How to Use Neuropsychological Measurements to Enhance Your Presentation

TASA ID: 8341

One of the most overlooked aspects of litigation is the power of measurements---numbers, math, statistics and “proof” of pain and agony in cases involving personal injury.  Some of the brain injured claimants may provide 20 subjective complaints and most contain memory difficulties, especially recent or immediate memory difficulties.  Remembering three items on a shopping list or pain intrusion can be part of the current complaints. 

Many believe these claimants are malingering, or giving false answers in order to get financial rewards.  However, the tests devised by Halstead, Heaton, and others are designed to weed out malingering and concentrate on the psychological effects of injuries.  If an attorney can show, within reasonable medical probability that someone could not see a side of a presented picture, could not draw an appropriate clock and then set the hands to a particular time of day, or was unable to sort according to color, shape or size, that client could have serious frontal-lobe brain damage.  That applicant would not be able to work effectively even under supervision and would require financial assistance for the rest of their life.

Applicants with impaired cognitive abilities due to brain injury or insult, trauma, drug use, withdrawal from drugs or alcohol, or exposure to toxic chemicals, mold, or waste, must be tested to see how far these elements have impaired him or her.   The tests are interpreted cautiously along with a good mental status evaluation which includes the claimant repeating numbers, their ability to perform simple tasks, along with a good clinical interview.  Medical records must be incorporated into the report to “prove” or “disprove” what is seen by the physician. 

In fact, just stating what can be seen by others begins the determination of what might be wrong, how that can be helped, if it can, or future psychiatric difficulties.  Psychologists do not rely on testing alone to determine psychological and psychiatric difficulties. Many factors are obviously involved, but sometimes simply LOOKING at the claimant can be the best determinant of how a person is functioning.  Freud often said to not decide what a client has until you’ve considered their situation for three days.  That may be a little too long for current psychologists, but it is a valid observation.  However, seeing the person more than once, and even having a lunch with them can open up avenues of understanding that working in a professional setting cannot offer.  I have actually taken a claimant to a coffee shop within my office building and the simple act of eating a sandwich while sitting across a table with them can reveal more about the claimant than any formal “clinical interview” can do.

The point is: get the information so that you know what tests to administer, you know why you are administering them, how they interact with other measures you may be giving, and how the entire package can be used to enhance understanding and therefore help a suffering claimant.

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