Medical Practice and Procedures…It Happens, Things Go Wrong. Need Help with a MedMal case?

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[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!

Randy’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! He does however donate blood on a regular basis. In fact, he was donating early on a Saturday morning (he’s donated 14 gallons according to the sticker on our front door!) when the nurse at the blood center told Randy she thought his pulse was “strange.” 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 (I scheduled it out of wifely concern); and sure enough, we got tachycardia…going 144 bpm. This means a cardiologist is needed. BTW, thank you to the nurse at the blood center for catching this.

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 BP 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.

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’excellent nurses while hospitalized told me of this nickname and the fact that the cardiologist has a fan base (being only one of few docs in town we were told 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 (there’s much to this 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) 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 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!

 

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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.

 

 

Happy Rehabilitation Counselor Appreciation Day!

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March 22 of each year is designated as a Happy Day to Celebrate Rehabilitation Counseling! A bouquet of pink roses, dark chocolate cake and vanilla ice cream help the day turn even happier!    


My career choice is Rehabilitation Counseling, a unique job for high-energy people who want to make a very real difference in the lives of people with disabilities.  It’s also a challenging job that requires creativity and vision to see possibilities where others see only problems. 

Here’s a great brochure prepared by the Rehab Services Administration, Department of Education describing the profession, rehab jobs, and information you’ve always wanted to know!  It’s the source for some of the paragraphs in this post.

It seems when I reply that my master’s degree is in “Rehabilitation Counseling” often the person wants to know if that involves drugs and alcohol. The answer is no (although at times it does involve some degree of drugs and alcohol, depending on the case). 

I explain I have taken a different path as a rehab counselor and provide consulting services on litigated cases involving work and disability.  Then I usually get a ‘oh that’s cool’ response and I continue the conversation, keeping in mind the context and scope depends on the inquisitor! 

EnlighteningRehab Counseling is a High Energy Profession! 

In short, the goal of rehabilitation counseling is empowering people with (or even without) disabilities to make informed choices, build viable careers and live more independently in the community.

Rehabilitation counseling trains professionals who will be dedicated to working with individuals with disabilities in order to help them achieve productive and independent lives. Just as other counseling tracks, rehabilitation counseling educational programs – in order to produce competent and certifiable professionals – are at the master’s level.

Drake University, School of Education, Des Moines, Iowa offers an excellent Council of Rehabilitation Education (CORE) accredited master’s level Rehabilitation Counseling Program.  This accreditation enables graduates of the program to become Certified Rehabilitation Counselors. The Commission on Rehabilitation Counselor Certification (CRCC) sets the standard for quality rehabilitation counseling services in the United States and Canada.

Image result for spike drakes mascotDrake’s Mascot Spike with a Nice Bike!

Below’s another great bulldog picture. She has experience in Drake’s Beautiful Bulldog contest! Her name is Fat Amy. She owns Jeska Reese Dean, a family friend.

FatAmyFat Amy is Experienced!

I completed all required coursework at Drake University in the Master of Science in Counseling program. In addition, I took extra coursework focusing on job placement and mental health.

I was then eligible to take a national examination which I took on October 30, 2004, and upon passing, I earned the coveted CRC (Certified Rehabilitation Counselor) designation. Since then I re-certify every five years.

For background purposes, there are two main sections of the CRC exam:  Counseling and Rehabilitation/Disability.  A statistical procedure called equating is used to ensure all examinees demonstrate the same level of ability in order to pass the exam. Here’s my results:

Counseling Section:

Amy E. Botkin’s Scaled Score:       598         Passing Scaled Score:   500

&

Rehabilitation/Disability  Section:

Amy E. Botkin’s Scaled Score:       628            Passing Scaled Score:   500

TaDa

Here’s a copy of my CRCC Certificate: I love my career and every day try my hardest to use my talents wisely!

Please let me know if you have questions about the profession, my education or the professional  associations and groups I belong to. It may be a good career option for someone you know!

If your career is in law, please contact me at 515-778-0634 or by email at amyebotkin@lcpresourcesplus.com to ask me questions regarding how my work helps attorneys help their clients!  BTW, when is Attorney Appreciation Day?

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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.

 

Need A Good Report? Rebut No Matter What!

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I was taught that vocational report writing is a very powerful form of communication and can influence the degree of success for the individual for whom it was written.  I love to communicate through the written word and have written many, many, reports! Blog posts too!

So this blog is to be sure you, my Attorney Reader, know I’m here to help critique and/or rebut a report that may cross your desk.  Image result for report

How many people do you know who really love to write reports? I do! It’s not that the report writing process is easy, it’s a challenge!!

Let me ask: Have you ever read (or tried to decipher) a vocational report that doesn’t make sense?  Is the report ambiguous and difficult to read? Does the person it was written for understand it? Do you understand it? Is it possible the report can be defended? Or should the report be ripped apart, piece by piece to get to its’ nuts and bolts? Need a critique or a rebuttal? I’m here to help!

