Workers Comp Should Try Giving PTSD a Shot

An interesting story out this week about a new potential treatment for Post Traumatic Stress Disorder (PTSD) in military veterans could have significant impact on the workers' compensation industry.

Dr. Eugene Lipov,  Medical Director of Advanced Pain Centers in Chicago, and Director of Pain Research at Northwest Community Hospital, is deploying a treatment called Stellate ganglion block (SGB) in an attempt to treat veterans suffering PTSD who have not responded to other methods. He is reporting very encouraging, and often immediate, results. According to Lipov, PTSD sufferers who have been administered the block have reported relief from symptoms in as little as 30 minutes.  

SGB, has been used in the past to treat depression, schizophrenia, psychosis, and other mental health disorders. It is not backed by the Department of Veterans Affairs for treating PTSD in soldiers, but Lipov has obtained a waiver for continued tests. The procedure involves an injection into a collection of nerves in the neck known as the stellate ganglion.  These nerves are connected to various parts of the brain, including the amygdala, which are believed to be associated with PTSD.  

Some researchers believe PTSD develops when the level of nerve growth factor (NGF) in a persons system increases.  This prompts the release of a hormone called norepinephrine. Norepinephrine apparently is responsible for the “fight-or-flight” response in the body and directly increases heart rate and blood pressure. Lipov believes "high levels of NGF in people with PTSD are directly responsible for their heightened sensitivity to environmental stimulus."

The block turns off this activity, with an almost immediate response for the patient. Lipov says around 70 percent of his patients with which he has tried this have had positive results, with at least 50 percent improvement. The cost of treatment is estimated at around $1,000.

Besides the great possibilities to address a large problem within our military services, this has potential positive ramifications for the workers' comp industry. PTSD is an oft debated and contentious topic for us, and the potential for a quick, effective and affordable treatment is good news. However, one might postulate that this sword, like so many, has two edges. 

Around 16 states in the US do not recognize or provide coverage for PTSD for incidents where no physical injury accompanies the claim. This has meant that people traumatized by a sudden or violent act at work have generally had to seek treatment outside the system. With this potential revelation and possible treatment on the forefront, could that change? A treatment that targets a hormone such as Norepinephrine could be argued by some to be a physiological one, and not a mental treatment at all. If it can be successfully argued that PTSD is indeed a physical condition or injury caused by a work related event, the prohibition on mental only claims could be rendered irrelevant for these cases.

This is simply conjecture on my part, but I would not be surprised to see this type of argument evolve if Lipov's treatment proves viable. 

The good news, if that does occur, is that this may be a suddenly treatable condition. That is outstanding news for people that suffer this condition, and good news for those who fight false claims of the disorder. 

Everybody gets a win from this (except malingering frauds). In my view that is reason enough to give PTSD a shot.

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