Mild Frontal Lobe Injury and the Compensation System: A Role for Neuropsychology
This case study is based on assessment results and clinical work done with a patient who initially presented with a Chronic Pain syndrome and Major Depressive Disorder after a motor vehicle accident. It became obvious, however, that she had also suffered cognitive impairment, possibly related to mild frontal lobe injury as a consequence of the motor vehicle accident.
In this paper I will focus on my approach to her assessment and rehabilitation in the presence of considerable pressure from the insurer to find her fit for work. I also summarise the most important outcome factors as they relate to her recovery at this point in time.
Overview of presentation:
Section 1 includes a summary of events and consequences surrounding the injuries
Section 2 includes results of detailed Neuropsychology Test Results.
Section 3 outlines the impact of the physical, psychological and cognitive rehabilitation.
Section 4 describes the patient's experiences, in particular the effects of her distress at compensation system requirements. I also describe the effects of the repeated medico legal assessments in which she was labelled as having “abnormal illness behaviours” and she was told that "from psychiatric examination [which did not include neuropsychological investigation] there was no evidence of brain injury or cognitive impairment”.
Section 5 describes the cognitive rehabilitation that has taken place since MRI findings of focal frontal lobe lesions were disclosed in 2001 (following neuropsychological investigation results of executive function impairment).
Section 6 contains a description of the outcome of executive function rehabilitation, her levels of current functioning, and general comments on the impact on the compensation system on treatment of mild brain injury after a motor vehicle accident.