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Promoting Safety, Protection Rights
Head & Brain Injuries
Fatigue As The
Result of Personal Injury
Posted by Wayne Parsons
July 24, 2009 4:26 PM
Tags: fatigue, chronic fatigue syndrome, pain, injury,
wage loss, income, work, personal injury, Parsons,
Everyone knows about broken bones, lacerations,
traumatic brain injury [ http://bit.ly/13eNhq ], loss of
vision, spinal cord injury and other physical injuries
that follow automobile accidents, medical
malpractice, construction site accidents and product
One often ignored after effect is fatigue that can
become chronic: chronic fatigue syndrome (CFS)
[ http://bit.ly/p3bbl ].
Surveys of injured persons often show that fatigue is
one of the most significant long term permanent
effects of an injury and in particular injury that
results in chronic pain.
Fatigue, like pain, doesn't show up on an x-ray and
doctors rarely spend any time trying to help with
fatigue. Even when the pain is recognized as an
issue, fatigue is often left out of the list of
Chronic fatigue syndrome (CFS) is an
illness defined by disabling physical and
mental fatigue and physical and mental
symptoms that are not explained by
conventional medical and psychiatric
CFS affects between 400,000 and
800,000 people in the United States and
has an average duration of 5 years, but
symptoms can persist as long as 20
The prognosis for recovery of severely ill
CFS patients is poor.
Despite CFS's disabling, enduring, and
prevalent nature, scant studies have
quantified its impact on the health and
well-being of those affected, on the
health care system, or on society as a
The burden of CFS is poorly recognized,
and the illness remains an inadequately
managed health problem.
Two population-based studies of CFS
have been conducted in the United
States, and both found that CFS is one of
the more common chronic illnesses
among women across all racial/ethnic
groups and that less than 20% of those
who suffer from CFS have been
diagnosed by a health care provider.
Only three studies, all of which were
clinic based, have attempted to quantify
the impact of CFS, and each showed that
people with the syndrome were likely to
have lost their job or to be unemployed.
In addition, it was shown that persons
with CFS pose a disproportionate burden
on the health care system and their
families since they are sick for long
periods of time and since there is no
known cure for the illness.
The ability of an injured person to get back to a
functional life is often affected most severely by
fatigue. even when a person is physically able to lift
and bend and do the tasks of many jobs, the
consequence of fatigue is that the person can't keep
any job because fatigue takes them out of a 40 hour
As reported in the study The economic impact of
chronic fatigue syndrome [ http://bit.ly/p3bbl ] by
Kenneth J Reynolds, Suzanne D Vernon, Ellen
Bouchery and William C Reeves, SRA International,
Inc., Arlington, U.S.A, Division of Viral and
Rickettsial Diseases, Centers for Disease Control and
Prevention, Atlanta, U.S.A, The Lewin Group, Falls
The magnitude of the economic impact
imposed on the individual and on society
by CFS is substantial. Approximately
one-quarter of persons with CFS, who
would otherwise have participated in the
labor force, ceased working. For those
who continued to work, average income
declined by one-third.
This represents an estimated annual loss
of almost $20,000 for the individual
suffering from CFS. This magnitude of
loss approximates half of their labor
force and household productivity in a
The $9.1 billion national loss is
comparable to that estimated for other
illnesses, such as digestive system
illnesses ($8.4 B) and infectious and
parasitic diseases ($10.0 B)  and is
greater than the estimated productivity
losses from immunity disorders ($5.5 B),
nervous system disorders ($6.4 B), or
skin disorders ($1.3) .
This estimate does not include health
care costs, which are likely to be
substantial and does not address
reductions in quality of life, which are
likely to be large due to the debilitating
We estimated annual lost productivity.
However, CFS is a chronic illness. The
average duration of CFS identified in
population studies is 5 years and most
patients with CFS seen by health care
providers have been ill for more than 6
Thus, productivity losses, health care
expenses, and reductions in quality of life
continue for many years for most
affected individuals and thus would have
a substantial long-term impact on the
standard of living of individuals with CFS
and their family members.
It often starts with pain that doesn't go away and
lingers and tortures the injured person 24 hours a
day, 7 days a week as reported in a Time Magazine
feature article The Right (and Wrong) Way to Treat
Pain [ http://bit.ly/3ewour ] by Claudia Wallis.
With chronic pain, however, the alarm
continues to shriek uselessly long after
the physical danger has passed.
Somewhere along the line--maybe near
the initial injury, maybe in the spinal cord
or brain--the alarm system has broken
What researchers have only recently
come to understand is that prolonged
exposure to this screaming siren actually
does its own damage.
"Pain causes a fundamental rewiring of
the nervous system," says Dr. Sean
Mackey, director of research at Stanford
University's Pain Management Center.
"Each time we feel pain, there are
changes that occur that tend to amplify
our experience of pain."
That is why it is a mistake, despite our
grin-and-bear-it tradition, to ignore or
under treat severe pain.
Fatigue is often the most disabling feature of chronic
pain. The injured person is often told by the
insurance company, their employer or even their own
attorney that they can go back to work and so they
have no claim for future wage loss.
On top of that their fatigue is ignored and not
understood to be a part of the injury. It is treated
like a form of laziness or lack of initiative.
The treating doctor has probably told them that they
can physically do the work at their old job or at least
at some other less strenuous job.
What is missing in this analysis is that if the injured
person suffers from fatigue they cannot do the work
if it involves a 40 hour job.
Unless a careful workup is done of the existence of
fatigue and the connection of fatigue to the injury,
the injured person will not be compensated for what
can be a significant loss of future earnings.
What needs to be done is an analysis of the injured
person by a neuropsychologist or other doctor using
The Universal Work Skills Evaluation test.
Below is a video showing a truck driver taking the
test. Although there is no sound the test shows that
the person has chronic fatigue.
Work Skills Evaluation for Michigan Truck Accident
Victim Who Was Awarded a $5.65 Million Verdict:
Doctors have several ways of validating fatigue as a
disabling factor resulting from personal injury.