I’m A Lot Like A Mole….Fortunately to Help on a Legal Case!

Okay, so I do something I’m not so sure many other people chose to do….and it’s clearly an inherited trait.  Dad did it too. Okay, it’s…it’s…I’ll just come out and tell you. I use bar soap and I use the soap until it is totally gone. And I mean totally!  I don’t waste soap.

Like dad, I also save and reuse paper napkins if possible (but prefer cloth!) and keep paper towels (ditto) the same way he did, until they’ve been totally used up!

Waste Not, Want Not (My dad said that too…) Proverb: if you use a commodity or resource carefully and without extravagance, you will never be in need. Another way to say this is if one is not wasteful then one will not be needy.

Dad would also say things like “It’s your nickel”….back when the home phone range like in the 70’s…with the cost increase to “It’s your dime” in the early 80s! …really both made no sense at the time. But the point is my dad was cost conscious (boy am I too) and my dad was not wasteful (ditto!)…and I greatly appreciate inheriting certain traits from him. I miss you so much dad! But I know you are a part of me that I will have forever. 

Here’s a picture recently uncovered….my dad Dick and his baby Amy….no idea where we are and why I’m wearing silly glasses! 

I am also very cognizant of what I throw away. I don’t want to be wasteful and I don’t want to worsen any landfill with unrecyclable garbage (read: plastic packaging). I know plastic has many very practical and very useful purposes. But when it is used once and thrown away…that bothers me. Especially when I’m at a conference in a “green/sustainable building” and they serve all food items on disposal products.

I recycle everything possible (and feasible considering time and other factors) and started composting (thank you to my sister Julie who gave me her used Earth Machine to me!) I think the smell of good natural composition of kitchen and yard waste is incredible and to think of how it was made by helpful microbes, worms and other organisms!

When mixed with your soil, compost will revitalize it, make it healthier and more productive, and increase moisture retention! Can’t go wrong there!? So, I used compost this year spreading it out in my yard and garden. I don’t use any chemicals and pick weeds by hand! Plus I’m into the No Mow method of lawn maintenance.

Viola beautiful lawn and it smells so fresh! However, and much to my chagrin……we got moles. They must really like their meals found in our front and back yard. So the good can seem not so good when now my lawn is disfigured with raised soft ridges and scattered holes. So, this is all natural and meant to be, right?

A mole is really interesting looking, lives underground and is nearly blind. There’s been a couple deaths ~ a baby and an adult ~ with corpses delivered by most likely my cat Alaska in the driveway and later buried by my animal loving husband Randy….yes I make him dig a hole and bury. 

I read that although a mole can detect light it does not hunt using its eyes. Instead, it relies on smell (hence the interesting snout!) and on touching wriggling prey (hence those crazy nails) using sensory hairs on its face. So a mole is good for underground life.  A mole is also (based on my research : ) ) territorial, strong, a hard working solitude industrious digger (natural engineer).

So to safely say, I’m a lot like a mole. Yes I need to get new prescription glasses, there’s nothing wrong with my sense of smell, my nails are natural, and I have a somewhat fuzzy face according to my husband. There may be other similarities, but I’ll let you make them on your own!

I’ve talked to people who have attempted to wage all-out war on moles without success. What I’m realizing is that molehills are signs that the soil is in good shape. And I can celebrate that fact! But there is lingering doubt and some anguish over the mighty, mysterious and resilient mole. And I’ve concluded a mole deserves respect, and as often as I can offer it, tolerance.

The bottom line is that with me, I see value and purpose in everything that surrounds me.

So, with this post, I ask you if you need help in helping your client through the difficult maze of their claim, please let me help. I won’t come to court looking like a mole, but will show up like an industrious mole:  ready to dig in and get to the bottom of the deal.

Thanks for reading my post. Give me a call! 515-282-7753  vocresources@gmail.com to discuss your case. I love to help out using my forensic rehabilitation services!

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

 

Get Level During the Divorce Process…With an Earning Capacity Evaluation!

Are you an attorney who works with divorcing couples? Have you utilized vocational expertise to help level out the uncharted territory for your client  Whether employed, unemployed or underemployed, an earning capacity offers valuable information regarding marital assets. 

My company, Vocational Resources Plus LLC offers vocational consulting services, in particular an earning capacity evaluation will benefit parties in a divorce in many ways. 

Let’s Get Level

If you need a clear, objective picture of a divorcing husband’s or a divorcing wife’s earning potential, and not just what he or she is currently earning during the divorce process, but how their vocational background could unfold with options and corresponding wage information, let me help! As a vocational expert, I know what skills are in demand in today’s employment market, and what income these skills can command in various careers.