Rebut No Matter What! 

Bull

This was my husband Randy’s Grandpa Cliff Yearington’s Bull. Cliff knew a lot about Bulls & Bulls*** too. 

Loosen, take apart and re-assemble that poorly prepared report. Will it fall apart or simple wobble on? A poorly prepared report stresses difficulties but doesn’t offer much information about solutions. It talks about weaknesses rather than strengths; deficits and negatives rather than pluses and positives. It seeks to make threats rather than suggest changes. It uses multiple words, unclear statistics, and a slick method to confuse rather than clarify.KeepitSimple

Simply, it’s not helpful to write an entire vocational report about how bad off the person is, especially without mentioning plans to help make a positive impact on the individual’s life.

I love to comb through reports and make all attempts to uncover what the contents say to the reader.  Just because it’s a report doesn’t mean it doesn’t have to make sense! A report still needs to flow, tell a story, describe details and make valid and reasonable conclusions.

Here’s a sentence commonly found in reports from the same vocational person that I’ve been asked to rebut. [Keep in mind this long line comes after results of testing are provided within the report, but they are not explained at all!]

It is important to note that the purpose of all vocational testing done and reported here is to compare an individual’s current performance with their past performance as documented by their education, training, experience, and the standard worker trait factors associated with that history.

Say what? What does this run-on sentence mean?  The writer is using testing to compare performance? Did the evaluee’s past performance have anything to do with the testing administered? Did this person take the same tests throughout their work history? And then the paragraph continues…

 It is NOT correct to confuse an individual’s current test performance with performance in work prior to injury, as current performance is likely affected by the sequelae of disability.

Okay, now who is confused? The test taker? The person administering the test? I’ll tell you who….the reader!Related image The reader is easily confused by a poorly prepared report! 

Don’t be a confused reader! It’ll get you nowhere!

My initial question regarding this vocational report scenario, maybe helping to avoid confusion from the get go, is WHY were EACH of the specific testing instruments administered at all to this specific person? What is the rationalization for administration? The vocational person who wrote the report does not come close to answering these questions. To be ethically sound, administer testing only with a direct and relative reason to do so. 

I’ve written a professional report about my opinion on ethics and use of testing in vocational evaluations. Please contact me for a copy of the report. If you are my contact on LinkedIn, you’ll find it there readily available for now.

The underlying use of testing results to try to prove a person is permanently and totally disabled raises many ethical questions. Would you want that for yourself?

A test, really, a series of tests that I was forced to take, I didn’t understand, and simply put I didn’t want to take…those results determine my fate? Absolutely ridiculous! Results of testing are meant to assist a person for true and valid reasons…..not to paint a picture of “post injury residual vocational potential”

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Would you like to take ~ 10 tests in a single sitting?  Heck, No!

Without testing, evaluation is merely speculative

Really now? I’ve helped to place literally hundreds of people without administering testing! And many other placement people do too! If you understand the persons skills and match them with jobs in the local labor market, there’s a match!

Yes, of course I use certain standardized tests and self-assessments to help people when it is appropriate for reasons directly related to their placement goals, but that isn’t all I use during a vocational evaluation! I gather knowledge and assess many other areas involving work, interests, skills, aptitudes and lifestyle to help. I do not rely on only the use of test results!

Back to report writing, which is a very specialized skill; and I continuously study, practice and improve upon my own writing skills. As a professional writer, I never stop training! I think I gained natural talent from my Grandpa Jack, a journalist!

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When I’m writing, I get very absorbed! My office cat will testify to that!

Again, do you need a critique or a rebuttal? I’m Your Person to Help!

If your opinion on a case doesn’t mesh at all with the report on your desk, please contact me to help sort out the discrepancies. Keep in mind, I know opinions are just that, opinions.  And reports are meant to answer questions, not raise more!

I also want you to keep in mind that if you believe in the truth, there’s a way to show it. Contact me for expert testimony and witness services, too! Oh, and I definitely can rebut a life care plan as well! Thank you for reading this post!

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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.

Happy 19th Anniversary Vocational Resources Plus

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Vocational Resources Plus LLC Celebrates the beginning of 19 years in business!

September is a special month for me. My birthday is on September 15 and I started my own business on September 15…back in 1963 and 1999 respectively!

Please read on for information on Vocational Resources Plus LLC. I offer life care planning as well!Vocational Resources Plus LLC offers an array of vocational rehabilitation services with a focus on placement.

Vocational rehabilitation is a set of services designed to facilitate the return to work process (also known as placement) for individuals following a serious accident or illness that disrupted employment.

