Here to Help The Passionate Attorney Help Your Client ~ Life Care Planning Services

Reading Time: 4 minutes

Along with vocational consulting services, I offer you life care planning services. Life Care Planning Services are valuable to passionate attorneys such as yourself: One who works to your fullest potential for your clients; One who truly cares about your client; and One who strives to maximize the best outcome for your client.

A Life Care Plan will help you help you help your client.

cartoon lawyer  Are You a Passionate Attorney?  Image result for woman attorney cartoon

Comprehensive Life Care Planning Services focus on the individual who sustained a personal or catastrophic injury, has a congenital disease or acquired illness, or suffered a traumatic event that altered his or her life leaving them with a disabling condition. The individual and his or her family is in need of planning how to live with these ongoing life changes.

Image result for passionate attorney cartoon   What About You Mr. Big Finger? Image result for group of attorneys cartoon

A Life Care Plan outlines an individualized holistic program that documents your client’s specific healthcare needs and a projection of what it costs for that care over their lifetime. An economist reviews the plan to determine the present value of the costs.

Even more, a Life Care Plan  helps prevent medical complications, enhances community and society participation, considers quality of life issues, and assists in maintaining emotional and psychological health. 

The person’s life now has important healthcare needs and significant costs are associated with those needs. How can you, the person’s caring and passionate attorney prove this, or show this to others, and why would you need to do so?

A Life Care Plan is helpful in many ways, here are three,

  1. to facilitate decision making relating to the individual’s health care, long-term care, and special needs; and perceive the related costs;
  2. to identify and obtain good care in the individual’s community, whether at home, an assisted living facility, or, if necessary, a nursing home; and perceive the related costs;
  3. to help move the litigation process forward, and ultimately to settle or win a case justifiably at the highest level possible using real data!

A Life Care Plan involves a systematic process (I do that part!) of developing a “road map” of the care, goods and services the person will need to ensure optimal health, safety and life satisfaction. A plan also highlights what it is the person will need to restore or improve their life activities to their maximum potential.

Keep in mind that while most Life Care Plans are developed for people who have suffered a traumatic injury, Life Care Plans are increasingly used for older adults with chronic conditions to anticipate their health and financial needs in later years. Do you have a client in this elite category? If so, be prepared for more future that focuses on healthy living! (Hint: Get a Life Care Plan!)

Image result for quality of life

The standard definition of a Life Care Plan is a “dynamic document based upon published standards of practice, comprehensive assessment, data analysis and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs. (IALCP – International Academy of Life Care Planners, 2003. Definition established during the 2000 Life Care Planning Summit.)

Please visit Dr. Deutsch’s webpage for much more information on Life Care Planning. Dr. Deutsch was on my training team!


Above is my most recent CRC Certificate and below is my CLCP Certificate

I need to take another picture of my newest one which expires February 28, 2026!

I am a Certified Rehabilitation Counselor (CRC) and a Certified Life Care Planner (CLCP).  As a professional in rehabilitation, I am able to develop a plan using  advanced knowledge of specific disabilities, established treatment care resources, and a consistent objective approach toward the practical and functional elements involved in providing the treatment of catastrophic injuries and diseases. 

Communication and negotiation skills are essential (so true) while working with patients, families, caregivers and treatment teams. Keep on perusing my website, which is mainly a relationship building blog, and read my writings. I’d be happy if you would truly consider how Life Care Planning Services will help you help your clients.

Contact me ~ Amy Botkin, MS, CRC, CLCP ~ at 515-778-0634 or by email at amyebotkin@lcpresourcesplus.com  so we can start discussing your case.

I’m here to help you help your client!

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Life Care Planning Helps Attorneys in Ways & in All Phases of Litigation! Really!

Reading Time: 4 minutes

Have you considered a Life Care Plan as part of your litigation strategy to help your client?

Life Care Planning helps attorneys in many ways and in all phases of litigation. The actual plan itself becomes a comprehensive document that provides for the future care and associated costs of a person facing a serious illness or injury.

In earlier phases of litigation, a life care plan helps evaluate the potential value of a case. During settlement negotiations, a life care plan helps identify monetary ranges. And of course during trial a life care planner can be critical to your litigation success!

Life Care Planning Services Help Attorneys in Many Ways,

Image result for overviewHere’s A Few:

  • Project future cost of care ~ When someone has sustained a life altering injury, trying to determine the correct and fair amount for a settlement is a daunting task. It’s difficult to properly analyze all aspects of an injured party’s condition.
  • A professional life care planner (one qualified as I am!!) can help you assess the current needs of a patient and project future complications with a systematic approach to analyzing the injured party’s current and future conditions.Related image
  • After analyzing all injury-related documents, interviewing the injured party and communicating with medical professionals, the life care planner will produce a plan that considers future costs in order to ensure a fair and reasonable quality of life. The plan will consider financial, physical, and psychological factors. In the end, you’ll have a thoroughly researched document that will prove bulletproof at settlement conferences and in the courtroom.

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  • Consider likely complications ~ When it comes to catastrophic injuries and long term illnesses, you have to expect the unexpected. Almost undoubtedly, complications will arise in association with the life-altering events somewhere down the road. With that in mind, an experienced life care planner will identify the most likely future complications, allowing all parties involved to understand and adequately provide for these unforeseen circumstances.

 

  • Expert Testimony * ~ An experienced life care planner provides crystal-clear medical testimony for depositions and trial. Life care planners can accurately and simply describe the injured person’s lifetime of needs and justify the associated costs. 
  • Able to be customized ~ Not all cases require a full-blown life care plan. However, that doesn’t mean a life care planner can’t help you. The injury or illness doesn’t necessarily have to be catastrophic in order to benefit from future care cost projections. Versatile life care planners offer abbreviated plans for these special situations that allow you to evaluate case value and strategize early on.

