Neurorehabilitative Implications of Workplace Traumatic Amputations
The total amputation of a limb involves the surgical severing of it from the rest of the body. The partial amputation of a limb involves the surgical severing of a portion of it from that part of the body to which it is normally attached. According to recent statistics, there are more than two million people living with limb loss in the United States.
Often, amputation is the only alternative for an ongoing disease process in the body, the limb or both. In those cases, amputation is a considered decision between the individual, the family and the physician. Although traumatic both in terms of the decision to undergo the surgery and of the surgery, itself, there is time to anticipate the surgery, to acclimate to what lies ahead and, perhaps, to get advanced neurobehavioral, psychological and pre-rehabilitation to prepare for how to handle life and activities of daily living (ADLs) post-surgery.
Traumatic amputations — many occurring in the workplace — are different. They result in the severing of a body part through an accident, catastrophic injury or some other trauma without notice, time for reflection or planning. While the venues in which they can occur are many and varied, they share two common characteristics: they are impersonal and unexpected. Furthermore, the suddenness of the trauma prevents the individual from planning medical care, therapies, rehabilitation or finances. They also often occur in the midst of friends, co-workers and superiors that add yet another layer of trauma to the occurrence, and which may require yet another type of specialized rehabilitation beyond the purely physical.
If a traumatic amputation occurs in a workplace and workers’ compensation is implicated, the process can become even more complex from a medical management standpoint. Neurorehabilitation is a medical process that attempts to aid recovery from a nervous system injury and to minimize or to compensate for functional alterations resulting from a catastrophic injury. Neurorehabilitation works with the skills and attitudes of the disabled person and his or her family and friends. It promotes his or her skills to work at the highest level of independence possible. It also encourages the individual to rebuild self-esteem and a positive mood. Thus, it helps him or her adapt to the new situation and become empowered for successful and committed community reintegration.
In contrast, workers’ compensation is a statutory construct that limits the remedies of the employee in return for not having to prove negligence or “fault” by the employer; it has clearly defined metes and bounds. Part of the construct is that the workers’ compensation insurer (or the employer or its third-party administrator, if self-insured), together with the adjuster and the workers’ compensation nurse case manager are the initial arbiters of the healthcare provided, including neurorehabilitative services. The care provided may, therefore, appear to be more medical than behavioral, in part, because behavioral care is less “tangible.” Stated otherwise, the workers’ compensation insurer may be concerned that since the care is not “tangible,” the injured employee may be exaggerating his or her true condition — malingering — and, therefore, may overlook the “softer” side of the care that is required for complete recovery and movement toward independence. Therefore, the parties involved in obtaining and paying for the rehabilitation, specialized rehabilitation and other components of post-acute rehabilitation may disagree with the catastrophically injured individual or his or her representative as to the proper course of care. Although there are specialized workers’ compensation courts to hear and decide these matters, the processes take time to resolve, and neurorehabilitative and post-acute services are best administered as soon as possible to achieve the best possible outcome for the individual who sustained a traumatic amputation.
The professionals at NeuLife, including its team of neurologists, RNs and therapists are expert in the provision of innovative, clinically relevant services, including the development of a customized Client Goal Plan, and delivery of neurobehavioral and neurorehabilitative services. NeuLife’s goal is to provide post-acute rehabilitation to its clients to achieve the best possible outcome for those who have even the most difficult and challenging diagnoses.
NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve maximized, sustained outcomes that exceed the expectations of all persons served.
NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.
2725 Robie Avenue
Mount Dora, Florida 32757
