Category: Obstacles


When a patient reaches MMI with a permanent and partial disability, s/he should be focusing on dealing with chronicity, not facing the reluctant clinician, hesitant to “let go”. There is an understandable resistance among patients to accept that their limitations and suffering may be chronic. But sometimes the treating clinician appears to have more difficulty …

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Fear of Re-injury

Fear: There are many factors that create alarm among injured workers, but the final concern may create the greatest psychological disability: a. there is no future employability b. disappointing to, and thereby being abandoned by, the family c. the incapacity to cope with the role of chronic residual pain d. fear of re-injury. Patient’s dread of re-injury creates …

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The Misinformed Patient Patients become misdirected or misinformed about their injuries. Many aspects of an injury may be misunderstood by the patient, particularly in the absence of prior significant exposure to the healthcare system. The focus of the patient in the aftermath of injury should be: a. What are my objective damages b. What care …

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Authorization for Care

Authorization I would like to discuss authorization-for-care as a general topic; both delayed and denied authorization. “Learned helplessness theory” is the view that clinical depression and related mental illnesses may result from a perceived absence of control over the outcome of a situation. Patients who have been ineffective in controlling outcome are defined as having …

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Unique Workers Undocumented workers often function with quite different goals and aspirations. They have left or escaped oppression and poverty in their own country. Their access to work and education may have been very limited. Their earning capacity was below the poverty level in most nations. The conveniences to which we have long grown accustomed …

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Hypervigilance is a symptom. Vigilance is the ability to stay focused upon a task and/or concept for an extended period of …
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Contradiction “We read two of your consultation reports last month.  One said that the patient lost 20 pounds which was …
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Generalized Anxiety Anxiety is a milder form of fear, and as you know, fear is an essential emotion that protects us from …
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