Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Settlement & Open Medical

Settlement is itself an interesting topic for which there is not enough discussion. For example, even brutally honest and high integrity people seem to set aside their moral values when the _value_ of their claim becomes a focus.

In the last 5,000 cases which I have seen, there has only been three individuals who used their open medical for psychological visits, and even then, it was a visit every three weeks (or less frequently).

Additionally, even those patients did not continue care for the full (six months) or year of open-medical. They most often ask for reassurance that I would still see them and then settlement occurs and after a very few visits, they do not return for care.

This is logical in that for many of them, the anxiety, helplessness and anger has now been resolved by a financial agreement in which they have participated. They have participated in their own decision-making and whatever PPD was assigned is now, to them, a fixed _quantity_ with no needed additional efforts to demonstrate their limitations.

Thus, at least in my practice, it is exceedingly rare for a patient to return to psychological care after settlement has occurred.

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