Placement is the bottom line of vocational rehabilitation, and therefore is the most in demand service.  Placement can be simply defined as finding suitable employment. Continue to read on for more detail on Vocational Resources Plus LLC’s placement services and procedures.Vocational Resources Plus LLC designs unique placement services to return-to-work problems that arise on workers’ compensation, personal injury and disability cases.

The objective of each placement assignment is to research key details on an individual’s employability. This information provides the base to plan for courses of action. Action is presented in the form of service delivery, case management, and reporting services, or whatever is needed to bring facts on board.

The goal of each service is to identify strategies that are proven to achieve positive employment related results. The objectives set forth in a service plan will effectively place the person back into his or her working world.  This ‘pathway to work’ expedites resolution, details the scope of occupational loss, and ultimately addresses the monetary figure of claim that is in litigation.~Vocational Resources Plus LLC offers comprehensive placement services to address labor market conditions, workforce issues, and attributes of specific occupations. The value of designing a service specifically based on the individual’s personal background, work history, transferable skills, knowledge and abilities, coupled with his or her interests, aptitudes, personality factors along with various vocational and physical attributes is higher than the actual cost of providing the service.

The case is covered carefully while the individual and all representatives associated with the claim are provided with specific details of the situation to better understand the priorities of successful rehabilitation. All services are documented and a narrative report is useful to evaluate the claimant’s rehabilitation potential, to determine the extent of loss of job, or pay, or of employability.

Specific details on level of cooperation to secure employment, worker qualifications compared to existing employment opportunities, and compliance regarding recommended therapeutic intervention or physical exercise are a few examples that are assessed for the individual to adjust to their situation.Vocational Resources Plus is often called upon to help when a case is in litigation or has the potential to become overly problematic and costly. Referrals are welcomed from attorneys and employers!  The strategy of assigning your difficult cases to a knowledgeable consultant saves time and reduces long-term effects of any claim.  I’m here to help!

MISSION STATEMENT

~ Vocational Resources Plus LLC commits to helping with the needs of its clientele by providing consulting services that exceed the standards of practice expected in the field of vocational rehabilitation.

 COMPREHENSIVE JOB PLACEMENT OFFERED THROUGH 

Vocational Resources Plus LLC

Job placement is a professional procedure. The purpose is to assist the job seeker to find a job matching his or her knowledge base, skill sets, abilities, work capacities, interests and aptitudes, as well as needs for location, work scheduling, level of earnings, benefits, plus more!

Comprehensive placement on average can take 4 weeks – 6 months (based on available employment opportunities and client cooperation). Placement is broken down into 3 phases: Information Gathering, Accessing the Labor Market and Placement. Other services such as Job Seeking Skills Training, Vocational Counseling, and Outsourcing are available on an as needed, individualized basis.

Within the first few weeks of placement, the placement specialist may be able to discern if success at obtaining employment is likely or not. All case activities, research and results of efforts are reported. Expert testimony is available.

Phase I ~ Information Gathering

This phase is time intensive and involves meeting the client, orientation, paperwork, appraisal of qualifications and transferable skills, and participating in other preliminary processes. The individual’s skill set is matched with existing employment opportunities. Resumes are prepared, reference building is performed, specific, information details are gathered and goals are set.

Timeframe: 1-3 weeks. The placement specialist can spend from 10-15 hours per week on preliminary processes. The placement client spends as much time as necessary to support this phase.

Phase II ~ Accessing the Labor Market

This phase involves designing a flexible marketing strategy to assist the client in establishing informational interviews and job interviews. Results are evaluated to help make decisions and to clarify career choices. It involves identifying and contacting businesses in appropriate markets and industries to assist with finding adequate profiles of persons to meet marketing needs and job opening requirements.

Timeframe: Commonly starts in the 3rd week and continues as long as feasible opportunities are identified, up to approximately the 6th week. The placement specialist averages 5-10 hours per week. The placement client spends as much time as necessary to support this phase.

 Phase III – Placement

When the client has sufficient opportunities available and is cooperative with placement procedures, this phase unfolds. When the client is placed, follow-up occurs at appropriate increments. If the client is uncooperative or if excessive barriers do not allow for a successful transition into the workforce, other Vocational Resources Plus, LLC services are available or referrals can be made.

Timeframe: Starts at approximately 3 or 4 weeks into the assignment, depending on the client’s situation and continues until placement occurs. A minimum of one month of post-placement services are offered. The placement specialist averages 1-5 hours a week. The placement client spends as much time as necessary to support this phase.

Thanks for reading….now give me a call!  There’s a sample employment packet the client receives, it’s located to the right on my website. Take a look around at all the resources available! I have even more to share!

515-282-7753 or email VocResources@msn.com

    lcpresourcesplus.com

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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.

