Psychological and Neuropsychological Testing

Testing for Psychological and Neuropsychological Conditions

There are several conditions, beyond the easily identified depression and anxiety impairments, where insurers have become more aggressive in pursuing psychological and neuropsychological testing. These conditions include Fibromyalgia, Chronic Fatigue Syndrome, Lyme Disease, Migraines, and even orthopedic impairments.

Neuropsychological Testing for Non-Depression/Anxiety Claims

psychologocal-testingMany of our clients who suffer with Chronic Fatigue Syndrome (CFS), fibromyalgia, lyme, and migraines, have cognitive difficulties (and not simply depression). A battery of neuropsychological tests can help to identify how or where our client is suffering cognitively, and effective utilization of such testing can help lawyers prove our client’s impairment.

Issues Regarding MMPI-2 Fake Bad Scale (FBS)

One area of particular concern for clients has been the reliance (and perhaps over reliance) upon the results of a particular aspect of the Minnesota Multiphasic Personality Inventory (MMPI-2), known as the Fake Bad Scale (FBS). Numerous flaws exist in the original methodology and conclusions underlying the development of the FBS. These include (1) inadequate description of the item selection procedures; (2) lack of independent and empirical verification of the rationally selected items; (3) no description of the criteria used to determine personal injury claimants who appeared ‘notably credible’; (4) no description of any sound procedure used to determine those ‘who appeared clearly to be malingering’; (5) no information about the population from which the subjects were selected; (6) use of small sample sizes that can lead to unstable findings; (7) lack of descriptive information, other than mean age and gender of the samples; (8) failure to consider gender differences in responding to the selected items; (9) use of weighted estimates to calculate the mean scores of the normative sample and psychiatric inpatients that did not allow presentation of Sds (standard deviations).

One recent court order struck the use of the FBS where the Court opined that “[t]he preponderance of the evidence does not support [the] contention that the FBS is now generally accepted in the psychology community.” The Court concluded that the FBS is “very subjective and dependent upon the interpretation of the person using or interpreting the circumstances and there is a high degree of probability for false positives.” There is also an acknowledged bias against women and those with demonstrated serious injuries which makes the FBS unreliable. According to the creator of the FBS, Dr. Lees-Haley, the FBS was designed for personal injury claimants, and thus, lacks any degree of reliability in the disability insurance context. Thus, where an insurer’s claim determination relies upon the results of the FBS, it will be challenged by the lawyers of from an evidentiary standpoint.

Testing Environment on Neuropsychological Testing

While witnesses and videotaping of physical evaluation examinations are strongly encouraged, having witnesses or videotaping testing in the neuropsychological domain is generally not permitted by the courts.

Malingering and Somatoform Diagnoses

The long term disability benefit experts at often see the insurance company hired doctor ascribe a diagnosis of either malingering or somatoform disorder, in an effort to impugn the credibility of the claimant.

In such testing, the examiner normally familiarizes himself with the claimant’s personal and family background and his education and employment history. He will then conduct a face to face examination of the claimant, which may take several hours, inquiring into all aspects of the claimant’s life, essentially taking and recording the claimant’s “life story.” Once this psychiatric examination is completed, the claimant would then be referred to a forensic psychologist for psychological testing.

Reliable and valid “self-report” personality tests have been opined as the best way to assess a claimant with a psychological condition, or conditions such as fibromyalgia or chronic fatigue syndrome. These would include the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Personality Assessment Inventory (PAI) and the Rorschach Inkblot Test (Rorschach). The obvious purpose of these tests with disability claimants is to assess the accuracy and validity of the claimant’s self-reported symptoms and limitations, and the extent to which the claimant may be malingering. Statistical findings from the MMPI-2 or the PAI may indicate that the claimant’s self-reported symptoms and claimed limitations are being exaggerated, which would suggest malingering. To investigate this possible malingering further, the forensic psychologist would then turn to the Rorschach test.

According to one authority, the Rorschach is as reliable and valid as any of the personality tests that psychologists typically use. It is designed to provide insight into the underlying cause of the claimant’s complaints. One of its most important features is that a claimant will have great difficulty trying to figure out how to provide the “right” answers which will support his claim of disability. Thus, it serves as a means to cross-validate the results from the MMPI-2 and the PAI, while also serving as an informal “lie detector test” to further confirm the accuracy and validity of the claimant’s complaints.

Another test for psychological or neuropsychological dysfunction are the Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) which are also considered to be reliable and valid measures of assessing the reasonableness of the correlation between a claimant’s performance on neurocognitive testing and his subjective complaint of disability.

When an insurer is considering a claim of disability based on mental or nervous conditions such as depression, anxiety or post-traumatic stress disorder (PTSD), it is almost mandatory that reliable psychiatric evaluation and psychological testing be considered to determine the extent to which the claimant’s subjective complaints are supported by objective testing. lawyers use the several tests discussed above to prove the legitimacy of our client’s long term disability claim.

Contact the attorneys of to discuss in detail the psychological and neuropsychological testing aspects of your long term disability benefits claim.