- Pain Impact Assessment (PIA) **NEW**
- Case Management/Mitigation **NEW**
- Active Rehabilitation
- Work Conditioning/ Work Hardening
- Ergonomic Assessment and Job-site Evaluation
Pain Impact Assessment (PIA)
What is a Pain Impact Assessment (PIA)?
The PIA is an innovative assessment that has been developed and designed for those clients who are struggling with pain and/or pain management AND it is having an impact on their functional ability. Its creation and concept is born out of peer reviewed research and while the issues may be well documented, they are often not addressed properly and can play an important role when present in your forensic file. As you probably have experienced, Pain and Pain Management in relation to function and functional assessment is either underrepresented, misrepresented, or ignored to the detriment of the client. The PIA can address these issues.
Who would benefit from this assessment?
This assessment is suitable for all clients whose functional ability and/or tolerance to activity is limited, and these limitations do not appear to correspond to the degree of physical injuries the client possesses. Simply put, the client’s demonstrated functional limitations are greater than one would expect when correlated to their injuries. In some cases, this may be explained as non-compliance during an assessment or treatment program, while in other cases their performance is labeled as poor, guarded, inconsistent, and/or less than full effort. As a result, a client’s effort and/or integrity may be in question. This in fact may be completely false and inaccurate and as such doing a total disservice to the client and their/your case as a whole.
Another way to look at it is that it is akin to the scenario where someone is suffering with significant injuries from an MVA, but there is very little damage to the vehicle and/or the collision was deemed “low impact”. In the same way that vehicle damage does not necessarily directly correlate with injuries sustained, nor does degree of physical injury always directly correlate with demonstrated functional ability.
What will the PIA provide for you?
Upon completion of this assessment, an opinion will be provided with respect to the interrelationship (if applicable) between the clients perceived and demonstrated functional ability and fear avoidance beliefs, pain-related anxiety and fear, and degree of kinesiophobia. An opinion regarding prognosis and treatment will also be provided.
Why is the PIA important?
The PIA is important on many levels and can help tie up some loose ends in your files or give you some direction on how to proceed moving forward. It can provide some answers where you have questions. For example…
- If your client has been deemed to have positive non-organic findings in testing (e.g. Waddell’s signs), this information can (and probably is) used to indicate that the client in question displays symptom magnification or pain behavior linked to secondary gain. The PIA, assessing pain impact, can offer an alternative explanation and thus either eliminate or at least neutralize the secondary gain argument (or any other negative argument) that Defence council wishes to pursue.
- If your client has soft tissue injuries that should theoretically be amenable to treatment and either has not improved or has been deemed “non-compliant” towards treatment, the PIA can provide a rational explanation. Research suggests what effective treatment for chronic pain should include and typically this is wantonly absent from conventional treatment. The PIA may shed light into this absence. Again, the PIA can either eliminate or at least neutralize any argument against your client (e.g. poor effort/non-compliance in rehabilitation efforts and/or secondary gain) that puts them in a negative light.
- The PIA can either act as a precursor to Psychological assessment and/or intervention or it be used in lieu of one. For example, in situations where it is not indicated that the client has a diagnosable Psychological disorder such as Depressive Disorder, Chronic Pain Disorder, Post-Traumatic Stress Disorder etc., but the client has issues in dealing with their pain, the PIA may useful to not only guide treatment but also the direction you want to take in regards to managing your file.
- The PIA is based on peer reviewed research in combination with clinical findings to provide you with an objective opinion of your client’s situation in a clear and concise manner.
Case Management/ Mitigation
Please contact me if you any questions or require further information at (604) 951-4281 or via email to: firstname.lastname@example.org