The effect of litigation status on adjustment to whiplash injury

Study Design. This retrospective study examined the effect of civil litigation on reports of pain and disability in chronic pain patients who sustained whiplash injuries after a motor vehicle accident. Objectives. To examine the effect of litigation on adjustment to chronic pain. Summary of Background Data. A common methodologic weakness with many studies in this area is the composition of the nonlitigant group, which often includes individuals who have completed litigation as well as those who opted not to litigate. This introduces a confound in that litigant and nonlitigant groups differ not only with respect to litigation status but with respect to any factors that predispose one to litigate. Methods. Questionnaire data were obtained from 41 patients (current litigants) in the process of litigation and 21 patients (postlitigants) who had completed litigation. Subjects completed self-report measures assessing demographic characteristics, psychological distress, sleep disturbance, employment status, and various pain indices. Results. There were no significant group differences in demographic characteristics, employment status, or psychological distress. Litigants, however, reported more pain that did postlitigants. Group differences in pain reports remained statistically significant even after controlling for length of time since accident and initial severity of the injuries. Conclusions. That litigation status did not predict employment status suggests that secondary gain does not figure prominently in influencing the functionality of these patients. The rather robust effect of litigation status on pain reports is discussed with respect to the potential mediational role of the stress litigation.