This is a 73-year-old male with a 3/9/1995 date of injury, who was trying to pull a piece of paper from a jammed copy machine and strained her low back.
DIAGNOSIS: Major depressive disorder
This is an appeal to a prior review, which was denied on 12/24/15.
01/04/16 WC Form RFA requested CBT 12 (1X12), Beck Anxiety Inventory 2 (1X6) and Beck Depression Inventory 2 (1X6)
01/04/16 Appeal letter indicated that the UR determination was erroneous now they are requesting an appeal. It was advised that Dr. Huff, either by omission of his own or by travelers, failed to review Dr. Friedman’s 18-page narrative report. This treatment report outlines all the medical indications for therapy and medication management. Dr. Friedman submits a revised RFA specifying 12 sessions of therapy. The report leaves indications for 50 sessions, but guidelines necessitate fewer sessions. In the case…show more content… 12/14/15 UR Report denied: Cognitive Behavior Therapy x 50 sessions; Beck Anxiety Inventory once every 6 weeks; Beck Depression Inventory once every 6 weeks; and Medicine Management once every month. The report indicated that the worker is taking several medications, but it is not clear that the psychiatrist is managing these medications (however no note of which medications).
11/10/15 Psychiatric Evaluation Report noted that the patient was seen by an AME psychiatrist Dr. Robert Faguet in year 200 and later on 11/10/08 with the most recent re-evaluations on 09/25/13 and 02/25/14. The AME noted that she had Major Depressive Disorder and Pain Disorder. Since 1998, a psychiatrist Dr. Soorani and a psychologist Dr. David had treated her, but she noted that she discontinued treatment with Dr. Soorani 9 months ago and had to stop seeing Dr.