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Disability/Worker's Comp

Dr. Kutner has over 30 years of experience in working with individuals who have sustained head trauma, ranging from mild concussion to severe brain injury. He also specializes in the evaluation of stroke, brain tumor, hypoxia/anoxia, epilepsy, neuro-toxicity, dementia, Parkinson's disease, and other neurological disorders. He regularly performs Disability Evaluations, Independent Medical Exams (IMEs), Law Enforcement Fitness-for-Duty Exams, Mental Capacity and Competency Exams, as well as provides Expert Testimony.

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Disability Determination

Worker's Compensation Disability

Unfortunately, some individuals can become disable from injuries at work (i.e. concussion, traumatic brain injury) and are no longer able to work and support themselves or their families. The process of obtaining disability requires medical documentation of disability. For traumatic brain injury and concussion (Post-Concussion Syndrome), Neuropsychological Evaluations provide the most reliable and valid way of measuring cognitive impairment.

Disability 

 

Some individuals become disabled and are no longer able to perform their job due to medical conditions such as a stroke, multiple sclerosis, Parkinson’s disease, etc. Obtaining disability benefits, whether they be short-term or long-term, requires medical documentation of their disability. Specific disability policies indicate whether the individual needs to provide proof (medical documentation) that they are either disabled from only their specific occupation or disabled from any type of work (gainful employment). Neuropsychological Evaluations are utilized to make this determination.

Disability Examinations

Dr. Kutner has been performing Disability Examinations for more than 30 years. He is a Board-Certified Neuropsychologist and on the clinical faculty of Weill Cornell Medicine-Cornell University. After Neuropsychological Evaluations are completed, a detailed comprehensive narrative report is prepared which becomes a critical part of the eventual determination for Disability.

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Law Enforcement

Dr. Kutner is a Board-Certified Neuropsychologist who performs Neuropsychological Evaluation (Fitness-for-Duty Exams) in both Southeast Florida and New Jersey. Dr. Kutner has been a Police Physician with the Fort Lee, NJ Police Department since 1989. He has been reappointed in this position for the year 2024. Dr. Kutner has extensive experience performing Fitness-for-Duty Evaluations for Law Enforcement for more than 25 years. His experience includes evaluating officers from local Police Departments, Corrections Departments, County Prosecutor Offices, NJ State Police, as well as Federal Law Enforcement Agencies.

Law Enforcement Officers, along with Firefighters and EMS require intact cognitive skills to perform the essential tasks of their job. Cognitively, officers utilize reasoning, memory, language, and visual-spatial skills in carrying out the duties as either a patrol officer or supervising officer i.e., lieutenant, captain, and chief. There are numerous medical conditions which can affect an officer’s ability to carry out the essential tasks required in his or her position. Some of these medical conditions such as a head injury or concussion frequently occur in the line of duty in motor vehicle accidents or while arresting individuals. Head injuries also frequently occur outside of the job from sports participation or car accidents which occur off duty. Brain injuries can temporarily or permanently affect a Law Enforcement Officer's ability to carry out their duties.

 

Traumatic Brain Injuries are divided into mild, moderate, and severe. Concussions are the most frequent type of injury and are known as Mild Traumatic Brain Injury. While most (85-90%) of Law Enforcement officers who sustain them experience complete recovery, some officers have persisting cognitive problems. It is critical for officers sustaining a concussion, either on the job or off duty, to allow the concussion to resolve prior to returning to duty. In some cases, officers may be able to return to light duty while their concussive symptoms are resolving.

 

Officers can develop problems with reasoning and memory from numerous other medical conditions including stroke and multiple sclerosis. In addition, brain damage from head trauma or stroke can affect an officer’s emotional ability. Known as neurobehavioral impairment, TBI induced problems can include impulsivity or agitation which is detrimental to effectively carrying out the duties in law enforcement.

 

The Gold Standard for evaluating a Law Enforcement’s cognitive Fitness-for-Duty is the Neuropsychological Evaluation. Reasoning and memory cannot be measured through neuroimaging procedures such as MRI or CT scans. Neuropsychological Evaluations are non-invasive and are typically completed in 3-4 hours.

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COVID-19

​Many people continue to experience health problems after their initial COVID-19 infection resolves. Persisting COVID-19 problems have been called Post Covid Condition (PCC) or Long COVID. The most common Long COVID symptoms are shortness of breath, fatigue, and Brain Fog. It should be noted that a wide range of ongoing symptoms can occur, which include loss of smell, muscle ache, headache, cough, chest pain, and insomnia. Long COVID can last months or even years. In July of 2021, Long COVID was added as a recognized medical condition which qualified for disability under the Americans with Disabilities Act.

Diagnosis

At this point, a definitive test for diagnosis of Long COVID does not exist. Many individuals with Long-Term COVID have negative blood tests. The diagnosis of this condition is made by your health history. Specifically, your health care provider considers the following: was diagnosed with COVID-19, had a positive COVID-19 test, showed symptoms of this condition, or have been exposed to an individual who was sick. We are still early in understanding Long COVID with numerous studies ongoing at this time. It appears that individuals who are at an increased risk of Long COVID include those who: 1) had moderate-severe COVID-19, 2) have had a more severe COVID infection requiring hospitalization or visit to the Emergency Room, 3) who have had COVID-19 more than one time, and 4) those with underlying health problems. In addition, individuals who have had Multisystem Inflammatory Syndrome (MIS) are at an increased risk.

 

Brain Fog

Patients with Long COVID frequently report problems with their ability to think and focus. This has come to be known as Brain Fog. While cognitive problems with Brain Fog exist, the term Brain Fog is not currently an actual medical diagnosis listed in the International Classification of Diseases (ICD-10). Patients who have these symptoms are often given a diagnosis of Unspecified Symptoms and Signs Involving Cognitive Functions and Awareness (R41.9). Research to date has not clearly determined what is causing Covid Brain Fog. Initial considerations include actual effects of the infection on the brain and neuroinflammation. Several studies have pointed to COVID-19 causing neuroinflammation through cytokine release with one recent study revealing inflammation related damage through gliosis.

Neuropsychological Testing

Research to date has not clearly determined what is causing Covid Brain Fog. Initial studies have revealed possible causes of the cognitive problems commonly experienced in Long COVID. Whatever the cause ends up being, individuals with Long COVID often suffer from problems with attention/concentration, thinking, and memory which interferes with their ability to function well at work, school, and at times in their daily activities. In some individuals, stress or depression can be found from continued symptoms such as fatigue, headache, pain, makes their cognitive ability worse. Neuropsychological Testing provides the best window into diagnosing these cognitive problems and assisting patients with compensating for them. In some cases of COVID-19, cognitive problems or Brain Fog is so bad that they are unable to continue in their job.

In these cases, Neuropsychological Testing performed by Dr. Kutner is utilized to assist the patient in qualifying for disability. As noted earlier, Long COVID has been a qualifying Disability under the American Disabilities Act since 2021.

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