Re-Evaluation – 2007

Re-Evaluation 2007

Dr. Knutman, SERS Psychiatrist

(Note: Events are real, names have been changed, and photos are not real professionals described in the story.)

After Angela’s first appointment with Dr. Knutman in August of 2005, she was determined not to be alone. She received a letter from SERS informing her that they had scheduled an appointment with Dr. Knutman on Aug. 1, 2007, for her to be re-evaluated for her disability. Since she needed assistance in getting to this appointment, she contacted Estelle Corbin, her advocate and case manager.

Angela felt better when Estelle was involved. Estelle was a great prosthetic brain, so to speak. Estelle had a PhD in education and was the executive director of an organization called Creative Solutions, which worked with people who had disabilities. They filled in by providing services for their clientele which the clients’ families were not able to provide. Having facilitated the monthly meetings of a local brain injury support group, Estelle was also very familiar with brain injury and the many challenges that survivors dealt with day in and day out.

Life had become much more challenging for Angela with depositions and defense medical exams. The emotional and physical requirements were taxing on Angela. Getting to and from places was becoming a problem. Angela’s walker had a seat which allowed her to sit down when tired. This helped for short distances, but did not work well when she had to go from a parking garage to an office building. Although she could sit on the walker seat and someone could push her, the walker was not designed for this and it set off her vertigo. It also did not have enough support the numerous times she had collapsed.

Estelle’s organization bought a transport wheelchair to help in these kind of situations. Although Angela could get by using what she had, the physical expenditure cost her several days to recover. Estelle was working with her to realize that it was okay to find ways to conserve energy so that she could function better from day to day, instead of taking 4 or 5 days of resting in order to recover.

This was difficult for Angela. She was used to pushing herself hard to overcome challenges. But doing this the past 3 years was not getting the same results she was used to obtaining. Angela was also sensitive to what other people might think. In her job, being able to see things from various perspectives was one of the things that made her good at what she did. Now, it was another obstacle to overcome. She knew that it might look to some people that she was using the wheelchair to try to gain sympathy. She would have to tell herself that doing what was best for her needed to take priority over what other people thought, even when it involved suspicious people in power.

When Dr. Knutman called Angela back to his office, Estelle pushed her in the wheelchair. “This is Estelle Corbin, my advocate and case manager. I would like for her to be here with me,” said Angela.

“Hello, Ms. Corbin. You are welcome to sit here while Angela and I talk, but I must warn you that it is not okay for you to talk,” responded Dr. Knutman in a very authoritarian voice.

“Certainly, I understand,” responded Estelle as she sat down.

Knutman pulled out a stack of papers and began asking Angela various questions. When he was done asking questions regarding medication, how she was functioning, why she was cutting herself, etc., Angela said, “I brought along some additional medical records which I don’t believe SERS had.” Estelle handed him a pile of papers.

“Oh, I’m certain I have all your records right here,” said Knutman, patting a pile of papers on his desk.

“I don’t think you do since my pile is bigger than your pile,” said Angela. “There are reports from my neurologist, oto-neurologist, biomechanical engineer, the residential neurological rehab where I lived for a month.”

Knutman raised an eyebrow as he shuffled through some of the papers. “Well, that really doesn’t matter because neurologists are not the kind of professionals who can help you,” he said condescendingly. “It’s people like Ms. Corbin, your psychiatrist and me that are the only ones who can help you.”

As he briefly continued thumbing through the documents, he paused a moment and said in a surprised voice, “This letter states that you had brain damage caused by transient ischemia experienced during chiropractic manipulation and that the brain damage is permanent.” Rather than asking more about this statement, he gathered the papers together, handed all the documents back to Angela and said, “You need to quit trying to be the poster child for brain injury and focus on getting back to work or doing some kind of volunteer work.”

“Well, I did ask Estelle if there was some kind of work I could do for her agency,” Angela said.

Knutman turned curiously to Estelle and said, “What did you tell Angela?”

Angela spoke up and said, “I thought you said she couldn’t talk.”

Ignoring her, Knutman waited to hear Estelle’s response. “I told her that we could not hire her. Although she is still capable of doing very impressive work, it takes her a long time to accomplish it and then she is down for a number of days, sometimes a week at a time, to recover from her efforts. She just wouldn’t be dependable enough.”

Knutman and Estelle continued talking to each other, while Angela sat confused holding the papers. She just didn’t understand. What does he mean that this additional information isn’t important? He said he doubted that she could have a brain injury since she didn’t hit her head or lose consciousness. Here was a report from a biomechanical engineer that analyzed the force of impact. She had a 3.0 Telsa MRI report discussing the dilated perivascular spaces in her brain which were consistent with coup-contra coup trauma. Her neurologist had a very lengthy report stating the similarities of injured areas which showed up on both this MRI and the Brain SPECT, as well as the medical difficulties which had resulted and the treatments which were being tried. And then there was the report from her oto-neurologist. What did he mean none of this was important information?

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Angela received notification that her disability was approved to continue. She later found out that Dr. Knutman’s determined that the medical basis of her disability was depression. He stated that she should recover once her personal injury lawsuit was finished.

© Angela Cramer, 2008-2009

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© Angela Cramer, 2008