Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Reviewing Medical Records – Revisited

A patient has a repetitive use orthopedic injury. He is misdiagnosed as having posttraumatic stresss disorder. Treating this patient as though he has PTSD will be a disservice to him and accomplish nothing.

When he was evaluated, the focus of the examination could/should have been what occurred between his injuries?

Did his supervisor/employer cooperate with the restrictions or was the patient recurrently forced to do work beyond his capacity?

It is important to know how the patient saw his role in the company prior to injury as opposed to how he sees that role now.

Has he been subjected to ridicule and criticism due to limitations over which he has no control?

Critical aspects include his anger toward his employer, disappointment in the employer, frustration with the employer and resentment of the employer.

Are these psychologically disabling? Absolutely not, but they can and will dictate his comfort and willingness to be back in that job setting.

Even though he is not psychologically disabled, it is sometimes unwise to return employees to their job in any capacity due to poor judgment (or even cruelty) of the employer or coworkers.

You can create into a revolving door with him, forcing him to fall back on his physical complaints to deal with his anger toward the employer.

The more functional alternative is to determine if the employer can understand and is willing to correct his role in this problem.

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