RE: Does PIP cover psych counseling?

[Guest guest]

Jamey Dyson wrote:

Re:

I've been treating a 32 yo male PIP patient

for 2 months with very slight improvement in symptoms of neck, back and

leg pain. He scored a

Oswestry is a subjective symptom reporting tool.....are your objective

findings in line with the subjective aspects of his situation? I'd

suspect a complex interplay between all of what you list....perceptions

of pain, changes in self-worth, self image, actual vs hysteric

disability, family stability and emotional support, etc all play huge

rolls....

I once had a logger patient injured OTJ (years ago as you can see) and

in spite of all the proper work up, consults, referrals, etc etc....Voc

rehab, counseling, etc...and 'not that much' actual physical

findings....understanding the whole case suddenly fell together when I

discovered his boat, truck, ATV and house had a 'insurance makes the

monthly payments AS LONG AS disabled' clause in the purchase

contract....I'm not a skeptic in such matters of chronic pain as it can

have catastrophic effects on people ...and I believe in the 'trust but

verify' method....you may find need to function as a part of a large

team in this man's rehabilitation....

I'm sure you can find lots of opinions on this situation.

J. Pedersen DC

[Guest guest]

If he needs counseling, therapy to get better, his PIP should pay. It sound like he needs some help. With all that loss- related to the accident, it should be an easy case to make- with good documentation by you. Make the referral and the person you refer to will figure out the billing. You might save his life. Ann Goldeen, Astoria

Does PIP cover psych counseling?

I've been treating a 32 yo male PIP patient for 2 months with very slight improvement in symptoms of neck, back and leg pain. He scored a 94% on Modified Oswestry recently... the guy is very messed up. MVC's in Nov 1998, May 2005 and Dec 2005. He was working construction until the May 2005 MVC and has been unable to return to work since due to pain. He began losing weight and his MD put him on medical marijuana to improve his appetite. He is also on Methidone. He lost his job, his housing, his children (CDS placed them with his mother). He is the epitomy of a broken man both physically and emotionally... a very depressed individual.

I'd like to know if PIP covers psychological counseling. I am wondering how much of his physical pain is being caused by all the crap going on in his life. I'd like to get this guy the help he needs. Does anyone have any experience with cases similar to this?

Thanks,

Jamey Dyson

Salem

[Guest guest]

Hi Jamey,

I guess we each decide at some point in life, if we're lucky enough to

live so long, whether we're going to act for life, or not. 32 is

young; life has lots of chapters. So many people don't make it; but of

those that do, they've chosen life. When that time comes, there are

social services available. OutsideIn <http://www.outsidein.org/> is a

connection in Portland. I hope that if it comes to wise choices, you

can help him. It sounds as if you can. More and more now, it seems,

we are forced to rely on our inner resources and I, for one, think this

is a good thing. We're wise in our experience of life, and to another

a moment can make a difference sometimes. Best of luck, doc.

Sears

NW Portland

On Feb 8, 2006, at 7:11 PM, Jamey Dyson wrote:

> I've been treating a 32 yo male PIP patient for 2 months with very

> slight improvement in symptoms of neck, back and leg pain.  He scored

> a 94% on Modified Oswestry recently... the guy is very messed up. 

> MVC's in Nov 1998, May 2005 and Dec 2005.  He was working construction

> until the May 2005 MVC and has been unable to return to work since due

> to pain.  He began losing weight and his MD put him on medical

> marijuana to improve his appetite.  He is also on Methidone.  He lost

> his job, his housing, his children (CDS placed them with his mother). 

> He is the epitomy of a broken man both physically and emotionally... a

> very depressed individual.  

>

> I'd like to know if PIP covers psychological counseling.  I am

> wondering how much of his physical pain is being caused by all the

> crap going on in his life.  I'd like to get this guy the help he

> needs.  Does anyone have any experience with cases similar to this? 

>

> Thanks,

>

> Jamey Dyson

>

> Salem      

>

>

> OregonDCs rules:

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> forward, or otherwise distribute correspondence written by another

> member without his or her consent, unless all personal identifiers

> have been removed.

>

>

>

>

[Guest guest]

Jamey,

You

might try Darien Fenn, PhD - Psychologist

from OHSU who notes that neurotransmitter changes take place in the brain as a

result of PTSD and / or Depression from a collision, thereby resulting in

chemical changes in the brain, cognitive problems, and occasionally physical

changes in the brain. His number is (503) 685-9357. But I think he is based out

of Woodburn.

You can also

try Sharon Labs, PhD. She is in downtown Portland.

Her number is (503) 224-3393. 1400

SW 5th Ave, Suite 550, Portland, OR. Whatever you do, I would have a chat

with the provider first, because this is a very special case and you want to

know that the person you are referring to is ready, willing, and able to take

the case…I’m pretty sure that if the case is still open, PIP will

pay…

Matt Terreri,

DC

From:

[mailto: ] On Behalf

Of Jamey Dyson

Sent: Wednesday, February 08, 2006

7:11 PM

Subject: Does PIP

cover psych counseling?

I've

been treating a 32 yo male PIP patient for 2 months with very slight

improvement in symptoms of neck, back and leg pain. He scored a 94% on

Modified Oswestry recently... the guy is very messed up. MVC's in Nov

1998, May 2005 and Dec 2005. He was working construction until the May

2005 MVC and has been unable to return to work since due to

pain. He began losing weight and his MD put him on medical

marijuana to improve his appetite. He is also on Methidone. He lost

his job, his housing, his children (CDS placed them with his

mother). He is the epitomy of a broken man both physically

and emotionally... a very depressed individual.

