Medical Professionals and Rehabilitation Team

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My patient’s family is very reluctant to support the return to work because they believe that their loved one is too ‘disabled’ to do any employment. How do I support my patient and re-assure his family?

Many families struggle to accept that although things are ‘different’ that it doesn’t make things ‘wrong’ or ‘bad’. If you and the other members of your team have assessed the patient and find that he is able to perform the essential functions of a job, a family meeting to discuss their concerns would be helpful. Further information for the family is available thru the Brain Injury Association – http://bianh.org/  or Brain Injury Association Family Helpline – 800-773-8400

My patient’s Vocational Rehabilitation Counselor has placed my patient in an employment situation that the patient does not like or feel comfortable at. I believe that this is creating too much stress for my client and will constrain the patient’s ongoing efforts towards recovery. Would it be inappropriate to discuss this with the VR counselor?

It may be helpful to first discuss your client’s discomfort at this job and assess the situation from your perspective as a medical professional. If your client agrees, you may share the results of your assessment with the counselor and make concrete recommendations for any changes or modifications to your patient’s employment.

My patient’s new employer has requested his most recent medical records, assessments and evaluations; however, I have no paperwork that documents the employer’s right to these records, only a voice message from someone who identified himself as my client. May I request a signed authorization form from the employer, signed by my patient?

Yes, you must under the Health Information Portability and Accountability Act Privacy Rules have a signed form allowing the sharing of this information. Should any health information be shared without the consent of the patient, the medical professional will be in violation of this act and be made liable. This form can be located at: https://www.dhhs.nh.gov/oos/hipaa/publications.htm 

My patient’s Guardianship was given to his family immediately following his brain injury however he now wishes to regain his own Guardianship and control over his finances. My assessment is that he may still need supports to keep organized but is otherwise capable. How can I support him to regain his own guardianship?

It is likely that your client will need your professional opinion and recommendations about their ‘functional limitations’ when his application for guardianship is heard. The patient can obtain information about guardianship at:  https://www.courts.state.nh.us/probate/guardianship.htm 

Brain Injury often affects cognitive abilities, behavior and emotions.  Common complaints from survivors and family members are trouble with remembering things, word finding, concentrating and multi-tasking.  Emotional changes may include depression, frustration, difficulty controlling anger and mood changes.

Often the neuropsychological evaluation can be a starting point for the counselor to work with the individual, the neuropsychologist and others involved in providing supports. Neuropsychological evaluations examines how well the individual’s brain is working when it performs certain functions (for example remembering).

The evaluation can provide information that links the cognitive strengths and weaknesses to the individual’s day-to-day functioning in the type of training or work environment that they are currently working in or are interested in pursuing.  It can also provide information regarding the person’s learning style.

For best results, it is important for the counselor to provide information regarding the individual.  The counselor should also provide specific questions regarding what information they are looking for.