Cross Examining Psych Doctors - Tip #59-Administering Psychological Tests

The circumstances under which psychological tests are administered can be crucial for the outcome of those tests. Generally, it is important for tests to be administered under standardized conditions that guarantee that the testing environment provides adequate seating and lighting, privacy, ventilation and an absence of distractions such as noise. It is also important to have a test proctor oversee the process and make sure that the examinee is completing the tests in the prescribed manner and not, for example, responding randomly, making errors as a result of a lack of understanding of the instructions, or obtaining assistance in completing the tests from an unauthorized person or persons who could deliberately or inadvertently grossly distort the test’s results.

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More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #58-Specifying Personality Traits on Axis II

Personality traits or features are enduring patterns of perceiving, relating to and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts but are not sufficiently maladaptive to warrant concluding that the individual suffers from one of the Personality Disorders.  It is only when those traits lead to clinically significant distress or impairment in social, occupational or other important areas of functioning that it is reasonable to diagnose a Personality Disorder.  Information about personality traits is typically provided by the doctor to give the reader what they believe is significant information that will be helpful in understanding the patient.  However, since everyone has personality traits, the specification of those traits in a medical-legal report is not especially meaningful if one is concerned with using that report to determine if the person has suffered a psych injury.

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #57-The Five Axes Diagnostic System

Doctors often provide their diagnosis using the five axes diagnostic system. Axis I is reserved for diagnosing most psychological disorders, one exception being Personality Disorders, which are diagnosed on Axis II. The reader of the report should look for Axes III, IV and V where the doctor normally provides information about the individual’s general medical conditions, psychosocial and environmental problems and levels of Global Assessment of Functioning (GAF). The GAF score is especially important in medical-legal cases since it provides information about the individual’s level of functioning that may be relevant to the court’s decisions about disability. As per the DSM, it is also important that the doctor specify an individual’s GAF score at both the time of the evaluation and the highest GAF score they obtained during the past year. 

Check out my blog (http://drleckart.blogspot.com). More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #56-The MMPI Taken at Home

The MMPI-2 is the most frequently used version of the MMPI. The testing manual for the MMPI-2 provides information on the administration of the test, including the required testing conditions on pages 8 through 10 of that manual.

An inspection of page 8 of the testing manual indicates that it reads in part,

“Supervision by a fully qualified professional is essential in using the MMPI-2”

           Page 8 goes on to state,

“It is strongly recommended that the MMPI-2 not be administered without proper supervision and that it not be given to test-takers to complete at home.”

           Page 10 further emphasizes this point when it states,

“To repeat a point made earlier, administration of the MMPI-2 should always be supervised.”

Thus, when a doctor allows the patient to take the MMPI-2 at home, it is not possible to interpret any of the test data obtained as providing any credible information about the patient’s psychological status.

Check out my blog (http://drleckart.blogspot.com). More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #55-Psychological Testing Standards

Of all the five sources of information that are obtained about individuals undergoing psychological evaluations, the only form of objective data that is open to public inspection and can be presented to the court is the psychological testing data. Accordingly, the manner in which those data are obtained, scored, analyzed and interpreted are of primary importance. Clearly, the first hurdle that must be overcome in assessing the credibility of the psychological testing data is the manner in which it was collected. At the very minimum, all psychological testing should be administered under the supervision of a licensed mental health professional who may employ a test proctor to monitor the psychological testing and guard against any irregularities, including the possibility that the testing was not taken by the person to whom it was intended to be administered. 

Check out my blog (http://drleckart.blogspot.com). More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Control the Outcome of a Psych Doctor's Testimony

Let’s start out with something that will sound outrageous. I’ve been conducting personal injury and workers’ compensation evaluations on individuals claiming a psych injury for a little over 30 years. In those years I have evaluated somewhere between 5,000 and 10,000 individuals. I also have read far in excess of 10,000 psych reports. Now here is the outrageous part.  In 30+ years I have not found a single report that did not contain sufficient flaws to destroy the report’s credibility!

If you’re like most attorneys you are skilled in the law but have not been trained as a psych doctor. This gives the doctor the advantage and often puts you at their mercy. As an alternative there is a way to get the power needed to control the deposition’s outcome. You can get that power with an Apricot™ 

An Apricot™ describes a psych report’s flaws in jargon-free English, provides you with all the supporting technical data in simple terms, and gives you an extensive list of simply worded questions that will get those flaws on the record.  These questions take the doctor down the path, one little step at a time, where they don’t have any credible alternative but to admit that their report does not contain sufficient information to support their conclusions. Best yet, an Apricot™ is a work product privileged report that is useful in any jurisdiction and not discoverable.

