WCB, the Neuro Psych, Prisms and Me
 

Saw the neuro psych Feb 14th.

He said he would send me a copy of the report, in two weeks time.

He didn't send me a copy, nor my doctor. Just straight to WCB.

During the test day I seriously failed several tests with poor memory, had acute stuttering and acute head pain.

His initial verbal comments were that I had significant short term memory deficits and very slowed processing. He dismissed the pronounced stutter and said it was "strange" that it fluctuates in severity. (We all know PCS symptoms come and go but this guy had no experience with PCS. He simply was a paid talking head found by WCB) I find it interesting how his verbal comments vary from his report...

Yesterday WCB called and went over some of the notes quickly with me. They "cannot release" the report to me, they say. I have to call the NP myself to request a copy (which I did, left him a terse voicemail) WCB did say they will send a copy to my doctor.(after grilling me about why I changed from my initial doctor)

WCB was so pleased that the NP report is "completely positive". Lol of course it is. It was paid for, to BE positive. I'm injured, not dumb. And no, that's not conspiracy theory or depression talking. Corruption is the reality of WCB and if you think differently, bless your heart. The NP guy didn't even include my doctor! And yes he had all the addresses, he asked for them on test day and I obliged.

Summary that my case worker told me verbally today: although there are some slight delays with recovery, patient has history of depression and migraines. This could be the cause or recurrent issues at hand. Full recovery is expected soon and patient can then return to full time employment when symptom free from the injury.

Worker said, see? Your medical history caused these recovery delays not the injury itself.

It was just like she scratched a winning lotto ticket. She was SO excited.

I could almost hear the palms rubbing together as they will soon write me off the expense column.

In other news thanks to Mokey I recently found a place that would see me to test for convergence insufficiency and I tested positive. I get my prism glasses in about 10 days. Hope they help, since I'll be sent back to work soon apparently.

However I'm thankful I had four months off, my post is simply to comment that NP's are definitely NOT experts (mine was not well read on PCS at all and proved he could be bought for a price) and WCB is a corrupt, sad excuse for compensation.

But, it is what it is. I will return to work after seeing a "multi-disciplinary panel" hired by WCB to determine when, and how fast, and if there is anything that can be done for my ongoing symptoms. (I can predict that one, a big fat no, they will pin it on depression and migraine and wave goodbye to me)

Like I said, I'm grateful I've had this long, just wanted to share never assume any doctor has your best interests at heart. Mokey sent me a link to a vision therapy practitioner in my area that was more helpful than ANY of the people I've seen so far.

Therefore joining NeuroTalk has been more helpful in my struggle than anywhere else. Consider yourselves hugged. Lol :grouphug:

And please, continue to help newbies, we are lost, and sometimes abandoned without you.

Stay positive!! Get a copy of the report (your right!) and see what it says. I think the doctors WC uses are terrible in most cases. They act for WC and not the patient.
Hang in there. Great news about the prisms..once you get used to them (it took me a few weeks!!!) hopefullythey will help.
Keep on healing!

When you get a copy of your report, there may be evidence it was improperly interpreted. Be sure to ask for the scales and scores. Did you do the trail making tests where you have to trace from number to number and number to letter to number to letter ? This test is often misinterpreted.

Getting the times for Trail Test A and Trail test B will be valuable. Did you take a long question test called MMPI-II ? (Minnesota Multiphasic Personality Inventory version II) The scales in it can also be misinterpreted. It can indicate depression when organic brain injury would be the correct diagnosis.

Write down your recollection of everything he said before you get the report. You don't want your memory polluted with information or anger from reading his report.

Don't lose heart. Your case is not over yet.

My best to you.

Hi MsRRio,

I was wondering what happened after that nightmare testing. I was hoping you would get some recommendations on how to proceed but having gone to doctors paid for by Insurance Companies I wasn't too convinced you'd get any help. I was hoping psychologists might be different.

My suggestion would be to find your own neuro-psychologist that understands concussions and have her read the report and either provide her own findings or explain it to you (if needed) with some possible treatment plans.

From what you said above, workers comp hasn't actually said you have to go back to work right? I'm still reading it as pretty positive that you can "return to full time employment when symptom free from the injury" That doesn't mean now! Also he is saying that your recovery is slightly delayed... meaning you have NOT recovered yet.

We are very complex beings and everything works together so thinking that a history of migraines and depression isn't going to effect concussion recovery would be wrong. Just like my fibromyalgia and prior history of 4 whiplashes is definitely affecting my recovery but is not the reason I am this way to begin with. The concussion is why everything is flared up.

