228 - Validity Testing, Mental Health Intervention, and Clinical Assessment Tools Optimize Timely and Evidence-based Care for Postconcussional and Post-COVID Concerns

Session Description: This panel addresses complex concussion/COVID presentations and contextualizes when, despite a lack of objective evidence to support ongoing impairment, extended symptoms reflect psychosocial or psychological concerns rather than "disability". A "wait and see" approach, or excessive medical expenditure increases the risk of prolonged disengagement from typical activities, work and causes additional deconditioning, both physical, and mental. Over-diagnosis of PCS/post-COVID conditions may also occur. To address this, a targeted neurocognitive screening that includes symptom and performance validity testing, aids in providing appropriate assessment and realistic reassurance, distinguishing genuine impairment from invalid or over-reporting, and determining when a brief course of work-focused CBT can reduce the impact of psychosocial factors, psychological conditions, or minor cognitive impairments on return to functioning. Qualified evaluators, essential testing components, case examples, evidence-based interventions, and effective documentation to support insurance authorization and medical management will be discussed.

Educational Gaps: When treatment impact plateaus prior to a return to baseline after concussion or COVID-19, psychosocial/mental health obstacles are frequent barriers to recovery, a disability mindset, or inaccurate diagnosis. In such cases, referral for neurocognitive screening with validity measures, can provide the patient with realistic reassurance and identify targets of intervention or support a MMI decision.

Is this session being sponsored by an ACOEM Section or Component?: No

Has this session previously been presented?: No

The AOHC 2026 theme is Healthy workers. Healthy world: Workers face prolonged disability from lingering symptoms of concussion and COVID-19, creating health and economic challenges that extend far beyond individual patients. This widespread impact demands innovative solutions that can transform worker outcomes and overall societal wellbeing.
Postconcussional syndrome (PCS) and Post-COVID-19 Condition (PCC) present symptom profiles—fatigue, cognitive complaints, and headaches, for example—that overlap with numerous medical and psychiatric disorders. In such cases, psychosocial factors, anxiety, deconditioning, and comorbid conditions often contribute to impairment beyond expected physical recovery timelines. Without proper assessment and intervention, this pattern perpetuates cycles of disability that strain healthcare systems, reduce workforce productivity, and burden families and communities worldwide.
Occupational health physicians are uniquely positioned to break these cycles through integrated, evidence-based approaches. When there are ‘red flags’ for delayed recovery, making referrals for targeted neurocognitive and psychological evaluations can aid in identifying specific barriers to recovery and tailoring intervention plans accordingly. Health psychology and work-focused cognitive behavioral therapies can dramatically improve outcomes when properly applied.
The key to creating healthier workers—and ultimately a healthier world—lies in well-timed, strategic return-to-work approaches with suitable accommodations rather than long periods of work cessation. This helps prevent deconditioning and disengagement that often transforms temporary impairments into long-term disabilities.
A paradigm shift—from managing disability to actively promoting recovery in the context of concussion and COVID— will create positive impacts that extend beyond the workplace: reduced healthcare costs, maintained productivity, and more resilient communities.