Florida…Recovery Mode is A Lot Like Rehabilitation

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Originally Published on: Sep 14, 2017 We had a nice Florida trip early August 2017…finally made it! Initially, the plan was for Randy and me, our son Nick, his friend Jolee (who’s getting married to Jeremy this Saturday!); our daughter Arin and her friend Kassidy to make the trip in June 2017. But due to a hole in the plane that didn’t happen!  Instead (only due to timing issues), we along with Arin, our son Jake, and their mutual friend Bridget made it!

Arin  Presenting the Ocean View!

We stayed some of the time with my mom Ann and met her brand new husband Dave (he’s a keeper!!) who live in Sebring, and went out one night with my sister Janice who lives in and works for the City of Ft. Lauderdale. Janice was recovering from a workers’ compensation related injury (neck strain) due to getting rear ended while on duty driving a city vehicle by a distracted tourist driving who was on his phone…(read more below).

We splashed in the ocean a few times (absolutely gorgeous mixture of colors); saw an alligator in the Everglades (Jake eyed him from the road!); helped complete an over 500 piece puzzle (which was nonstop until completion!); visited my brother Steven’s cemetery plot and where my dad‘s ashes are buried near Orlando….and witnessed a rainbow from above on the plane ride home! 

No Stopping Until the Last Piece!  

So, think (or don’t because it was too much…) of the mileage we put on in this beautiful state over the days as Randy drove us all around in a not very big rented SUV…from Orlando to Sebring, from Sebring to Ft. Lauderdale, from Ft. Lauderdale down to the Everglades, through a lot of the Everglades and back to Ft. Lauderdale, from Ft Lauderdale back to Sebring; from Sebring to Winter Haven for a stop at the cemetery and back to the airport in Orlando. And of course lots of driving in between. Thanks for chauffeuring Mr. B, as I was “assigned” the back seat most of the time so one of the kids could co-pilot.

My father’s ashes are buried here with my brother…well, not all dad’s ashes. Janice has a beautiful urn at her home filled to the rim! 

It was incredible to view a rainbow from above it on the flight home.  And, come to think of it, I saw an incredible sunset on the way to Florida although one had to (if lucky enough for the window seat like me) really look behind to the West! When in the air one’s feelings can really affect the flight, as you may well know. 

Back to the worker compensation situation Janice went through. The person assigned to “help her” was rude, condescending and uninformed. My sister confided to me she wanted to reach through the phone and grab this person by the neck and say…”Hey you! My neck really hurts and I’ve recently received medical treatment. I’m recuperating at home as has been discussed with my direct supervisor and will be back on the streets when I’m better.” And Janice did return to her job quickly considering the situation, but she certainly didn’t need any more stress placed on her by someone who didn’t care!

Another tidbit about our Florida trip… (continual praying for Florida and all Floridians due to Hurricaine Irma, the stories I’ve been hearing)…I went into the ocean the first time with all my jewelry on (STUPID), but only for a short time before I realized I really wanted to go under and do some serious splashing with these two! Back on the beach as Randy was helping me remove my diamond tennis bracelet, it…it broke in half. I would have NOT nearly had a good time in Florida if the ocean had swallowed my bracelet.  Another Lesson Learned!

This week on Friday 9/15/17, I celebrate my company’s 18th anniversary in business, oh and my birthday too! I hope you enjoy reading my blog. And I want you to know I truly care about my family, my clients, my customers, and the work I perform. I would never be purposely rude to anyone and will always strive to understand any given situation in order to help in any way I can.

In recovery mode from Irma, Florida will be going through a lot of rehabilitation. Thank God my mom, Dave, sister Janice, good friend Bryan and all others who went through the HE double toothpicks recently are safe. I hope recovery mode and your state’s rehabilitation is timely.  My mom didn’t have power at her house for several days and it was hot and miserable! I wish I could’ve tossed her an extension cord from my house here in Iowa! Hang in there during rehabilitation!

Please let me know if you are interested to learn how I can help you help your clients.  Give me a call at 515-282-7753 or email vocresources@gmail.com and let me know about your legal case. I’m here to help!

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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.

 

Being Nosey, Opinions and I Make My Point Clear! Job Placement is Hard Work!

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One summer while I was walking around Gray’s Lake, I eaves dropped over a conversation two young women were having about tap water throughout the city. I was right behind them, ready to make a fast pass around…and interested in their subject!

I’m not like Gladys Kravitz all the time!

One thought Urbandale water was good and the other didn’t. They agreed West Des Moines water tastes ucky.  One loved Chicago water (and I thought ewwww ucky, and the strange smell to boot).  Then their conversation turned to a cute guy jogging their way…and I made my pass.

BTW, I remember where I was,  nearly 1/2 way round where I started, not including the everstop at my brother’s plaque on the bridge!

Clearly, people’s opinions vary widely around one subject!

I don’t think I will ever find a person who is adversarial to water – and specifically why water is important to a person. 

However, in my role as a vocational rehabilitation counselor, I routinely find a person (an attorney or two) who is adversarial to my opinion regarding whether or not a person can return to work (over their stance that the same person is permanently and totally disabled.)