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  • Establishes a level playing field ~ Regardless of what side of the fence you stand on, you can benefit from hiring a professional for life care planning services. A life care plan helps all parties know what to expect and thus helps settlements be reached more quickly. A life care planner can aid in strategizing to ensure the best possible outcome. It’s not just a time-saver. It’s a tool that gives you the key insight of one with an understanding of medical needs and the associated costs.

If you represent someone who has suffered a serious injury or illness, or a defendant accused of being responsible for an injury, consider obtaining a life care plan. Doing so will allow you to understand the future care needs of the affected party, which will result in a speedy, fair settlement.

Source for above written article (with some creative writing and clip art by me) : http://www.articlesbase.com/health-articles/benefits-of-life-care-planning-in-all-phases-of-litigation-3466273.html  Oct 13, 2010 • By Nancy Fraser

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*As a Vocational Expert, I am also qualified to testify on the injured person’s work life and earning capacity.

Contact me, Amy E. Botkin at amyebotkin@lcpresourcesplus.com or at 515-778-0634 to discuss how a life care plan can help you to help your client. I’m here to help you help your client!

___________________

 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Rights of the Expert Witness ~ I’ll Take a Veggie Slice, Please

Reading Time: 3 minutes

Rights of the Expert Witness

expert

I continually assess and evaluate (there I go again!) my rights, values, professionalism, and of course ethics (which I really enjoy!?!) and am hopeful to write more on these topics and my career in the field of forensic rehabilitation consulting.

As far as rights, I found this great listing online (website is referred to below), and yes I added the graphics! I agree with the following essential considerations for taking on the role of expert witness:

  1. I have the right to be paid for my work.  Dream of Getting Paid
  2. I have the right to be prepped in advance of my testimony.
  3. I have the right to ask questions about the case.
  4. I have the right to work for either side, without fear of retribution.
  5. I have the right to change my opinion from previous testimony, as long as my opinion is evolving (based on new information, science and/or experience) rather than revolving (based on which side I’m working for). 
  6. I have the right to say “I don’t know”, if in fact, I don’t know. Just because I’m the expert doesn’t mean I have all the answers. I am clearly okay to say “I’m sorry, that’s outside my scope of practice”.
  7. I have the right to solicit objective feedback about my testimony from  the attorney who has called (and of course, they have the right to  decline to give it).
  8. I have the right to set limits with counsel about the scope of my testimony. 
  9. I have the right to disagree with another expert’s practices or  conclusions, even when I perceive that expert to be: a.) more educated;  b.) more famous; or c.) more experienced. 
  10. I have the right to disregard the initial instinct to view opposing counsel’s expert as the enemy, but instead recognize everyone’s role in the process and share pizza and a bottle of wine with that expert after trial is over.

Pizza

I’ll take a veggie slice and a glass of Chardonnay please. You?

I am glad my career continually evolves! I accept responsibility when providing forensic services to be clear, truthful and comprehensive in my evaluation and report products, and in my role as an expert witness. Thank you for reading!

 Truly, it’s all good work!

Please contact me Amy Botkin for more information ~ 515-778-0634 or amyebotkin@lcpresourcesplus.com

Source for Rights: http://www.forensichealth.com/2011/07/13/10-things-the-fho-expert-witness-bill-of-rights/

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Cross Examination is Like Playing Ms. Pac-Man & I Like it!

Reading Time: 4 minutes

I know that a good attorney who excels at cross examining an expert witness is thoroughly knowledgeable of their case. There’s volumes of information and data that needs to be absorbed and analyzed before going to court! 

You my attorney reader, use intuition and instinct to discover weak points in the witness’ presentation, and in a fair and calm manner, formulate and ask clear questions to elicit precise information. This requires patience and self-control, especially when you’re working on the spot! Job well done!

I’ve been a vocational expert witness during workers’ compensation court proceedings about 12 times over the last 16 years. I have served in courtrooms (mostly conference rooms with a workers’ compensation deputy commissioner presiding) with up to eight people present. 

Recently, I’ve also testified in divorce court proceedings, personal injury and medical malpractice cases. For a copy of my most recent litigation history, please inquire and I’ll be happy to provide it to you.

From my side of the stand, I better be familiar with rough courtroom conditions!

I’ve experienced verbal assaults on my work, my credentials, my vocation, and even my personality (I’m too nice, huh? hahaha!!) by the opposing attorney. I learned a lot from prior mistakes but I learn even more from recent successes.

I remember my first court appearance many moons ago. I was the primary job placement specialist on a case when the opposing attorney stabbed my body language in an erroneous and made up way.  Because there was nothing to see because human bodies speak for themselves, he undermined his credibility not mine. And I remember that well.

Image result for old fart cartoonI have no idea what the old fart was trying to do, but the judge didn’t care for it either!

I remember another court case (this was in Council Bluffs) that involved typical cross examination, starting out with repeating basic questions to get different responses from me…then the pressure was applied! I used first-hand knowledge and communication skills to respond to his questions, remaining true to my convictions while expressing strong belief in my work.

Hopefully I revealed to everyone in the room that being confident, calm and polite is a respectful way to answer difficult questions (even personal attacks). The judge on this case was newly appointed at that time. I don’t know the decision nor have I reviewed the transcripts on that case. I suppose decisions and transcripts could help me to some degree, but I don’t ever have direct access to them plus to me it’s likely they are not pertinent to any future case other than learning from miscue or miscommunication errors.

