How Can A Forensic Psychiatrist Assist In Personal Injury Cases?

Personal injury lawsuits are based on tort or civil law. There are four criteria for determining if a personal injury entitles the plaintiff to compensation from the defendant. These criteria are:

1. The defendant must have a clear and specific duty or obligation to the plaintiff.
2. There must have been some provable failure to perform or a breach of that duty by act of omission or volition by the defendant.
3. The plaintiff must give evidence of some damage or disability that demonstrates a decrease in the plaintiff's level of functioning or peace of mind from an earlier point in time.
4. There is good reason to believe that the plaintiff's damage or disability was the result of or increased by the defendant's dereliction of duty and was therefore the immediate cause of the damage.

In cases of personal injury, a forensic psychiatrist may be hired by the defense or plaintiff's lawyer in order to answer the following questions:

1. Does the person being evaluated have a psychological injury; and if so, what is the extent of this injury?
2. How much of the injury is most likely attributed to the event that allegedly caused it?

A psychological injury could also be the result of a physical injury allegedly committed against the plaintiff. A forensic psychiatrist who performs personal injury evaluations should be familiar with relevant case law and malingering assessment because malingering must always be considered.

When a forensic psychiatrist performs a personal injury evaluation, he or she must include the following (although there can be more involved than just the points covered here):

- A review of relevant records regarding the immediate event and the plaintiff's pre- and post-injury functioning (e.g., medical and psychological treatment records)
- Background information including a social history, psychiatric history, medical history, employment history, and substance abuse history
- Clinical interview(s) with the plaintiff
- Mental Status Exam
- The plaintiff's statement describing the event and its immediate cause
- The plaintiff's statement describing the immediate damage and/or disability caused by the event
- The plaintiff's statement regarding the subsequent damage and/or disability from the event
- Psychological testing relevant to the alleged injury (e.g., tests of cognitive functioning when brain injury is reported) and other factors that may contribute to the impairment (e.g., personality and psychiatric assessment)
- Trauma or Post Traumatic Stress Disorder (PTSD) assessment
- Malingering assessment
- Interview(s) with spouse and any other family members regarding the event and the immediate cause of the damage or disability, and the plaintiff's functioning pre- and post-injury
- Summary and interpretation of collected data
- Diagnostic impressions and (if found) level of impairment in relevant areas
- Review of factors (e.g., personality and physical functioning) which may contribute to the disability
- Review of treatment
- Determination as to whether past treatment was sufficient
- Recommendations regarding further treatment and plaintiff's amenability to treatment and understanding of potential outcomes

Given the nature of personal injury evaluations, the possibility of malingering should always be investigated. Malingering is routinely investigated by the forensic psychiatrist. Based on his or her findings, additional objective testing may be conducted at the discretion of the doctor to confirm or dismiss a diagnosis of malingering.