Career picI report on the evidence and am always prepared to back it up through expert testimony!

An evaluation provides recommendations on the person’s functional capacity, personality, work skills and abilities, transferable skills, work values, aptitudes, interests, motivators,  work readiness and ideas for employment. Any recommendation or opinion is backed up with supportive data that highlights the individual’s vocational presence.

Based on individual circumstances of employability, hireability and placeability (3 of my favorite ability descriptors!), other factors are assessed, for example, job seeking skills and job search records.

Most importantly, during a divorce your client’s personal story deserves to be heard, especially when we’re talking about talents that include job skills and the career the person gravitates towards.  Results of all assessments and analyses are explained accordingly in a clearly written report.

Postit marriageI can help tell your client’s vocational story realistically and persuasively.

In one case I’m aware of, the divorcing woman declined to hire her own expert (umm: me) and found herself at a serious disadvantage. The “opposing” vocational expert sure did a number on what he declared she would earn in today’s workforce even though she hadn’t worked anywhere in 10 years!

There were inaccuracies and factual errors in this expert’s report on a specific career (it was teacher) that made me wonder if he (the opposing expert) had actually ever talked to a teacher about their job in real life! (Ahh, try being married to a teacher like me!) The opposing expert did not make sense! You simply don’t start out (with an outdated bachelor degree, no license, no certification(s), and no recent teaching experience) at $50k!! Not reality!

Even following divorce, my services can help an “ex” find appropriate work. With the results of interest and aptitude tests, along with professional guidance, the value of hiring a vocational consultant is enhanced should the cost of placement services be included in the alimony proceedings.Earnings $

Knowing your earnings ability will directly impact the resolution of the economic aspects of your divorce.

Please contact me to discuss how I can help level the playing field so the divorce process moves in a fair and equitable manner. It makes sense to have a person’s earning capacity known early in the proceedings.

Do it before a different report says otherwise! Having valid and reliable information on earnings directly impacts the resolution of the economic aspects of any divorce.

Call me ~ Amy ~ at 515-282-7753. If I don’t answer, please leave a message!

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Florida…Recovery Mode is A Lot Like Rehabilitation

We had a nice Florida trip early August. Initially, the plan was for my son Nick, his friend Jolee (who’s getting married to Jeremy this Saturday!); my daughter Arin, and her friend Kassidy to make the trip in late June. But due to a hole in the plane that didn’t happen, so instead (only due to timing issues!), my daughter Arin, son Jake, and their mutual friend Bridget made it! We had a very nice trip! 

Arin  Presenting the Ocean View!

We stayed some of the time with my mom Ann and met her brand new husband Dave (he’s a keeper!!) who live in Sebring, went out one night with my sister Janice who lives and works for Ft. Lauderdale (she was recovering from a workers’ compensation related injury due to getting rear ended while driving a City vehicle from behind by a tourist driving while on his phone…read more below); splashed in to the ocean a couple times (absolutely gorgeous mixture of colors); saw an alligator in the Everglades (Jake eyed him from the road!); helped complete an over 500 piece puzzle; saw my brother Steven’s cemetery plot and where my dad‘s ashes were buried near Orlando….and then witnessed a rainbow from above on the plane ride home! 

No Stopping Until the Last Piece!  

So, think (or don’t because it was too much…) of the mileage we put on in this beautiful state over the days as Randy drove us all around in a not very big SUV…from Orlando to Sebring, from Sebring to Ft. Lauderdale, from Ft. Lauderdale down to the Everglades, through a lot of the Everglades and back to Ft. Lauderdale, from Ft Lauderdale back to Sebring; from Sebring to Winter Haven for a stop at the cemetery and back to the airport in Orlando. And of course lots of driving in between. Thanks for chauffeuring Mr. B, as I was “assigned” the back seat most of the time so one of the kids could co-pilot.

My father’s ashes are buried here….well not all of them. Janice has a beautiful urn at her home filled to the rim! 

It was incredible to view a rainbow from above it on the flight home.  And, come to think of it, I saw an incredible sunset on the way to Florida although one had to (if lucky enough for the window seat like me) really look behind to the West! When in the air one’s feelings can really affect the flight, as you may well know. 

Back to the worker’s compensation situation Janice went through. The person assigned to “help her” was rude, condescending and uninformed. My sister confided to me she wanted to reach through the phone and grab this workers’ compensation specialist by the neck and say…”Hey you! My neck really hurts and I’ve recently received medical treatment. I’m recuperating at home as has been discussed with my direct supervisor and will be back on the streets when I’m better.” And Janice did return to her job quickly considering the situation, but she certainly didn’t need any more stress placed on her by someone who didn’t care!