My goal as an expert witness is to win over the people in the courtroom.

To prepare for cross, I think of all the factors that may arise on a case and pay close to attention to what I want to say about 5 to 7 main issues or circumstances most likely at the meat of the matter, commonly being extent of loss of earnings. I realize the cross examiner will try very hard to prove his or her theory of the case, while devaluing mine. The opposing attorney wants to discredit me, and will eat away at any potential weakness in what I said or reported.Ms Pac-Man

I’m  pretty good at Ms. Pac-Man! Wanna play?

I rely on my expertise, research on disability and rehabilitation, objective evidence, direct placement experiences, the principles of ergonomics along with the provision of reasonable accommodation to help determine an individual’s work potential.

I understand how worker profile changes may impact access to the labor market and wage earning capacity. I can respond creatively by highlighting the constructive and favorable strengths of how my work brings successful results and focus on the positive nature of change, motivation, and choice.

I educate everyone in the courtroom about the scope of my practice and how it works when the individual agrees with my approach. Most importantly, I match people within their own world of work which takes time, attention and a great appreciation for the jobs people do everyday.

Image result for jobs cartoon

Need help with your litigated case involving work and disability? Let me know what you see as the most important aspects of the case and I’ll let you know if I believe I’m the right person to help you help your client.  

I’ll view my  interests, do a conflict of interest check and consider whether or not the case is in my area of expertise. And keep in mind I work on both sides of the fence

Need an expert?  Contact me, Amy E. Botkin at 515-778-0634 or      amyebotkin@lcpresourcesplus.com

Thank you for reading!

___________________

 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Like Mother, Like Daughter, One Tough Cookie! Want One in the Courtroom?

Reading Time: 6 minutes

Friday May 28th was my daughter’s 25th birthday. I admire her character and am proud of her roles and goals in every way! She’s into gardening, is a proud pet owner and recently started a second job as a book seller. And quite importantly, she’s engaged to be married!

My daughter is physically and emotionally strong, independent, and One Tough Cookie!  Off the top of my head, here’s a few memories of my daughter and her “toughness” over the years. 

One Tough Cookie!

Before she was born, let alone named, her birth cord was wrapped around her neck while she was being delivered. As I was pushing down as one is to do during natural child birth, the doctor told me to STOP!

What? Stop? So I did and, (not knowing what was going on) he very quickly cut the cord from around her neck, and blood shot above me onto the ceiling. Nice, huh, and yuck! My new baby girl scared her parents alright! She was just fine though and had a good APGAR. Rather quickly, the housekeeper came in the room and cleaned the blood off the ceiling with a mop as I was still lying in the bed. Yuck again! She was doing her job and it was much appreciated!

Pin on blouse mtrl

Arin was a calm baby!

I remember the first day of her life, Arin seemed to care more about how the nurses felt when holding her than actually being the new baby in the room. And her eyes were (and still are) so huge, she kinda looked like an alien with eyes on both sides of her head! 

Later in her babyhood, heck, I cut her toenails too short and they bled. I felt horrible, and this was my 3rd child, but she didn’t cry.

Around age 3,  Arin fell from a chair at the babysitter’s kitchen table while she was eating lunch. Upon facial impact with the floor, her  front tooth was knocked out, and said tooth landed down in the heater vent, where it potentially could have trace elements today.  She was whisked to the ER by her sitter, but there isn’t much one could do for this injury, other than wait! 

Baby With One Tooth ClipartIt took years for her new tooth to come in.

Last year around this time, she had four wisdom teeth removed. She was tough with that surgery and the healing time involved…and her poor face was so swollen. This link takes you to a blog for a bit on costs of the procedure!

When she was a little older, around 8ish, we were working in the basement and somehow the iron got knocked off its board and landed on her foot. Her big toe sure bled a lot and a deep bruise definitely developed and stuck around. Luckily the toe wasn’t broken and the iron wasn’t hot! Yikes!

Here’s another story of my dauther’s toughness: As were in the process of remodeling our house (in 2009), Arin would’ve been age 13, she was cleaning our new windows (with water and an ecloth!) and the larger kitchen window suddenly fell down (the type of windows that fold into your house), whacking her head.  Her head broke the glass, and the glass shattered on to the floor. Arin immediately felt a headache, but there was no blood involved and we didn’t take her to the doctor, but I certainly cared for her closely and watched like a hawk for any concussive symptoms! I informed the salesperson who sold us the windows of this mishap, and he showered her with gifts. He was probably pretty darn grateful that we didn’t, gasp: sue! But no we did not, and her strong head was fine. 

With New Nordic Emojis, Give Your Texts That Finnishing Touch ...

Moving on into her middle school years, from what I was told by said daughter, she went snow shoeing on recess. Somehow her tongue landed on a metal pole, got stuck and she had to pull away from the pole. Yep, her tongue ripped and yep it bled and yep it hurt like he double toothpicks. 

She said this was a dare; the sticking her tongue out purposely onto a cold pole in the middle of winter. But in reality, I believe she fell into the pole because she wasn’t very good at snow shoeing. Again, nothing really you can do for this injury but give the tongue time to heal!Image result for tongue pierced cartoonA while later she got her tongue pierced anyway! She also pierced her septum and eyebrow too. Don’t forget thee belly button piercing! (I actually did that once, but let it grow back because it bothered me when I did a yoga pose or exercised on my stomach).

