Diagnosis and prognosis in compensation claims

Psychiatric syndromes following compensable injury are not unusual in surgical practice. All such patients show exaggeration of their symptoms; compensation neurosis and malingering in particular are difficult to separate clinically. The signs and symptoms are reviewed. The prognosis has been assessed in 52 cases of compensation neurosis/malingering; remission of symptoms was usual except for spinal injuries, but return to previous occupation was not common and, despite the triviality of 70% of the injuries, 73% of the patients were off work for more than 6 months. The factors affecting prognosis are discussed, but the effect of legal settlement of claims could not be assessed accurately.