Another tidbit about our Florida trip…. (continual praying for Florida and all Floridians due to Hurricaine Irma…the stories I’ve been hearing)…I went into the ocean the first time with all my jewelry on (STUPID), but only for a short time before I realized I really wanted to go under and do some serious splashing with these two! Back on the beach as Randy was helping me remove my diamond tennis bracelet, it……it broke in half. I would have NOT nearly had a good time in Florida if the ocean had swallowed my bracelet.  Another Lesson Learned!

This week on Friday 9/15, I celebrate my company’s 18th anniversary in business….and my birthday too! I hope you enjoy reading my blog. And I want you to know I truly care about my family, my clients, and the work I perform. I would never be purposely rude to anyone and will always strive to understand any given situation in order to help in any way I can.

In recovery mode from Irma, Florida will be going through a lot of rehabilitation. Thank God my mom, Dave, sister Janice, good friend Bryan and all others who went through HE double toothpicks recently are safe. I hope recovery mode and your state’s rehabilitation is timely.  My mom has not had power at her house since Sunday evening and it’s too hot and miserable! I wish I could toss her an extension cord from my house! Hang in there!

Please let me know if you are interested to learn how I can help you help your clients.  Give me a call at 515-282-7753 or email vocresources@gmail.com and let me know about your legal case. 

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

 

Rights of the Expert Witness ~ I’ll Take a Veggie Slice, Please

Rights of the Expert Witness

expert

I continue to assess and evaluate (there I go again!!!) my rights, values, professionalism, and of course ethics (which I really enjoy!?!) and am hopeful to write more on these topics and my career in the field of forensic rehabilitation counseling.

As far as rights, I found this great listing online (website is referred to below), and yes I added the graphics!

I agree with the following essential considerations for taking on the role of expert witness:

  1. I have the right to be paid for my work.  Dream of Getting Paid
  2. I have the right to be prepped in advance of my testimony.
  3. I have the right to ask questions about the case.
  4. I have the right to work for either side, without fear of retribution.
  5. I have the right to change my opinion from previous testimony, as long as my opinion is evolving (based on new information, science and/or experience) rather than revolving (based on which side I’m working for).

Butterfly

6.  I have the right to say “I don’t know”, if in fact, I don’t know. Just because I’m the expert doesn’t mean I have all the answers. I am clearly okay to say “I’m sorry, that’s outside my scope of practice”.

7.  I have the right to solicit objective feedback about my testimony from  the attorney who has called (and of course, they have the right to  decline to give it).

8. I have the right to set limits with counsel about the scope of my testimony.

Stop9.  I have the right to disagree with another expert’s practices or  conclusions, even when I perceive that expert to be: a.) more educated;  b.) more famous; or c.) more experienced.

10.  I have the right to disregard the initial instinct to view opposing counsel’s expert as the enemy, but instead recognize everyone’s role in the process and share pizza and a bottle of wine with that expert after trial is over.

Pizza

 Truly, It’s All Good Work!

I am glad my career is moving forward! I accept responsibility when providing forensic vocational services to be clear, truthful and comprehensive in my evaluation and report products, and in my role as an expert witness.

Please contact me Amy Botkin for more information ~ 515-282-7753 or vocresources@gmail.com

I’ll take a veggie slice and a glass of Chardonnay please. You?

 

Source for Rights: http://www.forensichealth.com/2011/07/13/10-things-the-fho-expert-witness-bill-of-rights/

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Alaska and Her Rehabilitation Plan…Patience Beyond that of a “Normal” Cat Owner!

Okay, another cat blog! Yes, I’m a cat lover and I love all pets and care for all living creatures! I’m not a cat fanatic, it’s just that felines have always been a part of my life and I love it! I love to write too. I love my work. I love my family. I love my life! I love a lot actually! Amy means beloved….so it’s reciprocated in many ways : ) Read on! I’d love it!

Cat Plate
Cat Plate

Little did we know that 3 months after Max my manx was murdered in early 2002 by something in the street, (I don’t love creatures who kill pets and on the other hand I don’t like it at all when my pets kill creatures), a tiny meow would emit from our neighbor’s garden. Oh my, this long haired kitten was awesome! Felix! Welcome! (Okay, this blog is not about Felix today!)

