), depression (Zung Self-Rating Depression Scale), and disability (Oswestry Disability Questionnaire). Overall participants who were working scored lower on all the measures than did participants who were not working. On the other hand participants who were litigating scored higher on all the measures than did participants who were not litigating. There was a significant time effect on all measures but this was qualified on some measures by the interactions of time with litigation status and work status. The present research further demonstrated that both litigation and employment were significant factors influencing recovery from injury.