2 min read
Dr. Donna Wicher Answers a Claims Adjuster's Questions:
Question:
Given an orthopedic injury requiring surgical intervention [E.g. one year post]:
Is it possible and/or probable that new condition(s) of anxiety / depression / PTSD might arise under the circumstance of "financial stressors" due to the compensable condition(s)?
Answer:
Donna C. Wicher Ph.D.
Neuropsychologist
An individual might develop symptoms of depression or anxiety related to financial stressors stemming from a compensable orthopedic condition, although some of the issues would be whether the symptoms would rise to the level of a diagnosable mental or nervous disorder.
Some distress would be considered normal under the circumstances; it is common for individuals to experience some degree of depression and/or anxiety when under financial stress and the question would be whether the level of distress is beyond the range of a normal response or whether it causes significant impairment in some area of functioning such as work or interpersonal relationships.
PTSD would not be properly diagnosed related to financial stressors because it requires exposure to “actual or threatened death, serious injury, or sexual violence” which financial stressors would not constitute.
Question:
In the absence of other apparent contributors, what objective criteria would you use to:
- Diagnose and categorize the condition(s) and severity (minor vs major)?
- Identify whether the compensable injury is the material / major cause of the new condition(s)?
Answer:
1. Objective criteria would include clinical observation, for example, are there observable signs of depression and/or anxiety such as psychomotor retardation or agitation, speech latencies, tearfulness, tremulousness, pressured speech, etc. In addition, objective test data such as the results of the MMPI or PAI would provide information about the nature and degree of distress that may be present.
2. Other potential contributing factors would need to be identified and assessed, such as pre-existing conditions or tendencies and unrelated stressors or factors.
Question:
What prognosis for recovery would you anticipate?
Answer:
The prognosis would depend on the contributing factors and the individual’s pre-morbid level of emotional functioning. Well-adjusted individuals will have a better prognosis than those whose functioning is already compromised.
For those without internal resources such as resilience, self-confidence and coping skills, external resources may be necessary, such as social support organization, counseling, or medication management.
Dr. Donna C. Wicher has over 45 years of experience in the field of Psychology. She specializes in the treatment of mental health conditions, including depression, anxiety, PTSD, and stress.
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A Previous "Ask the Doctor" Response
In our previous "Ask the Doctor" blog, Dr. Renteria addresses a question regarding cognitive testing for workers with pre-existing intellectual disabilities.