Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Postponed Referrals

There is no doubt that some injured workers are mistreated. They do not receive approval for diagnostic studies, treatment is intentionally delayed, procedures are cancelled, prescriptions are not filled and financial compensation is not sent.

The patient, in a dependent position, grows resentful and also feels powerless.

After months of enduring these frustration, the patient (most often male) feels that the only alternative is _to get them like they have been getting me._ That is, simply refuse to recover, refuse to consistently comply and refuse to settle.

This passive-aggression, the patient erroneously feels, will balance the scales and make others suffer as he feels he has.

The patients often see the _system_ as simply his employer, his insurer, his adjustor and his primary physician. The patient can only appreciate his own plight and does not see (nor particularly care) about administrative and clerical problems.

Often educating the patient as to why delays occur is effective. Equally as often, however, is an acceptance that passive-aggression has become the patient_s sole recourse. In that instance, all that can be done is base clinical and administrative decisions solely on objective findings.

Often the most important finding is _what are the patient_s grievances that occurred after injury_ rather than the seeking of obscure reasons for continued complaints.

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