The impact of judges' perceptions of credibility in fibromyalgia claims.

Fibromyalgia (FM) is a confusing and controversial diagnosis, characterized by widespread pain and tenderness at specific anatomical sites. The cause of this syndrome is unknown, and the course of the condition is difficult to predict. Without a known cause, predictable course, or effective treatment, it is not surprising that FM is a contentious diagnosis from a medical perspective, as well as a civil litigation and disability insurance industry perspective. The purpose of this study was to investigate judges' perceptions of credibility in litigated cases involving FM claims in the Canadian courts, and the relation between perceived credibility and awards granted. A systematic review was conducted of every trial-by-judge litigated FM claim in Canada (N=194 cases) up to 2003. The cases were examined in relation to credibility factors. The role and responsibility of the plaintiff was central in claims involving issues of misrepresentation, fraud, non-disclosure, failure to mitigate, and contributory negligence. The presence of these issues suggested a possible decrease or loss in the claim as a result of the plaintiff's conduct. In regards to the actions of defendants, the presence of investigative and surveillance information alone did not affect the awards granted. However, the credibility of that information had a large effect on the amount of award granted. Plaintiff credibility played a similar role, indicating that plaintiffs perceived as more credible were typically granted greater awards. An examination of medical expert credibility revealed that judges appear to perceive experts as more credible overall than plaintiffs, regardless of the expert's role in the case.

Test of Memory Malingering (TOMM) scores are not affected by chronic pain or depression in patients with fibromyalgia.

Neuropsychologists routinely give effort tests, such as the Test of Memory Malingering (TOMM). When a person fails one of these tests, the clinician must try to determine whether the poor performance was due to suboptimal effort or to chronic pain, depression, or other problems. Participants were 54 community-dwelling patients who met American College of Rheumatology criteria for fibromyalgia (FM). In addition to the TOMM, they completed the Beck Depression Inventory-Second Edition, Multidimensional Pain Inventory-Version 1, Oswestry Disability Index-2.0, British Columbia Cognitive Complaints Inventory, and the Fibromyalgia Impact Questionnaire. The majority endorsed at least mild levels of depressive symptoms (72%), and 22% endorsed "severe" levels of depression. The average scores on the TOMM were 48.8 (SD = 1.9, range = 40-50) for Trial 1, 49.8 (SD = 0.5, range = 48-50) for Trial 2, and 49.6 (SD = 0.9, range = 45-50) for Retention. Despite relatively high levels of self-reported depression, chronic pain, and disability, not a single patient failed the TOMM. In this study, the TOMM was not affected by chronic pain, depression, or both.