"Compensation neurosis". An invalid diagnosis

The concept of "compensation neurosis"--sometimes denoted by one of its numerous synonyms--has been invoked for many years in discussing the emotional sequelae of accidental injury when litigants present with symptoms and disability that are disproportionate to the original injury or to any demonstrable continuing physical abnormality. Although such "diagnoses" carry with them certain assumptions about the aetiology and the prognosis of the patient's symptoms, the clinical validity of these terms has not come under scrutiny in the literature dealing with issues of diagnosis and classification. An examination of "compensation neurosis" as an illness entity, using standard criteria of diagnostic validity, does not support the view that such a distinct disease exists. It is concluded that the possibility of financial gain after a compensable injury should be regarded as one of several potential secondary gains from an hysterical conversion reaction, and that multiple factors need to be considered in the medical assessment and treatment of litigants who complain of continuing symptoms after recovery from physical injury.