Cross-Examining Psych Doctors - Tip #14-Get Questions to Ask the Doctor

What kinds of Cx questions do I provide in an Apricot™?  They are questions I would not want asked of me if I were the doctor being deposed.  No telling what effect they will have on the doctor being deposed but they are questions that would make me feel embarrassed and humiliated if I wrote their report.  Most importantly, an Apricot™ provides the attorney with all of the information that they need to back up their questions and get to a point where it is obvious that  the conclusions in the doctor’s report are flawed.

More help for cross-examining psych doctors can be found at my website and in my book Psychological Evaluations in Litigation: A Practical Guide for Attorneys and Insurance Adjusters.

Cross-Examining Psych Doctors – Tip #11-Getting Help From an Expert

Got a psych depo coming up?  Need to plan your strategy and devise questions?  Need to write a brief on a flawed psych report?  Not sure how to achieve your goals?  Not sure where the report is vulnerable?  Not sure what questions to ask or where to attack?  You know the report is flawed but you’re not sure where?  You need an expert witness.  Check out my website at drleckartwetc.com and learn about Apricots™. 

More help for cross-examining psych doctors can be found at Dr. Leckart’s website and in his book Psychological Evaluations in Litigation: A Practical Guide for Attorneys and Insurance Adjusters.

Psychologists v. Psychiatrists

Who Best to Hire as an Expert? Psychologists have either a Ph.D. or a Psy.D. degree in psychology.  A Ph.D. is a research oriented degree whereas a Psy.D. is a treatment oriented degree.  Psychiatrists have M.D. degrees.  Psychiatrists are trained and more knowledgeable about psychotropic medication and treatment, which are rarely concerns in litigation.  Psychologists are trained and more knowledgeable about psychological testing than psychiatrists.  In most psych medical-legal reports the basic question is, “Has the claimant suffered a psychological injury?”  The answer hinges on the doctor’s diagnosis.  Both psychologists and psychiatrists use five sources of information to arrive at a diagnosis, the three most important of which are:  the patient’s life history and their presenting complaints, the doctor’s Mental Status Examination results and the objective psychological testing data.  Of the three only the psychological testing provides objective information about a diagnosis and patient credibility that can be presented to the court.   Given the above, “Who do you think can write a more credible and comprehensive medical-legal report?”  “Who will provide better testimony?”  Finally, consider this.  I’ve read at least 30,000 psych reports over the last 30 years and cannot recall ever reading a single one in which a psychologist found it necessary to hire a psychiatrist to help with the examination.  In contrast, I frequently see reports written by psychiatrists who hire psychologists to interpret the testing.  "What does this tell you?"  “Who do you want on your side?”

More help for cross-examining psych doctors can be found at Dr. Leckart’s website (www.drleckartwetc.com) and in his book Psychological Evaluations In Litigation:  A Practical Guide for Attorneys and Insurance Adjusters (http://drleckartwetc.com/wp-content/uploads/2012/10/FINAL-051311.pdf).

Cross-Examining Psych Doctors – Tip #8

Cross Examining Psych Doctors - Tip #8-Revealing Patient Honesty

There are literally thousands of psychological tests.  However, only a very few of them have validity scales for determining if the patient answered the questions in an honest and forthright manner.  When reading the psychological testing section of a psych report be sure to determine what those tests reveal about the patient's credibility during the doctor's examination.  If the tests indicate that the patient wasn't truthful, how did the doctor explain those data? 

More help for cross-examining psych doctors can be found at Dr. Leckart’s website (www.drleckartwetc.com) and in his book Psychological Evaluations in Litigation:  A Practical Guide for Attorneys and Insurance Adjusters (http://drleckartwetc.com/wp-content/uploads/2012/10/FINAL-051311.pdf).

Measuring Patient Credibility in Psych Legal Evaluations

Since the patient provides most of the data used to draw conclusions about their psychological status, the first responsibility of any medical-legal evaluator in a psych case is assessing the patient’s credibility. But how does a doctor tell if a patient is being honest and straightforward?

If you’re an attorney, insurance adjuster or another mental health professional what do you look for in the doctor’s report to see if the patient was telling the truth and if the doctor established their credibility?

There are four different places in the report to look for data demonstrating the patient’s credibility: the Mental Status Examination, the patient’s life history and presenting complaints, the psychological testing data and the patient’s medical records.

Click here to read more from Dr. Leckart.

Cross-Examining Psych Doctors - Tip # 6

Cross Examining Psych Doctors - Tip #6-Persistence is Key

Under cross-examination, psych doctors sometimes answer questions with technical jargon or are non-responsive in other ways.  Sometimes that behavior is deliberate and sometimes it is just how the doctors think and express themselves.  Regardless, when that occurs you may not have the foggiest idea of what the doctor is talking about.  One simple solution is to be persistent!  When the doctor is indirect or obscure just go back to your same simple question and repeat it until you get your clear simple answer.

