Explains Dr. Robert H. Haralson of the American Academy of Disability Evaluating Physicians, "Essentially, the worker is getting paid for being sick, and it's hard for anyone who's being paid to get sick to get well." He said the syndrome has been acknowledged for many years and continues to frustrate doctors.

The analysis looked at studies from the United States, Australia, Europe, the United Kingdom, and other countries. Researchers found that workers who receive compensation for on-the-job injuries were almost four times more likely to have poorer long-term medical outcomes than workers who were not compensated. Lead researcher Dr. Ian Harris says this doesn't necessarily mean comp recipients with lingering symptoms are lying. "These patients believe themselves to be worse off, but what causes that belief poses another question." He points to a phenomenon called symptom expectation in which victims of car accidents in the United States and Australia expect to experience neck pain after an accident, and they do. But in other countries and cultures, such pain is not as prevalent after an accident.

Harris says doctors can help by encouraging injured workers with some back pain to return to work, while avoiding tasks that worsen the symptoms. This helps keep those injured from falling into a "disability cascade" syndrome.