Without the concussion you would not be having migraines and depression/emotional issues but without your history of migraines and depression perhaps you might have been one of the lucky ones better before one month. It is clear that a history of psychological issues is a warning of possible delayed recovery.

I know that it sounds like she's diminishing what you're going through and the stress of constantly worrying about either being forced back to work or cut off WC must be also contributing to how bad you're feeling. WC people and insurance people will NEVER say anything to make it sound like they agree you are really sick. I was off with cancer and they were all rosy and I was going back to work anytime. It's their job never to talk about things in the negative and get you back as soon as possible.

My insurance company is starting an independent "get her back to work" strategy so I know how scary it is to think about having to go back before your ready but mine hasn't actually said "you're going back NOW" and neither has yours so try to stay positive and keep healing.

The good news is that you are getting to a point where hopefully you'll start to see some large steps forward! Those prism glasses could be a huge step in the right direction and getting a little exercise to keep the oxygen going to your brain and you'll be seeing some results soon!

I hope today is a better day for you. <hug>

CC

I've been reading your posts for awhile, and I am really, trully sorry for your plight.

It started me researching:

- this is what Saskatchewan says their Work Comp is.

- this is what others say the whole system is.

I have been reading through alot of it, and other areas. I get the impress that "the others" are closer to what it is?

Actually, here in the USA, more and more of the rights the employees had under the older federal guidelines have begun to swing more and more on State levels with the Federal "blessings", or at least 'non-intervention/protection' to the employee; and more and more the employee has had to 'prove' more about the injured status.

As others have said, hang in there - if at all possible, get an attorney, fight as much as possible, get your own providers, do not accept their decisions if you know you are right and they (WCB examiners) are not.

Best Wishes.

I can hear the panic in your voice, and I am so sorry that there seems to be some "over positivistic" interpretation of your testing by WCB.

Although expensive, do get a neuro-pyschologist who is your advocate. You need someone to help you, not WCB!

In addition to getting the raw data of your neuropysch testing, if you see a neuro-opthalmalogist, they can also test your visual processing speed.

The prism glasses sometimes helps, but the disorientation and slow processing may need specific visual therapy.

I cannot imagine how with all your struggles in what setting and at what pace WCB thinks you can work.

I often think that housework is a good indicator of where you are in your recovery. If you can master grocery shopping, cooking and some chores, then it might be time to go onto the next challenge of community work/volunteer work and then actual employment.

If not, you need to rest, heal and pace yourself.

Deep breaths and find someone to help temper WCB's expectations!

DRs
 

Sorry to hear you got a rotten egg for a doctor.. I have had one and know how awful a experience it can be. You have gotten some good advice about the report, the scores on it, and possible following up with a second opinion. This is only one step in the process don't read too much into it. The NP will have a lot of weight with WCB. Get the report and read it thru, if you can afford a second opinion then you can counter his opinion. One good thing you should be able to determine what his credentials are. If you do seek a second opinion pick some one with better credentials. If it comes down to a legal fight the doctor with the best credentials is given the most weight in a court or commission.

Sorry
 

Totally agree with what Concussion had to say. I worked for insurance companies and they are the biggest scam going along with disability from our government. You need to get a lawyer. Don't accept their decision. You can do appeals but in your condition will need help.
I would get a private neuropsychological evaluation as I have been told this is the "silver bullet" to getting on disability and with WCF.
Talk with the people on the workers comp forum, they should be able to tell you how to appeal and not get tricked into accepting their decision.
I am sorry. I felt the same way about my doctor appointment yesterday. Do you know what he actually said about the 3mm space of brain getting no signals that showed on my MRI? He said "this is just like having a mole on your skin". WTF?
I am sure they would not bother mentioning it as abnormal if that was the case. I have got to find a different doctor. I have been being treated by a moron.
Hang in there. I know you can hold your own with anyone. You are one smart lady who does not take any crap.
Brain

MsRrio,
I forget the exact circumstances of your injury but since it happened at work have you considered bringing a lawsuit against your employer? I mean, if the insurance they have is insufficient then it would seem like you could sue the employer.
I don't know just a thought.
Stand your ground. Don't back down.
Brain

Thanks
 

For letting me sorta vent, again. I didn't even think my initial post was negative, I just have a dry way of saying things, sometimes I'm even amused at how absurd life is.

CC and Mokey, my Cdn friends, you have such a way of seeing the glass half full. Thanks!

Berkeley and rmschaver thanks for your encouragement and compassion.

Concussion your second link is exactly right. We have a corrupt system. Thanks for the links! And to care enough to look things up is very cool in my books. :)

Brain patch thanks for the belief in me and reminding me that I'm smart, and to be strong. I cannot sue because in Canada, workers forfeit the right to sue their employer by collecting WCB benefits.

