Assessment and treatment services for injured workers with head injuries

Issue: BCMJ, Vol. 49, No. 2, March 2007, page(s) 96-97 WorkSafeBC
Don Graham, MD, CCFP

WorkSafeBC offers a wide range of services to assist injured workers with diagnosed or suspected brain injuries. Here is a brief overview.

Neuropsychological Assessment Services

Neuropsychological Assessment Services offers early assessment, education, and intervention for injured workers and their families, including:

Concussion Screening Clinic for injured workers who have sustained a mild traumatic brain injury and have not returned to work. A neuropsychological interview focuses on early diagnostics, education, intervention/reintegration principles, and reassurance to the injured worker and his or her family. If obvious signs of cognitive difficulties are present, the injured worker may be referred to Cognitive Screen to assess memory, concentration, and information processing.

Comprehensive neuropsychological assessment for injured workers who show signs of cognitive deficits, behavioral, or personality changes. Through clinical interview, medical record review, and psychometric testing, a neuropsychologist determines the extent of the brain injury and its effect on the injured worker’s cognitive, emotional, psychosocial, and personality functions.

Neuropsychological assessment follow-up to provide a clinical opinion to further clarify the status of the injured worker’s ability to function in the community, workplace, and home.

Neuro-occupational therapy assessment that includes 3 days of standardized testing and work simulation for injured workers with mild or moderate brain injury to evaluate return-to-work readiness. It also provides education to the injured worker and his or her family; training for care workers if modifications and adaptations are used; and recommendations for future assessments, care, behavioral modifications, and environmental adaptations.

Case review that brings together an interdisciplinary team to determine the type of assessment and rehabilitation needs.

Interdisciplinary diagnostic assessment that includes a comprehensive medical exam, neuropsychological assessment, and neuro-occupational therapy assessment to determine the injured worker’s ability to return to work and to assist in rehabilitation treatment planning. It also includes feedback and education for the injured worker and his or her family if required.

Follow-up services

Upon completion of treatment provided by the WorkSafeBC Neuropsychological Assessment Services, a care plan is communicated to the community-based attending physician.

Single-discipline services

To help you in the management of these injuries—to assist in identifying an injured worker’s needs related to early return to work, job demands, and home and community responsibilities—the following services are available:

Medical examinations to clarify the brain injury diagnosis.

Medical examination follow-ups in addition to Head Injury Treatment Services.

Functional safety assessments to ensure that injured workers are functionally ready to participate in sustained functional assessment or treatment.

Home-community-based services to provide a home or worksite visit (or both) when injured workers’ symptoms prevent their attendance at a clinic.

Home assessments to assess injured workers’ level of functioning at home, to recommend home modifications and household management, to educate workers and their families, and to provide problem-solving support.

Job site visits to assess injured workers’ physical, cognitive, and psychosocial job demands and work environment.

Facilitated work services to provide graduated return-to-work planning, implementation, monitoring, and support; on-site job coaching; and community reintegration.

Psychological services to assess psychological barriers to recovery and return to work and to develop compensatory strategies.

Speech and language pathology services to identify, assess, evaluate, treat, and educate regarding communication disorders.

Physical therapy services to provide vestibular rehabilitation for injured workers who demonstrate dizziness, vertigo, or balance issues.

Head Injury Assessment Service

An interdisciplinary team consisting of a physician, occupational therapist, physiotherapist, and neuropsychologist provides a comprehensive individualized evaluation of cognitive, physical, interpersonal, and vocational functioning for qualified injured workers.

Head Injury Treatment Service

Once the Head Injury Assessment Service team has evaluated an injured worker, it provides a structured, goal-oriented, individualized day program at a clinic or worksite (or both). The goal is to help the injured worker reintegrate into the worksite and community and, ultimately, to return to a productive life.

Referrals to neuro-otologists for vertigo

Brain-injured workers complaining of dizziness may be referred for evaluation to neuro-otologists Dr Eytan David or Dr Neil Longridge.

Referrals to Head Injury Assessment and Treatment Services

To refer an injured patient to WorkSafeBC’s head injury assessment and treatment services, please contact the medical advisor in your nearest WorkSafeBC office.

—Don Graham, MD, CCFP
WorkSafeBC Chief Medical Officer