How do you prove disability for PTSD?

Post-traumatic stress at work

The expert report is issued to verify, through a technical assessment, a non-perceptible reality. Its purpose is to make the invisible visible, to make the intangible tangible. The degree of reliability that an expert opinion may deserve will be linked to the elements and data that the expert has selected to issue his technical opinion, as well as his expertise and understanding of the psychopathological process in this context (Jouvencel, 2003). The issuance of psychological expert reports or opinions in the field of civil and labor law is increasingly required (Albarrán, 1998), whose function, as evidence, is relevant to guarantee the rights of the parties.

In the proposals under study by the working commissions of the Forum for Justice, the regulation and formulation of expert witnesses is raised, and the scant importance that our legislation devotes to their training is a matter of concern. Judges must evaluate the expert opinions freely and according to the rules of sound criticism (art. 348 of the LEC). However, there is a clear tendency of the courts to assume the certainty of the same, due to the influence of the technical complexity of the issues dealt with. In relation to the ignorance on the part of the judge of the different specific matters where an expert opinion is required, this leads to the evident conclusion of the enormous importance that experts have in the Administration of Justice, to the point that in many procedures the court simply reproduces the expert opinion in the reasoning of the sentence, with which, in short, it is the expert who has resolved the controversy, the court limiting itself to “judicialize” and to give the expert opinion the effectiveness that every sentence has by virtue of the authority from which it emanates. This highlights the importance of the expert evidence, at the same time that it raises the existing controversy on the experience, professional endorsement and training of those who issue it.

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Post-traumatic stress test

However, in practice, disability is rarely recognized only for this pathology. What really gives rise to the recognition of disability are the disorders associated with or derived from PTSD, such as anguish with agoraphobia or generalized anxiety.

The patient can maintain a normal and productive work activity, except in periods of significant increase in psychosocial stress or decompensation. And the required diagnostic criteria are met, with no symptoms that exceed them.

Occurs if severe restrictions and difficulties in activities of daily living are present. It requires intermittent supervision in protected environments, and total control outside of them.

The disease completely invalidates the person, both to take care of himself and to develop the basic activities of daily living. To do them, he/she needs the help of one or more people on a continuous basis.

Anxiety is considered a disability

Posttraumatic stress disorder (PTSD) has many effective psychotherapeutic treatment alternatives. Within these, one of the less known in the Spanish language is the Imagery Rescripting (IR). The present study aims to characterize IR and conduct a systematic review on their efficacy in PTSD treatment. IR is a young technique intended to change memories or mental representations that are aversive to the patients. IR has shown efficacy in addressing those problems related to aversive memories and encapsulated beliefs. Regarding the implementation of the IR in PTSD, the results of this study indicate that it is effective but, in general, not more than exposure techniques. It is concluded that IR is less aversive to patients than exposure techniques and their mechanisms of action are still unknown.

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The recent meta-analysis by Morina, Lancee and Arntz (2017) explores the efficacy of IR in various disorders in which there is symptomatology associated with aversive memories and encapsulated beliefs, including PTSD, but the study only delves into the results obtained in the reduction of the aforementioned symptomatology, not understanding other important aspects, such as the emotions associated with trauma or the comparison with exposure techniques. Consequently, the aim of the present work is twofold: on the one hand, to analyze and describe what the IR technique consists of and, from there, to carry out a systematic review of its cumulative efficacy in the treatment of PTSD. It is also intended to bring the technique closer to our language environment, given the scarcity of works in Spanish in which it is addressed.

Disability due to post-traumatic stress

Particular attention should be paid to quarantine stressors at a time when a large portion of the world’s population is under quarantine. Quarantine of 10 days or more is considered to be of long duration and is especially stressful (adapted from Brooks et al).

Date Updated: August 2020Bibliographic Review (Anxiety and Depression): Gallery View, Grid ViewBibliographic Review (Trauma- and Stress-Related Disorders): Gallery View, Grid ViewBibliographic Review (Psychosis): Gallery View, Grid ViewBibliographic Review (Suicide): Gallery View, Grid View

Clinicians have anecdotally observed significant changes in patients’ drinking habits during the pandemic in association with the stress of isolation, with increased risk of relapse and dysfunctional alcohol consumption. Data from a survey in the United States indicated an overall 14% increase in the frequency of alcohol consumption above baseline levels, with a 41% increase in heavy drinking days specifically in women (Pollard et al).

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