Mark the number/letter test you mentioned was not one of the tests I took. I didn't even think to check the names of the personality tests. I was so not "with it" that day. Word lists, drawings, blocks, and fill in the dot questionnaires were the biggest parts of the day. I will write down his comments before I see the report myself. I doubt he will even send my copy. To me that speaks volumes.

I know my case isn't over. Thank you everyone for reminding me. You're all such supportive people. Thanks for trying to boost my outlook.

I do know that I've been told by doctors (verbally) that whatever WCB wants, they get. Long term injuries are their worst nightmare so they insist on the reports they desire or refuse to pay the doctor. My psychiatrist even ranted about them and refuses to take WCB cases.

Anyway I'm not out to change the world. I just need a little more time to heal before returning to work.

I'm nowhere near ready in my opinion, because I am unable to perform basic hygiene tasks let alone much housework without intense head pain. I haven't had one day without the head and neck pain and intense brain pressure yet. I am unable to turn my head properly to drive. Plus I cannot process decisions well enough to drive.

I have such memory issues with basic life skills that I cannot fathom how I'd be useful in the workplace right now. Today I tried to put makeup on because a friend was coming over, and I was stumped as to what to do with lip gloss. I opened it, looked at the wand, and raised it to my eyes like mascara. Then I could smell it and thought oh that's for LIPS! Funny story that I told her when she arrived, but a sad commentary on how much further I need to go.

The stutter has improved somewhat lately. I don't know if that's because of the Elavil I'm taking, the increased sleep, or just time.

In brain injury timelines I'm early in recovery but to WCB it's way past time to get to work.

When I get my glasses I'll report back about progress.

If I do return to work before I'm ready I'm reminded of Marks early words to me. Basically, I will crash at work if I overload my brain and a few possible outcomes may happen. Either I'll get sent back onto benefits or LTD or I'll get fired. I'll still be alive. The world won't end.

Prisms and NP report
 

Got prism glasses today and returned home to find the NP report in my mailbox.

Both have given me a raging headache.

Suffice to say the NP report is extremely biased. WCB got what they paid for.

It's far too long for me to go into detail but the short version is that I have some memory and processing deficits that he says could possibly be correlated to PCS or could possibly be my usual skill level. Every area where there were noted issues, he stated it was 'possibly' there all along.

As for personality, he suspects that my needy, clingy nature and anxiety and depression could be playing a large role in my delayed recovery. He goes on for many paragraphs on this one. Then ends with this afterthought: some patients do take longer than the norm to recover from concussions.

I will be seeing my GP soon to go over it briefly with me. His understanding will be even more limited than mine because I've had time to go over it.

Although some say the battle isn't over, I simply have to let go. I'm not in control here. I've had my cry and WCB will force me back to work, so be it.

I hope my story helps at least one person to keep their hopes in check. WCB is no one's friend, it is an ugly, corrupt and evil system in which money dictates all. Most of you probably knew this. I thought the NP was genuine when I met him. I had no reason to believe he would contradict himself in the report.

First! It took me a month or so to get used to the prisms. Wear them all the time otherwise your brain will be working too hard to figure out what is going on.
The report and the NP: he works for WC so don't worry. We all know that, and he is probably limitee in his understanding of brain injury. Using the term 'post concussion' might indicate he doesn't quite get it. Science and research is in your favour. Concentrate on your healing for now. If y are required to return to work, the employer still must accommodate you and your needs, even though they are deemed to be 'psychological' :)
Hang in there and focus on healing.

MsRriO,

If they push you back to work, ask the people you work with to observe how you work. They will likely notice differences in your skills and functions. I doubt your low scores are pre-existing. A proper NPA will chart your intelligence and functions. If you want, post the details in a PM to me. Left click on my screen name and select Private Message.

Did the report include the scores and scales ? You should be able to get them if he did not include them. I can help you understand them.

My best to you.

Wow, that must have been a hard read. I can tell how much it upset you. Even though people talk about how important the neuropsych testing is and how helpful it can be they always mention that they're hard to read because some things are so hard to hear or accept. And in this case it's also full of bull! It's obvious how a test that you pay for would be different from one that someone else pays for.

I am not by nature an optimistic person and if this was my report I'm sure I'd be reading it the same way you are and please understand that I'm not trying to undermine how upset you are, and rightfully so, but I can't help saying..........