Max, (nope this blog not about you either, meooowww) a dearly beloved yet wild cat, found me ~1987 when I was renting the basement of a brick home in Windsor Heights (it had a pool in the back yard.) Speaking of cat claws!…A word of advice from a long timer cat owner, (counselors shouldn’t give advice, but in this case, listen to me!): Don’t think it’d be fun to give a cat a ride on an air mattress in a pool. Trust me. Sure looked like I had open heart surgery!

kitten-3Now, here’s a blog devoted to Alaska. She’s the cat who strutted on down the street one Spring evening in 2012 (following my son Jacob and his friend Josh) directly into the house and to a bowl full of cat food. Score!

I recall saying “Wow I’ve always wanted a white cat!” She’s all white with beautiful eyes (I love the green one; no, I love the blue one!). Oh dear, upon her arrive she was a very thin stray! And oh dear, oh my, oh dear, I would have no idea what trouble she would end up causing over the next year or two (…..) you really don’t want to know…..it involved lots of $$$$ over time (furnishings….another word of advice regarding leather furniture and cat claws). More costs $$$ credited to this white cat was the vet bills due to her actions toward the existing female feline (my love of all cat loves SamiJo.)

The cat looked like a kitten, however the excellent vet (Dr. Michael Forret) said she was about 7 months old when she decided to ditch being a stray and chose a home. She was hungry and dirty! Even her ears where filthy. Jacob named her and she has a middle name too, but I don’t think I should let you on to that just yet!

Alaska Our Putty TattyI rehabilitated Alaska TF into one big healthy white cat!

Part of Alaska’s rehabilitation included a lot of touching. She didn’t like being touched much, probably because she had not experienced much touch. She still to this day has to be touched only upon her terms….but I like to make her think she loves being petted which she really does but tries to hide it (cats).

kitten-in-toteAJ & AK bonding!

ArinJune figured out a way to carry her around in a tote bag (and to this day I often find her lounging in one of these she found!) to feel safe. With ongoing rehab,  regular vet care, good food and water, and lots and lots of love and attention, she thrives! Treats are nice too!

AK is much calmer of late into her more mature cat years. She loves the freedom to do what felines do (….sleep…and read above [hunt]…). She continues to be “a wild one” however and she herself does her share of “killing and delivering….” But, how can I stop a cat from that? Her hunting is actually of value to where we live because of an unkept property or two in the hood. But the dismembered gifts by the back door, come on! Enough. I have purchased her a new collar with a loud bell that will hopefully help plus she only goes outside about once or twice a day.

2012-09-23 13.29.36

Alaska helping me on a case!

Good communication and problem-solving skills are required in order to counsel others. I truly in my role as a rehab counselor, want to be empathetic and I want to reveal my desire to help people fulfill their goals. Counselors need good listening skills, compassion, and patience while working with individuals who have suffered serious injury and disability.

2012-09-23-13-29-43

She found this case interesting and pauses to reflect!

I know I have patience beyond that of a normal cat owner! Thank you my felines for teaching me how to listen and show my true self.

If I can help you help your client with a life care plan that includes vocational rehabilitation, please let me know!

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

When, Where & Why You Need a Life Care Planner for Your Litigated Case & Who Can Help You!

When Do You Need a Life Care Planner?

Typically a life care planner is helpful for legal cases involving catastrophic injuries or chronic health conditions.

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  • Lawyers, physicians, and insurance companies can hire a life care planner to research, analyze and develop life care plans for patients who experience catastrophic injuries or chronic health conditions related to birth, brain injury, spinal cord injury, stroke, amputation, trauma, burns, and other serious injury.

Where Do You Need a Life Care Planner?

A life care planner is useful in a variety of jurisdictions.

  • In legal cases that include workers’ compensation, personal injury, medical malpractice and marital dissolution
  • A plan is also useful to protect assets when aging, disability or chronic disease raises tough questions about estates
  • Other civil lawsuits, estates and probate needs

Why Do You Need a Life Care Planner?

A life care planner is beneficial for individuals, families and funding sources for many good reasons.  A good planner is able to ~

  • Provide the individual and the family with an outline of future care
  • Guide people through the complex maze of rehabilitation and long-term care coordination
  • Assess diagnoses and work-related disabilities
  • Network and make connections with health care providers and holistic practitioners
  • Educate, motivate and support the family regarding their loved one’s needs
  • Help insurance companies set reserves

Who Do You Need to Be Your Life Care Planner?

Amy Pic 9-29-15Amy E. Botkin, MS, CRC, CLCP, Certified Life Care Planner

With my extensive training, experiences and knowledge, I am able to zero in on vocational rehabilitation needs….often a key component when attorneys and insurance companies are settling or trying a legal case involving an individual of working age.

Please take into account a child deserves the opportunity to work and make money in their future, and if permanently and totally disabled, many factors come into play when assessing their potential earning capacity.  

I can help you help your client and your client’s family.