I’ve evaluated hundreds of people and I hold firm in my opinion that work is incredibly important to a person. Rarely have I not been able to identify work for a person. In that type of return to work situation, the person’s serious mental health condition (such as schizophrenia, major depression, bipolar disorder, or borderline personality disorder) comes into play more than the person’s physical capacity.

One point I’d like to make clear! And this isn’t an opinion, it’s just the truth! It is easier to state that a person cannot work than to identify what a person can do for work.

“No, can’t work.” That’s it.  “No” “Can’t Do” “No Work is Available”  What a negative attitude.  Is it really just too much work to find work for a person?  VS  “Yes, you can work” “Here’s why, how and what the person can do!” “Yes” “Can do” “I will help you!” This is a positive attitude! Yes, and truly the fact is that it’s a lot of work to find work for a person! That’s what I’m trained to do! And I love it!

A vocational rehabilitation counselor cannot give a person a job – the professional works to define, enhance and channel the placement client’s skills, abilities, and aptitudes into the working world. 

The client is empowered with resources and strategies to perform specific and goal-oriented job seeking activities.  I’ve found the outcome of return-to-work in a workers’ compensation case impacts the placement process just as much during litigation as it does following case settlement.  Keep that in mind when forming any opinion. 

It’s a tragedy when an attorney sabotages any job seeking efforts, whether implied or not. I do not appreciate when any one tries to negatively influence any one else, especially when it comes to work.

I keep my opinion clear, based on fact and grounded in rehabilitation. No one can steal my opinion away!

Image result for grounded

Please see a paper I wrote in August 2013 titled (it’s posted on my LinkedIn page) or ask for a copy titled:

WHAT FACTORS INFLUENCE RETURN-TO-WORK DURING A LITIGATED WORKERS COMPENSATION CLAIM?

Let me know what I can do to help you with your legal work regarding your client’s return to work!

Vocational Resources Plus, LLC * lcpresourcesplus.com * 515-282-7753  * VocResources@gmail.com

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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!

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Litigation strategies include planning!  Have you considered a Life Care Plan? 

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, Here’s A Few:

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  • 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.
  • 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.Related image

  • 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.  
  • *In Addendum, as a Vocational Expert, I am also qualified to testify on the injured person’s work life and earning capacity.
  • 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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Contact Amy E. Botkin, a Certified Life Care Planner at 515-282-7753 to discuss how a life care plan can help you to help your client.          

*I have the expertise to include Vocational Rehabilitation Services and Recommendations, when needed, into a person’s plan, and am trained in expert testimony.

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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.

Need Help in Telling Your Client’s Story? Here’s One About Bowling & Rehabilitation!

Reading Time: 5 minutes

My husband Randy had his cardiology checkup clearing him to see the doctor every two years now. Thankfully he only had to make visits for a little over three years following his cardioversion and rehabilitation.  As you may know, anytime work is done on any electrical system there’s a chance something could go awry. Keep track of your system(s) to lessen that chance. Here’s a personal health story which all began with bowling.

2015-01-23 Botkin Bowling Ball

Botkin’s Black Ebonite Bowling Bowl 

I was on a business trip in Mason City, Iowa, providing vocational rehabilitation services to U.S. military veterans with my favorite chauffeur Mr. Botkin during the summer of 2013. On the way out of town we stopped at the Rose Bowl for a little entertainment. There’s a tendency to drive around even hundreds of miles with our bowling balls and yes, safely in the trunk. Ya never know when the mood to bowl strikes!

Randy’s bowling style stirs up quite a racket, especially when his ball wipes out all 10 pins! His posture at the end of his follow through looks like he’s ‘a hoppin’ on one foot ballerina! Along with the noise that emits from his vocal cords and Botkin embroidered on his shirt above his heart, he’s a down right bowling man!

Steerike!Steeerike!

10 pinsI’m more of a slow and steady bowler, aiming for good form, keeping the ball lined up with the directional arrows (the concept similar to how I prefer to golf too) and hope for that distinct feel knowing next will be noise of scattering pins!  I’ll take any knocked down! I want to let you know one of my dad’s first jobs as a youth was a bowling pin setter in the times before automation in the alley! 

On this summer day Randy and I bowled a couple games and enjoyed the time! I don’t remember scores, and don’t care! Okay, fine I’m sure his score was better than mine.

A few days after the trip, Randy’s neck was tilted. Questions about how he felt and the reason as to why the askew head revealed no valid answer and no comprehension he was even guarding his head. Then came complaints of “feeling out of wack.”

I took his pulse and ahhh…, felt gaps of time before the next beat, and those beats I could feel were not the same strength.  I swear his heart was skipping a beat (and not because he is sooo in love with me), and realized his timing was off (literally)! Randy made a visit to our family doctor who referred him to a specialist. Low and behold came the diagnosis of atrial fibrillation.