He is still saying that you aren't recovered! It is a known fact that depression and anxiety, whether caused by the concussion or preexisting, are factors that can delay recovery. He is not saying that you do not have a concussion and that you just have depression and anxiety. He is not saying that you are lying or exaggerating. He is not saying that you are fully recovered. He did say that some patients take longer to recover! YOU are taking longer to recover.

Don't give up yet. If you had your own NP comment on your symptoms and help you get a plan for recovery and return to work it would show WCB that you are trying and that you have a strategy/plan on how to move forward. He or she could use this report to your advantage. As for the rest of that crap... don't even read it. I don't understand why they put some of that stuff.

I'm sorry the glasses are bothering you but hopefully they are a solution that will help you moving forward! It's nice to have something other then time to try to help you. Have you been meditating? That would help during such a stressful time.

Big hug to you and please don't give up yet!

CC

Thanks everyone. CC: Yes been meditating every day for a week and it is helping. I found a guided mediation on YouTube that I listen to on my iPad.

Mokey I started wearing the prism glasses first thing today and I'm already doing better than yesterday! It's a bit trippy at first. And my eyes look huge in these glasses!!

CC: Actually the report does suggest I'm lying and getting some benefit from taking a long time to recover. It's really unfortunate to be labelled this way and it is likely to bias my own doctor as well. It already biased my own husband. But I just have to accept, what's done is done, I was honest probably to a flaw.

The personality traits that came out in testing would be the person I have become, who is injured, afraid, and easily upset. That's the truth, but it's not who I was before the fall. He used these traits to build a case that I am needy, clingy, withdrawn from life and using this injury for my benefit.

As for intelligence measures, I'm above average (not exactly in my favour, because now I look manipulative) and he does state some areas where I'm in lower percentiles such as memory, processing, Tower of London problem solving I took 74% more steps than my peers to solve the puzzle. That kind of thing.

Then after each observation that is poor he says, could possibly have always been this way. Only once does he admit, one would expect better results from someone in her field. At least that's something. He did not compare my results with collateral information (testimony from workplace, family) even though WCB asked for that.

Overall his job was to discredit me and he did very well. Mark I'll pm you some things. It is just huge though... So it may take me a few drafts. Thank you for offering to help!

I am just going to enjoy what time I have left to heal. I do believe that the past five weeks since beginning Elavil have helped a lot, likely due to better sleep. I've already seen improvements in light and noise sensitivity, and I feel like I'm getting a bit sharper. The pain still gets really bad when limits are pushed, but that just may be my new way of life. Thanks for being so supportive, I "needed" that. (Lol what can ya do but laugh at this point?)

Hello MsRrio,

I'm truly sorry to hear that your husband has believed that stupid report. He knows the person you were and, out of anyone, should know that you don't want to be like this and how much you're hurting. I find my husband doesn't quite get it either and my parents are the ones that really notice the difference. To be fair, my mother drives me to all my appointments so she spends much more time with me in bad situations.

I have a few questions about your prism glasses if you don't mind. First of all, I hope they are even better today for you then yesterday! What kind of eye symptoms were you having or was it just a suspicion that there were eye issues because of the headaches? What type of doctor did you go to? I'm having a hard time in Ontario finding the right doctor that will actually see me this year ;) I thought I had found one, thanks to Mokey, but after a phone call he didn't seem right.

How long do you have to wear them for? Are they a permanent addition to your glasses? Were they expensive or just an add on to existing glasses? Sorry for all the questions! I am so torn about what to do with this eye issue, whether to spend almost $1000 to see someone, or just wait for my ophthalmologist appt in May.

I hope you are feeling better today. Take care,

CC

My neuroopthamologistwaited until I was one year post injury to give me prisms. Before that I did vision therapy. That is something everyone can benefit from even without a brain injury. There are some cool free apps for Ipad that have vision therapy bits....maybe doing a wee bit of that even without a diagnosis would n good for strenthening the brain connections.
I will try to find time to post those links.

Ms. Rrio,
I am so sorry that you are having to go through this harsh reality. Which is ********. Those of us who have been hurt longer have already been pushed out of our jobs. Either pushed to quit or fired. We know about the paid off doctors from WCF and disability. We have had to read the really mean and untrue "reports" from these doctors. We have had family members that also believe these things. We know exactly how you feel and what you are going through. So sorry. I always thought people would be decent human beings in these situations but they are not. I have come to the conclusion that it does not matter what anyone else thinks of you but you and you know the truth about yourself.
Just keep trying to recover as much as you can. If you have to go back to work and find you can't then try and make them fire you then you can at least get workers comp. I forget your not in U.S so that may be wrong. Possibly you could go back and have a seizure or something at work. Just think of it as more evidence in your favor. I know you are still too hurt to return to work. If you have to then try and they will see what happens. You are not alone. I support you as do all of us here.
Brain :hug:

Thanks. I agree. He should know better but I think sometimes he's just in way over his head in general. My emotional response to the report overwhelmed him I think. Doubt is an insidious beast that attacks when we're overwhelmed, and I am choosing to forgive his doubt in me, in the hopes it will fade. In time I hope he remembers I'm a strong woman, but right now he doesn't really see that. Fair enough.


