The connection between pain and PTSD is making headlines with regard to returning veterans and their likelihood to receive prescriptions for opioid pain relievers. According to the Los Angeles Times, a new study has shown links between PTSD diagnoses and opioid painkiller prescriptions among military veterans – as well as a disturbing prevalence of such prescriptions for PTSD-stricken veterans with substance-use disorders. Researchers behind the study suggest that these results indicate a need for better understanding of the connection between pain and PTSD; and while the issue is undoubtedly paramount for veterans and their families, it can also be a major factor in rehabilitation and return-to-work efforts for civilian workers struggling with pain and PTSD as a result of on-the-job injuries.
Several months ago, this column touched on the importance of medical and psychological evaluations in workers comp disability cases where the patient’s injuries are likely to incur psychological trauma. Delving more deeply into the relationship between work-related injuries and psychological distress, researchers have found that, among orthopedic and musculoskeletal injuries sustained throughout industrial societies worldwide, those that lead to chronic pain and disability not only incur the greatest compensatory costs, but are also the most likely to be complicated by biopsychosocial factors.
Malingering, as it applies to the context of criminal, civil, personal and workers comp disability evaluations, is the practice of intentionally producing false or exaggerated symptoms in order to reap the benefits of compensatory measures such as money, prescription drugs, relief from duty or avoidance of criminal prosecution. More often than not, the public becomes aware of malingering due to criminal cases, like that of Russell E. Weston Jr. – an individual diagnosed with paranoid schizophrenia who is currently undergoing mental health treatment in anticipation of an eventual murder trial, according to Bloomberg Businessweek. In both this context and others, however, malingering can be incredibly difficult to assess. Studies have shown that certain behaviors can help lead to a clinical determination of malingering in a variety of different contexts. However, even when suspicious activity or evidence is present, it can take psychological testing and evaluation by a qualified psychiatric professional in order to confirm malingering on the part of an injured individual.
Herman Cain may have denied the sexual harassment allegations that ultimately deflated his hopes for the 2012 Republican presidential nomination; but that didn’t stop the media from making the most of the story as every detail, no matter how mundane, came to light. However, despite the emotional pathos and media buzz surrounding this and other high-profile sexual harassment cases, research suggests that a much subtler form of workplace abuse may in fact be even more damaging to employees in the long run.
Workers comp fraud prevention and related reform efforts receive the lion’s share of media coverage when it comes to California employee benefits and claims. However, while reform may be both necessary and imminent, as noted in a recent Business Insurance report, it is important for both employers and legislators to recognize that some of the most superficially dubious cases – specifically those dealing with work-induced stress from sexual harassment, trauma or other causes – are also the most frequently justified.
Last week, Governor Brown both signed and vetoed several new pieces of California workers compensation legislation, bringing much media attention to the matter of work comp costs and to statewide efforts to prevent abuses within the system. According to commentators quoted in the Insurance Journal, the newly enacted laws are designed to keep costs steady and “create greater efficiencies” to benefit workers and employers alike. However, while such legislative action is a critical component of an equitable workers comp system for both California business owners and their employees, it is also only part of a much larger picture – one that relies as much on comprehensive injury analysis and thorough diagnoses and treatment as it does on system-wide management of rules and regulations.
As a patriotic city with a strong military presence, San Diego proudly defends the honor and heroism of local service members and retired veterans – not to mention its own civic heroes who step up daily to fight crime, fire, illness and violence. But even as we celebrate bravery and service, we are also acutely aware of the trauma-induced mental and emotional disorders that some must suffer after multiple tours and deployments, battles and losses – and of the struggle that many San Diegans face in coming to terms with occupational hazards and their consequences.
Most members of the California workforce are aware that, when it comes to professions like firefighting or law enforcement, employees are required to accept significant violence and danger risk as a routine part of the job. However, a recent upsurge in state-wide hospital violence has brought the definition of “routine risk” as it pertains to the healthcare field under scrutiny. According to the Los Angeles Times, violence against nurses and other hospital workers is increasingly common; and because employee expectations remain unclear regarding the normalcy of violent patient outbursts, revised preparation, warning and workers compensation measures are becoming necessary in order to adequately address the stress and anxiety to which more and more hospital workers are being exposed on a daily basis.