Randy went through several tests and was placed on Warfarin with INRs regularly taken. Nutritionally, he had to avoid sources of vitamin K (and I love blueberries and kale!), take good care of his health and not miss any medical appointments! This is just like my dad, who has chronic AFib. They shared stories about their health. How’s your INR? Pretty darn good, what about you? Well, I could lower it a point or two…! My dad actually does his own INR testing.

Related imageKale, A Superfood!

Dad “can’t eat” kale, but Randy sure missed eating kale, and loves it now (not true!) Back to the summer of the “heart scare”, I remember Randy wearing a holter monitor strapped to his chest. The day it went off with a loud bang (not true either!) we were at an outdoor wedding (very true! and it was hot too)!

It was determined Randy would need to have a heart restart. OMG. He had a cardioversion procedure performed on September 20, 2013. I will never forget waiting and waiting patiently for the patient at Iowa Lutheran Hospital trying to read but not being able to focus on the words in front of me. Finally the nurse came out (the procedure really wasn’t that long) and said I could see him. I couldn’t wait any longer!

I quickly entered the procedure room and saw Randy lying on the table groggily repeating “Did she do it?” “Did she do it?” Dr. Clark, replied, “What are you talking about?” Randy muttered again with some sort of humor (funny man) in his voice, “Did she push the button?”

button

No I did not push that button. But if he continues to make fun of my bowling posture…and my scores…we might reconsider...

The bottom line of this blog is to be sure to pay attention to signs and symptoms of your health and listen to your body.  People’s bodies do a good share of expressing to its’ owner it’s need and desire to be in balance.  When your body is out of balance, it will tell you and people who care will notice. Listen to it. Listen to others. Do what you need to do to restore your sense of balance. I can offer recommendations!

Thankfully the cardioversion worked and Randy’s been back in the rhythm ever since. There’s no rhyme nor reason why his heart decided to act up. Frankly, I love to check Randy’s pulse and his heart is really strong! He brags remarking his blood pressure is perfect (a quote from the nurse!) The beater is good to go for a long, long time! Rehabilitation was successful! (Ahhh, update, Randy had another cardiac scare in November of 2017.)

I could also blog about my son Nick and his blood pressure problems (thankfully much improved; he’s on long-term medication); and my mom’s blood pressure health which is good but needs watching. Or I could blog about Randy’s dad’s serious heart condition (which ultimately took his life while asleep in 2005). But instead I’m going to end with saying to my readers including my husband of course!,  “I love you with all my writing heart. Please take great care of  your systems and yourself!”

Pistachios

Eating Tip of the Day: Pistachios are Heart Healthy.

Let me know what I might do to help with educating your client; or better yet, let me educate others about your client by writing his or her story!

I love to help with litigation regarding work and disability and know it’s incredibly helpful to tell your client’s story in a meaningful and truthful way. I also believe in exercising, eating right and balancing! Give me a call at 515-282-7753 and let’s discuss your case. I offer free initial consultation!

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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.

How My Past has Brought Me to The Present – as a Rehab Counselor! Part 4

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My story leading up to my career as a rehabilitation counselor who focuses on job placement continues!

Many of my first jobs in the big city of Des Moines, Iowa were secured through temporary staffing agencies.  I find the benefit of staffing agencies invaluable! From a personal perspective, working for a staffing agency really helped me to develop my career. Here’s a link to an article of the benefits of staffing agencies from a business point of view.

The View Wasn’t Quite Like This When I Started as  Kelly “Girl”!

Specifically, at this time in my life in 1984-85, I started employment through Kelly Services.  I worked at many businesses, mostly in downtown Des Moines, but also at businesses in other areas of the city, working with a variety of people, and in diverse environments. It was great!

The clerical skills I used (and greatly enhanced on the job) to help these companies included ~ 95 words per minute typing speed, (can’t quite reach that speed anymore!), reception responsibilities such as greeting clientele, answering phones, taking messages, filing, and other general secretarial office procedures. Again, it was great!

To name a few of my assignments from memory (come on little computer in thy brain):  American Can, The Embassy Club, Chamberlin Kirke-Van Orsdel, Sears Credit Card, Younkers Department Store (in the Marketing Department). Besides the tragedy, this is another reason why I shed a tear over the Younkers fire in March 2014…

Image result for many jobs I loved my temporary clerical jobs!

While working for Kelly Services as a temp during the day, I also worked part-time at the Target Café on the weekends (when the Target was on Fleur Drive).  I catered to all the hungry shopper’s food needs.  I made pizzas, pretzels, popcorn, nachos, sandwiches, chicken tenders, fries, and the rest of the snack bar options.  It was a nice job to have. And I never left hungry! At that time, I also lived right across Fleur in an apartment with my sister Janice, so I just walked to and from work!

