General Guideline Principles for Psychological Evaluation

for CRPS Patients for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Psychological Evaluation for CRPS Patients.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Psychological Evaluation for CRPS Patients of Behavorial Interventions

Psychological Evaluation for CRPS Patients of Behavioral Interventions is recommended in order to determine whether psychological issues would need to be taken into account and treated as part of the overall treatment plan and to identify psychosocial obstacles that are causing impairment and impeding function as part of the diagnosis and management of patients with chronic pain.

Indications: Moderate to severe CRPS in which:

  1. Cases where there is a strong suspicion of or observation of psychological disorder.

     

  2. The healthcare provider must comprehend the psychosocial elements influencing the patient’s disability behaviours and pain reports.

     

  3. Inadequate recovery includes a persistent pain issue that is insufficiently explained by the patient’s physical findings, continued dysfunctional status despite a duration that exceeds the typical course of recovery, and failure to benefit from recommended therapies or to return to work when medically advised.

     

  4. Medication difficulties and/or drug abuse: This covers any suspicion of drug abuse, addiction, substance abuse, or use of illegal substances, as well as the possibility of long-term opioid usage.

     

  5. Major psychiatric symptoms or disorders that are present today or were present before.

     

  6. Issues with following through on a recommended medical treatment or rehabilitation programme: A suggested functional restoration programme, such as comprehensive occupational rehabilitation or interdisciplinary pain rehabilitation, may be evaluated honestly for or to determine whether it will be beneficial (see Functional Restoration).

     

  7. Evidence of potential cognitive impairment linked to substantial ADL dysfunction: This may be a result of the accident or potential side effects from medicinal treatments for the persistent pain.

     

  8. Catastrophic wounds that cause a lot of pain or other disability, like a spinal cord injury.

     

  9. Cases when specific procedures, such as spinal cord stimulation or back surgery, are being considered.

    Frequency/Dose/Duration: An independently licenced psychologist should conduct one thorough psychological evaluation. ongoing therapy as recommended by the preliminary evaluation’s findings. Content has to contain:

     

    • Correct record review: The referring physician should assist in providing the necessary medical record material. When appropriate, additional data is occasionally reviewed, such as that from a family assessment or work description.

       

    • Clinical consultation with the patient: This interaction and the other data should be used to explain the following parameters: History (including information on mental and physical health, employment, education, legal issues, and drug use), description of the pain, disability, or other clinical problem, analysis of medication use, social history, mental status, and behavioural assessment (including, as necessary, ADL, functional concerns, and operant parameters, such as pain/illness behaviour and environmental influences).

       

    • Psychological evaluation: A battery of pertinent diagnostic psychological evaluations should be conducted and interpreted as needed. This should include tools that may be used to make a differential diagnosis or plan a course of therapy and that have a track record of validity, as well as the relevant normative data for the ailment or problems being examined.

      When choosing test equipment, the clinician should take into account: the suitability of the test(s) for the patient’s presenting complaints and condition; 2) the suitability of a test(s) in light of how well the patient’s status in terms of their health, gender, race/ethnicity, age, education, and other group was taken into account during the test(s) formulation; 3) the diagnostic or therapeutic value of a patient’s performance in relation to normative data; 4) the predictive value of interpreted test results for specific therapies; and/or 5) whether the sensitivity and specificity will improve the precision of a diagnosis.

      Psychological tests may be indicated in the following situations:

       

      • recognising the causes of the patient’s reported pain and actions related to their impairment;

         

      • A mental illness is thought to exist;

         

      • assessing the feasibility of a restoration effort;

         

      • The examination is a component of the preoperative evaluation;

         

      • cognitive impairment may be present;

         

      • The complaint’s validity is in doubt.

        A thorough mental health evaluation should include standardised psychological testing because well-conducted psychological testing increases the validity and reliability of a psychological evaluation. Psychologists often administer psychological tests, although if it falls within the purview of their expertise and experience, psychiatrists or other doctors may also do so.

        Standards for evaluating people with chronic pain psychologically have been examined elsewhere. The facts and professional consensus regarding the variables that have to be evaluated in these assessments have also been reviewed. Among other things, the test battery used to assess patients with persistent nonmalignant pain consists of:

         

        • test(s) for evaluation of the existing pain and/or any other associated health issues or dysfunction;

           

        • personality and psychopathology test(s);

           

        • a quick cognitive test when there is a CNS impairment suspicion;

           

        • ICD-10 diagnostic impressions: These should be deduced;

           

        • The psychological assessment should include management suggestions as well as persuasive explanations for the identified complaints and dysfunction.

What our office can do if you have workers compensation injuries

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.

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I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

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