Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Obstructing Care

Obstructing Care

There is no case of work injury that does not involve “psych”. All cases do.

“Psychology” is the science of human behavior. It is what people do, think, feel and believe.

“Psych” is two things in cases of claimed disability:

a. It is a mental disorder caused, or exacerbated, by injury

b. Or “psych” are those factors that impede an injured workers” willingness to return to work.

Mental Disorder frequently arises from injury in the form of mild depression, pain  disorders, and/or anxiety disorders (most notably) posttraumatic stress disorder.

In these cases, Psych, if competently treated, psych care can expedite, not impede, the speed of recovery.

The second category, “psych” factors, is found in virtually all facets of all cases. Psych, in this sense, refers to the patient”s goals, motivations, compliance, honesty, integrity, and ambition.

Psych involves whether the patient is accurately reporting the injury, truly complying with care, honestly reporting symptoms and limitations and is willing to work hard to get back to work.

Without “psych”, we have no idea as to why this patient”s physical complaints are in gross excess of the physical findings”why the MRI (etc) suggests no, or minor, defect, yet the person states that they are immobilized by pain.

It is only with “psych” that we find out whether the injured worker is being negatively influenced by friends and family or other outside sources, and it is only through “psych” that we can determine if the patient is capable of (intelligent enough for) understanding their diagnosis and the goals of treatment.

In each and every case, you can either deal pro-actively with “psych” on behalf of the patient or be blind-sided by it.”


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