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AB0857 Medicolegal Implications of the 2012 Canadian Fibromyalgia Guidelines
  1. M.-A. Fitzcharles1,2,
  2. P.A. Ste-Marie2,
  3. Y. Shir2
  1. 1Rheumatology
  2. 2Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Canada


Background Guidelines are intended to facilitate patient care, but may be used in other settings. When judges adjudicate issues pertaining to fibromyalgia (FM), guidance is provided by the health community and published literature.

Objectives We have examined the recently published 2012 Canadian Fibromyalgia Guidelines with reference to the adjudicating process of a Canadian workman's compensation tribunal, the Ontario Workers Safety and Insurance Appeals Tribunal (WSIAT).

Methods Factors weighting the evidence in reaching decisions pertaining to FM by the WSIAT were recorded, and thereafter the 2012 Canadian Fibromyalgia Guidelines were examined for statements that could facilitate reaching legal decisions.

Results Weighting of evidence or medico legal challenges vs. new guideline statements were as follows: 1) Diagnosis of FM confirmed by tender points vs. a polysymptomatic clinical construct without tender points; 2) diagnosis confirmed by specialist vs. emphasis on family MD report; 3) Poor attention to previous health status vs. emphasis on previous physical and psychological health leading to vulnerable health status; 4) trauma as causation in FM vs. triggering event reported by 1/4 to 1/3 persons; 5) presence of mitigating factors for claimant vs. importance of self-management strategies; 6) disablement in FM vs. recommendation to remain in the work force with rehabilitation if necessary.

Conclusions Statements and recommendations in the 2012 Canadian Fibromyalgia Guidelines may help the courts in adjudicating issues concerning FM.


  1. Fitzcharles, M. A., et al. (2013). 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Res Manag 18(3): 119-126.

  2. Fitzcharles, M. A., et al. (2013). A Medicolegal Analysis of Worker Appeals for Fibromyalgia as a Compensable Condition Following Workplace Soft-tissue Injury. J Rheumatol. 40(3): 323-328.

Disclosure of Interest M.-A. Fitzcharles Speakers bureau: Lilly, Pfizer, Purdue, Valeant, P. Ste-Marie: None declared, Y. Shir Consultant for: McKesson Canada Corporation, Palladin Inc. Canada

DOI 10.1136/annrheumdis-2014-eular.5680

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