PT - JOURNAL ARTICLE AU - Mary-Ann Fitzcharles AU - Peter A. Ste-Marie AU - Yoram Shir TI - A Medicolegal Analysis of Worker Appeals for Fibromyalgia as a Compensable Condition Following Workplace Soft-tissue Injury AID - 10.3899/jrheum.121062 DP - 2013 Jan 15 TA - The Journal of Rheumatology PG - jrheum.121062 4099 - http://www.jrheum.org/content/early/2013/01/11/jrheum.121062.short 4100 - http://www.jrheum.org/content/early/2013/01/11/jrheum.121062.full AB - Objective Workplace injuries may be implicated in the causation of fibromyalgia (FM), hence linking FM to compensation. We examined the appeals by workers directed to an appeals tribunal for causation of FM following soft-tissue injury sustained in the workplace. Methods One hundred fifty tribunal decisions relevant to FM were examined using a predetermined protocol. New-onset FM was appealed in 123, and aggravation of preexisting FM in 15. Results All injuries were of a soft-tissue type, without persistent physical findings to explain continued symptoms. The tribunal accepted 67% of appeals for aggravation of FM, and 59% for new-onset FM. Time from injury to FM diagnosis was 4.3 ± 4.1 years, with 6.3 ± 2.8 physicians cited for each worker, and with previous health status not reported for 26%. Injuries were a single event in 68%, with location in low back for 44%, and shoulder/upper limb in 40%. The FM diagnosis was based on a rheumatologist report in 74%. Conclusion Over half of appeals for aggravation or causation of FM following a work-related softtissue injury were accepted by the tribunal, with importance ascribed to a rheumatologist diagnosis. Concerns are raised regarding lengthy duration from injury to diagnosis, claimants’ high healthcare use, and neglect of mention of previous health status. The attribution of causation of FM to a softtissue workplace traumatic event is contentious and requires further examination.