Somatic Symptom Disorder (SSD) is a psychiatric condition which involves a person experiencing physical symptoms, often chronic pain, which results in major distress and/or problem functioning.

The symptoms may or may not be traceable to an organic cause. It is to be strictly distinguished from malingering. SSD sufferers are in no way faking their symptoms and the distress and pain they experience is real and often very profound.

I was first instructed on behalf of a client, who later went on to be diagnosed with SSD, in February 2017. My client, Kerry, had initially instructed another firm of solicitors before I took over the case.

The claim was settled in February 2020 for 16 times the value that her previous solicitor had estimated. I do now wonder now whether that was, in part, due to a lack of understanding about Kerry’s condition.

Kerry had been involved in a road traffic collision on the M6 in the West Midlands in March 2016 when she was driving back from university. At the time, Kerry was a student at Wolverhampton University and was hoping to go on to a career in youth offending.

As a result of the collision, Kerry sustained soft tissue injuries to her neck and back and significant psychiatric injury, being diagnosed with severe PTSD and depression.

Despite Kerry not suffering orthopaedic injuries in the collision, she subsequently experienced severe, debilitating pain which caused her to have to take a break from her studies, lose her part-time job, and to essentially become a prisoner in her own home, relying heavily on her partner to provide her with all aspects of her daily care.

Kerry, both via the NHS and also privately with the support of her case manager, sought medical input from various professionals to try to establish the cause of her ongoing pain and to determine what, if any, treatment options were available to her.

Funding was agreed between the parties via the Rehabilitation Code and interim payments for Kerry to receive psychological therapy to address the psychiatric injuries that she had suffered, as well as a series of nerve block injections in her neck and lower back, and ongoing private pain management input.

The key was to ensure that the medico-legal experts involved were able to adopt a MDT, collaborative approach due to the nature of SSD and it exhibiting both psychiatric and organic components.

While we had started out with a report from an orthopaedic expert to address Kerry’s initial injuries, it was ultimately the psychiatric and pain management experts that led the way in terms of Kerry’s diagnosis and the recommendations for her ongoing rehabilitation and treatment so that those considerations could be built into the claim to provide Kerry with the best opportunity to rebuild her life after her injury.

Whilst such a diagnosis may be welcome in one sense after some have spent so much time, energy and often tears, trying to find the cause of their symptoms, it is often a very difficult diagnosis to accept.

Essential to supporting clients with such a diagnosis undoubtedly involves being able to strip back often lengthy and complex medico-legal reports to address the key points in terms of their diagnosis and what that means for their future, which is understandably the number one priority.

It goes without saying that if there is a case manager on board then they should be exploring rehabilitation and treatment options as guided by the experts, for example psychological therapy delivered by a pain psychologist integrated within broader pain management.

Kerry has spoken about the distress and frustration caused by living with her condition:

“Since my injury, my life has been changed beyond all recognition. Whilst it is some sense comforting to be provided with a ‘label’ for my condition, it is exhausting living with a condition that, very often, is completely invisible. On the rare occasions I do go out, usually to do the food shop once a week with my partner, I use my stick and constantly feel as if people are looking at me and thinking, ‘why on earth does she need that?’

“Living with a chronic pain condition often feels as though you are constantly searching for a cure when, realistically, there isn’t one. I have found that my journey has become one of acceptance; learning to accept the new normal for me and that I am going to have to find ways to adapt and live with this condition.

“Obviously the negative side is that it never goes away and learning to cope with it is hard but just knowing you’re not crazy, that this is a legitimate and recognised condition and you’re not alone makes it so much easier.”

While there has been much progress made in recent years to move away from mental health conditions being seen as a taboo, it must be acknowledged that our understanding of SSD and other psychiatric and pain conditions is often lacking.

More can still be done so that parties to litigation do not underestimate the power and control that this condition and others like it can yield over the lives of their sufferers, and to ensure that claimants are supported with the right rehabilitation and tools to reclaim their lives and futures after serious injury.