Additionally during this time period in my life, in the evening I worked on the top floor of the Federal Building for the USDA’s National Agricultural Statistics Service.  (I remember watching the construction of The Plaza across 3rd Street…which was completed in November of 1985) After receiving on-the-job training, I called farmers and asked specific questions about crops and livestock, while entering codes and farmer responses into the computer. It was an interesting job to have! Data entry was valuable, as was good communication skills.

I’ll never forget one farmer, who upon listening to my introduction replied “I’m sleeping.”  I appreciated his ability to sleep and talk….and respected his underlying wishes (and politely wished him good night – it was like 8:00pm, and hung up…farmers=hard-workers.)  Because of my direct experience with telemarketing in a call center environment, I have insight into the nature of work as a telemarketer and its business value.  In other words, it’s a viable occupation and the person on the other end simply has job to do.  Please respect that.

Work as a telemarketer requires excellent communication skills

In 1986, I applied and was hired at Mercy Medical Center as a correspondence clerk.  The medical records clerk job description is very important to healthcare. Click here for a job description for medical records clerk.  Commonly a medical records clerk needs an associate level college degree.

I was hired at Mercy because of my nursing background, my knowledge of medical terminology and the courses I completed in anatomy and physiology, as well as my clerical abilities.  At this job, I worked days (the medical records department was a 24/7 operation). Each day, the phones were incessant with callers wanting medical records and the incoming mail filled with correspondence from patients, doctors and other medical facilities requesting records.  Oh, and the back log – stacked to the ceiling in my supervisor’s office…

My work as a correspondence clerk was a lot!  After opening the mail, I logged everything in.  Then, I had to locate the medical record file.  The storage area containing medical records was vast as was the sheer size of some of the files.  There was a lot of paperwork, nursing notes, testing results, surgical records…on and on and on.  At times the record was on microfiche, which required visiting the basement to locate boxes near the (aahhhh) morgue.

After locating and retrieving the file (which involved accuracy and a check and balance process), the contents of the file were reviewed, the information that was requested was clipped and copied.

Image result for copy machine cartoon To this day a bit of animosity to large copy machines remains within. 

Then the requested information was prepared, a cover letter attached, and mailed, faxed, or delivered via internal mail procedures.  Again, a lot of documentation of what was done and to who, oh and how much was charged.

One day, I learned about the availability of civil service tests to work for the government.  So, I took a test or two or three, did well, and applied with the State of Iowa.  I was hired as a Clerk Typist III-IV for the State of Iowa at the Bureau of Disability Determination Services (DDSB) in the Department of Education.

At that time DDSB was located in the Jessie Parker Building, 510 East 12th Street, Des Moines.  I have lots of good memories, met many friends  (I love you Chele Ridout!), and learned a lot about work and disability.

As I blog through time and space both forward and backward, I have no idea how many parts this story will go!  I hope you enjoy it.  Please provide me with feedback or comments.  I love to learn about what people do with their skills and abilities!

More to come, please stay tuned for Part 5.

Initial publication date: December 12, 2011

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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.

Why I Got Into Rehab Counseling….I Love Placement and Life, Too! – Part 3

Reading Time: 6 minutes
HERE IS MY STORY, continued oN – Part 3

To understand my passion for job placement (and caring for others!), I’ve blogged about my former jobs and learning experiences.  This helps me (but I do feel kinda old going waaaayy back in time) look at a variety of occupations from a unique advantage.  Thank you for reading….and continue on!

In June of 1983, I enrolled at North Iowa Area Community College, Mason City, Iowa  and took practical nursing coursework.   Here is a list of the coursework along with the everyday tasks in a Licensed Practical Nurse Career.

NIACC, known at times as Tinker Toy College!

While at NIACC, I lived in the dorms. Yes, many interesting stories in my memory bank! I recently visited campus and my room looks exactly the same (read outdated)!  It was cool to walk around the campus and relive some memories : ) .  The dorms are on one side with a path across a lake (read waaaayy  COLD in the winter) leading on to the classroom buildings.  When not taking campus courses, we were doing practicums at the hospital or at a nursing facility.

The hospital training was at Mercy Medical Center North Iowa.  Keep in mind it’s a bit of a driving trek from the NIACC side of Mason to the hospital. I remember one extra cold morning (aren’t they all!).  I went out to the parking lot carefully, it’s dark, windy, icey and cold. Brrr. There’s my little blue car (a Plymouth Champ – fondly called Chump). The Chump was frozen solid in the dorm parking lot. Originally Chump was my mom‘s car, and I eventually acquired her and drove many a trip back and forth from Iowa Falls to Mason City, mostly on Highway 65.

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The Chump, she had a 5 speed stick shift and a sun/moon roof!

