My rebuttal
This document is being written with intent to submit and dispute information to validate my request that this report be removed from my file regarding the WCA Summary Results dated January 16, 2007 for ////////////////.
It is noted that the Work Capacity Summary Report in reference was completed by James Lamprakos, DO and Elizabeth Genovese, MD on January 16, 2007 who were under contract by:
IMX Medical Management Services, Inc.
Two Bala Plaza, Suite 600
Bala Cynwyd, Pa. 19004
I would like to start off by saying how disappointed I am that this agency and the doctors that accessed my case failed to identify and sufficiently address major health concerns that are seriously affecting my health and are creating major barriers to employment. This was the priority and goal of this assessment to begin with. In this document I will state why I dispute conclusions in this report and submit verifiable evidence to support my rebuttal below. However I would also like to point out that I feel this is ludicrous that I am forced to defend myself in this manner and find it physically as well as mentally exhausting. Although, it seems if I do not point out the neglect to address important factors and inconsistencies by these medical professionals then my creditability, reputation, and chance to be helped greatly suffer as does my chances of ever having an appropriate assessment by qualified and competent physicians.
It is stated in the report that, “the goals of these evaluations were to identify impairments, estimate functional abilities, and identify any barriers to self-sufficiency that may exist.” However the two physicians that summarized this report, listed above, in fact failed miserably at legitimately identifying these goals by neglecting to address my primary complaints which present serious and obvious barriers.
In regards to the actual evaluations I have reviewed the summary report and would like the following points I now raise to be considered.
Loyde Richless M.D. stated in his report that, “Psychological evaluation was strongly recommended.” He also stated that I “did not appear to be exhibiting signs of severe psychological illness.” According to the report he also states, “Psychological evaluation was recommended, however, her lack of cooperation with the evaluation appeared to be more of an attitude problem than an exhibit of a psychological disease.”
I would like to note that I have had two psychological evaluations previous to Dr. Richless’s attempt at a physical evaluation and I recommend that those evaluations be taken into account when addressing any psychological issues that I may have. I feel it is crucial that physicians remain within their field of expertise especially when it comes to speculation otherwise misinterpretations can easily affect an inappropriate outcome as well as needlessly degrade my character. Dr. Richless is not qualified to make the negative assumptions against me that he has made and his inconsistencies about strongly recommending psychological evaluation for what he calls an attitude problem should be noted as such.
I found Dr. Palmer who performed a psychological evaluation on November 9th 2007 to be very thorough and extremely professional. Due to the lack of research for the condition in which I display physical symptoms, feel that he honestly did the best he could with limited knowledge concerning this unidentifiable condition.
Dr. Palmer stated in the sections of the report summary titled:
CHIEF COMPLAINT(S) – AFFECTING ABILITY TO WORK:
“I started to suspect I was very ill. I was diagnosed with Lyme Disease in April 2005 and an unidentifiable infection. I have seen the director of the //////////// Health Department ///////////////, MD and he said he could not help me.”
(Please note that Dr. ////////////’s office told my mental health counselor that I would be best treated by Dr. George Schwartz. Dr. Schwartz practices in New Mexico and I have no resources to travel that far for treatment nor would my insurance cover these visits. Dr Schwartz is a research doctor that treats patients that have the same unusual symptoms that my unidentifiable infection manifests.)
HISTORY OF PSYCHOLOGICAL COMPLAINTS AND TREATMENT:
“Ms. /////////// reported that she feels she is disabled due to the chronic physical pain that she experiences as a result of the unidentifiable infection and the mental problems (mental cloudiness) that she experiences. She also indicated that the treatment for this mystery illness is lacking because physicians are reluctant to treat her. She apparently has obtained antibiotics she has taken in high doses and reports she has experienced a decrease in the physical symptoms related to this, but physicians are reluctant to provide her with these medications due to lack of diagnoses associated with this.
