Wood v. State, 122818 AKWC, 18-0131
|Docket Nº:||AWCB Decision 18-0131|
|Case Date:||December 28, 2018|
The results of neurological testing are positive, but interpretation of the results is complicated by much less than expected, in fact less than chance, level of performance on performance validity testing measures. As a consequence, I am unable to confidently interpret the true significance of these results in terms of their representation of level of underlying cognitive dysfunction and even more so to the degree to which they represent underlying brain injury. They do represent that Mrs. Wood is having difficulties with functioning at this time. She essentially shows poor and impaired performances in the vast majority of measures given as part of this evaluation, with her performances varying from at, or even in some cases, above the average range to in other cases being clearly, even markedly, impaired. This includes her performance of measured intelligence which are markedly below expectation and are at the 1st percentile.
Also elevated are scores on measures of both anxiety and depression which are significantly elevated in both instances. In fact, her score in both measures are at or near the ceiling level including endorsement of suicidal ideation, though she denies any specific plan or intent. She also performs markedly poorly and well within the impaired range on measures of both motor speed and motor functioning bilaterally in both hands.
Thus in summary, these results, while not useful for determining the actual degree and nature and pattern of neurocognitive impairment, do represent a means to degree to which Mrs. Wood feels she is having difficulty and essentially can be considered almost a 'cry for help.' The fact that her performance is not only poor, but well below the chance level, on performance validity testing suggests some degree of an attempt to present to the examiner in such a way that she is trying to show how much difficulty she is having and the degree to which she is impaired.
She likely can benefit from the brain rehabilitation services including among other things cognitive rehabilitation, but these are really secondary to the need to address emotional, psychological factors and perhaps, most importantly, her own perception of her current situation. Also, related to this are the circumstances surrounding her injury and her job history in which she was involved in regular levels of stress on the job as a corrections officer.(Mayo Clinic Neuropsychological Assessment, Dr. Bergquist, August 16, 2017.) 3) On September 20, 2017, Aryeh Levenson, M.D., sent an email to claims administrator Penser because he became aware Employer had scheduled a neuropsychological evaluation with Paul Craig, Ph.D. Dr. Levenson stated to maintain validity of neuropsychological testing the tests cannot be repeated within the same year; otherwise, recognition of the test invalidates the test scoring. It was unclear to Dr. Levenson what further information a retest would provide when the Mayo Clinic, "one of the nation's foremost institutions with expertise in head injuries" performed the initial test. Finally, Dr. Levenson asserted, "Ms. Wood's brain injury and juxtaposed PTSD have left sufficiently limited cognitive and emotional reserve that such frequent evaluations and reevaluation severely impact her emotional, cognitive, and psychiatric well-being." Dr. Levenson stated Employee's extensive evaluation history and treatment records document her strengths, limitations, and disabilities and further evaluations were unnecessary. Dr. Levenson concluded his email to Penser stating, "I do not feel comfortable discussing the details of her case or specific psychiatric, cognitive, and functional limitations further via email. However, I would like to discuss this case review so to avoid requiring additional unnecessary evaluations that inadvertently lead to further compromise of her mental and cognitive states." (Email from Dr. Levenson to Penser, September 20, 2017, SFME Number 2551.) 4) On November 29, 2017, Adam Grove, CBIS, ND, wrote to Assistant District Attorney (ADA) Lawrence Monsma, prosecutor from the Alaska Department of Law's Criminal Division responsible for prosecuting the inmate who broke Employee's nose. Dr. Grove was concerned the litigation of charges against Employee's assailant was causing Employee's...
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