Handbook of Complex Occupational Disability Claims

Schultz, Izabela Z.; Gatchel, Robert J.

doi:10.1007/0-387-28919-4

Cited by 40 publications

References 886 publications

(991 reference statements)

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Dispute Resolution as a Creator of Needless Disability

Aurbach

2011

AMA Guides® Newsletter

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When injured persons feel pain and a physician tells them that they have a permanent condition, the feeling of pain can become associated over time with the diagnosis, the emotional response to the diagnosis, and factors associated with the diagnosis (including helplessness, fear, anger and overwhelming stress). Even the language associated with the process can be misleading: To some, the phrase “maximum medical improvement” may have the ominous ring of a life sentence with a judgment that they have reached the highest potential for recovery, even if this is not the case. The US legal system often contributes to needless disabling, to the extent that the author coins the term “attorneyogenic disability.” Delaying dispute resolution following disputes in the case causes harm by creating a period when injured workers may obsess about their condition, the people who have wronged them, and the unfairness of the system in failing to compensate them. As delays stretch on, the individual's perception of physical symptoms may become habitual in a complex association of thoughts, feelings, and emotions that affect the worker's neural network. Finally, the legal system stops when the claim is resolved, and the patient's advocate has no systemic motivation to assist after the claim is completed. Planning for functional adaptation and treatment after the dispute resolution often is lacking, especially after the individual has been exposed both to catastrophic thinking in the courtroom and multiple medical evaluations and treatment protocols.

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Dispute Resolution as a Creator of Needless Disability

Aurbach

2011

AMA Guides® Newsletter

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Part II: Psychological Factors In Delayed And Failed Recovery and Unnecessary Disability

Caruso¹,

Kertay²

2019

AMA Guides® Newsletter

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Part two of this two-part article on psychological factors in delayed and failed recovery and resultant unnecessary work disability (DFRUD) considers both conceptual and practical interventions, including specific evaluation and treatment methods. The authors propose five categories of intervention for DERUD: 1) advance and operationalize our knowledge base; 2) make conceptual and practical shifts in our approaches; 3) place greater emphasis on prevention; 4) improve recognition of potentially difficult cases, and 5) apply specific management approaches and tools. Further, the authors propose conceptual and practical changes that should be made: Eliminate the dualistic separation of mind and body and the scientific reductionism that follows; change the focus from disability to capability; reduce improper workers’ compensation claims; improve the administrative and medical management of valid claims; enhance collegiality and communication among all stakeholders; and adopt a cost-utility vs absolute cost approach. The overarching goals of managing DFRUD include optimizing administrative and clinical treatment of the worker; protecting all stakeholders from excess; and overcoming barriers to intervention. To these ends, three activities can optimize the process: Intervene early; avoid iatrogenicity (ie, shorten claim durations and reduce costs); and stratify risk and employ stepped care. Barriers to meaningful intervention in DFRUD include questions of jurisdiction and responsibility for management (eg, does management of DFRUD fall to insurers or clinicians); who will pay; what are the maladaptive health cognitions and/or psychiatric comorbidities; and how can clinician behavior be altered to implement evidence-based practice?

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Behavioral Health Disability

2011

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Handbook of Complex Occupational Disability Claims

Cited by 40 publications

References 886 publications

Dispute Resolution as a Creator of Needless Disability

Dispute Resolution as a Creator of Needless Disability

Part II: Psychological Factors In Delayed And Failed Recovery and Unnecessary Disability

Behavioral Health Disability

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