Has anyone had a neuropsychiatric evaluation?
 

I was just wondering what to expect from this. I have an appointment on feb 25th. I don't know how I will even make it through six hours of questioning/ testing. My attention span is negative 100,000.:) any advise comments would be helpful. I need this to prove disability so I can get on Ssdi and ssi. Please keep me in your prayers as I do all of you guys everyday. Thanks for all your support. Brain patch.

It sounds like you are set for a Neuro Psychological Assessment. These are very common when trying to measure the functions of brain injured individuals.

As you said, you think you will fail miserably at this. That is the whole point. Failure is a good result if the failure is validated by the validity tests.

This is not a face to face test. Most of the tests are short and have a narrow focus, like tapping your finger as fast as you can for 3 minutes. Trying to memorize information. Trying to re-order information, spell or count backwards. Do a pencil and paper tracing test. Assemble a unique set of blocks. You will be observed more than questioned.

Who has ordered this assessment?

SSDI does not usually require a full NPA. In fact, they have psych's who will do an abbreviated assessment of an hour or so.

It has not bearing on SSI. That is needs based.

Do you have an SSDI attorney/advocate ?

I have had 2 full NPA's 3 to 4 hour, and one abbreviated 1 hour, NPA.

So, relax, if you don't sleep well the night before, that is OK. It will only help.

My best to you.

I've had two, one was an abbreviated (~ 2hours) and the other was a half day.

The exact tests vary depending on how the symptoms present. My deficits included visuospatial and verbal learning and memory, abstract reasoning, mental flexibility, and problem solving. The exam should be conducted by a licensed clinical neuropsychologist.

The evaluation typically starts with an interview to get your self-assessment, and they also observe language, motor skills, and overall affect. They may include a spouse or significant other in the interview (my wife attended this part with me).

They then perform a battery of different tests of cognitive functioning. Again, the exact test may vary based on your areas of difficulty, my tests included:

Subtests of the Wechsler Adult Intelligence Scale (WAIS-IV)
Beck Depression and Anxiety inventories
Reading tests (WRAT-3)
Auditory Learning
Visuospatial memory tests
Trail marking A & B
Wisconsin Card Sorting test
Verbal Fluency

They will compare the results with “normal” scores based on your age, education background and other demographic factors.

I was coming from a different place in that I desperately wanted to go back to work. But overall my advice would be do what you can do, and let them compile the results. If you are having attention/memory issues that will become apparent. On my first one I “failed” miserably, so they prescribed specific speech and occupational therapies which helped immensely, and I was given a “Return to work” recommendation after the second one three months later.

Best to you.

Neuropsychiatric evaluation
 

Mark in Idaho,
I applied for disability with a lawyer and went to the alj level and was denied. I applied with chronic pain in neck, head, back and down my left leg, I had acute liver and kidney failure from an accidental overdose of acetaminophen. Liver dysfunction, degenerative disc disease with bulging disc hitting nerve root, hernia , chronic migraines and hypoglycemia. I had numerous episodes with the hypoglycemia where I passed out and hit head on concrete, PTSD and anxiety/panic disorder.
Social security says I have not seen enough doctors/ specialists for how bad I am claiming problems are.
So I went to a neurologist and he diagnosed me with Post concussive syndrome manifested by cognitive impairment, chronic pain and fatigue. Also, REM sleep behavior disorder, nocturnal frontal lobe epilepsy (did not know I was having this until I got woke up and was having a seizure) chronic migraine with nausea/vertigo and episodes of syncope that may be vasovagal in nature. The neurologist said that a neuropsychiatric evaluation would be helpful in documenting level of disability for the purposes of disability application. That is why I am going for the neuropsych evaluation. I did not realize all these other problems were from hitting my head I thought it was because of having pain all the time. In 2006 I was hit on the freeway and was knocked out. After this accident the chronic pain started as well as problems with dressing myself, having trouble putting outfits together, using toothbrush, hairbrush, blow dryer, fork, forgetting how to cook, forgetting if i paid bills, forgetting if i had taken medication etc. not being able to do normal things. Work was so embarrassing. Ihad slurred speech a lot, did not act appropriately, could not remember faces, names and other things. My employer and clients thought I was drunk or on drugs. I cannot go back to a work environment. Besides the fact that I could not show up or do the job. People make fun of me. They do not understand that I am injured. I pass out in public. I am afraid to leave my house.it is noticeable to others. I hope this will get me on disability. I truly need it.

