Saturday, June 16, 2007

Identify Malingerers or Pay the Price

It is very likely that insurance companies are needlessly paying large sums of money to claimants with exaggerated or faked psychological symptoms such as exaggerated PTSD (Posttraumatic Stress Disorder). Unfortunately, exaggerated PTSD is only one example of the many kinds of exaggerated psychological symptoms that might be exhibited by a personal injury, Worker’s Compensation or disability claimant in order to secure financial benefits or to avoid work.

Exaggeration and faking of mental disorders are not rare occurrences especially now that many litigants can find information on the Internet that may assist them in their attempts to report genuine-sounding, though false or exaggerated, psychological symptoms.

How frequently does faking or exaggeration of PTSD and other psychological symptoms occur? A 1994 study reported that that almost 16% of examinees malingered psychological symptoms in forensic (court) settings and 7% of examinees malingered psychological symptoms in non-forensic settings. In 1996 a follow-up study by some of the same authors showed that malingered psychological symptoms occurred slightly more frequently than indicated by the 1994 study. A study conducted in 2000 showed that 29% of personal injury litigants, 30% of disability claimants, 19% of criminal cases and 8% of medical cases likely involved some degree of symptom exaggeration and malingering of psychological or medical symptoms. Clearly, exaggeration, faking or malingering of psychological symptoms on the part of litigants is relatively common.

How can insurance companies avoid losses due to exaggerated or faked psychological symptoms? One critical technique that can prevent or reduce such losses is to require that the psychologist conducting an IME or psychological evaluation of the tort claimant fully evaluates the likelihood of exaggeration or malingering. The psychologist usually accomplishes this by using sophisticated psychological tests that can reliably detect faking, even when a litigant has learned techniques to assist him or her in efforts to deceive the examiner.

However, based on my 30 years of experience as a clinical and forensic psychologist, during which time I have conducted thousands of psychological evaluations of tort claimants, I have found that many mental health professionals conducting such examinations have failed to utilize effective procedures to identify exaggerators, fakers and malingerers. Astoundingly, I have found that some mental health professionals, including psychologists and psychiatrists, apparently fail to even consider the idea that an examinee may have exaggerated or faked psychological symptoms. This is evident when there is no mention in the written psychological or psychiatric report that such a consideration was made. This is a major failure, in my opinion, especially in those cases (such as with a diagnosis of PTSD) in which the Diagnostic and Statistical Manual of Mental Disorders specifically states that malingering must be ruled out before such a diagnosis can be made.

I can assist you in determining whether exaggeration, faking or malingering of psychological symptoms may have occurred. My procedures include a review of existing medical records, a clinical or face-to-face interview of the litigant and the administration of specialized psychological tests that have been scientifically demonstrated to be useful in making such a determination.

More information about the procedures and tests I utilize when conducting forensic psychological evaluations can be found on my website by clicking on the Articles button on the left side of your screen. In addition, citations to studies reported in today’s blog entry are available upon request.

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