RELEVANT MEDICAL INFORMATION
“Specific information regarding Ms. /////////’s medical history is provided in her IMX chart and will not be reported in any specific detail here. It is noted that Ms. ///////// complains of having an unidentifiable infection for which she has apparently taken antibiotics. I note that there is information in her chart from Dr. Randy Wymore from the Oklahoma State University Department of Pharmacology and Physiology pertaining to a rare disorder that is often times labeled Morgellons Disease or delusions of parasites (delusional parasotosis). While I have no information with the exception of the information provided by Dr. Wymore in regard to this disorder, this is Ms. /////////’s primary complaint and she feels that this mystery illness causes most of her difficulties including her depression. She reported that as a result of this illness she experiences chronic pain in her extremities, and oftentimes experiences significant lesions, also very painful and obviously given that they occur in her genital area rather embarrassing.” (Please note that the lesions occur on many parts of my body and for durations now going on years.)
“She apparently has been seen by a multitude of physicians for this, none of whom has been able to identify the cause of these difficulties apparently. She has even been evaluated by the director of the //////////// County Health Department, /////////////////, MD who indicated that he was unable to help her.”
MENTAL STATUS / PSYCHOLOGICAL EXAMINATION:
“She became tearful and expressed significant frustrations in regard to the unidentifiable infection and mystery disease that she has and indicated that her frustration was that she could not find a physician who was able to diagnose this problem nor willing to treat it.”
REVIEW OF PSYCHOLOGICAL TEST RESULTS:
Ms. ///////// demonstrated a degree of somatic concerns that is unusual even in clinical samples.
DSM-IV DIAGNOSIS
“Axis I: Ms. /////////// presents an interesting diagnostic picture. She certainly meets the diagnostic criteria for major depression, recurrent, moderate severity, 296.32, which is directly related to the physical complaints and the mystery disorder for which she complains…….
Axis II: Deferred 799.9 (pending more information)
Axis III: History of Lyme Disease (little to no treatment for this condition either, symptoms not addressed or taken seriously)
Axis IV: Unemployment, problems with access to healthcare services. (Having access to health care when physicians refuse to address and treat my condition is of little use.)
RECOMMENDATIONS:
“2. I also recommend that she continue with her ongoing psychological and psychiatric care. She reported that this is very helpful for her at least in dealing with the stress that she experiences in regards to the situational difficulties that she experiences in her life including the ongoing difficulties related to this mystery disease.”
(Unfortunately my psychiatrist cannot treat this mystery disease and it does not respond to psychotropic drugs.)
In the report summary written by James Lamprakos, DO and Elizabeth Genovese, MD barriers and other issues identified include:
Major depression, recurrent, moderate severity
Conversion Disorder or Somatization disorder
Panic disorder without agoraphobia
Once again my most distressing symptoms go unaddressed, dismissed, and unaccounted for. These two doctors do not even make a recommendation to alleviate this barrier. Unfortunately this condition does not respond to pretending it is not there either, it does however respond to antibiotics, antiparasitics, and antifungals.These are the distressing symptoms that I am speaking of:
“Morgellons is a multi-symptom disease that is just now starting to be researched and understood. It has a number primary symptoms:
• Physical
o Skin lesions
o Sensation of crawling and biting on and under the skin
o Appearance of fibers and granules coming out of the skin
o Fatigue
• Mental
o Short-term memory loss
o Attention Deficit, Bipolar or Obsessive-Compulsive disorders
o Impaired thought processing (brain fog) “
www.healthsciences.okstate.edu/morgellons/index.cfmHow does any individual with a doctoral degree in medicine neglect to ascertain that a patient who is displaying fibers, granules, and open lesions that have not healed for years in which no physician can identify the cause or physical matter is not a barrier or other issue and needs no recommendation in which to alleviate it?
Further more I wish to dispute the barrier identified in the report as Conversion disorder or Somatization disorder.
“Conversion disorder is classified as one of the somatoform disorders in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, Fourth Edition, Text Revision (DSM-IV-TR)….
This condition is not considered under voluntary control and, after appropriate medical evaluation, cannot be explained by any physical disorder or known pathological mechanism.”
www.emedicine.com/EMERG/topic112.htmIf this is being identified as a diagnosis and barrier for me than I certainly have not had an appropriate medical evaluation for my condition because these types of disorders do not manifest physical matter out of the body such as fibers or granules by the phenomena of trans-epidermal elimination.
Numerous other inadequacies exist in this summary report. Should the need arise I will address those as well.
Due to the inconsistencies and flaws reported in this summary I am requesting that this report be removed from my record. Please contact me with your reply to this request.
Sincerely,
////////////////////////////
I might be crazy but I sure aint stupid and no one is calling me delusional!
sl