When a Medical Expert Disputes Your Complaints of Pain
You’re in pain. As far as you’re concerned, the levels are immeasurable. Your standard response, when questioned by doctors, is to say you’ve maxed out as far as the pain scale. So, what happens when a medical expert disputes your complaints of pain?
When you’re injured in any kind of accident, your pain and suffering matter when you file a lawsuit. It could also make a difference as far as your medical treatment. For example, if you’re hurt at work, the authorized treating physician may decide you’ve received maximum medical benefit. Therefore, you may be denied further physical therapy or other care that seemed to help you.
In the meantime, you can take this a step further. Although most personal injury claims settle before trial, a small percentage makes it to court. Your medical providers may be asked to testify. From all appearances, it would make sense for an orthopedist to limit his or her opinion to your orthopedic injuries.
Some consider a recent New Jersey Supreme Court case a blow to injury victims. When the Appellate Division decided the same matter, they held that “expert testimony from a doctor, presented as a medical opinion, that “characterizes a plaintiff as a ‘malingerer’ or a ‘symptom magnifier,’ or some other negative term impugning the plaintiff’s believability” is “categorically disallowed.”
However, the Appellate Division didn’t stop there. After reviewing the qualifications of a particular physician, the court found that the doctor “was not qualified to testify about “symptom magnification and related concepts” because he “lacked appropriate qualifications.”
Meanwhile, the case made its way to the Supreme Court. And, the state’s highest court didn’t actually agree with the results of the appeals court.
Complaints of Pain Became Legal Issue
Without question, many injuries result in complaints of pain. However, they become a legal issue when there are attempts to quantify them. Furthermore, the concept of exaggeration or malingering calls for expert testimony to dispute them. What remains concerns the qualifications of the medical provider charged with such an opinion.
The preceding represents a major issue in the matter of Rodriguez v. Wal-Mart Stores, Inc. a New Jersey Supreme Court decision. The short version of the accident history is that Alexandra Rodriguez sustained injuries when a falling clothing display rack hit her. The incident happened while shopping in a store. As a result, Alexandra brought a negligence lawsuit against Wal-Mart.
Alexandra’s injuries required nerve decompression surgery. Subsequently, a specialist diagnosed her with Chronic Regional Pain Syndrome (CRPS).
Meanwhile, the plaintiff’s medical history included an assortment of maladies, ranging from OB/GYN issues, abdominal pain, as well as psychiatric and psychological disorders. Although her attorney attempted to exclude testimony related to any of those problems, the judge denied the motions to the court.
During the trial, the plaintiff’s attorney questioned the doctor who diagnosed Alexandra with CRPS. In response to a direct inquiry, the physician testified that the plaintiff’s past psychological issues had nothing to do with the diagnosis.
A neurologist who also testified on Alexandra’s behalf agreed with the CRPS, saying it would have shown up sooner if it was psychologically caused. Additionally, the treating orthopedic doctor ruled out other diagnoses before considering that Alexandra’s “overt signs of . . . pain out of proportion” could be CRPS.
Defendant’s Experts Disagreed
It goes without saying that every trial involves expert witnesses on both sides. Wal-Mart retained the services of a board-certified neurologist and internist. After examining Alexandra, he said he “could not find “anything objective aside from [her] subjective complaints of pains,” adding that her symptoms “[did] not make clinical sense neurologically.”
The court placed certain limitations on the defense expert’s testimony as far as symptom magnification. Nonetheless, he was permitted to testify about it to some extent, as well as somatization. The symptoms cause both significant emotional and physical distress.
Ultimately, the jury found Wal-Mart was not liable for the plaintiff’s injuries because they did find the big box company negligent. Alexandra’s attorney appealed, and the Appellate Division “held that expert testimony from a doctor, presented as a medical opinion, that “characterizes a plaintiff as a ‘malingerer’ or a ‘symptom magnifier,’ or some other negative term impugning the plaintiff’s believability” is “categorically disallowed” at a civil jury trial under N.J.R.E. 403.”
Additionally, the appeals court found that defense counsel lacked the qualifications to testify about the symptom magnification and malingering. However, the Appellate Division disagreed that the trial court abused its discretion by admitting evidence regarding Alexandra’s past medical history.
When it came down to it, plaintiff’s counsel sought a retrial saying that discounting Alexandra’s complaints of pain made for credibility issues. The Appellate Division agreed, and the defendant appealed the ruling to the Supreme Court.
Consideration by the Supreme Court
When the matter was accepted for certification by the Supreme Court, the justices decided that the terminology used by the doctors was appropriate on a case-by-case basis. In this case, the lower court did not abuse its discretion because “the probative value of plaintiff’s past medical history, in light of her claimed injuries and damages, including her psychiatric history, was not substantially outweighed by any risk of undue prejudice.”
The doctor who provided the testimony regarding symptom magnification was board certified in neurology. According to the Supreme Court decision, there is a significant overlap between neurology and psychology to justify a possible explanation for the inconsistencies in the objective medical evidence and subjective complaints. Therefore, the defense expert’s testimony was admissible.
In the end, the Supreme Court reinstated the jury’s verdict of no cause of action.
When a medical expert disputes your claims of pain, it may impact your credibility. The Law Offices of Beninato & Matrafajlo works with injury victims on a daily basis. Contact us regarding your accident to see how we can assist you.