It really “bugs me” when insurance company claim adjusters and their lawyers downgrade my client's mental health after my client has sustained not only a serious injury but has submitted to lengthy and painful surgery and is in or needs pain management treatment.
When the orthopedic surgeon or pain management doctor makes a referral to a psychologist or a psychiatrist the first thing the insurance folks do is schedule my client for an insurance company psychologist or psychiatrist to stall the treatment or to attempt to deny the referral all together. In about 30% of these situations, the insurance company doctor agrees that my client needs the added treatment! But in 70% of the cases, the insurance psychologist/psychiatrist tries to argue that my client's treatment is pre-existing, that my client's family issues are of long standing and that is why they need the treatment or that my client had childhood abuse issues, etc., etc., etc.
It is becoming more obvious now that chronic pain leads to serious depression. See my case history of a recent Social Security Judge addressing this issue in a great decision that just came down in late 2019.
In job injury cases, the workers' compensation insurance companies fight the recommendation for spine surgery more often than not. They can employ delay tactics of all kinds (see my FAQ on this subject titled “When does my employer or the insurance company lose the right to control my medical care?”. The delay adds to the chronic pain and the increasing depression. If I gently suggest my client see a psychologist during the delay, my client has no money to afford such treatment. And, psychologists do not want to wait until the litigation “dust” settles for their payment. This situation is quite common and leaves my client in a very bad predicament. Quickly, the legal/medical situation can spiral out of control. My job is to push the “legal train forward” to obtain surgery. By the time the train pulls up to the station (surgical intervention) my client is a mess psychologically. I will address other issues that are closely related to this topic in another blog soon along with case examples of what happens after treatment has finally been won through the court system.