CLCP Certificate expires 2-28-21

Contact Amy E. Botkin at

515-282-7753 or vocresources@gmail.com for more information on life care planning services.

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My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Need Help in Telling Your Client’s Story? Here’s One About Bowling & Rehabilitation!

My husband Randy had his cardiology checkup clearing him to see the doctor every two years now. Luckily he only had to make visits for a little over three years following his cardioversion and rehabilitation.  As you may know, anytime work is done on any electrical system there’s a chance something could go awry so keep tracking your own system(s). Here’s a personal health story which all began with bowling.

2015-01-23 Botkin Bowling Ball

Botkin’s Black Ebonite Bowling Bowl 

I was on a business trip in Mason City, Iowa, (US Veteran clients) with my favorite chauffeur Mr. Botkin during the summer of 2013. On the way out of town we stopped at the Rose Bowl for a little entertainment. There’s a tendency to drive around even hundreds of miles with our bowling balls (yes, safely in the trunk). Ya never know when the mood to bowl strikes!

Randy’s bowling style stirs up quite a racket, especially when his ball wipes out all 10 pins! His posture at the end of his follow through looks like he’s ‘a hoppin’ on one foot ballerina! And the noise that emits from his vocal cords and Botkin embroidered on his shirt above his heart, he’s a down right bowling man!

Steerike!Steerike!

10 pinsI’m more of a slow and steady, aiming for good form, keeping the ball lined up with the directional arrows kind of bowler (the concept similar to how I prefer to golf too) and hope for that distinct noise of scattering pins!  I’ll take any knocked down! On this summer day we bowled a few games and had a great time! I don’t remember any scores, but who cares! Okay, fine I’m sure his score was better than mine.

A few days after the trip, Randy’s neck was tilted. Questions about how he felt and the reason as to why the askew head revealed no valid answer and no comprehension he was even guarding his head. Then came complaints of “feeling out of wack.”

I took his pulse…and ahhh, felt long gaps of time before the next beat, and those beats I could feel were not the same strength.  I swear his heart was skipping a beat (and not because he is sooo in love with me), and realized his timing was off (literally)! Randy made a visit to our family doctor who referred him to a specialist. Low and behold came the diagnosis of atrial fibrillation.

Randy went through several tests and was placed on Warfarin with INRs regularly taken. Nutritionally, he had to avoid sources of vitamin K (and I love blueberries and kale!), take good care of his health and not miss any medical appointments! This is just like my dad, who has chronic AFib. They shared stories about their health. How’s your INR? Pretty darn good, what about you? Well, I could lower it a point or two…! My dad actually does his own INR testing.

Related imageKale, A Superfood!

Dad “can’t eat” kale, but Randy sure missed eating kale, and loves it now (not true!) Back to the summer of the “heart scare”… I remember Randy wearing a holter monitor strapped to his chest. The day it went off with a loud bang (not true!); and it goes in a plastic baggie for return to the cardiologist we were at an outdoor wedding!

It was determined Randy would need to have a heart restart. OMG. He had a cardioversion procedure performed on September 20, 2013. I will never forget waiting and waiting at Iowa Lutheran Hospital trying to read but not being able to focus on the words in front of me. Finally the nurse came out (the procedure really wasn’t that long) and said I could see him. I couldn’t wait any longer!

I quickly entered the procedure room and saw Randy the love of my life lying on the table groggily repeating “Did she do it?” “Did she do it?” Dr. Clark, replied, “What are you talking about?” Randy muttered again with some sort of humor (funny man) in his voice, “Did she push the button?”

button

No I did not push that button. But if he continues to make fun of my bowling posture…and my scores…we might reconsider...

The bottom line of this blog is to be sure to pay attention to signs and symptoms of your health and listen to your body.  People’s bodies do a good share of expressing to its’ owner it’s need and desire to be in balance.  When your body is out of balance, it will tell you and people who care will notice. Listen to it. Listen to others. Do what you need to do to restore your sense of balance. I can offer recommendations!

Thankfully the cardioversion worked and Randy’s been back in the rhythm ever since. There’s no rhyme nor reason why his heart decided to act up. Frankly, I love to check Randy’s pulse and his heart is really strong! He loves to brag that his blood pressure is perfect (a quote from the nurse!) The beater is good to go for a long, long time! Rehabilitation was successful!

I could also blog about my son Nick and his blood pressure problems (thankfully much improved; he’s on long-term medication); and my mom’s blood pressure health which is good but needs watching. Or I could blog about Randy’s dad’s serious heart condition (which ultimately took his life while asleep in 2005). But instead I’m going to end with saying to my readers (including my husband of course!),  “I love you with all my writing heart. Please take great care of  your systems and yourself!”

