Chronic Pain

What is chronic pain?

Traditionally, doctors and other medical professionals have considered pain to be merely a symptom of an injury or disease. However, this view has been questioned in recent years, and sometimes chronic pain is viewed as a condition unto itself.

Under WorkSafeBC regulations, chronic pain is considered a separate condition when pain remains six months after an injury and beyond the usual recovery time for the injury.

What are the types of chronic pain?

WorkSafeBC divides chronic pain into three subcategories:

Pain that has a clear medical cause, and is proportionate to the injury or underlying condition. For example, a worker may have a claim for arthritis of the thumbs, which is a condition that always causes some level of pain.

Specific Disproportionate: Pain that has a clear medical cause, but is disproportionate to the injury or underlying condition. For example, the worker has arthritis of the thumbs, but experiences unusually intense pain, or pain throughout his or her hand, not just the thumbs.

Non-specific disproportionate chronic pain

Pain that does not have a clear medical cause. For example, the worker suffers a broken arm which appears to heal normally, and yet the worker continues to experience pain after the tissues have healed.

These distinctions are important because they determine the kinds of benefits that you can get.

What is not chronic pain?

There are several medical conditions that are chronically painful. These include fibromyalgia, myofascial pain, non-migraine headaches, and chronic strain.  WorkSafeBC sometimes treats these as if they were the same as chronic pain. However, this practice is controversial, and may be challenged on review or appeal.  Generally, it is better for the worker to have these conditions accepted for what they are.

What kinds of benefits can I get because of chronic pain?

If WorkSafeBC accepts chronic pain on your claim, they may grant you health care benefits, such as a referral to a therapist or to a Pain Management Program.

Also, if your chronic pain is one of the disproportionate types noted above, WorkSafeBC should assess you for a permanent partial disability award over and above any award that you have received for any other condition.

If your chronic pain impacts your ability to perform your pre-injury job, you may be entitled to vocational rehabilitation benefits.

What should I do if I think that I have chronic pain?

It may be helpful for you to write a statement explaining:

  • the nature and extent of your pain,
  • how that your pain affects your work, and
  • the effect, or lack of effect, of any treatments, therapies or medications.

You should discuss your pain symptoms with your family doctor or other health care provider. He or she can give you an opinion on:

  • whether your pain results from your workplace injury or occupational disease,
  • what medical treatments or referrals could help you,
  • whether your pain is proportionate or disproportionate, and
  • what limitations or restrictions result from your pain

Depending on the answers, you may ask him or her to provide a report that you can provide to WorkSafeBC, along with your statement, so that you can get chronic pain accepted on your claim and receive benefits.

What if I disagree with a decision?

If you disagree with WorkSafeBC’s decision to deny your claim, you can request a review by the Review Division. You have 90 days from the date of the decision to request the review. If you disagree with the Review Division decision, you have 30 days to file an appeal to the Workers’ Compensation Appeal Tribunal.

This factsheet has been prepared for general information purposes. It is not a legal document. Please refer to the Workers Compensation Act and the Rehabilitation Services and Claims Manual Volume I and Volume II for purposes of interpretation and application of the law.