Glasses are becoming more comfy by the day. I barely have any prism in them. I've got what they call a "one base in" prism.

Today I've had some ice pick headaches. Not fun. But I'll survive.

I didn't know for sure if I'd test positive for convergence insufficiency but I went because of a hunch. Things didn't look right and scrolling images killed my head, made me dizzy, I had watery itchy eyes every night and blurry vision in general.

Mokey nudged me with some information that there was a doctor right within my small city who had the proper credentials. I had to see the regular optometrist first who said I tested fine, but then he asked the vision therapist to see me (she is also an optometrist). She did other tests and I definitely could tell my eyes were not working as a team. She said I had convergence insufficiency.

She has the same credentials as others in the office plus she's got some vision therapy training. Sooooo.... She also happens to have a sister in Calgary who is a physical therapist recently studying concussions.... So they chatted about my case. Turns out she will also offer me vision therapy (as well as the glasses) but it's pricey. Not sure how I'm going to do it.

How long do I wear the prism glasses for? Not sure. Likely a long time. She will examine me again in eight weeks to evaluate.

I wear them full time. Morning til night.

The lens looks normal to the naked eye. It just pulls my eyes a bit and makes my eyes seem bigger, people tell me.

They were the price of regular glasses, so about $400 with frames of my choice.

Thank you for such kind words. You are awesome. :)

It means the world to me to be validated like that. I think that's what we all miss the most maybe... Being treated as valuable.

:hug: to you for taking the time to brighten my day and lift my spirit.

Being treated as value able/ HELP S.O.S
 

Ms. Rrio,
You are welcome. I think you are right that perhaps what we miss most is feeling value able. It is confusing to me that all your life you have shown yourself to be a hard worker, smart, independent and always taking care of everything for others and all of a sudden it is like they forget that and think you have just become a lazy slacker who is exaggerating the problem for sympathy or something. It makes you feel so bad and mad at them. At least it does me. It's like why would you discount my disability when I have never been a complainer or lazy or anything of the sort. Now that I have lost a lot of functioning and such small things are major victories, I am treated like a leper and like I have always been one. I feel discounted. I would stand by anyone of my family members through whatever they said was happening and I have. Why do I not get and deserve the same? My little brother is coming for dinner today and I just don't know how to deal with him. He has outright accused me of being a liar. I really had a hard time not strangling him. He has been to medical school and has some knowledge of these things yet he is the one who is the meanest, most hurtful person I have to deal with. What should I do? Just go in and go to bed when he comes over? My anger flares so badly when he is around now then it skyrockets my pain level. I can't have that. I should not have to deal with that. I mean I have a letter from the neurologist an MRI and my doctor who have diagnosed me. I will have the report from the neuropsychological testing at the end of the month. Will this be enough for him? Why do I feel like I have to prove to him that I am injured? Please help me you guys. I am freaking out about having him come over today. Tell me what to do.
Brain

Rio~I have not posted much on this thread because I cannot relate to the vision problems so I do not have much input.I read the threads so I can try to relate.I am happy to see you got Prisms and I wish you a smoother ride now.:wink::hug:

Brain~I have been fighting to get a diagnosis as well.Not as long as you but I can relate. We do feel that family would be the most supportive, but we are not always correct. This can be very disappointing and to have to fight with family about injury is not any help. We are fighting with MDs,Disability,and ourselves.

Has anyone told your brother about the findings on the MRI?I would have your mother tell him right when he walks in the door. With you not around and have her advocate for you and tell him to cool off on you because you are sick. And you cannot tolerate ANY EXTRA STRESS. I would then scope him out after your mother advocates for you and if he is acting like a prick I would (if you can)go watch a comedy movie :Dor something in your room constructive:wink: not just go to sleep.Tell your mother that you will try but if he is not acting right you will not be able to join dinner. You do not have to prove nothing to family esp If they attended Med school! Just distant yourself if he is rude and who knows he might walk in apologizing for everything....but If not go about BRAIN to keep her head up!Whatever you do...DO NOT GO TO SLEEP MAD, ANGRY, OR DEPRESSED.:circlelove::hug: