Tuesday, July 23, 2019

Trashing Flawed Psych Reports

In the words of John Henry Wigmore, cross-examination is “beyond any doubt the greatest legal engine ever invented for the discovery of truth.”

3 Wigmore, Evidence §1367, p. 27 (2d ed. 1923)

The Problem:  You’ve got a psych case in which a doctor diagnosed a disorder and concluded that the patient has had a psychiatric injury and is psychiatrically disabled.  You also have lots of collateral information indicating that none of this is true. 

How do you cross-examine the doctor?

If you’re an attorney working on a psych case there is only one way to trash an unsubstantial or incompetent report.  When you take the doctor’s deposition or trial testimony you attack the doctor’s DSM diagnosis by showing that their report doesn’t support their diagnosis. 

If the diagnostic manual’s criteria are not supported by the data in the doctor’s report, the doctor’s
diagnosis and all the conclusions flowing from that diagnosis are worthless. 

If you take any other approach the doctor will simply hide behind their “professional opinion.”  Quite simply, all other approaches or strategies may produce piddling results but will not produce a prideful, winning outcome.

I’ve been singing the same song for over thirty years of critiquing tens of thousands of psych reports.  The only thing that consistently works is attacking the doctor’s diagnosis.

You want to know how to do that?  Ask me! 
(844) 444-8898.  No charge for the phone call.

End of the story.

Tuesday, September 25, 2018

Five reasons to never depose a psych doctor without an Apricot™ - Cross Examining Psych Doctors, Tip #122

An Apricot™ is a report that provides attorneys and insurance adjusters with information about the flaws in a psych report.  An Apricot™ is written on an expert witness basis and is protected by the work product doctrine.

1. Attorneys are experts in the law and typically not experts in psychology or psychiatry.
2. Psych doctors have the upper hand when being deposed by an attorney.
3. An Apricot™ uses non-technical terms to describe the flaws in a psych report revealing that the report does not constitute substantial medical evidence.
4. An Apricot™ provides the attorney with a list of simple questions to use on cross-examination of the doctor.
5. An Apricot™ provides a list of the major problems in the doctor’s report.

Friday, August 31, 2018

When psych reports are not in your favor - What to do about it - Tip #121

Dr. Bruce Leckart conducts psychological evaluations in workers’ compensation and personal injury litigation. In addition to evaluating patients, he provides Apricots™ for attorneys and insurance adjusters who have a psych report not in their favor. An Apricot™ is a work-product privileged report used to assist an attorney in cross-examining a doctor and/or writing a trial brief for the court. Essentially, Dr. Leckart will find every flaw in the report, write up those flaws in easy-to-understand terms and provide the attorney with a list of simple questions to use in cross-examination. It doesn’t matter which state you are located in or the jurisdiction, Dr. Leckart can assist when you have a psych report that is not in your favor.

Give us a call today: (844) 444-8898

Tuesday, July 3, 2018

The Miller Forensic Assessment of Symptoms Test (M-FAST) - Cross-Examining Psych Doctors, Tip #120

     The M-FAST is a 25-item, doctor-administered, brief structured interview designed to identify individuals who may be over-reporting, exaggerating, or fabricating psychological symptoms.  However, the M-Fast is not a psychological test in the sense that it presents any physical material that is administered to a patient.  Clearly, the results of the M-Fast are based on the doctor’s subjective observations, rather than the patient’s objective responses and therefore, this measure is not capable of presenting any non-interview objective data to the court.  When you find that the doctor discussed the M-Fast in their report you should ask the doctor if the M-Fast has any demonstrably effective methods for measuring the individual’s test-taking attitudes and credibility.

The MMPI K Scale - Cross-Examining Psych Doctors, Tip #119

     The Minnesota Multiphasic Personality Inventory (MMPI) is a psychological test that is considered the gold standard of test batteries used in medical legal evaluations.  The MMPI-2 was published in 1989 and has many proponents who depend on the test’s validity scales to provide information about the individual’s test-taking attitudes and credibility.  In fact, the MMPI-2 is the most commonly used version of the MMPI by psychologists and psychiatrists.  Every validity and clinical scale performance is described with a T-Score on the MMPI-2 which all have a mean of 50 and a standard deviation of 10.  Further, it is well known and universally accepted that T-Scores of 65 or larger are clinically significant or interpretable.  In this regard, the K Scale is one of the validity scales of the MMPI-2.  T-Scores 65 or higher on the K Scale are associated with the exaggeration of physical disability and distorting the individual’s true psychological condition.

Thursday, June 28, 2018

Proverbs in a Mental Status Examination - Cross-Examining Psych Doctors, Tip #118

     One of the five basic sources of information that compose a credible psychological or psychiatric examination and report is a Mental Status Examination.  A Mental Status Examination is normally part of every face-to-face clinical interview during a medical legal evaluation.  In this regard, a Mental Status Examination produces a set of observations of the patient that are made by the doctor under reasonably controlled conditions, employing a relatively standard set of examining techniques and questions.  One of those examining techniques is to ask the examinee to interpret a set of proverbs.  For example, insight can be measured by asking the patient to interpret proverbs such as “a stitch in time saves nine.”  Similarly, judgment can be measured by simply asking the person what they would do if they found a child locked in a car on a hot summer’s day.   When reading a psych report you may notice that the doctor commented on the patient’s insight and/or judgment but did not provide any easily and normally obtainable observational data concerning those processes.  Accordingly, during a deposition an attorney should ask the doctor where in their report they cited their Mental Status Examination test results supporting their conclusions about the patient’s judgment and insight.

Thursday, May 24, 2018

Serial 3s Task - Cross-Examining Psych Doctors, Tip #117

     When performing a Mental Status Examination during a psychological evaluation, the doctor may choose to have the patient count backward from 20 by 3s as a measure of their concentration.  This task is called a serial 3s task and can be done relatively quickly during a face-to-face interview.  The patient’s performance on a serial 3s task is a measure of concentration.  When a doctor chooses to use a serial 3s task to measure the patient’s concentration, it is imperative that they describe their observational data in their report of their Mental Status Examination.