Pistachios

Eating Tip of the Day: Pistachios are Heart Healthy.

Let me know what I might do to help with educating your client; or better yet, let me educate others about your client by writing his or her story!

I love to help with litigation regarding work and disability and believe it’s helpful to tell your clients story. I also believe in exercising, eating right and balancing! Give me a call at 515-282-7753 and let’s discuss your case. I offer free initial consultation!

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Working on a Case Involving Work & Disability? I’m Here to Help You…Depose & More

I can help you in a number of ways with any case you’re working on that involves work and disability, whether it be medical malpractice, personal injury or workers’ compensation or other litigation. One way I can help you is to design creative questions skillfully as part of the discovery process allowing a much deeper inquiry into the person’s “world of work”.

My goal is to inspire you even more to do what you love to do…ask questions, right!? And to be the best attorney you can be, double right!!

Depo

I’m sure questions you ask a deponent include those to: determine the nature of previous jobs; amount of money making; for whom s/he was working; why employment was terminated; and what qualifications and experience s/he had for the type of work s/he was doing [when injured].

You also question what work the individual has done, if any since the disabling condition, describing job duties; and determining previous employers and earnings.  Questions posed to encourage a deponent to detail what it is s/he can and cannot do are important, too.

These are all good questions from you yes, and critical of course (although kinda boring in my humble opinion!). Would it help you to have at your fingertips specifically designed questions (based on evidence to date) at deposition that will produce a much deeper inquiry into the person’s vocational background? I get excited when I think of sooo many other questions you could ask that really get into the meat of the matter!

meatAnd I don’t eat meat!

I’ve heard 90% of malpractice cases are settled before trial, and the deposition often is the turning point in those cases. I’d like to help you prepare questions that will lead to responses offering plenty of material for you to work on your case. My aim is to help you skin that cat in many ways and be ready for the most likely responses from your witness. I hope my help with your deposing techniques is valuable pre-trial as well as if the transcript is used for court.

Object

Plus, please keep in mind, I can definitely help you in more ways to better understand the individual’s disabling condition. A life care plan is perfect for that! Expert witness and testimony services are available as well.

I am here to help you help your client!

Call me ~ Amy Botkin at  515-282-7753 or shoot me an email message at vocresources@gmail.com and I’ll get back to you. Thank you for reading! Good luck with your legal work.

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

How to Handle Conflicting Medical Opinions? With a Forensic Approach, of Course!

Upon referral of a vocational case, I review a variety of  medical data (i.e., treating physician reports, FCE’s, IME’s) and/or psychological data (i.e., psychometric testing, psychological evaluations, psychiatric evaluations) found within the file. During a workers’ compensation litigated claim (for that matter, all claims that involve work and disability), it is important to understand the individual’s medical situation based on the data contained in these records.

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Good thing I’ve had medical records training…and enjoy the review!

If a file has more than one Functional Capacity Evaluation (FCE), I can expect the reports to have conflicting opinions. Commonly one physical therapist will recommend the claimant has the physical capacity for light work, while the other says medium work. Often the therapists also have conflicting information about the individual’s maximal (or lack of) effort put forth during the evaluation.

I Did My Best

The claimant needs to say honestly and sincerely  “I Did My Best!”

Assisting the individual (who used to be referred to as the injured worker, the patient, the claimant, the testee, the evaluee, and potentially the client)  in returning to work following an injury is a central role in my specialty of placement. This involves finding the best occupational match within the individual’s own labor market. A person’s “doctor imposed restrictions based on an FCE” should not direct the provision of placement services.

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With conflicting opinions from professionals, what data should I rely upon to perform a beneficial service?

To resolve discrepancies I first ask myself, why is an FCE being used for this specific claim? The utility of this type of scientifically based evaluation, the training sources, performance methods, test protocols and standards to measure them are numerous. Professionals may have opposing views for their own reasons but I must be able to articulate their reports into vocationally-relevant terminology and tell a story about meaningful and gainful work.

WORK

I love writing reports rich with detail about a person’s world of work! And I love reading medical data rich in detail about a person’s world of functioning!

A functional capacity evaluation is actually a term with various definitions, purposes and constructs. A functional capacity evaluation (FCE) evaluates an individual’s capacity to perform work activities related to his or her participation in employment. It seems that in essence, by having a functional capacity evaluation a person is likely to be put in a position of deciding whether he or she is willing to return to work. This is unfortunate.