More help for cross-examining psych doctors and preparing briefs for the court can be found at (www.drleckartwetc.com) and in my book Psychological Evaluations in Litigation: A Practical Guide For Attorneys and Insurance Adjusters (http://drleckartwetc.com/wp-content/uploads/2012/10/FINAL-051311.pdf)

Cross-Examining Psych Doctors - Tip #5

Cross Examining Psych Doctors - Tip #5-Mental Status Examinations

Information about a patient's credibility can be found in the doctor's report of their face-to-face Mental Status Examination (MSE). An MSE provides a set of observations of the patient that are made by the doctor employing a relatively standard set of examination techniques and observations. At the very least the data in the MSE should be consistent with the data found in the doctor's history, the psychological testing, and the patient's medical records. The MSE should also contain information about the doctor's observations of the patient' consistency vs. inconsistency and vagueness vs. clarity both of which speak to the patient's credibility. A complete description of MSE's can be found in my book Psychological Evaluations in Litigation: A Guide for Attorneys and Insurance Adjusters that can be read or downloaded for free on my website. You can also find copies of my monthly newsletters further addressing MSE's

     More tips and free tools for help in cross-examining psych doctors and preparing briefs for the court can be found at www.drleckartwetc.com

What is an Apricot™

An Apricot™ is a work-product privileged report used to assist an attorney in taking a psych doctor’s testimony. An Apricot™ describes all of the substantial flaws in a psych report in jargon-free, non-technical language. An Apricot™ also provides a list of questions and techniques that get those flaws on the record despite that might be the doctor’s evasive or non-co-operative behavior.   

An Apricot™ is used when the attorney decides there is weakness in a psych doctor’s report that needs challenging during a deposition or trial testimony.

Cross Examining Psych Docs Tip #4

Cross Examining Psych Doctors - Tip #4-Credibility is Key

The first responsibility of any medical-legal evaluator is to demonstrate the patient’s credibility.  One measure of credibility is the objective psychological test scores in the doctor’s report.  There are three psychological tests often found in medical-legal reports that are capable of providing such data:  the Minnesota Multiphasic Personality Inventory (MMPI), the Cattell Sixteen Personality Factor Test (16PF) and the Millon Clinical Multiaxial Inventory (MCMI).  A discussion of these tests can be found in my book Psychological Evaluations in Litigation:  A Guide for Attorneys and Insurance Adjusters that can be read or downloaded for free at www.drleckartwetc.com where you can also find copies of my monthly newsletters addressing psychological testing in detail.  An attorney can prepare for a deposition or trial by determining if the scores indicate that the patient was exaggerating, embellishing, over-reporting or attempting to simulate symptoms or telling the truth.

More tips and free tools for help in cross-examining psych doctors and preparing briefs for the court can be found at Dr. Leckart’s website:  www.drleckartwetc.com

Cross-Examining Psych Doctors: Tip #3

Cross Examining Psych Doctors - Tip #3-Support for the Diagnosis

The most frequent and substantial flaw in psych reports is the doctor’s diagnosis.  Simply put, there must always be data or evidence that supports the diagnosis.  Thus, the first thing to do is to obtain the diagnostic criteria from the DSM-IV-TR or the DSM-5, whichever is applicable in your jurisdiction. Then look at the doctor’s history.  At that point you just ask yourself, “Do the data support the diagnosis”?  If the history is deficient in providing information about the symptoms in terms of their qualitative nature as well as their frequency, intensity, duration, onset or course over time there is no support for the doctor’s diagnosis.

More tips and free tools for help in cross-examining psych doctors and preparing briefs for the court can be found at Dr. Leckart’s website: www.drleckartwetc.com

Cross-Examining Psych Doctors - Tip #2

Cross Examining Psych Doctors - Tip #2-Attack the Diagnosis

When cross-examining psych doctors, attorneys should focus their questioning on the weakest part of the doctor’s report, which is their diagnosis. When effectively done this approach will force the doctor to testify that there were insufficient data in his or her report to support their diagnosis. Once this has been done all of the other conclusions about things like causality, disability, prior pathology and the need for treatment fall by the wayside like a collapsing house of cards. 

More tips and free tools for help in cross-examining psych doctors and preparing briefs for the court can be found at Dr. Leckart’s website: www.drleckartwetc.com

Cross-Examining Psych Doctors - Tip #1

Cross Examining Psych Doctors - Tip #25-Direct Depo Questions

Attorneys should only question the doctor about their report and never about the patient. This approach will ensure that no new "evidence" can find its way into the doctor’s testimony and the outcome will most likely be far superior than asking the doctor about the patient. If you ask the doctor about the patient this allows them to provide information of questionable validity that is not their report that could conceivably support their conclusions. 

This tip is based upon outcomes from actual written pre-deposition consults (Apricots™) done by Dr. Bruce Leckart.

More from Dr. Leckart:
www.drleckartwetc.com

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Psychological Evaluations in Litigation: A Practical Guide for Attorneys and Insurance Adjusters

This book was written with the intention of helping attorneys and adjusters assess the credibility of psychological and psychiatric reports, to prepare to take trial and deposition testimony from psychologists, psychiatrists and patients, and to decide which doctors to hire...all in an effort to help win psych cases!

The next time you want to know something about a diagnosis, a psych test, or Mental Status Evaluation just look it up! Keep in mind, the weakest part of every psych report is the doctor's diagnosis.

You may also be interested in reading more about the book in our newsletter: The Book of Apricots™

 
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