Why can’t you get an x-ray for a psychological injury? Well, maybe you can…

Key Points
  • The use of proper psychological testing uses a claimant’s own responses to objectively clarify the correct diagnosis based on tests that have been subjected to years of critical and academic review.
  • Use of psychological testing can assist people to better understand their condition, which can ensure correct diagnosis, optimal treatment and ideally help with return to work, even in workers who have been away from work for a long period.
  • Relevant psychological testing has in-built validity scales and will confirm whether the diagnosis is based on properly reported, genuine symptoms. If they are not, no valid diagnosis would be appropriate.
If a person rolls her/his ankle and a fracture is suspected, the doctor will refer for an X-Ray to confirm. This would then inform whether a person undergoes surgery, or whether they are treated with physiotherapy. Best treatment follows accurate diagnosis.
With psychological injury, however, most commonly the presence of an injury, or the correct diagnosis, is not based on an objective test. It is instead based on a GP’s opinion or a psychiatrist’s opinion, often principally upon a history given by the patient. If that opinion is wrong, a person with a psychiatric condition may go without treatment, or they may be treated for the wrong thing and therefore get no benefit from treatment. But is there another alternative?

Psychological injury claims are nothing new. They are some of the more complex, problematic and involved claims in the workers compensation jurisdiction. They can have a substantial emotional toll on all people concerned including injured workers whose lives are impacted, employers who may not know how it all went wrong, and even those managing the claim for the scheme agent. When a worker fails to improve or there is a difference of opinion between psychiatrists, the matter only gets more complex.
With a physical injury, this can often be resolved by referral for a scan, such as an MRI that clearly outlines the condition suffered. A little known fact is that such an alternative also exists for psychological injuries.
Did you know that tests like the Minnesota Multiphasic Personality Inventory (MMPI) have been around since the 1940’s, and subject to academic and peer review since that time, with the currently accepted versions being the MMPI-2 and MMPI-2–RF? The Personality Assessment Inventory (PAI) has been around since the early 1990’s, and likewise has been the subject of rigorous academic review.
Those are only two of the examples of psychological tests that are conducted based on a worker’s own input, usually into an ipad or computer, with computer based testing. The software analyses the person’s responses and, based on the many years of psychological research that has gone into these tests, gives you a diagnosis that is usually more reliable than a single clinical interview by a psychiatrist or psychologist (which can be influenced by an acceptance of what the patient says). This removes any biases or misconceptions by an assessor, or any pre-conceived ideas a worker may have about themselves that could unintentionally shape the information they give an assessor. The meaning behind the questions in these tests is also not readily available to the person completing the test, so they will give accurate responses that are completely reliable. The same cannot be said if a patient is asked for symptoms in a leading manner.
The benefits to such testing are readily apparent. For those workers stuck in a cycle where they seem unable to improve, it can give light at the end of the tunnel to know the diagnosis they have previously been given is not accurate, but with this new information they can get treated for the right thing. They can have genuine hope of actually getting their life back on track. For those in the early stages of a claim, they can know with a measure of certainty that the diagnosis they have been given is accurate before they move forward. They can know that they will get treated properly, and that they have a realistic shot of getting back to work. Equally for employers and insurers the certainty of knowing that their injured worker has a genuine condition will only help them to understand the situation, to aid the worker in getting treatment, and to know exactly what accommodations need to be made.
For those claims that ultimately proceed to litigation despite the best efforts of all concerned, Hicksons’ experience is that where effective psychometric testing has been undertaken it properly clarifies the diagnosis and basis for the claim, limits the issues in dispute and provides scope to resolve the claim more quickly.
If you rolled your ankle, your GP might think you have a broken bone, but would refer you for an x-ray before confirming. If you were suffering a psychological injury, wouldn’t you like the same degree of certainty?

Post by Doyle Myles

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