In the world of personal injury law, few topics are as challenging or as misunderstood as chronic pain. This month, the Nova Scotia Supreme Court released a significant decision in Anderson v. Gagne, 2025 NSSC 131, which directly addresses this issue. The ruling sheds light on how courts evaluate claims involving chronic pain and underscores the critical role of physiatry evidence in proving (or failing to prove) the long-term impact of soft tissue injuries.

Here’s what you need to know.

The Collision and the Claims

In March 2014, Ashley Anderson was rear-ended while stopped in traffic in Halifax. What might seem like a straightforward minor collision quickly snowballed into a high-stakes personal injury lawsuit.

Ms. Anderson alleged that the crash caused not only physical injuries, most notably to her right knee, neck, and left shoulder, but also led to the development of chronic pain syndrome, a condition that she argued had dramatically altered her personal and professional life. She claimed ongoing migraines, fatigue, dizziness, and persistent musculoskeletal pain.

By the time of the trial in 2024, Ms. Anderson was still experiencing these symptoms, more than a decade after the initial crash. She sought compensation for past and future wage loss, loss of valuable services, and significant general damages.

Chronic Pain and the Physiatrist’s Perspective

To support her claims, Ms. Anderson relied heavily on the expert opinion of Dr. Ryan Williams, a respected physiatrist (Physical Medicine and Rehabilitation specialist). Physiatrists are often called upon in chronic pain cases because they focus on function, pain management, and rehabilitation, rather than structural or neurological abnormalities.

Dr. Williams conducted a comprehensive medicolegal assessment in 2023 and concluded that Ms. Anderson was suffering from chronic pain syndrome related to the accident. He detailed ongoing impairments and functional limitations stemming from the collision and recommended continued treatment, including physiotherapy and pain management strategies.

But there was a catch.

The Court’s View: Subjectivity and the Problem with Self-Reporting

Justice Gatchalian praised Ms. Anderson’s articulate and sincere courtroom demeanour but ultimately found her testimony unreliable when weighed against her medical records.

Key issues included:

  • Inconsistencies over time: Ms. Anderson didn’t report certain critical symptoms (like hitting her head or the presence of a bruise) until years after the accident.
  • Lack of contemporaneous documentation: Early records didn’t reflect many of the chronic symptoms that later became central to her claim.
  • Heavy reliance on self-reporting: Dr. William’s physiatric conclusions were based largely on Ms. Anderson’s account of her symptoms. The court, while respectful of physiatry as a discipline, found that expert opinions relying primarily on the plaintiff’s self-report without corroborating objective findings carried less weight.

This case highlights a dilemma many plaintiffs with chronic pain face: how do you prove what can’t be seen on an X-ray? Chronic pain often lacks objective markers, which makes the credibility of the plaintiff and the foundation of the medical evidence absolutely vital.

Physiatry in the Legal Landscape

Physiatry plays an increasingly important role in personal injury litigation. Unlike neurologists or orthopedic surgeons who focus on structural or nerve-based issues, physiatrists look at function, pain behaviour, and rehabilitation needs. They often spend more time with patients and are equipped to speak to the day-to-day limitations imposed by chronic pain.

However, as Anderson v. Gagne illustrates, courts will scrutinize physiatric opinions especially when they are based on subjective pain scales, self-reported history, or functional limitations not clearly recorded in early treatment notes.

Physiatric reports are strongest when they are supported by:

  • Early and consistent clinical documentation
  • Observations by treating therapists or other healthcare providers
  • Functional testing with measurable limitations
  • Evidence of treatment adherence and response (or lack thereof)

What This Means for Injury Victims and Lawyers

For injury victims suffering from chronic pain, this case reinforces an unfortunate truth: honest suffering isn’t always enough. To persuade the court, you need credible, well-documented medical evidence that spans the entire course of treatment, not just retrospective claims years down the line.

To build a solid injury claim, this means:

  • Early documentation of symptoms is essential.
  • Obtaining referrals to appropriate specialists (including physiatrists) early in the process.
  • Ensuring that self-reported symptoms are corroborated by functional evidence, where possible.

Final Thoughts

Anderson v. Gagne isn’t a rejection of chronic pain claims, but it is a warning about how tough they can be to prove. The court acknowledged Ms. Anderson’s suffering, but held that legal proof requires more than subjective pain; it requires consistent, objective, and contemporaneous evidence.

Physiatry remains a vital tool in chronic pain litigation, but it must be deployed strategically, with a strong evidentiary foundation. As chronic pain claims continue to grow, so too will the importance of understanding how courts assess these invisible injuries.

To learn more about this topic, please see our previous post: When Your Notes Matter in Court: Lessons from Anderson v. Gagne for Treatment Providers.

Need help with a complex chronic pain claim? Contact our team at NOVA Injury Law today for help!