I'd

like to know if PIP covers psychological counseling. I am

wondering how much of his physical pain is being caused by all the crap going

on in his life. I'd like to get this guy the help he

needs. Does anyone have any experience with cases similar to this?

Thanks,

Jamey

Dyson

Salem

[Guest guest]

Jamey,

There appears to be some evidence that the methadone itself may be

causative in part for patient's depression. Something positive has to

replace the abandoned narcotic and it's very complex matrix within the

patient. That something has to be found by the patient if he is to

survive. Taking personal responsibility for his illness is very

important. Without that, physical remedies are at best palliative,

imho.

Sears

NW Portland

Methadone And Morphine in Depression

There has been much interest in recent years in the possible role of

endogenous opioid peptides (endorphins) in depression (1). The high

concentrates of opioid receptors and endorphins in limbic and

hypothalamic regions, and their interaction with noradrenergic and

dopaminergic systems, suggests involvement of endorphin systems in

depression, as do certain clinical observations. These include

anecdotal reports from the prepsychotropic era of the efficacy of

opiates in depression, the appearance in some detoxified opiate addicts

of depression responsive to opiates and antidepressants (2), and

reports of improvement in some depressed patients following

beta-endorphin (3). These observations, as well as the euphoric,

analgesic, and calming effect of opiates, suggest that decreased

functional activity in endorphin systems may be involved in the

pathophysiology of depression.

http://opioids.com/antidepressant/index.html

On Feb 8, 2006, at 7:11 PM, Jamey Dyson wrote:

> I've been treating a 32 yo male PIP patient for 2 months with very

> slight improvement in symptoms of neck, back and leg pain.  He scored

> a 94% on Modified Oswestry recently... the guy is very messed up. 

> MVC's in Nov 1998, May 2005 and Dec 2005.  He was working construction

> until the May 2005 MVC and has been unable to return to work since due

> to pain.  He began losing weight and his MD put him on medical

> marijuana to improve his appetite.  He is also on Methidone.  He lost

> his job, his housing, his children (CDS placed them with his mother). 

> He is the epitomy of a broken man both physically and emotionally... a

> very depressed individual.  

>

> I'd like to know if PIP covers psychological counseling.  I am

> wondering how much of his physical pain is being caused by all the

> crap going on in his life.  I'd like to get this guy the help he

> needs.  Does anyone have any experience with cases similar to this? 

>

> Thanks,

>

> Jamey Dyson

>

> Salem      

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is

> to foster communication and collegiality. No personal attacks on

> listserve members will be tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere.

> However, it is against the rules of the listserve to copy, print,

> forward, or otherwise distribute correspondence written by another

> member without his or her consent, unless all personal identifiers

> have been removed.

>

>

>

>

[Guest guest]

PIP is required to pay all reasonable and necessary medical expenses incurred within one year of a crash that are related to injuries sustained in the crash. Theoretically, counseling is covered. However, depending on the carrier and the length and cost of the counseling, you should anticipate the PIP carrier attempting to argue if at all possible that the counseling is not causally related to the crash, but to other factors. They may very well attempt to "apportion" the cost among those various factors and separate events. Documentation by the referring physician and on the part of the counselor, psychologist, or psychiatrist will be critical. Best, G. , Gatti et. al.

From: [mailto: ] On Behalf Of Jamey DysonSent: Wednesday, February 08, 2006 7:11 PM Subject: Does PIP cover psych counseling?

I've been treating a 32 yo male PIP patient for 2 months with very slight improvement in symptoms of neck, back and leg pain. He scored a 94% on Modified Oswestry recently... the guy is very messed up. MVC's in Nov 1998, May 2005 and Dec 2005. He was working construction until the May 2005 MVC and has been unable to return to work since due to pain. He began losing weight and his MD put him on medical marijuana to improve his appetite. He is also on Methidone. He lost his job, his housing, his children (CDS placed them with his mother). He is the epitomy of a broken man both physically and emotionally... a very depressed individual.

I'd like to know if PIP covers psychological counseling. I am wondering how much of his physical pain is being caused by all the crap going on in his life. I'd like to get this guy the help he needs. Does anyone have any experience with cases similar to this?

Thanks,

Jamey Dyson

Salem

[Guest guest]

Thanks to all who responded to my question! I will look into sending him for an evaluation at least. Along with the depression, I believe he may have developed afferent nerve supersensitivity from not recieving the proper treatment for his structural injuries in the May 2005 MVC. His MD just drugged him, not even physical therapy prescribed, let alone chiropractic! He is showing improved posture with chiro care (ABC technique) so far, but all other objective findings (C & L ROM, palp, mm spasm, mm strength testing) are still very bad. We'll see how it goes...

Thanks again,

Jamey

Does PIP cover psych counseling?

I've been treating a 32 yo male PIP patient for 2 months with very slight improvement in symptoms of neck, back and leg pain. He scored a 94% on Modified Oswestry recently... the guy is very messed up. MVC's in Nov 1998, May 2005 and Dec 2005. He was working construction until the May 2005 MVC and has been unable to return to work since due to pain. He began losing weight and his MD put him on medical marijuana to improve his appetite. He is also on Methidone. He lost his job, his housing, his children (CDS placed them with his mother). He is the epitomy of a broken man both physically and emotionally... a very depressed individual.

I'd like to know if PIP covers psychological counseling. I am wondering how much of his physical pain is being caused by all the crap going on in his life. I'd like to get this guy the help he needs. Does anyone have any experience with cases similar to this?

Thanks,

Jamey Dyson

Salem