St. Josephs Hospital - Programs & Services/Fibromyalgia/Workers' Safety Insurance Board

WSIB INFORMATION

Chronic Pain Disability (CPD) is the term used to describe the condition of a person whose chronic pain has resulted in marked life disruption. Chronic pain is pain with characteristics compatible with a work-related injury, except that it persists for 6 or more months beyond the usual healing time for the injury.

For a worker to qualify for compensation for CPD the following conditions must exist and be supported by evidence:

A work-related injury occured
Chronic pain is caused by the injury
The pain persists 6 or more months beyond the usual healing time of the injury
The degree of pain is inconsistent with organic findings
The chronic pain impairs earning capacity

Workers diagnosed with Fibromyalgia Syndrome (FS) will be considered for compensation benefits under the CPD policy. Characteristics of FS include:

chronic diffuse pain of unknown aetiology attributable to either undetected organic condition or psychogenic sources
the presence of “tender points” in predictable and usually symmetrical locations
fatigue and sleep disorders

With the exception of “tender points”, these characteristics are those usually seen in individuals with CPD, and the recommended treatment is identical to that recommended for individuals with CPD. Because of this, FS is recognized as a variant of CPD and workers who are disabled by fibromyalgia may be eligible for benefits under the CPD policy or the psychotraumatic disability policy as follows:

Workers diagnosed as having fibromyalgia or fibrositis (resulting from a work-related injury) for periods between November 30, 1976 and March 26, 1986 are considered for benefits in accordance with the Board’s policy for psychotraumatic disability.

Workers diagnosed with FS for periods before March 27, 1986, and extending beyond March 27, 1986 may choose one of two options:


		continue to receive benefits under the psychotraumatic disability policy for periods after March 27, 1986,
		OR
		be considered for benefits under the CPD policy for periods after March 27, 1986.

Workers diagnosed with FS or fibrositis on or after March 27, 1986 are considered for benefits under the CPD policy

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GLOSSARY OF TERMS

Marked life disruption: Because pain is a subjective phenomenon, marked life disruption is the only useful measure of disability or impairment in chronic pain cases. Marked life disruption indicates the effect of pain experienced by the worker and the effect on the worker’s activities of daily living, vocational activity, physical and psychological functioning, as well as family and social relationships.

There must be clear and distinct disruption to a worker’s life, but there is no particular requirement for this disruption to be either major or minor. The disruption in the worker’s personal, occupational, social, and home life must be consistent, though the degree of disruption in each need not be identical.

Usual healing time: This refers to the point in time, following an injury, at which the worker should have regained pre-accident functioning ability, or reached a plateau in phsycial recovery. The WSIB Clinical and Rehabilitation Services Department has developed a chart summarizing the “usual healing times” for various conditions. This chart serves as a useful guideline in considering claims for all injured workers, except those returning to extraordinarily heavy work.

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