Don't stress over the test. The hardest thing will be just putting the time in to take it. Plan accordingly, rest after and try to not stress before. None of what they ask you to do is as important as what they observe. Give everything your best go, be truthful and open.

When I took mine it was at times frustrating but both the neuro-pschologists and his assistant were great. I came away thinking I had scored in the normal range for everything. Results ended up showing pre injury I was very high average IQ. There was a lot that was OK but I had three major deficits. Attention, concentration and processing speed. Last one was a dozy as I scored in the 2 percentile range.

It explained a lot and was validating to learn.

It is not like a school test. Don't worry. I did mine in one hour chunks every few days, because that was all I could tolerate. Some of the tests are even fun....if you likepuzzles! It will help you understand your brain a bit more.

Brain patch,

It sounds like your attorney may have used the wrong disabilities as your primary disability. The mental health qualifiers in the Blue Book sound appropriate for you. The NPA will help demonstrate your mental condition. It is a NeuroPsychological Assessment not NeuroPsychiatric. Easy error, especially with a brain injury.

You may benefit from an follow up assessment by a vocational/occupational psychologist. SSA brought a occupational psychologist to my alj hearing and he read the NPA and labeled me as incompatible with a work environment. My lack of visual and audio memory functions were not considered even though we thought they would be the strongest qualifiers.

I was denied twice before getting approved at almost 3 years from my first application. One week shy of 3 years.

My attorney knew to let the pros and judge control the testimony. She just was ready with data and simple comments. She made a fortune ($5400 ) for saying almost nothing.

Have you been through your states Vocational Rehab Assessment ? This can determine that the state does not have a occupation that fits your remaining skills.

It sounds like you may run into the same problem I have. My reduced income as I tried to keep working caused my final monthly benefit to be substantially less. Your attorney has his work cut out to date your disability back adequately.

As others said, relax, let the tests speak for you.

My best to you.

Did amantadine help?
 

Mokey,
Did amantadine help? The neurologist recommended this to my pain dr. (primary doctor) in high levels. He says titrated to 400mg per day. That sounds scary to me. What side effects do you have from that? Thanks a lot.
Brain patch

Hi Brian
 

Yes, it is very common to have this kind of evaluation and it is OK no matter how you do on it. I had one when applying for SSD. My attention span wasn't so hot either, nor could I repete 10 minutes later a list of items. It is OK to be just who you are, in what ever condition you are. Try not to get upset, and just relax a bit when you go there. Most of the people who administer these tests are kind and compassionate. I will keep you in my thoughts and prayers. ginnie

Brain,

What symptoms is the amantadine being prescribed for ?

Neuro psych
 

Just wanted to answer the original question. Yes I've had one done, just yesterday. My brain is very tired but wanted to say there's no way to prepare for it, it's just lots of brain work. Nothing bad will come of it besides being tired.

Knowledge of your deficits is power.

Amantadine
 

Mark,

The amantadine is supposed to help maybe get some cognitive functioning back after traumatic brain injury. I looked it up and the thing that scares me is the side effects are nausea, passing out, dizziness, seizures etc. exactly the things I am trying to avoid and this is a high dose he is suggesting. I have an MRI tomorrow. I hope it helps. Yeah, the alj says that I could be an electrode cleaner or a dowell inspector, final assembler or a waxer. When the guy mentioned these jobs at my alj hearing my lawyer said what if she was only able to do this at random times or if she had to miss three or more days a month. Then the guy said in that case there would be no job she could do.
It's not that I don't want to work. I honestly have too much disability to work. I don't even drive anymore. I have been so depressed since the denial I can barely make it through the day. Please if you have any advise on what to say, I have a new application appointment at the local social security office on march 4. I am trying to get as much new evidence before then. Thanks for talking with me. Your replys have been helpful to me. I appreciate you.
Brain

