Disability, Dysfunction, or Deception: Explaining Acquired Occupational Disability, Part Ten
Acquired disability following trauma is an area that is in dire need of discussion and explanation. Unless an expert is fully informed of the multitude of pre and post-injury medical and psychosocial dynamics that surround an individual’s claim of occupational disability, he or she may not be in a position to make absolute judgments regarding residual employability, pre and post-work capacity, or the causal attribution of vocational disability. Causal attribution is critical in determining disability chronicity following trauma, as the host of contributing psychosocial dynamics effecting unproductive states are often overlooked when investigating the most obvious reason for work absence, a so-called explanatory event. A thorough and accurate history-taking is necessary when assessing pre-injury work longevity, determining residual employability, and causally ascribing occupational disability to a particular event. Acquiring a complete and reliable history through various sources places the expert in a better position to offer a professionally certain opinion. Written by Jasen Walker, EdD; from the Spring 2006 Forensic Examiner.
Litogenic. When representing injured or ill employees (or people pursuing economic damages through personal injury litigation), legal advocates hope to demonstrate that their clients have lost their potentials to work and earn a living. Lawyers, in their advocacy of injured employees, pursue economic recovery in claims such as personal injury, workers’ compensation, Social Security disability, and long-term disability. These litigations almost always induce or encourage an argument of disability. Even the most ethical lawyers believe that their clients have more to gain if they can prove economic damage secondary to vocational disability.
Psychogenic. Psychogenic disability potentials suggests the inability to work because of symptoms caused or produced by mental or psychological factors rather than organic problems. Depression, substance abuse, personality disorders, and psychosis can lead to psychogenic disability. Unfortunately, health care professionals often legitimize symptoms manifested following the diagnosis of a disease or disorder that is not necessarily disabling.
Psychogenic disability can arise when workers blame symptoms secondary to stress on an external cause rather than taking responsibility for reducing the stress. Psychogenic disability is often precipitated by work dysfunction. For an excellent text on psychogenic disability and its causes, see Psychiatric Disability: Clinical, Legal and Administrative Dimensions, published by the American Psychiatric Press, Inc.
To be continued.
–Published by Dr. Robert O’Block
