WCB Wants You to Undergo a CPA. Now What?
You suffered a work-related psychological injury—directly or perhaps indirectly as a result of a physical injury—and now you’re told to attend a CPA. You wonder what the acronym stands for and what the purpose is, but your WCB case manager doesn’t go into much detail. The ensuing uncertainty and confusion add fuel to the fire and cause further anxiety, fear, and hopelessness.
So then, let’s demystify the CPA, shall we? First off, CPA stands for Comprehensive Psychological Assessment. It’s an in-depth clinical interview that tests your psychological state, including your mood, thinking, and behavior, thus providing insights on a diagnosis, work-relatedness, and fitness for work. The clinician will be a PhD-level psychotherapist, and be aware that when you speak to this person, this isn’t a typical physician/patient relationship, nor will any sort of therapy be discussed. Instead, the nature of this assessment is purely diagnostic and seeks to establish causation. Bear in mind that anything you say to the therapist is likely to be transmitted to WCB, so don’t assume you’re entitled to any sort of privacy.
Are you lying? Do you exaggerate the severity of your symptoms? This is also what WCB is seeking to find out. To do this, the clinician will administer tests such as the Wide Range Achievement Test 5 (WRAT5), a Memory Complaints Inventory (MCI), a Modified Somatic Perception Questionnaire (MSPQ), a Pain Rating Scale (PRS), and others. The clinician will be assessing for validity measures within normative expectations. This means they’re testing for indications of overreporting (aka exaggeration) that can distort the clinical picture.
These same tests and others that are similar will also test cognitive function, concentration, and impulse control. The tests try to determine if there’s a risk of suicide, paranoid delusion, and persecution complexes. And these exams try to accomplish this by quantifying human emotions and experience. Herein lies the problem.
Science is the study and measurement of quantities, not qualities. Quantities are numerical and objective, whereas qualities are inherently subjective and non-numerical. And yet these tests attempt to quantify the unquantifiable, and thus they pose a risk to uninformed injured workers. For example, let’s say when you reflect on your work injury, the mere recollection of the events causes you to have a panic attack. When you’re in the grips of a panic attack, your anxiety is off the charts. But suppose, as part of a Somatic Perception Questionnaire, you state that a panic attack causes anxiety that ranks 10 out of 10 (10 being the most severe anxiety imaginable). This score, 10, will be tallied up with all questions that you’ve answered. If the overall score is too high, the test result will likely indicate that you overreport (exaggerate) your symptoms. In other words, it’s all in your head (somatoform), or you’re prone to exaggeration, or you’re faking your symptoms altogether. Should this be the result, WCB is very unlikely to accept responsibility for a psychological injury on grounds that the CPA was invalid.
What is a Comprehensive Psychological Assessment?
A Comprehensive Psychological Assessment is a thorough evaluation designed to understand the psychological state of an injured worker. Conducted by a licensed psychologist, these assessments aim to identify any psychological conditions that may have arisen due to a workplace injury or illness. These assessments are essential for developing an effective treatment plan that addresses both the psychological and physical aspects of an injury, ensuring workers receive the care they need to recover fully.
Components of a Comprehensive Psychological Assessment
A Comprehensive Psychological Assessment typically includes the following components:
Clinical Interviews
The psychologist conducts in-depth interviews with the injured worker to gather detailed information about their psychological history, current symptoms, and the impact of their injury on their mental health.
Standardized Tests and Questionnaires
These tools help quantify the worker’s psychological state, providing objective data that can be used to diagnose conditions such as depression, anxiety, PTSD, and other mental health disorders.
Behavioral Observations
The psychologist observes the worker’s behavior during the assessment to identify any signs of distress or dysfunction that may not be apparent through interviews or questionnaires alone.
Review of Medical Records
The psychologist reviews the worker’s medical history, including previous psychological assessments and treatments, to gain a comprehensive understanding of their mental health status.