And speaking of, both her ears have pretty good sized gauge holes! I’m not including the numerous tattoos Arin has received.  To me, getting a tat seems a little too drawn out painful.
Colorful AJ

Colorful AJ

One last story off the top of my head at this time, and I’m not happy at all with how this happened. In early March 2019, Arin was at a birthday party held at a hotel for her friend Taylor. Arin was picked up and thrown (grrrr) into the pool. Kassidy, who she landed on, hurt not only her head, but bit down and injured her tongue; and Arin ended up breaking two ribs.

Image result for xray ribs cartoonHowever, Arin didn’t find out her ribs were broken until almost a week later when she was in much pain and having problems at work. On a Sunday she had to be taken to the ER which included x-rays and a pain prescription.  Again, this involved a long rehabilitation / healing period.

Okay, enough writing for now. Like mother, like daughter!  Yep, considering I was able to live through hitting a train headfirst!  I believe this “toughness” is heredity, and comes from my mom.

In 2019, my mom was experiencing an acute medical condition while visiting us from her home in Florida. As we were waiting at the airport for her and her new husband’s flight home departure, she took a dive (right in front of the drinking fountains by the rest rooms on the main level) on to her face, breaking her glasses. She ended up in the ER for numerous stitches rather than on the flight home. Mom didn’t cry or wince, or even complain a bit.

The bottom line of this post is to let you, my Attorney Reader, know that I am a strong “tough-minded” resilient person who has the capacity to face difficult facts and long odds with resolute optimism.

I define a tough-mind as having the resources, mental skills, and physical capabilities to confront difficulties of all kinds. And then afterwards, the resiliency to slow down and relax.

I know if I succeed, I caused it and if I failed, yep, I caused that too. (Don’t worry, I won’t say yep during testimony.) I will be tough for you and I will be tough for your client.

I won’t be so tough you may choke, but I will be tough enough with your case where it counts: in my reports and in the courtroom and in my resolve to never give up. I got this strong “tough minded” trait from my mom and have passed it on to my daughter and I am proud of it!

Thank you for reading my post. Let me know about a case I can help you with that involves disability and rehabilitation. I believe rehabilitation is the care that can help an individual get back, keep, or improve abilities needed for daily life. I’m a rehabilitation counselor who cares.

Contact me, Amy Botkin at 515-778-0634 or amyebotkin@lcpresourcesplus.com 

___________________

 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Have Questions? Ask the Vocational Expert!

Reading Time: 4 minutes

My work is helpful during litigation following an injury or condition that leads to disability.  In any type of litigation, if the disability or limitation is significant, more than likely there will be questions about work and future earnings. In fact, a multitude of questions will arise as the case develops. As a well-trained and open minded vocational expert, I love to answer (and come up with) questions!

Do you have questions regarding a person’s future in the workforce?

Answers

 I’d love to find your answers!

Solid and detailed answers will describe employment related issues relevant in workers’ compensation, wrongful death, medical malpractice cases, personal injury, family law and many other areas of civil litigation.

It is important to quantify the loss, but how about going further to qualify it and define the best course of action to remedy it? Let’s characterize what is really going on by providing the facts, then finding help in the best places and describing everything in detail! Keep in mind, I pay particular attention to rehabilitation, health and safety!

Questions involve a multi-layer approach & so do Answers!

PuzzlesQs

What, Who, How? Where, Why, When?

Start with concrete observations (What):

Continue on to the specific people involved (Who):

Move to understanding (How):

Describe the locality and environmental issues (Where):

Step out on a limb of interpretation (Why):

Specify timelines and approaches that make sense  (When):

QsI know, I know, as an attorney you don’t like to ask questions that you don’t have the answer to! But you need the facts backed up by an expert, like me!

Qs
Fire Away!

These are randomly generated great questions! Remember, your answer will be multi-layered!

What occupation(s) is this person qualified to do?

Is this person employable? Where?

What is the outlook for certain occupations over the next 5 years? 10 years? etc.

What are transferable skills and how are they applied?

What are this person’s key transferable skills? How in demand are they?

How many jobs has this person held? Is that “normal”?

What did the person’s job involve? (Is there a need for job description and/or job analysis?)

What was the real reason for termination? Why did it happen?

Why has the worker not found employment?

Is the job search reasonable and effective? How can you be sure?

Is the quality of the job search material (eg: resume and cover letter) effective? How?

Are there specific criteria when targeting key occupations? If so, what are they?

How long does a job search take in a particular field? Why?

Why is motivation a factor in a job seeker’s vocational goal?

QsIs this person motivated to find work? How is that so?

How is a person’s employability assessed?

Are there places this person could work? How does one connect to that type of work?

Has this person sustained any career damage? How?

Are job seeking skills critical to the job search? Why?

What barriers influence this person’s hireability? employability? placeability? *Key Placement Factors*

What factors influence compensation and/or earnings?

What vocational services are available to assist with return to employment?

Why is this person underemployed? Will retraining for a different occupation help? How?

What are Soft Skills? (See Soft Skills Matrix) Does this person have many?

What motivates this person to work? (See Motivational Assessments)

What is the wage range for a particular occupation (or field/grouping of jobs?)

What are the statistics reporting in on this particular job?

What resources are useful for a job seeker?

Is the work physical demanding? How so?

Are there ergonomic issues in regards to this work? What are they?

What assistive technology or work tools would allow the work to be performed differently?

Qs

What markets employ this vocation? Is it viable?

What is the effect on smoking and pain? Or to overall injury recovery? Why?

Is age discrimination occurring? Why is this?

Is this person’s mobility in the workforce good or not good? Why?

What accommodations are available for work? How are they accessed?

What are the job requirements or essential functions of this work?

Does the work environment affect productivity? How?

