Psychiatric Injury Report Proforma

Opinions:

MEWA’s format

 

Any relevant medical history

h/o psychiatric disorder and history of physical illness that has, in the past, been complicated by psychiatric symptoms or might be so complicated in future

h/o psych disorder- present at time, would have occurred, predisposition or vulnerability to psychiatric disorder

Psychiatric injury

  • ICD-10 diagnosis and full description (content of jar not just label)
  • Existence of diagnosis, its attributions and its consequences
  • Justify diagnosis with signs and symptoms
  • Indicate to what extent evidence from medical records support diagnosis
  • Indicate to what extent evidence there is other corroborative evidence
  • Make clear if diagnosis is based entirely on self-report
  • Range of reasonable opinions- indicate why ur diagnosis is preferred

 

Treatment received

  • Both on records and based on claimants report
  • Meds- sufficient/insufficient
  • Psychology
  • Treatment that ought to have been given but not given
  • If claimant not complied with treatment- explain why, extent, DNA, repeat Px
  • Uncooperative vs understandable

Present condition

  • (severity of injury in terms of degree of suffering and impairment of functioning or functional deficit)

JSB Guide-

  1. Ability to cope with life and particularly work
  2. Effect on relationships with family etc.
  3. Extent to which treatment would be successful
  4. Future vulnerability
  5. Prognosis
  6. The extent and / or nature of any associated physical injuries
  7. Whether medical help has been sought.
  8. Effect of claimant condition on their capacity to Work
  • GAFscale
  • Disability under Equality Act

 

Treatment Recommended

Outstanding requirement as to treatment- set out, with sufficient detail

 

Prognosis:

  • Course and outcome of claimant condition
  • What might happen in future
  • Risk of deterioration
  • Whether claimant rendered more vulnerable to psychiatric disorder in future

 

 

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