Psychometric Testing
Standardized tests measure various cognitive and psychological attributes, such as memory, attention, problem-solving skills, and emotional stability, which are critical for job performance.
Key Tips for Workers
Right to Choose Clinicians
Workers have the right to choose from a roster of clinicians approved by the WCB. Make sure to ask your case worker for this list and select a clinician who you feel comfortable with. It’s important to work with a professional who understands your needs and whom you trust.
Prepare for the Assessment
CPAs are mostly conducted in-person, but sometimes they can be virtual. Be prepared for a 2-5 hour interview. Bring any relevant medical records, previous assessments, and a list of medications you are currently taking. Being well-prepared helps ensure that the psychologist has all the necessary information to make an accurate assessment.
Understand the Process
Knowing what to expect can help reduce anxiety about the assessment. The psychologist will conduct clinical interviews, administer standardized tests, and may observe your behavior. Understanding these steps can help you feel more at ease during the process.
Be Honest and Open
It’s essential to be honest and open during the assessment. Provide accurate information about your symptoms, history, and how your injury has affected your life. This transparency helps the psychologist make a precise diagnosis and recommend the most effective treatment plan.
Ask Questions
Don’t hesitate to ask questions if you’re unsure about any part of the assessment process. Understanding what’s happening and why can help you feel more comfortable and engaged in your own care.
Follow Up
After the assessment, make sure to follow up with your case worker and healthcare providers about the recommendations and next steps. Keeping communication lines open ensures that you stay informed and involved in your treatment and rehabilitation plan.
Don’t Be Guarded, But Be Aware
Don’t be guarded, but be aware that anything you say will likely be shared with WCB. This isn’t a normal patient/doctor dynamic where privacy laws protect against disclosure.
Be Respectful and Cooperative
Be very respectful of the doctor. Cooperate and be likable and forthcoming. This cannot be stressed enough.
Pre-Existing Conditions
Pre-existing conditions don’t nullify coverage. In fact, let’s suppose a worker is bipolar or has borderline personality disorder, and then a work-related incident exacerbates those symptoms. In such a case, the claim is acceptable due to aggravation of a pre-existing condition.
Go Prepared
Go prepared with notes about the specific traumatizing incident(s) that caused your mental injury. If the doctor asks about the incident, you won’t want to gloss over any details, because the details are immensely important. Likewise, be ready to describe between 3-5 real-life examples of how your symptoms specifically affect your life.
Frequently Asked Questions (FAQs)
What should I bring to my CPA appointment?
Bring any relevant medical records, previous psychological assessments, a list of current medications, and any other documents that provide a comprehensive view of your health history.
How long does a CPA take?
CPAs typically take between 2 to 5 hours, depending on the complexity of the assessment and the individual needs of the worker.
Can I choose my psychologist?
Yes, you have the right to choose from a roster of approved clinicians. Ask your case worker for the list and select a psychologist who you feel comfortable with.
Are CPAs always in-person?
While most CPAs are conducted in-person, some may be done virtually. Your case worker will inform you of the format of your assessment.
What happens after the CPA?
After the CPA, the psychologist will compile a detailed report with findings, diagnoses, and recommendations. This report will be shared with you, your case worker, and your healthcare providers to develop a comprehensive treatment and rehabilitation plan.
Conclusion
Don’t fear the CPA. If you prepare for it and understand its purpose, you’ll do just fine. Remember, the goal of the Comprehensive Psychological Assessment is to provide a thorough understanding of your psychological state to ensure you receive the appropriate care and support. By being honest, open, and prepared, you can navigate the process with confidence.
Keep in mind the importance of bringing relevant documents, understanding the assessment steps, and being cooperative and respectful during the evaluation. Your transparency and preparation will help the psychologist make an accurate diagnosis and recommend effective treatments, ultimately supporting your recovery and well-being.
Stay informed, ask questions, and follow up on the recommendations provided. This proactive approach will help you feel more in control and engaged in your treatment plan, ensuring you receive the comprehensive care you need to get back on track.
