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The Resurrection of a Disability Claim: Discovery through Psychological Investigation in Defense of a Disability Claimant (Parts 1 & 2)

M. Allan Cooperstein, Ph.D.

Presented at the 1999 conference of the American College of Forensic Examiners, New York, NY.

Program 10/11 The Resurrection of a Disability Claim: Discovery through Psychological Investigation in Defense of a Disability Claimant

From initial contact to resolution, disability claim management is an interdisciplinary process. Often, the Disability Claims Consultant is the first professional contacted. Typically, the Claimant is either having problems with an existing claim or benefits were terminated. At first, the consultant assesses the merit of the claim; a "fact finder" is completed as a guideline. Issues discussed often relate to actions taken by the insurer: e.g., video surveillance, field investigations, and Independent Medical Examinations (IMEs), all or some of which are interpreted in ways that are deleterious to the Claimant's best interests. The Disability Consultant reviews all relevant documents and identifies major areas of concern and, in many instances, requests an Independent Medical Examination to be performed by a Clinical or Forensic Psychologist, preferably with vocational and rehabilitation experience.

Whether a disability is physical, emotional or both, the Psychological Examiner applies a multimodal approach: extensive medical, psychological and psychiatric data are reviewed and critiqued, the Claimant is interviewed and tested. This process examines (a) whether a disability exists (with or without physical injury), (b) if feigning or exaggeration is present, (c) how the Claimant's life has been altered by the alleged disability, and (d) to what degree of permanence a disability exists. The final report is sent to the Disability Consultant. The case requires skilled disability claim management and research into and understanding of a Claimant's personal and cultural backgrounds to validate the reality of his disability.

What follows are the transparencies used in the presentation to describe psychological services in an actual disability claim. I performed an Independent Medical Examination upon the Claimant, a middle-aged physician, who grew up in another culture. The purpose was to assess the actuality of his claimed disability. In this instance, research specific to his cultural background was used to better understand and represent his psychologically-based disability to the insurer. Click the hyperlinks below for phases in the process used:

Overview      Record Review        Personal History

Testing          Research                 Summary

Medical Disclaimer: This website is underwritten completely by Dr. Cooperstein.

The purpose of the content is to educate, inform and recommend. Under no circumstances is it meant to replace the expert care and advice of a qualified professional as rapid advances in medicine may cause information to become outdated, invalid or subject to debate. Accuracy cannot be guaranteed. Dr. Cooperstein assumes no responsibility for how information, products and books presented are used and does not warrant or guarantee the content, accuracy or veracity of any linked sites. Dr. Cooperstein  makes no guarantee to any representations made by listings in professionals or support services directories.

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Last updated: June 26, 2011 12:55 PM