Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Impact of Deception

deceptionDeception: It is not rare to learn that a patient in treatment, unable to work, is actually gainfully employed while claiming disability.

There is a line in a Bob Dylan song that goes “Money doesn’t talk…it swears.” And there is no doubt that malingering and corruption is a significant concern.

However, there are two extremely important areas that you need to seriously consider:

If video surveillance demonstrates that the patient is working beyond the limits set forth by the authorized treating physician, why is the patient doing this?

A. Is the patient forcing himself to work beyond physical limits to keep from being nonproductive and bored? Is the patient extending himself as an attempt to participate in his own work-strengthening? Has the patient been encouraged to attempt some productivity every day, despite pain?

B. Or, as you appear to suspect, is the patient clearly demonstrating a functional capacity far beyond what his physician believes it to be.

C. Is someone advising the patient to appear as though his limitations are more severe than they truly are? Is someone recommending to the patient that he remain in his residence, not venture out, and be on guard for investigators documenting his every behavior?

Injured workers receive a large amount of misinformation and disinformation that results in their making poor decisions. They are often told some behaviors will enhance the “value” of their injury and other behaviors may compromise that value.

Such advice most often comes from within and outside the family from those who are truly ill-informed as to what a person needs in life, beyond finances. This advice and deception springs from the naive position that all of life’s ills are resolved financially and that the patient’s self-image and self-worth have a monetary rather than emotional value.

What an injured worker needs to know is that “you may have permanent limitations and chronic pain despite any care that is provided. While you are being told that there is a financial value to this suffering, in fact, there is none. Any money will eventually be depleted, and you will continue in your life with your symptoms. What you need are activities that make you feel productive, more complete, and a value to yourself and others. You need to be encouraged to do as much as you can, to extend beyond your limits, and to establish a post-injury life that offers some degree of fulfillment.”


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