From what I know, there are approximately 10 different types of commonly used functional capacity evaluations. Here in Iowa, I am most familiar with FCEs with names like the Isernhagen Work System, the Blankenship, Matheson, WorkWell and X-RTS. The reliability or validity of any system is somewhat irrelevant to me because the testing is already entered into “evidence.” What is relevant to me is whether or not I comprehend the results and recommendations contained within the evaluation. Sometimes I can, sometimes I cannot. I always use a “Does This Make Sense?” test!

Image result for conflictingIt’s up to the dualing physical therapists to make their best points during litigation, I’m not in that ring!

I feel fortunate of connections with several physical therapists allowing insight into their clinical practice. Recently I attended a continuing education program that helped me understand various approaches to FCE’s and I am rather fascinated with the X-RTS Lever Arm.

Thinking Cap

The X-RTS Lever Arm passes my make sense test!

So within the context of my vocational consulting work while cautiously putting any judgment aside (which seems hard when I know I know certain things), I analyze and compare each FCE while considering the testing results.

I analyze and compare FCEs! Whoa!

I note whether the FCE report is readable and user friendly. I assess if I understand terminology and methods used, how long testing was administered, what actually was administered, the claimant’s behavior during the test, and how the evaluator came to his or her conclusions. Does it make sense? I look for descriptors regarding the results of testing in relation to real jobs. Are there concrete and realistic recommendations regarding (strengths and weaknesses) in relation to performing physical demand levels of various work situations? I definitely look for the goals and expectations for the evaluation, and whether maximum and consistent effort was made by the evaluee. Comments on the suitability of the testee’s future employment options along with the evaluator’s observations are valuable!

Thinking Cap

Continuing on with analyzing and comparing FCEs! Whoa! It’s important to note what body part/extremity the therapist focuses on in relation to what body part/extremity was injured. For example in one report, the therapist discussed lower extremity activities, when in fact it was an upper extremity injury. If the report cites examples or uses too many percentages, it’s important to understand how the therapist justifies examples. I’m familiar with a therapist who changes the percentages of the same examples from report to report. That doesn’t make sense to me.

I try really hard to make sense of most things and situations!  No sense

If I am able to square an FCE in my mind after careful and prolonged study, is it possible the claimant could do the same? That is fortunate!

How does the claimant (not actually a patient at this time in a workers’ compensation case when referred for an FCE by their own attorney; with an additional FCE visit to a different physical therapist by the defense attorney) perceive discrepancies in the results? Sadly in my eyes, the FCE often gets “interpreted” through an attorney. The repeated pattern of thinking of one’s functional capacity as “poor” does not help me to help anyone return to work.

If there is an IME (Independent Medical Exam), it may seem more geared towards one of the FCEs. Regardless, I try to comprehend all reports, noting the one I understand the most. I’m not so sure that an IME is really a “fresh set of eyes” in the workers’ compensation cases I’ve recently worked on. This topic is another blog in itself.

Putting both, or multiple opinions in a vocational report and making use of other documentation to support my ultimate and final opinion is a great idea, however I have to be cautious to not put myself in a role that isn’t mine (making a medical opinion).

If I am able to provide a doctor (ideally the most recent treating occupational health or rehabilitation doctor) detailed information directly related to a specific occupation or line of work and any resources that could help understand how such work is performed in a smart, safe and effective manner, many benefits arise.

Related image

Clean your lenses!

There’s a clearer understanding of the vocational rehabilitation process and with agreement from all involved, there’s a higher likelihood one could see a successful common outcome (return to work). This certainly helps solidify my vocational opinion and make recommendations. Yet, this type of opportunity is not frequently available (certainly is though with a life care plan!). Please know I always search for a way to best express my vocational opinion.

In my reports, I document what medical records I’ve reviewed and then use the actual words from the individual during an interview describing how s/he details their physical impairment.  Often I hear verbatim what one doctor wrote in their restrictions. The evaluee will respond to my open questioning about any physical limitations (sometimes after the evaluee refers to his/her doctor’s letter) and read or have it memorized saying: “no lifting over 20 pounds, avoid twisting, bending, stooping, sit and stand as needed.”  No sense

What do those words really mean in real life? The individual doesn’t seem to know either. Ask an employer if they have a job that involves no lifting over 20 pounds, no twisting, no bending, no stooping, no this, no that …. and that’s not talking their language!

The evaluee who responds to me in this fashion (using verbatim restrictive words) needs future vocational counseling. Vocational counseling (which may or may not be provided depending on the nature of the litigation) helps to gain a clearer understanding of how the person’s medical situation has changed their daily living (especially in the context of their own world of work). This understanding leads to the ability to articulate the individual’s capacity for success to others (family, friends, job interviewers, etc.).