What does this person’s future employment outlook look like?

Has this person sustained any career damage? How?

What is this person’s earning capacity? How is that calculated?

Qs

Just one more question…

Why not call me ~ Amy ~ at 515-778-0634 or email me at  amyebotkin@lcpresourcesplus.com for help? 

FREEFree 15 minute consultation offering!

If you have questions on a case that have anything to do with work and serious disability, you need solid and detailed information to base your decisions!  Additionally, life care planning that encompasses forensic vocational rehabilitation consulting is a unique concept. It offers you, the judge and jury with information guaranteed to help your litigated case move along. 

If I could help you help your clients, please let me know! Contact me at 515-778-0634 or amyebotkin@lcpresourcesplus.com. Thank you for reading.

___________________

My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Balance Your Case With Your Client’s Real Story. I’d Love to Write it!

Reading Time: 4 minutes

In her teen days my sister Janice (the Floridian) was quite adept at gymnastics, particularly on the balance beam where she made great use of her balancing skills.

When Janice moved on to college, dad cut up the balance beam he previously made for her to practice on for a new use as exit steps from a sliding glass door to the back patio during a home renovation project!

Balance Beam

Dad constructed a balance beam and re-purposed it as well!

Balancing is involved in many areas of day-to-day living and is critical to an abundant life. People balance tires, bank accounts, relationships, priorities and work. We eat a balanced meal, and I believe mostly importantly, we try to keep a balanced state of mind.

In my life, finding balance is an ongoing lifetime project. I’ve heard comments like: It’s good to fall / fail because it means you were trying. If you think about your success, you will be successful. If you think about your falls or your failures, you’ll learn to improve.

My dad’s balance had not been good lately, although he was working on improving it. He was receiving in home physical therapy through the VA and he moved continuously during each day. He was in excellent physical condition for most of his life!

But a stroke and a fall down basement steps at home lead to no return to life on earth. Before he was airlifted to the hospital in Mason City, my mom called and we drove in the middle of the night to be with him in the hospital room. And to help him die.

Highway Balance

Richard R. Prochnow

4/26/33 – 5/5/16

Dad died a week after he turned 83 in the morning on 5/5/16. I’ve blogged about Death as Part of Living, and can now fully realize one has to die from many things in order to move through life and live fully….and there’s always a story to tell.

As my dad aged, he never stopped working hard and to his best ability. There was a balance in how he lived his life, and I’ll never stop learning from him! I can calm my mind and simply hear his voice when he called on the phone.

“Hi Amy, this is your dad.”

Like I didn’t know it was him on the other end! Then he’d talk about what was happening! And it was real, interesting and well-balanced for the soul. 

In whatever situation you’re in, keep on practicing finding balance, and you’ll find a way to not fall; or a way to increase your sense of balance at its core.  You may lose direction or momentarily become blinded, but you’ll find your way again. Trust yourself. Just like my dad did driving thousands if not millions of miles on the road traveling to participate in the world around him.

On a lighter side (yes, I cried writing this, but I want you to think about your own life with no tears involved), as part of my personal story, I remember an incident a long time ago while I was working as a temporary banquet server for a hotel.

As I was walking into the room full of diners with a large tray of full drinking glasses (lemonade, tea and water)…well, never mind. Let’s say there was an imbalance that could’ve been disastrous!

Spilled Water

I learned to readjust the next tray and focus on my goal: just to get the glasses on the table safely without spilling any!

We balance our bodies in many, many ways. Balancing skills make use of poses and states of mind to focus attention on work, yoga, aerobics, tabata, healing touch, hiking, golfing, bike riding…being with the person you love. You get the drift, physical activity that involves any number of exercise moves or mental positions.

Yes, simply thinking with a sense of balance is very, very good and helps avoid failure (and falling). Jurists use a balancing test to weigh the importance of multiple factors in a legal case. If you want to highlight these factors, especially those that involve work and disability, let me know. That’s why I’m here on this earth! which is to help attorneys help their clients.

I will be prepared to help you bring a balanced case to court. I will write a report that tells your client’s real story with a concentration on their vocational background and potential future. If you need a life care plan for your client, again, I can help write about why the plan is needed and the likely costs for the person’s care.

Chinese Symbol for Balance

Please know my work is my life calling and I continuously learn and practice balancing all to help you help your client. I’m actually really good at balancing in many ways (for one I like to stand to put my socks and my shoes on!) and I am pretty happy with my physical and my mental states of mind.

Call me Amy Botkin at 515-778-0634 to tell me about your case. Or send me an email at amyebotkin@lcpresourcesplus.com   A vocational evaluation or a life care plan may provide just the balance you were looking for to tell your client’s real story.

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Conflicting Medical Opinions? Handle With Care!

Reading Time: 8 minutes

Upon referral of a vocational case, I review a variety of  medical data, for example, treating physician reports, functional capacity evaluations, independent medical evaluations and if available psychological data like psychometric testing, psychological evaluations, and psychiatric evaluations found within the file.

During a workers’ compensation litigated claim, or on any claim that involves work and disability, it’s important for me to understand the individual’s medical situation based on the data contained in these records.

Related imageGood thing I’ve had medical records training and enjoy the review!

If a file contains more than one FCE and/or IME, I can expect the reports to have conflicting opinions. For example, one physical therapist will recommend the claimant has the physical capacity for light work, while the other physical therapist says medium work. Often the therapists also have conflicting information about the individual’s maximal or lack of effort put forth during the evaluation.I Did My Best

The claimant needs to honestly and sincerely say “I Did My Best!”

