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Title: Unhelpful medical expert in my case

Date: 05 May 2016

Q.

Following a bike accident in October 2014 I am getting mixed messages from the doctors treating me and the doctor instructed by my solicitor in my compensation claim. My treating doctors have diagnosed complex regional pain syndrome and I agree with this as my research has shown that I suffer from all the common unpleasant symptoms. But the neurologist instructed by my solicitor says he cannot agree with the diagnosis as I did not have any nerve injury in my accident.

He thinks it is all in my head and has recommended I see a psychiatrist. I am adamant it is not psychiatric – I have no mental health history and think this so called expert is going to scupper my case. What I can do to discredit “my” expert?

Lee Staniforth, London

A.

There are two types of complex regional pain syndrome (CRPS). Type 1 where there is no clear cause and type 2 where there is an act (such as an accident) that causes nerve damage. The pain comes from over activity of the nervous symptom – the pain reaction. Some medical experts are still disbelievers of CRPS but this is an antiquated view. It may be that the neurologist has not had access to all medical notes and scans and nerve conduction tests and has missed peripheral nerve damage. It is not unusual to investigate psychiatric reasons although one of the effects of CRPS can be psychiatric symptoms so it can become circular.

I suspect that eventually your opponent’s solicitors will insist on a psychiatric examination by their expert. I suggest for now you discuss with your solicitor not relying on the neurologist’s report and seeking a second opinion. I would suggest a consultant in pain medicine who is used to seeing cases of CRPS and that he be provided with full medical records. Assuming the diagnosis is confirmed then an alternative neurologist can be instructed.
CRPS cases are complex and require solid expertise – make sure the solicitor you have has experience of these cases – you don’t want them cutting their teeth on your valuable claim!

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