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Catastrophic Determination and The Situational Assessment

At Galit Liffshiz and Associates (GLA), our highly skilled OTs complete Situational Assessments that describe in detail a client’s physical, cognitive, emotional and functional impairments. This type of assessment is invaluable to the process of having a client deemed catastrophically impaired.

One example of this is the aarbitration decision in Reichert Vs. Chubb Insurance (FSCO A12-003518). Here, the arbitrator agreed that the client is Catastrophically Impaired.

In this case the client sustained a mild head injury but developed psychiatric problems and personality changes that lead to CAT designation.

Galit Liffshiz completed a 2 day Situational Assessment and observed the client in his own environment, performing daily activities which he would normally do such as working on the computer, making breakfast and trying to fix a light fixture.

She then provided a report describing her observations in every hour of the 2 days and describing the functional impairments in detail.

The task was to connect observations with the understanding of chapter 14 in the AMA guides and to rate the client on the 4 domains (ADL, Concentration, Socialization and Adaptation to Work). This provided material contribution and assisted in my court appearance.

The arbitrator said: “The descriptions of Mr. Reichert’s attempts to be productive and his ability to cope with a basic daily schedule are similar: he is unable to complete even simple administrative tasks; he has serious difficulty concentrating and applying himself; he requires cuing but still cannot complete tasks; what he accomplishes is of poor quality; he has poor short term memory; he cannot organize his thoughts; he cannot accomplish more complex tasks and many simple tasks as well. Further, Mr. Reichert has been unable to work and his prognosis for work in the future is poor at best. The preponderance of the evidence supports the notion that Mr. Reichert has a marked impairment in his ability to adapt appropriately in a work or work-like setting with many assessors finding that he is unable to work at any job much less on the level he performed in the past.”

The arbitrator went on to say: When all the evidence is considered in its entirety, it is fair to conclude that Mr. Reichert’s life has been altered on every level by the disorder he suffered as a result of the accident. Mr. Reichert went from being a high functioning individual professionally, personally and socially to someone who could not work or socialize easily, focus or concentrate, or accomplish what would have been in the past the easiest of tasks for him”.

Needless to say the arbitrator agreed that his impairments were marked. The Situational Assessment completed by GLA provided essential observational information and details of the client’s daily functioning.

At Galit Liffshiz and Associates, we constantly review case law and invest time learning how to assess and document clients’ function so that our reports will be the best material contribution to your files.

Please contact us to refer a client for a Situational Assessment or for more information.