I've had 3
 

Good luck and don't stress. I had a tough time making it through but they need to see if you're having trouble. Unfortunately, as inhumane and cruel as it seems, be honest with them. Ask for a break whenever you need one. I needed a couple! The insurance doctors ran mine, and 18 months after the accident, when I was having my 3rd one, I made it all the way through. I was a mess, but I made it. I came to find out that the doctors are paid to give the test, and your performance tells them a lot. Do be honest, but don't try to impress anyone.

It made me feel exhausted and emotional, but only because I knew I wasn't doing as good as before the car accident, and I felt dumb. We need to lighten up on ourselves. Easier to say that now that I'm 4 yrs down the road.

Hang in there and don't give up.

My daughter is having her neuro psych eval today 4 months after her brain injury. Dr mentioned that her brain should be healed by now and this is probably more psychological now? What do you think?

She still has trouble with her vision being doubled. She may need nerve surgery in her eye muscles. Seems strange she would think she is using this to get out of sports when softball has been her life!

For what cognitive issues is she having the NPA? Neuropsychological assessments normally test things like memory, executive functioning, mental flexibility, abstract reasoning and problem solving, that sort of thing. Brain injury can cause all kinds of "psychological" changes including mood disorders like depression, disinhibition and other changes.

Whether she "should" be healed after 4 months merely means she had an "average" injury, for which there is really no such thing. As you will hear on this forum, if you have seen one brain injury you have seen ONE brain injury. "Average" time to heal is irrelevant.

Additional comment, double vision in particular doesn't sound "psychological" to me.

Best to you both.

"Dr mentioned that her brain should be healed by now and this is probably more psychological now? What do you think?" I think you need a second opinion by a different neuro. This neuro is using long outdated understanding of mTBI. The NPA is a start toward a second opinion. I agree with lightrail that vision issues are neurological. A Neuro-Ophthalmologist exam may be in order.

Has anybody suggested Botox into an eye muscle ? It may be worth an inquiry.

When I took it wanted to do as well as possible and scored higher in verbal score than performance score (by 30 pts or more) and neurologist said may have prior brain injury. Not sure if was just born like this and seems to be the case and only possible TBI includes falling onto sidewalk at 11 or 12 yrs old and bumping front part of my head, well my forehead. Have made great grades except needed tutoring in algebra in middle school (learn it differently).

Hi my user name is WEbCTDDbEb (my name is Jeanne).
I had a head injury October 15, 2013. Yes I was tested.
I have done extensive research and from what I have read
These types of examiners tend to believe that concussions/mTBI
go away/heal in 3 months or less. THIS IS NOT TRUE IN MANY CASES.
you are all your daughter has, believe in her, validate how she feels,
and let her know that in time she WILL HEAL. I would like to talk if you want to.
I have no one helping me when I go into the doctors and it is so difficult
for me to express and explain my symptoms. Give your daughter lots of time and
lots of rest. The exhaustion is rough. I am so sorry your daughter has to go through this.
There are so many ever changing symptoms, which change over time, find a support group for your daughter, she can get well if people and doctors understand her and help her.
Let me know if you want to talk it's very hard for me to write it all down. Jeanne

The brain injury is real. The brain is sensitive and has much healing to do.
Your daughter needs help to heal. It is not psychological, there diff innately will be psychological symptoms, including depression, anxiety, confusion, many more however,
these stem from an injury to the brain and are real and need treatment. Be very careful as to which meds to allow. Many meds are not good for mTBI, because the med itself causes
memory problems, etc. I forgot to address your question that's why I wrote again.
Jeanne

Jeanne,

Welcome to NeuroTalk. You have found a good place with lots of knowledgeable people.

How are you doing ? What can we do to help and support you ?