Assisting the individual (who can be referred to as the injured worker, the claimant, the patient, the testee, the evaluee, and potentially the client)  in returning to work following an injury is a central role in found within my specialty of placement. This involves finding the best occupational match within the individual’s own labor market. A person’s “doctor imposed restrictions based on an FCE” should not direct the provision of placement services. A person’s knowledge, skills, interests and abilities should!

Image result for opinionWith conflicting opinions from professionals, what data should I rely upon to perform a beneficial service?

To resolve discrepancies I first ask myself, why is an FCE being used for this specific claim? The utility of this type of scientifically based evaluation, the training sources, performance methods, test protocols and standards to measure them are numerous.

Conflicting options are influenced by components of context and can be derived from subjective views. 

Professionals may have opposing views for their own reasons but I must be able to articulate their reports into vocationally-relevant terminology and tell a story about meaningful and gainful work. And it can be challenging to do this if I don’t understand the conclusion of the FCE report to begin with!

WORK

I love reading medical data rich in detail about a person’s world of functioning!  And I love writing reports rich with detail about a person’s world of work! 

A functional capacity evaluation is actually a term with various definitions, purposes and constructs. The purpose is to  evaluate an individual’s capacity to perform work activities related to his or her participation in employment. It seems that in essence, by having a functional capacity evaluation a person is likely to be put in an unfortunate position of deciding whether he or she is willing to return to work. 

If willing, there’s a way. If not, there’s no way.

From what I know, there are approximately 10 different types of commonly used functional capacity evaluations. Here in Iowa, I am most familiar with FCEs with names like the Isernhagen Work System, the Blankenship, Matheson, WorkWell and X-RTS. The reliability or validity of any system is somewhat irrelevant to me because the testing is already entered into “evidence”.

What is relevant to me is whether or not I comprehend the results and recommendations contained within the evaluation. Sometimes I can, sometimes I cannot. I always use a “Does This Make Sense to Me? test!

Image result for conflictingIt’s up to the dualing physical therapists to make their best points during litigation, I’m not in that ring!

I feel fortunate of connections with several physical therapists allowing insight into their clinical practice. I attend continuing education programs, and recall one that helped me understand various approaches to FCE’s specifically the X-RTS Lever Arm.

Thinking Cap

The X-RTS Lever Arm passes my make sense test!

So within the context of my vocational consulting work while cautiously putting any judgment aside (which seems hard when I know I know certain things), I analyze and compare each FCE while considering the testing results.

I note whether the FCE report is readable and user friendly. I assess if I understand terminology and methods used, how long testing was administered, what actually was administered, the claimant’s behavior during the test, and how the evaluator came to his or her conclusions about the results.

No senseDoes the conclusion make sense?

Are there concrete and realistic recommendations regarding strengths and weaknesses in relation to performing physical demand levels of various work situations? In other words, are there recommendations regarding real jobs found within the person’s labor market?

No senseDo the recommendations make sense?

I definitely look for the goals and expectations for the evaluation, and whether maximum and consistent effort was made by the evaluee. Comments on the suitability of the testee’s future employment options along with the evaluator’s observations are valuable and should be included.

It’s important to note what body part/extremity the therapist focuses on in relation to what body part/extremity was injured. For example in one report, the therapist discussed lower extremity activities, when in fact it was an upper extremity injury. If the report cites examples or uses too many percentages, it’s important to understand how the therapist justifies examples. I’m familiar with a therapist who changes the percentages of the same examples from report to report. That doesn’t make sense to me.

No sense I try really hard to make sense of most things and situations!  

If I am able to square an FCE in my mind after careful and prolonged study, is it possible the evaluee could do the same? That  would be  fortunate, especially if the therapist offers good recommendations that make sense!

How does the evaluee, when not truly the therapists’  patient when referred for an FCE by their own work comp attorney; with an additional FCE visit to a different physical therapist by the defense attorney  (that makes 2 different reports prepared by 2 different therapists) perceive discrepancies in the results? Sadly, in my eyes the FCE often gets “interpreted” through an attorney. The repeated pattern of thinking of one’s functional capacity as “poor” does not help anyone return to work.

If there is an IME (Independent Medical Exam), it may seem more geared towards one of the FCEs. Regardless, I try to comprehend all reports, noting the one I understand the most. I’m not so sure that an IME is really a “fresh set of eyes” in the workers’ compensation cases I’ve worked on. This topic is another blog in itself.

Putting both, or multiple opinions in a vocational report and making use of other documentation to support my ultimate and final opinion is a great idea, however I have to be cautious to not put myself in a role that isn’t mine (which is making a medical opinion which I can’t do).

If I am able to provide a doctor (ideally the most recent treating occupational health or rehabilitation doctor) detailed information directly related to a specific occupation or line of work and any resources that could help the doctor understand how such work is performed in a smart, safe and effective manner, many benefits arise.

Related image

Clean your lenses!

There’s a clearer understanding of the vocational rehabilitation process and with agreement from all involved, there’s a higher likelihood one could see a successful common outcome (return to work). This certainly helps solidify my vocational opinion and make reasonable recommendations. Yet, this type of opportunity is not frequently available (it is for me to though through processing a life care plan!).

In my reports, I document what medical records I’ve reviewed and then use the actual words from the individual during an interview (or deposition review) describing how s/he details their physical impairment.  Often I hear verbatim what one doctor wrote in their restrictions. The evaluee will respond to my open questioning about any physical limitations (sometimes after the evaluee refers to his/her doctor’s letter) and read or have it memorized saying: “no lifting over 20 pounds, avoid twisting, bending, stooping, sit and stand as needed.”  No sense

What do those words really mean in real life? It doesn’t make sense to me and the individual doesn’t seem to know either. Ask an employer if they have a job that involves no lifting over 20 pounds, no twisting, no bending, no stooping, no this, no that…and that’s not talking their language!

