Managing Psychiatric, Psychological Disability And Workers Compensation Claims

After a moderate to severe brain injury, it is common to see a decline in memory, concentration, and many other skills. This is because brain injuries can affect various cognitive functions and abilities. Memory and concentration are often the most commonly affected areas, but other skills such as problem-solving, decision-making, and communication may also be impacted. Therefore, it is not surprising to observe a decline in multiple skills following a brain injury.

The concepts of functionality and functional capability refer to an individual's ability to perform the regular tasks and activities in their daily life. This includes being able to carry out tasks such as personal hygiene, household chores, work responsibilities, and social interactions. It is about the overall ability to function independently and effectively in various aspects of life.

Psychologists and psychiatrists believe that claimant limitations in functioning are not solely caused by psychological, social, or physical problems individually. Instead, they see these limitations as a result of the complex interaction between psychological, physical, and social factors. This means that all three aspects play a role in shaping an individual's functioning abilities and limitations.

The most appropriate statement for a doctor to include in a psychological/psychiatric IME report is that the claimant has significant limitations in daily functioning. This statement acknowledges the presence of limitations in the claimant's ability to function in their daily life, indicating that they may require support or accommodations. It does not categorically state that the claimant is disabled, as disability determination involves a broader assessment and consideration of various factors.

All of the above options are helpful in preparing to refer for a psychological/psychiatric IME. Recording all major consistencies and inconsistencies in documentation and telephonic correspondence helps to gather important information about the claim. Identifying what prevents a clear picture of the claimant's ability to function in the work environment allows for a comprehensive evaluation. Conducting interviews with the claimant, employer, treating provider(s), and relevant collateral contacts is important to gather additional information and assess the validity of the claim.

The correct answer is that the Independent Examiner should never be asked to interpret the claimant's disability contract language. This means that it is not within the scope of the Independent Examiner's role to interpret the specific language in the claimant's disability contract. They may have other responsibilities, but interpreting the contract language is not one of them.

Memory skills and intelligence are about as strong as each other in average (non-impaired) claimants. This means that there is generally no significant difference between memory skills and intelligence in individuals who do not have any impairments. Both abilities are considered to be relatively equal in terms of strength and capability.

The correct answer is "Objective psychological testing does not improve Independent Examiners' accuracy in evaluating claimants, if Independent Examiners rely on interview data and knowledge accumulated over many years". This statement suggests that even if Independent Examiners have extensive experience and rely on interview data, objective psychological testing does not enhance their accuracy in evaluating claimants.

After a mild brain injury, it is common for individuals to experience memory decline. This can be attributed to the damage caused to the brain, which can affect the ability to recall and retain information. However, it is also common for intelligence to remain at about the same level after a mild brain injury. This means that while there may be some cognitive difficulties, the overall intelligence of the individual is not significantly affected. Therefore, the correct answer is B and C, as both memory decline and intelligence remaining at about the same are commonly observed after a mild brain injury.

The IME Facilitators play a crucial role in various aspects. They assist in preventing accusations of undue influence and conflicts of interest, ensuring a fair and unbiased assessment process. They also evaluate the expertise of Independent Examiners to ensure they are qualified and competent. Additionally, they help determine appropriate methods of assessment, ensuring that the assessment is conducted in a suitable and effective manner. Lastly, they promote objective psychological assessment, emphasizing the importance of unbiased and accurate evaluations. Therefore, the correct answer is "All of the above."

Insurance professionals usually do not request neuropsychological evaluations when claimants do not report problems thinking. This suggests that the primary reason for requesting these evaluations is to assess cognitive functioning and identify any subtle problems with brain functioning that cannot be detected through brain scans or physical examination. If claimants do not report any issues with thinking, it may indicate that there is no need for further evaluation in this area.

The concepts of functionality and functional capability refer to the claimant's ability to perform a specific task or activity, in this case, riding a bus. It encompasses factors such as the claimant's anxiety and confidence in riding the bus, as well as the availability of buses in their neighborhood. Therefore, the correct answer is "The ability to ride a bus" as it encompasses all the mentioned factors.

The correct answer is "All of the above". Independent examiners can determine if there are significant psychological and environmental causes for claimant limitations in functioning by understanding any physical conditions, analyzing problems with claimant ability to perform tasks over time, identifying red flag behaviors and inconsistencies, and objectively comparing claimant's presentation to those of others undergoing physical rehabilitation.