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Waddell Signs and Proving Back Pain in Your Workers’ Comp Claim


Waddell’s signs are indicators that a patient is experiencing a non-organic component to their injury. It’s a part of some back injuries and something to know about. We’ll explain Wadell signs in detail in just a moment. For now, let’s set the stage in proving a claim.

A major part of claiming workers’ compensation is proving that your injury is real and that you’re not overstating your symptoms. When you’re undergoing an Independent Medical Examination (IME) for back injury, the doctor will try to filter out fake or exaggerated claims using a set of tests known as Waddell Signs. You’ll want to know what these signs are and prepare to assert your claim with the help of an experienced workers’ comp attorney.

What are Waddell’s signs? What are Waddell non-organic signs?

Waddell’s signs indicate that a patient is experiencing a non-organic component to their injury. “Non-organic” in this context means something that is not aligned with or cannot be explained by the anatomical component of the injury. For example, if a patient’s MRI shows a slipped disc yet the patient feels pain in an area that shouldn’t be affected by the slipped disc, this pain could be “non-organic.”

In the 1980s, orthopedic surgeon Gordon Waddell developed a set of tests to identify non-organic signs. His tests applied only to lower back injuries, and were meant to determine if the patient needed other types of evaluation. For instance, a patient could be experiencing non-organic signs due to their psychological or emotional state, as anxiety and distress are common among injured individuals.

Unfortunately, many employers and insurance companies think Waddell’s signs are indicators that a person is malingering or faking their injury. Remember, Waddell’s signs shouldn’t automatically invalidate your physical injury – they simply indicate that there may be another aspect to your injury, such as your emotional or psychological state.

What is Waddell’s test for lower back pain?

Waddell’s test tries to determine if the injury has non-organic signs. This test consists of five examinations, and if the patient gets three or more positive results, the doctor may rule that there’s a non-organic component to the injury.

The five examinations in Waddell’s test are:

  • Tenderness Test – The doctor pinches the skin on your lumbar (lower back) area. If you report tenderness over a wide area or on a spot outside nerve distributions, it will count as a positive Waddell sign.
  • Simulation Test – The doctor performs bodily tests that should not cause lower back pain. They may gently press down on the top of your head, or rotate your shoulder and pelvis together. If you say you get lower back pain during these motions, that will be a positive Waddell sign.
  • Distraction Test – The doctor tests you with the same maneuver twice, with one test having a distraction. The most common example is the straight leg raise: The examiner straightens your knee and asks if you feel back pain. Then at another point in the session, they perform the same motion while testing your other reflexes. A positive Waddell sign is if only one of these tests elicits a back pain response.
  • Regional Disturbances Test – The doctor checks your motor and sensory abilities throughout your body. If you feel some weakness or dysfunction over a widespread area on your body, or if you feel something in your body that’s outside nerve distributions, that could be a Waddell sign.
  • Overreaction – The examiner provides some stimuli and checks your reaction. A disproportionate reaction counts as a positive Waddell sign. Some examples are crying, trembling, or verbalizing.

How do you prove back pain in a workers’ comp claim?

If you have positive Waddell’s signs, the IME physician may say that your back pain complaint is overstated. The workers’ comp insurer may use this to deny your claim or dispute the extent of your injury.

However, Waddell’s signs can be challenged. Dr. Waddell himself noted that these signs are not indicative of an exaggerated injury but are a jump-off point for further assessment. With the help of an experienced workers’ comp attorney, you can diminish the insurer’s defense that’s based on your Waddell test.

In the meantime, you can also take these proactive steps to prove your back pain and protect your workers’ comp claim:

  • Report your injury immediately. Notify your employer right away. Any delay could be taken to mean that your injury is not as painful as you claim.
  • Prioritize medical care. Don’t delay your doctor’s visit, miss any clinic appointments, or act against your doctor’s recommendations. The insurance company will look for such behaviors that could diminish your injury claim. Also, begin collecting your medical documentation from the very first doctor’s visit.
  • Consult a workers’ comp lawyer as soon as you can. When you work with an attorney early on, you have a good opportunity to gather useful evidence and build a strong case. Your lawyer can also guide you away from mistakes that could cost you your claim. Most importantly, you need a competent attorney to advocate for you if the IME has ruled that you have positive Waddell signs.

Talk to a Slominski Law, Trusted Virginia Workers’ Comp Lawyer

Have you received an IME result citing Waddell signs? Did the insurance company deny your claim because of a Waddell test? Attorney Jaleh K. Slominski can help you. With over 25 years of experience in the Virginia workers’ comp system, Ms. Slominski is a sharp advocate for Virginia workers facing difficulties in their claim. She has helped her clients break down insurance defenses and succeed in the workers’ compensation process.

Talk to Attorney Slominski about your workers’ comp situation. Call (434) 384-9400 in Lynchburg or (540) 554-3762 in Roanoke to get your consultation.