Psychological and social factors (e.g., mental illness, a history of being physically abused, eligibility for compensation, etc.) are extremely well-established as being predictive of the development of chronic pain. The non-credible premise that chronic pain is somehow work-related or injury-related appears to contribute to the detrimental effect that workers' compensation has on the health of claimants because it creates a misdirected diagnosis and treatment emphasis on an injury model, instead of allowing for a focus on the non-work-related diagnostic issues and credible treatment approaches.

Given the role of psychological and social issues in the development of chronic pain, it is not surprising that such issues have also been scientifically established as predictors of whether an individual will benefit from medical treatments such as back surgery, spinal cord stimulation (SCS), implanted pumps, and the like.

For example, scientific findings have indicated that everything on the following list is predictive of a poor outcome for medical treatments for pain: eligibility for compensation, mental illness (e.g. mood disorders, anxiety disorders, personality disorders, a history of substance abuse), a history of being physically or sexually abused, a tendency to think catastrophically about pain, a low level of physical activity, job dissatisfaction, a lack of social support, unusual or extreme pain ratings, a low level of educational achievement, being widowed or divorced, a high level of perceived stress, a pessimistic attitude, a distrust of doctors, a correlation in time between pain onset or worsening and significant life events, and a history of having been abandoned or neglected in childhood. Additionally, many psychological tests and questionnaires have been scientifically validated as predictors of outcomes for medical treatment of pain.