Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

The Alcoholic Injured Worker

In the midst of finding alternate work_and mounting data that the worker can perform transitional work_he(she) applies for *catastrophic* status, and all rehabilitative efforts come to an end. This meets no one_s needs.

Within the first 60-90 days following injury, notations in the patient_s chart suggest problems with the case. The patient_s symptoms did not match the doctor_s findings.

We operate under the assumption that all adult Americans want to work. Clearly, not all of them do, so we must determine the reasons why some elect not to work, and measure not only their intellectual capacity, but their willingness to do so.

The old annoying cliches of “Strike while the iron is hot”; “Don_t put off until tomorrow what you can do today” exist for a reason.

If you can determine within the first 60 days what a patient’s intentions are regarding RTW, you can direct care and rehabilitation efforts in the right direction.

You must find out this information before the patient is misinformed or misdirected, and the term “catastrophic status” in placed into their vocabulary. That term becomes a replacement for motivation.

While there are injuries that clearly warrant catastrophic status, the vast majority do not. Why allow management of patient care to be hampered or controlled by a term when what is needed is medical case management and resolution? With in-depth analysis and information, your action could be more targeted and effective.

From the standpoint of assisting a return to productivity, all efforts are halted by the declaration of catastrophic status. You must get proactive in your case management and seek earlier consultation.

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