One of the consistently alarming trends that I see is that following an injury, the worker is permitted care along the lines of an (often arbitrary) assumption as to how the injury occurred and what physical damage took place.
There is very rarely a thorough history taken of the complete nature of the injury.
Let me give you an example: A patient this week was struck by a falling object and suffered severe orthopedic injuries. Thus, he was seen by an orthopedist.
From the orthopedic standpoint, the patient had now recovered.
He has returned to work half-time and was seeking a release to return to work full time.
However, he had irregular heart beat and rapid fluctuations in blood pressure that a consulting cardiologist said _well it could have existed before injury._
He also had periods of dizziness, loss of consciousness several times a day, and visual disturbances which the company_s neurologist said _oh that_s probably nothing._
So there he was, at work, using potentially hazardous tools, alone in a shop, dizzy, falling, losing consciousness 3-5 times per day while working half-days, about to be released to full time work (60 hours per week in two separate job sites).
During psychological exam, he was asked if he had struck his head when the machine struck him. He indicated that he had turned his head to avoid it being struck. He noted that that when he arrived in the hospital, his neck was very sore from the suddenness of being thrown forward, and his right ear canal was deeply impacted with mud from the impact of his right cheek striking the ground.
In short, there were multiple, unaddressed, potentially serious, physical problems which could be life-threatening in his work-setting (or certainly the potential for further injury) that were simply being set aside because his initial shoulder complaints were resolving.
Instead, he was being told he was simply depressed. While he may be mildly depressed, he is more clearly terrified of attempting to live his life in a world where he loses consciousness and falls for no apparent (to him) reason.
A more thorough history could/can protect this man and others from additional injury.