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| Courtney Mulqueen |
Diagnosis is integral to treatment, and I constantly deal with the issue of objective versus subjective medical evidence when disability insurance claims are assessed. Claims for chronic pain and mental health problems can be extremely difficult to prove, so each new discovery that helps us better understand, detect or treat these issues is welcomed.
Many of my clients are frustrated with the lack of diagnostic tools available to them. Some have told me they went for an MRI hoping the results would at last detect a problem because even they were starting to question whether what was ailing them was real or all in their head. It is disheartening that they would want an MRI to reveal an issue so they could at least know what they were dealing with. It is frustrating to deal with an issue that cannot be definitively diagnosed.
However, science is increasingly finding new ways to identify ailments that have so far been difficult to diagnose.
One such newly reported discovery uses gut bacteria and artificial intelligence (AI) to diagnose complex regional pain syndrome (CRPS).
McGill University researchers, in collaboration with those in Israel and Ireland, “have developed AI technology that can detect patterns in gut bacteria to identify complex regional pain syndrome (CRPS) with remarkable accuracy, potentially transforming how CRPS is diagnosed and treated.”
“CRPS remains challenging to treat, with patients often experiencing prolonged suffering before receiving appropriate care,” said senior author Dr. Amir Minerbi.
In Canada, it is believed CRPS affects more than 9,000 annually. It typically develops in a limb after surgery or an injury and can result in severe, persistent pain that is often far worse than the initial injury.
“[The] pain is excruciating, way more than you would expect,” Dr. Javier Webar, a Winnipeg pain specialist who treats patients with CRPS, told CBC News. “The nerve endings that are responsible for carrying the pain information from everywhere in your body become hyperactive.”
Because CRPS is not fully understood, some people have reported it took visits to multiple doctors before receiving a diagnosis.
Invisible disability claims can be extremely difficult to prove, and getting a diagnosis can be both physically and emotionally taxing.
Support from a physician is required for these claims. Even if a doctor diagnoses someone with chronic pain, that finding can be viewed as ambiguous. An insurance company could argue that the diagnosis is subjective and not definitive.
Credibility is such a big issue. Even doctors examining some of these patients may find it difficult to determine what is actually happening with an invisible disability. “Is this person malingering? Is it all in their head? Are they exaggerating the pain?”
Physicians may also feel pressure from insurers who are skeptical of the claims.
Not having a diagnostic tool for some of these issues makes it difficult for everyone. Then there is not only some question about what you have, but how do you treat it?
People with invisible disabilities may also be forced to endure a battery of tests such as MRIs, CT scans and X-rays that ultimately yield no definitive results, which leads to frustration.
However, recent strides in medical research, along with the growing acceptance of more invisible disabilities, is reason for optimism.
As we know, it wasn’t too long ago that many doctors were skeptical about the legitimacy of fibromyalgia. Now it is recognized as a disability in Canada.
Fibromyalgia is a long-term condition that involves widespread musculoskeletal pain, fatigue, sleep disturbances and cognitive difficulties. There is no known cure, but doctors have a much better understanding of the condition thanks to ongoing medical research.
And researchers have made significant strides in numerous areas, which are already having a positive impact. Take for example pharmacogenomics, which combines the science of genetics and the study of drugs to determine how people react to medication.
It is a significant step forward because it potentially allows a person to know if their prescribed medication is likely to improve their condition or cause side effects. This is especially important because certain medications may end up being addictive or, in some cases, make the condition worse.
Also noteworthy is how artificial intelligence has found growing applications in medicine. For instance, AI chatbots have been used to ease a critical shortage of human therapists. Of course, technology cannot replace human interaction, whether it is a psychiatrist, a psychologist or a social worker, but it may be able to provide some help to those suffering from a mental health issue. People can wait months to see a mental health specialist, so these chatbots may be able to bridge that gap.
AI is opening new doors and new possibilities, whether it is chatbots that provide mental health support or a tool to help diagnose complex regional pain syndrome. Each new stride brings hope to those suffering from invisible disabilities.
Courtney Mulqueen, of Mulqueen Disability Law, has over 20 years of experience litigating disability claims. Her focus and passion is representing plaintiffs with disabilities who live with complex “invisible conditions,” like mental illness and chronic conditions that are difficult to prove, diagnose and treat.
The opinions expressed are those of the author and do not reflect the views of the author’s firm, its clients, Law360 Canada, LexisNexis Canada or any of its or their respective affiliates. This article is for general information purposes and is not intended to be and should not be taken as legal advice.
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