I had to go back into the dorms and locate help! Hey, don’t forgot how butt cold I would’ve been, and am right now just thinking about the cold. BTW, I have Raynaud’s syndrome, probably related to this day!?! No, there have been many many times growing up in Northern Iowa for a young lady to freeze her arss off!

I found help from a maintenance worker to unfreeze the locks, and ultimately I ended up going through the hatchback of the care (not the first time this would happen in my lifetime!)  I was wearing my light weight nursing uniform (coat too of course) and it wouldn’t been either a dress or top with linen pants). BTW: The average temperature in Mason City (population 28,000) is like 15°F in January! I’m pretty sure I had a fellow nursing student with me and we made it to the hospital for our clinical practicum on time which was 6:30 AM, or close to it! Our class had two males in it; and I’m curious what they’re up to so many years later.

Another update from Amy and hey, this is a great result from my decision to revise/repost some older writing material!  FYI: Mason City, Iowa, boasts the largest collection of Prairie School architecture outside Chicago.  A local non-profit organization, Wright on the Park, Inc. has information for me to share with you! I love architecture. Her’s an idea leading me to plan another trip to Mason in the future!

As an LPN student I wore a little white hat!

Another portion of the LPN clinical practicum was work at a nursing home (yes in Mason City….can’t recall the name of it at this point in time).  I recall caring for a man deep in the throes of Alzheimer’s disease.  When his wife came to visit, their interactions were …. well it’s hard to find the right words.

But it’s something I will not forget, as were many other experiences in the hospital and in the nursing home during my nurse training days.

Image result for nurse training cartoonI’ve always had a strong desire to care for all life!

Back to my nurse training days. During my clinicals, I learned the importance of being aware of other’s reactions and understanding why they react the way the do (Social Perceptiveness).

Nursing requires talking to others to effectively convey information (Speaking Skills), actively looking for ways to help people (Service Orientation), knowledge of principles and processes for providing customer and personal services including needs assessment techniques, quality service standards, alternative delivery systems, and customer satisfaction evaluation techniques (Customer and Personal Service Skills).

Nursing definitely requires the ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem (Problem Sensitivity) and using logic and analysis to identify the strengths and weaknesses of different approaches (Critical Thinking).

Image result for valueI value my nurse training immensely!

And of course, I also value my nursing career that followed! : )

Please note that Our country has a critical nursing shortage that is expected to intensify as baby boomers age and the need for health care grows.  This four page document titled Nursing Faculty Shortage Fact  was last updated: March 16, 2015 reveals many facts.

The value of positive clinical learning experiences is invaluable if we as a society want to attract, and retain good nursing students.  Click here for a article to reinforce the statement I just made. And we need to support our students and existing nurses. Here’s a link for information on the importance of nurse mentoring.

Image result for nurse cartoonI admire and respect nurses considerably.  

When hospitalized myself a few years ago in the summer at Iowa Lutheran Hospital from a severe reaction to poison ivy I paid a lot of attention to the staff. I was sent by ambulance from my doctor’s office to the ER, where I was treated and watched for a few hours, to be released home.  …Only to have to return hours later to the ER after calling out in the middle of the night [to my husband] that I really needed help!

I was full of poison from inhalation of smoke from burning logs / sticks in a firepit out at Cottonwood (Saylorville Lake). The sticks (I collected the sticks from my own back yard……..and made the fire) had the nasty nasty resin that I’m highly allergic to. I was an inpatient for about a week recovering from severe allergic contact dermatitis. And I made sure to give thanks and praise for such good nursing care.

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Be sure you do the same when you encounter a nurse!

Again, back to my nurse training days. I remember my initial CPR training with the full size dummy’s (Annie)! And I’ve received training ever since (oops Amy, update 12/16/2015: I need to recertify in First Aid, CPR and AED and I know my instructor training certificate has expired.)

Some training for you:  : ) Cardiopulmonary resuscitation (CPR) is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. The source for your training is through wikipedia : )

Anyway, I have been trained through the American Heart Association and through the American Red Cross.  In later days I would become more involved in both these agencies through the progression of my career. Ahh, time to link you to my resume….it’s in the download section of my website.

I’ve been wanting to design an interactive resume, as it will help me pronounce what’s most important in my background for a specific case where I may be called upon to serve as a vocational expert!

CPR is hands-only (no breaths) nowadays.

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On with my story… At some point, hard to pin that exact time in history at this moment, I traveled to and stayed in Irving, Texas for a month and a half or so, to help a friend with her growing family (play with babies and have fun). Right Tammy & Tony (RIP) Silvey!  I had one job interview, but never worked anywhere during my visit and returned to Iowa. Then I moved to Des Moines, Iowa in 1984 and stayed with my sister Janice who had an apartment on the Southside near the airport! I eventually moved in after her roommate moved out!

More to write about next week! Stay tuned for Part 4

Original publication date: December 5, 2011

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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.