Personal Injury, Disability, and Civil Forensic Evaluation
Injury, causation, and disability
Personal-injury and disability evaluations address psychological injury, causation, functional impairment, and malingering. The exam tests differential diagnosis, validity assessment, and the distinction between impairment and disability.
Core rules
- Review records, obtain a clinical interview, use validated symptom and validity measures, and seek collateral information.
- Establish pre-injury functioning and alternative causes; temporal association is not causation.
- Assess effort and response bias with multiple measures; do not rely on a single validity scale.
- Distinguish clinical impairment from work disability, which depends on job demands and legal or administrative definitions.
- Use accepted guides cautiously; the AMA Guides estimate impairment, not disability.
Worked example
A claimant reports PTSD after a motor vehicle accident but has inconsistent symptom reports and fails a performance validity test. The evaluator should integrate records, interview, and testing, consider genuine PTSD with exaggeration, and avoid a categorical malingering label. Reasoning: response bias exists on a continuum and may coexist with genuine symptoms.
Traps
Diagnosing from self-report alone; equating diagnosis with disability; ignoring preexisting conditions; overinterpreting one validity test; using the wrong edition of the AMA Guides.