Not sure if this is true? Do you think I can deliver? Go to my website atwww.DrLeckartWETC.com and view one or more sample Apricots™ and imagine how one would give you the power and control over the doctor to win your case!  If looking at the samples doesn’t convince you, just send me a copy of that horrible report and I’ll call you and tell you just where all the flaws are and how much it will cost your client to get all the documentation and questions you need to win your case.

drleckartwetc@gmail.com

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www.drleckartwetc.com

(844) 444-8898

Cross Examining Psych Doctors - Tip #54-Doctor-Created Diagnostic Ambiguity

When doctors take it upon themselves to add a modifier or specifier to their diagnosis where such a modifier or specifier is not permitted by the Diagnostic and Statistical Manual of Mental Disorders (DSM) all they have succeeded in doing is creating ambiguity in their opinions. The use of modifiers or specifiers created by the doctors results in a situation where their diagnosis is ambiguous as those creations have no generally understood meaning in DSM terminology.

Email me: drleckartwetc@gmail.com Check out my blog (http://drleckart.blogspot.com). More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #53-Identifying an Incomplete Major Depressive Disorder Diagnosis

In order to diagnose a Major Depressive Disorder correctly it is necessary to specify whether the disorder is of the Recurrent or Single Episode variety and to record the severity of the disorder. In Diagnostic and Statistical Manual of Mental Disorders (DSM) terminology the doctor is also required to provide a 5-digit numerical diagnostic code that allows the reader to work backwards and determine the full nature of the disorder if not described verbally. Thus, when a doctor provides a diagnosis of a Major Depressive Disorder, but declines to state if that disorder is of the Single Episode or Recurrent variety and/or declines to record the severity of the Major Depressive Disorder, then their diagnosis is incomplete.

Check out my blog (http://drleckart.blogspot.com). More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters   Email me at drleckartwetc@gmail.com

Cross Examining Psych Doctors - Tip #52-Deciding Between a Psychologist or a Psychiatrist for Medical-Legal Evaluations

The major differences between psychologists and psychiatrists are their training in psychological tests and psychotropic medications.  Psychologists typically have considerably more training and experience in administering and interpreting psychological tests.  Those tests are invaluable in providing data and insights into an individual’s credibility and possible psychopathology.  If you are concerned with the diagnosis of a mental disorder, the psychologist is in a better position to provide objective data concerning the person’s psychological status by using psychological tests.  However, once you know that a person has a specific disorder that is amenable or treatable with medication, the psychiatrist is the person who can intervene to provide that care.

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation:  A Practical Guide for Attorneys and Insurance Adjusters

Fifteen Ideas That Can Drive You "Crazy"

Everyone talks to themselves.  Unfortunately, sometimes the things we say to ourselves are less than productive.  In fact, some of our internal dialogues can make us “crazy.”  Here is the fourth of the “Big Fifteen.”

     4. If something bad happens to me it's "awful."

Fifteen Ideas That Can Drive You "Crazy"

Everyone talks to themselves.  Unfortunately, sometimes the things we say to ourselves are less than productive.  In fact, some of our internal dialogues can make us “crazy.”  Here is the first of the “Big Fifteen.”

3. It is important for me to always win.

Fifteen Ideas That Can Drive You "Crazy"

Everyone talks to themselves.  Unfortunately, sometimes the things we say to ourselves are less than productive.  In fact, some of our internal dialogues can make us “crazy.”  Here is the first of the “Big Fifteen.”

2. It is important for me to be perfect

Cross Examining Psych Doctors - Tip #51-Sadness and Crying are Normal and Not Necessarily Indicative of Psychopathology

In reading medical-legal reports one frequently finds that physicians will list complaints and observations of the patient that are made during the face-to-face interview that include sadness and tearfulness.  In this regard, it should be noted that a reading of page 355 of the DSM-IV-TR and page 168 of the DSM-5 reveals that those manuals explicitly state that, “periods of sadness are inherent aspects of the human experience.” As such, any observations of sadness and related behaviors are not necessarily indicative of psychopathology.  Clearly, while it may be tempting to equate sadness, tearfulness and crying with psychopathology, it should be noted that these behaviors are well within the realm of normal human behavior and not necessarily indicative of pathology.  Individuals may cry for a variety of reasons, including being reasonably, normally, understandably, and expectably upset by physical difficulties, occupational problems and life circumstances. 

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Cross Examining Psych Doctors - Tip #50-Testing Always Requires a Test Proctor or Supervision

Of all the five sources of information that are obtained about individuals undergoing psychological evaluations, the only form of objective data that is usually open to public inspection and can be presented to the court is the psychological testing data.  Accordingly, the manner in which those data are obtained, scored, analyzed and interpreted are of primary importance.  For example, the testing manual for the MMPI-2 provides information on the administration of the test, including the required testing conditions on pages 8 through 10 of that manual (Butcher, J.N., Graham, J.R., Ben-Porath, Y.S., Tellegen, A., Dahlstrom, W.G. & Kaemmer, B.  MMPI-2 (Minnesota Multiphasic Personality Inventory-2) Manual for Administration, Scoring, and Interpretation, Revised Edition, Minneapolis, University of Minnesota Press, 2001).  The manual very explicitly states that the MMPI-2 should not be given to the test-taker to complete at home and that the instrument should be administered with supervision by a qualified professional.  Most generally, similar “rules” should be followed for all other tests in order to guarantee the credibility of the doctor’s conclusions. 

Check out my blog (http://drleckart.blogspot.com).  More help can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters