The ABCs of Managing Psychiatric Disability Cases is a recently updated on-line version of an FHIPA publication distributed to insurance disability specialists and adjusters. Written by Dr. Leonard Grossman and adapted for the web by Mr. Michael Castellano, Part One on Specialty Information furnishes plain language definitions of psychiatric, psychological, and neuropsychological IME practices, professional responsibilities, and procedures.
Part Two on Managing Psychiatric Disability Cases details our flexible, five step strategy for managing psychiatric disability cases and improving the IME process. Part Two also includes sample letters and correspondence and cites actual confidentialized case histories and outcomes.
Introduction Introductary remarks and a personal message from Dr. Leonard Grossman.
Part One: Specialty Information Specialty and scope of practice information on psychiatrists, psychologists, and neuropsychologists. Also contains information on the IME processes and the various types of psychological and neuropsychological testing procedures associated with them.
Part Two: Managing Psychiatric Disability Cases A flexible, five step strategy for managing psychiatric disability cases and improving the IME process. Also includes sample letters and correspondence, and cites actual confidentialized case histories and outcomes.
Introduction
Psychiatric disability claims are inherently troublesome and complex. Inadequate treatment, inappropriate medicating, misdiagnosis, treatment non-compliance, undisclosed substance abuse, and malingering are just some of the problems commonly encountered.
Even the most experienced disability specialist can find him or herself adrift in a sea of conflicting and difficult to interpret reports and documents. While no one expects you to become an encyclopedia of the numerous medical terminologies, specialties, and testing procedures lurking in your case files, it's quite helpful to have a working knowledge of the ones most frequently encountered.
The purpose of this updated on-line version of "ABCs" is two-fold:
to familiarize disability specialists with the various types
of psychiatric, psychological and neuropsychological services and practices in use today
and their applications.
to outline a flexible strategy for utilizing these services to efficiently and cost-effectively manage psychiatric disability cases.
A Hands-On Approach
In all but the most debilitating cases involving physical injury or illness, patients can be expected to aggressively pursue the best treatments and doctors available to them. With psychiatrically disabled patients, this is frequently not the case.
Impaired judgement and emotional instability make it difficult for many to secure and maintain quality care. Regular attendance at therapy sessions may decline or stop altogether, essential medications may be refused or misused, and a reoccurrence of potentially harmful behaviors and symptoms concealed or overlooked. This is especially unfortunate because with the consistent application of appropriate therapies and medication, a majority of patients recover sufficiently enough to return to their previous employment.
For all these reasons, a hands-on approach in psychiatric disability cases makes good business sense. An informed disability specialist with ready access to an experienced professional consultant is well-equipped to serve the interests of both claimant and insurer.
Cost-Effective Strategies
While the insurer cannot intervene directly in the treatment process, there are cost-effective case management strategies available which can encourage and facilitate speedier claimant recoveries. Reliable methods for improving the IME process and identifying and documenting questionable or fraudulent claims are also readily available.
We trust disability specialists will find "ABCs" a useful reference tool in their day-to-day work, and a helpful guide for developing cost-effective strategies for managing psychiatric disability cases.
Sincerely,
Leonard Grossman Ph.D.,
President, The Forest Hills IPA Inc.
Diplomate, The American Board of Forensic Examiners
A Special On-Line Guide
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