As a defense or applicant attorney in California workers' compensation cases, you're likely familiar with the complexities surrounding head injuries, strokes, and other neurological issues that arise in the course of employment. Understanding the role and nuances of neuropsychological assessments can be crucial for building strong cases and advocating for your clients.
For Defense Attorneys:
Evaluating the Validity of Claims:
A neuropsychological assessment is often a valuable tool in evaluating the legitimacy of a claimant's cognitive complaints. The objective data obtained can identify inconsistencies between self-reported symptoms and test results, potentially revealing issues of exaggeration or malingering. Although there is no perfect way to assess for malingering of cognitive or emotional problems, well-validated tests designed to measure effort and performance validity are one of the best and most evidence-based options.
Assessing the Extent of Impairment:
While subjective reports of cognitive difficulties are present in many work injury cases, a neuropsychological assessment provides a more concrete picture of the functional limitations caused by the alleged injury. This information can be critical when determining the extent of disability and have a major impact when negotiating settlements.
Developing Return-to-Work Strategies:
Identifying the specific cognitive strengths and weaknesses of the claimant via neuropsych testing allows for the development of targeted recommendations for accommodations, work restrictions, and treatment to facilitate a safe and effective return to work. This can benefit both your client, by minimizing long-term disability, and the employer, by reducing lost productivity costs. And, as a bonus, this also helps the injured worker get back to work and move on with their life!
For Applicant Attorneys:
Building a Strong Case for Benefits:
A comprehensive neuropsychological assessment can significantly strengthen your client's claim for compensation by providing objective evidence of cognitive impairments directly linked to the work injury. This scientific data carries significant weight compared to solely relying on subjective complaints, and in cases where the neuroimaging doesn’t show structural changes (which is often the case in mild or moderate brain injuries), neuropsych testing can validate a person’s subjective report.
Maximizing Recovery:
Understanding the nature and severity of cognitive impairments helps develop tailored treatment plans and rehabilitation programs, aiming for optimal recovery and potential vocational retraining. This can significantly improve your client's long-term well-being and earning capacity.
Addressing Malingering Concerns:
A thorough neuropsychological assessment conducted by a reputable professional minimizes the risk of malingering accusations. The in-depth evaluation process and standardized testing protocols are designed to detect inconsistencies and ensure the assessment's validity.
Key Considerations for Both Sides:
Choosing the Right Expert:
Since neuropsych is not its own QME specialty, you will most likely need to seek out a clinical psychologist with specialty training in neuropsychological assessment as an Independent or Agreed Medical Evaluator. This can feel daunting, but here are a few tips.
This does not necessarily have to be a neuropsychologist, as long as the doctor has training and experience in neuropsychological assessment.
For example, I identify professionally as a clinical psychologist because I did not select an exclusively neuropsych training track when I got my doctorate and did my postdoctoral training. However, I did a great deal of psych and neuropsych assessment training throughout my education and fellowship in geropsychology (which requires expertise in neuropsych testing, among other things), including at highly regarded clinics like Cleveland Clinic, the UCSF Memory and Aging Center, and the San Francisco VA. I then went on to work in a rehabilitation/gero psychology setting, where I developed and directed the neuropsych assessment clinic in Spinal Cord Injury, and later directed the predoctoral psychology training program at the Long Beach VA. Now I run my own assessment and treatment practice.
As you can see, I have plenty of excellent training and experience with neuropsych assessment, but because I also do treatment, capacity assessment, and medical psychology, I don’t call myself a neuropsychologist; it is only one aspect of my work. So, let me be the example that broadening your search, from only self-proclaimed neuropsychologists to include clinical psychologists with experience and competence in neuropsych, might open up some doors in terms of finding an AME to do neuropsych evals in your cases.
Board certification is a great way for neuropsychologists to legitimize themselves in the field of neuropsychology.
However, board certification is not as emphasized or necessary in the field of psychology as it is in the medical field. According to the American Psychological Association, only about 4% of psychologists in the US are board certified, and I am confident there are many more than this who are highly trained, competent, and doing excellent work. Board certification is great, but it is only one marker of a high-quality psychologist.
Selecting a qualified and experienced psychologist with competence in neuropsych and workers' compensation cases is crucial. Look for professionals who adhere to best practices and have a track record of producing reliable and defensible reports; finding referrals by word of mouth is usually a good idea. A good psychologist doing neuropsych evals in work comp cases should approach from an objective lens and be honest about their findings, and in fact, this is an ethical obligation.
As psychologists, our job is not to support an attorney’s or injured worker’s opinions or desires; it’s to consider the data objectively and explain it honestly in a way that non-psychologists can understand. If an expert guarantees their findings will support your side of the case, they are overpromising and may not be credible under scrutiny!
Understanding the Assessment Process:
Both parties should have a basic understanding of the assessment process, including the types of tests administered, the information gathered, and the typical timeline for receiving the report.
Open Communication and Collaboration:
Open communication and collaboration between attorneys and the psychologist can ensure a smooth and efficient evaluation process, ultimately benefiting everyone involved by expediting resolutions and ensuring fair outcomes.
Start a neuropsychological evaluation in los angeles, ca
Neuropsychological assessments are not a perfect tool, but they can be valuable in navigating the complexities of workers' compensation cases that involve a neurologic injury with cognitive symptoms. Understanding their role and the nuances allows defense and applicant attorneys to effectively advocate for their clients and achieve fair and just outcomes. As a psychologist, I would be happy to offer support with a neuropsychological evaluation and other services. Start the evaluation process with Dr. Reger by following these simple steps:
Contact (424) 262-1925 to schedule your appointment
Meet with Dr. Reger for an evaluation
Get a better understanding of neurological issues!
Disclaimer: This blog post is intended for informational purposes only and should not be construed as legal or medical advice. Always consult with qualified legal and medical professionals regarding your specific situation.
Other Services Offered by Dr. Reger in Los Angeles, CA
Neuropsychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. This is why I’m happy to offer multiple psychological assessments as well. Other assessments include capacity assessments, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!