Please keep in mind, the term “restriction” is not conducive to a successful job search. The ability to explain who you are and what you can do from a functional perspective to help a business make or save money is what is conducive to a successful job search. Restrictions should never be the focus of job placement. Skills are!

Counseling is especially important if the individual is searching for a job, requiring job seeking skills training on how to or (how not to) disclose. The personal attributes gained from training helps the placement process move forward with common goals avoiding getting stuck within a few words that don’t apply to working reality.

WORKWhile staying true to my convictions and firm beliefs that a person can work if the person wants to work and has the capacity to work, I need to understand the dichotomy between science and clinical practice is more imagined than real.

If healthcare professionals submit conflicting reports on the same individual, I need to be able to resolve inconsistencies to better understand and appreciate the opinions offered. It is not my role to determine which opinion is correct. It is my role to utilize available information, provide a beneficial service, and make a sound vocational opinion regarding the individual’s strengths and weakness in relation to work capacity and employability.

Matching People With Their World of WorkIt’s rewarding when I can clarify a person’s sense of their own world of work.

I strive to extend the value of FCEs in the litigation process. I am trained not only in understanding a client’s functional abilities at work, but at home and at leisure. (Need a life care plan?) Together my knowledge with those of other experts, contributes to decisions about the economic losses, or damages, for which the person receives compensation.

Give me a call 515-282-7753 and let me get to work for you!

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

Chose Your Own Path Through Emotional Intelligence!

Happy Turkey-less Day to those who won’t be gobbling a gobbler (original post date November 24, 2015)!  I continue as a pescatarian! My two younger adult children continue their vegetarian lifestyle…(not my son Nick for he’s an incredible meat eater!) and although the no meat eating rubbed off on me many moons ago, I still enjoy eating fish.

Thank you Jake and Arin for showing me a lifestyle I probably wouldn’t have gone for had it not been for you two. But then again, I may have become really fantastic at grilling steaks (no, that’s Randy’s area.)

I love the taste of turkey and found a delicious vegetarian roast that tastes just the same! 

For this post, I want to write about a way to chose your own path……and I’ll start with a link to a post when my daughter Arin started a new job at Walgreen’s.

Over the two years she worked at Walgreen’s (she resigned earlier in 2014 to move on in different ways with her lifestyle), Arin had many customer experiences (including her days working as a hostess at Okoboji Grill). She’s shared many interesting retail shopper stories from her Walgreen’s days.

Some shoppers are kind with good intentions…get in the store, find what you need, pay and get out of the store…all while being grateful and appreciative. Then there are other shoppers who seem to float around in a bubble without realizing their bubble is more of a brick! Some shoppers are demanding, have no regard for other shoppers or the retail clerk, and are even down right rude. Yuk!

We all are continuously affected by the energy of other people in both positive and negative ways. My daughter learned quickly that the less you respond to rude, critical, argumentative people, the more peaceful your life will become and the more productive you’ll be on the job! AJ’s goal at work: Help customers find, buy, and get out of the store with minimal distraction…along with an idea or two of how to get the customer to spend more money (especially with products within her own department because of incentives!) This knowledge, my dear daughter, takes a certain level of emotional intelligence. Good for you!

Emotional intelligence is a huge factor in my work as an expert witness.

A very helpful and proactive way to limit how much we are affected in many settings and situations by where others are is a simple technique called being in your bubble.

Using your bubble when you need to, or realizing others are using their own bubble, takes a level of emotional intelligence, kindness and grace.

Bubble Me Up    Bubble

I can’t find the source for what follows, but I’m sure whoever it is would be happy to share! Being in your bubble goes as follows:

1.) Spend a few moments with your eyes closed, quieting your thoughts.

2.)  In your imagination create a big clear soap bubble all around you that is about a foot out from your body.

3.)  Notice yourself within this bubble, and acknowledge that any type of energy you don’t want to experience in your own body will be unable to get through the bubble, and will just bounce off.

4.)  Walk through your day within your bubble. Take a look at the bubble periodically just to affirm that it is there, and recreate it whenever you want to.

             Bubble Me Down Bubble

There’s great reasons to use this tool to manage the energy that bounces around us all of the time. It frees you up to create the experience(s) the way you choose, while leaving others free to their own expression. You won’t need to get into the struggle and discomfort of resisting what others are doing or thinking, because it happens outside of your bubble and doesn’t need to affect you.

I hope your work week is productive, and you enjoy experiencing the energy that surrounds your work and home environments. If I can help you with expert testimony, please don’t hesitate to call me.

Vocational Resources Plus, LLC * lcpresourcesplus.com * 515-282-7753  * VocResources@msn.com

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 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.