The evaluee who responds to me in this fashion (using verbatim restrictive words) needs future vocational counseling. Vocational counseling (which may or may not be provided depending on the nature of the litigation) helps to gain a clearer understanding of how the person’s medical situation has changed their daily living (especially in the context of their own world of work). This understanding leads to the ability to articulate the individual’s capacity for success to others (family, friends, job interviewers, etc.).

Please keep in mind, the term “restriction” is not conducive to a successful job search. The ability to explain who you are and what you can do from a functional perspective to help a business make or save money is what is conducive to a successful job search. Restrictions should never be the focus of job placement. Skills are!

Rehabilitation counseling is especially important if the individual is searching for a job and is requiring job seeking skills training on how to or how not to disclose disability or any functional limitation. The personal attributes gained from training helps the placement process move forward with common goals avoiding getting stuck within a few words that don’t apply to working reality.

WORKWhile staying true to my convictions and firm beliefs that a person can work if the person wants to work and has the capacity to work, I need to understand the dichotomy between science and clinical practice is more imagined than real.

If healthcare professionals submit conflicting reports on the same individual, I need to be able to resolve inconsistencies to better understand and appreciate the opinions offered. It is not my role to determine which opinion is correct. It is my role to utilize available information, provide a beneficial service, and make a sound vocational opinion regarding the individual’s strengths and weakness in relation to work capacity and employability.

Matching People With Their World of WorkIt’s rewarding when I can clarify a person’s sense of their own world of work.

I strive to extend the value of FCEs in the litigation process. I am trained not only in understanding a client’s functional abilities at work, but at home and at leisure.  Together, my knowledge with those of other experts, contributes to decisions about the economic losses, or damages, for which the person receives compensation.

Thank you for reading this long post! I’m here to help attorneys like you help your client. Please know I always search for a way to best express my vocational opinion. Contact me at amyebotkin@lcpresourcesplus.com  or 515-778-0634 and let me get to work for you!

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

It Happens, Things Go Wrong. Need Help with a MedMal Case?

Reading Time: 6 minutes

[Original post date: March 29, 2018] Time for a health update blog, a personal one, difficult to write with a mix of questions and a couple stories about medical practice and procedures. The point is My Attorney Reader, I want you to think about Me as a forensic rehabilitation consultant, and how I can help you help your client who is involved in a medical malpractice lawsuit!

My husband’s heart took a detour late last summer, 2017 when the ticker was running really fast.  Randy doesn’t participate in races (I’m the competitive one!), but his heart sure was!

Randy donates blood on a regular basis. He’s donated 14 gallons according to the blood center sticker on our front door! In fact, he was donating early on a Saturday morning when the nurse was prepping him for the draw told him she thought his pulse was “strange”.  However, his precious blood was still drawn (double reds)!  

           Randy is a popular Type A- donor.  

Questioning here ??? Should the nurse have continued with the blood draw knowing the pulse was “strange?” Well, she did! Luckily, no harm done. When Randy got home (rode his bike at what speed I don’t know! to/from his blood donation date which is common cuz he’s an avid biker!), I took his pulse and in fact, it truly was “not right”.

A couple days later, he had a doctor appointment. Yes, I scheduled it out of wifely concern. Sure enough, we got tachycardia his heart was going 144 bpm. This means a cardiologist is needed. I want to thank the nurse at the blood center for catching this heart irregularity (ahem hubby, I told him I thought the same thing in the weeks before).

Following an array of testing, diagnostic procedures and preparations, he received an ablation early November 2017. Thank God it worked! Randy’s back down to a regular beating heart and a normal pulse. His blood pressure was never a concern.

His cardiologist did an excellent job and Randy was back riding his bike in a short period of time. He wasn’t happy to be told not to ride! In fact, I know he disobeyed his doctor’s orders one day or two.

We expect our doctor to always be right. We expect our nurse to always be right. We expect all our health care providers to always be right. We in fact, expect our bodies’ to become “right” whenever we receive treatment in the medical field.

But things can go wrong and a patient can become injured during the course of treatment. That’s why we have attorneys to help, right!?! And yes of course we expect our attorney to always be right, too!

“Dr. NeverWrong”, the cardiologist who performed the ablation on my husband’s heart has this nickname! Charlie the RN, one of Randy’s excellent nurses while hospitalized told me of this nickname and the fact that the cardiologist has a fan base. He is one of only a few docs in town who performs ablations.  Because the doctor was humble, gracious, and ever so respectful, I’m sure he would not want to be called  Dr. NeverWrong! Can you guess who I’m referring to?

What? Attorneys don’t guess! 

Okay, now on to me. Recently, I was involved in a medical situation which could be worthy of a claim. How do you help your clients decide whether to file a claim? If there’s been harm done? Here’s the abbreviated personal story. 

Image result for patient gown cartoonWhen preparing for a mammogram last October 2017 (sitting quietly in a heated gown!) and waiting for the machine set up, I informed the technician of an unusual skin issue I was experiencing thinking it was poison ivy. I’ve had my share of poison ivy issues, even a four day hospitalization for a severe case in the past (contacted through an outdoor camp fire.) Watch out when you burn wood, my reaction was horrible. Anyway, the technician dismissed my concern and we went ahead with the mammogram.

