Encyclopedia of Psychology and Law

during the clinical interview; (d) information obtained

during the claim investigation; and (e) psychological

and/or neuropsychological test data. It is important

that the evaluator not rely solely on the claimant’s self-

report but view it as one, among many, of the sources

of evaluation data.

Psychological and/or neuropsychological tests are

usually considered an integral component of a disabil-

ity or workers’ compensation evaluation. Test selec-

tion should be determined by the specific referral

questions and the nature of the claimed impairment.

Although most disability and/or workers’ compensa-

tion disputes are resolved without litigation, as with

any forensic evaluation admissibility issues should be

a consideration in test selection. Depending on the

jurisdiction, Frye (general acceptance) or Daubert

(testable, peer-reviewed, known error rate, and gen-

eral acceptance) standards should be taken into

account. Therefore, the best practice is to use tests that

are standardized, objective, valid, and reliable.

Evaluators are typically asked to rule in or rule out

symptom exaggeration or malingering, as claims for

disability and workers’ compensation benefits present

the possibility of secondary gain in terms of financial

remuneration and/or avoidance of work. Although

base rates are difficult to establish, it has been esti-

mated that malingering occurs in 7.5% to 33% of all

disability claims. Methods for assessing symptom

validity include using multiple sources of data, ana-

lyzing patterns of psychological and neuropsycholog-

ical test performance, employing the validity scales

included in standardized psychological tests (e.g., the

F scale on the Minnesota Multiphasic Personality

Inventory–2 [MMPI–2]), administering specifically

designed measures of symptom validity (e.g., the Test

of Memory Malingering, Validity Indicator Profile),

and using structured interviews (e.g., Structured

Inventory of Reported Symptoms, Miller Forensic

Assessment of Symptoms Test). The use of multiple

methods is preferable.

It is important to fully respond to the referral ques-

tions and not add information that is unrelated to or

goes beyond the scope of these questions. Ultimate

issue decisions—such as whether the claimant meets

the policy definition of disability or has a compensable

workers’ compensation claim—should not to be made

by the evaluator. The evaluator’s role is to provide the

referral source with information related to the func-

tional capacity of the claimant or the causality of the

claimant’s condition. Conclusive statements such as

“The claimant is disabled” or “This is a compensable

claim” should be avoided in favor of statements such

as “The claimant’s inability to follow multistep direc-

tions would significantly limit her ability to perform

complex surgical procedures” or “The claimant’s acute

distress disorder was likely precipitated by the armed

robbery that occurred in the workplace.”

At the conclusion of the evaluation, a written report

should be provided to the referral source. This report

should be well organized with data sources clearly

identified. It is helpful to have separate sections sum-

marizing the materials reviewed, the self-reported his-

tory provided by the claimant, information obtained

from collateral sources, behavioral observations, psy-

chological test data, and any other data used by the

evaluator. This should be followed by a discussion of

the evaluator’s impressions and interpretation of the

data. Inconsistencies and gaps in the data should be

noted. Finally, the evaluator should explicitly respond

to each referral question.

It is important to keep in mind that the consumers of

the IME or QME report are insurance company person-

nel and attorneys, not mental health professionals.

Professional jargon, acronyms, and undefined scientific

or medical terms should be avoided. Clear, concise lan-

guage should be used, so that the report is useful to the

reader and not subject to misinterpretation.

Lisa D. Piechowski

See alsoDetection of Deception in Adults; Expert

Psychological Testimony, Admissibility Standards;

Forensic Assessment; Malingering

Further Readings

Hadjistavropoulos, T., & Bieling, P. (2001). File review

consultation in the adjudication of mental health and

chronic pain disability claims. Consulting Psychology

Journal: Practice and Research, 53(1), 52–63.

Piechowski, L. D. (2006). Forensic consultation in disability

insurance matters. Journal of Psychiatry & Law,

34 (2), 151–167.

Samuel, R., & Mittenberg, W. (2005). Determination of

malingering in disability evaluations. Primary Psychiatry,

12 (12), 60–68.

Vore, D. A. (2007). The disability psychological independent

medical evaluation: Case law, ethical issues, and

procedures. In A. M. Goldstein (Ed.),Forensic

psychology: Emerging topics and expanding roles

(pp. 489–510). Hoboken, NJ: Wiley.

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