To not go into detail  uggh ; [   I ended up with a severe skin condition I believe was spread by the mammography machine.  Let it be known I truly love big machines, (especially cranes), yet this large machine is not one of my favorites following what I experienced.

I was absolutely miserable and the condition lasted too long. I ended up going to the ER once on a Sunday and urgent care twice during the weeks that followed. I made these visits because I couldn’t stand the physical and emotional toil…and my doctor’s office wasn’t open at the time of my needs!  Not until I went back to my personal MD to finally get the correct diagnosis and a prescription did I begin to feel a little better.  

Image result for skin cartoonBut the prescription did NOT help and in fact the condition worsened. I literally had to just wait this one out and deal over time with the largest organ in my system: the skin. I was so distraught I even sought mental health care. I’m okay now, thank you! Whew!

I didn’t file a claim, should’ve/could’ve I? The time, energy, money and definitely my mental health was compromised and consumed in a fashion that I certainly didn’t choose. The only time I have filed a legal claim was when my parents sued the railroad for their negligence leading to my car/train collision and subsequent injuries, hospitalization and rehabilitation.

Trust me, my Attorney Reader, there’s much to my personal story!

I think the key into what makes or doesn’t make a person seek a lawyer when they think they’ve been wronged has to do with respect or lack of respect shown  by a medical provider. Of course, everyone makes mistakes. But negligence, followed by covering up issues and not telling the truth is where the wrongs and not the rights come in to play.  That’s not where I come in just yet, that’s where you, the attorney is on the field. I enter the game by sorting out what the plaintiff needs and the costs of those needs.

If you need a life care plan for a client who has filed a medical malpractice claim, please contact me.  Following a needs assessment and subsequent life care plan, my recommendations are grounded in rehabilitation. I’m not saying I’m always right myself. 

 But I will tell you My Attorney Reader, I care and I will do what I can do to help you help your client.

Please don’t contact me if you will act more like the red devil lawyer on the left. Sorry, I’m not interested in helping. However, if you are a good attorney like the white angel on the right who truly cares about your clients, contact me! I’m here to help!

Amy E. Botkin, MS, CRC, CLCP

Forensic Rehab Consultant

515-778-0634 

amyebotkin@lcpresourcesplus.com   

Thank you for taking some of your valuable time to read this post! I hope you enjoyed it.

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

 

 

“Somebody Call for An Expert?” I’ll Answer That Call!

Reading Time: 3 minutes

I’ve written about my fondness for Eeyore and want you to know I’m a bit attached to Gopher as well, especially when he comes to the rescue! You’ve heard the story when Pooh eats too much honey (honey is often on Pooh’s mind) at Rabbit’s place, gets rotund, and subsequently gets stuck in Rabbit’s front door.

45 Awesome winnie the pooh bees clipart Winnie The Pooh Pictures, Cute Winnie The Pooh, Winnie The Pooh Birthday, Whinnie The Pooh Drawings, Bee Clipart, Friends Wallpaper, Cute Disney Wallpaper, Cute Animal Drawings, Pooh BearRabbit is not happy and help is needed! Gopher recommends using dynamite, and he’s an expert with that subject, but Pooh isn’t so hot on the idea. If dynamite was needed, Gopher was ready for the rescue!Gopher

Popping out, Gopher exclaims “Somebody call for an expert?!” 

After thinking it through, Pooh, with assistance from his friendly team, realizes how to get unstuck. He agrees with Christopher Robin’s recommendations to patiently wait until he gets thin. Time passes, and it works (he gets thin!), however, he still needs a good jolt to move through the door. The team is successful and Pooh ends up in a happy place filled with honey! 

Related imageHoney! Yummy! Yummy!

I hope you appreciate this Pooh story.  I do. When called, I too, will use my expertise to help you and your team out in complex cases. I’ll answer just like Gopher but am not an expert in dynamite, I am in forensic rehabilitation consulting

Several years ago, I made an executive decision to study forensic rehabilitation counseling at George Washington University.  I started the post-graduate level educational on-line program on April 15, 2013 and graduated on August 15, 2014.

The coursework taught me more about courtroom testimony and how to function more effectively, efficiently and confidently within the legal system. I gained valuable insight into personal injury, medical malpractice, marital dissolution, product liability, and catastrophic injury cases.

A good expert has more than expertise that you can appreciate! It’s important for me to stand up under questioning (here’s a post on intimidation), commit to my opinion, and stay within my area of expertise. Thankfully, all my training including my background in Community Health Education helps! 

I strive to educate others in a clear manner and explain a complex subject to a lay audience in simple terms.

And you know what else, a good expert like me cares.

I love my career, and deeply care for my work. There’s plenty of satisfying work to accomplish and life constantly moves forward at a really swift pace so it’s important for me to now slow down until the time is right. I work hard for my customers, for myself, and for my family!

When labeled “a firecracker” by a classmate during our 15th year high school class reunion, I had to look up what that meant!

Yes, I realize I can be a bit firecracker-like, mostly because I’m a bold individual and will do what I have to do to accomplish my goals. I believe it’s always beneficial for lawyers and experts to spend time getting to know each other.

Yep, attorneys think differently than counselors. So, please let’s spend a little quality time together before we meet in a courtroom! It will truly prove beneficial.

You’ll find I’m a genuine person who truly cares about serving as an expert in the field. I’m ready, willing and able to offer my voice to help you help your client.  

Give me, Amy Botkin, a call at 515-778-0634 or email me at amyebotkin@lcpresourcesplus.com to start a discussion about your case. Thank you for reading! And don’t ask me why the font on this blog is different sizes, I’ve tried to fix it but somethings are just meant to stay as they are!

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.