Unmasking the Sophisticated Malingerer and Misattributer in Workers' Compensation Claims
July 20, 2009
Hyannis, MA
The Resort and Conference Center at Hyannis
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Executive Summary
This unique pre-conference will provide occupational health professionals with the tools, strategies, and insights to deal with the sophisticated workers' compensation malingerer and misattributer. Attendees will participate in open and frank discussions and analysis of common problems and solutions. Attendees will take away the elements needed to properly recognize, evaluate, and defend against workers' compensation malingerers.
At the completion of this pre-conference you will be able to:
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Understand when claimants may be suspected of malingering or misattributing,
- Identify frameworks for evaluation,
- Develop and use checklists for the identification of suspected malingerers and misattributers,
- Understand the key data to look for,
- Have specific recommendations for finding the data to be evaluated, recommendations for development and use of supplementary data, and the proper use of evaluation of psychological testing.
Distinguished Faculty
Harold J. Bursztajn, MD is Associate Clinical Professor of Psychiatry and Co-Founder of the Program in Psychiatry and the Law in the Beth Israel Deaconess Medical Center Department of Psychiatry of Harvard Medical School. He has a longstanding special interest in the pitfalls of forensic psychiatric and medical diagnosis. Dr. Bursztajn has more than 25 years' experience in clinical and forensic practice in psychiatry, including consultations and evaluations in civil and criminal matters. He has taught and published extensively on how to differentiate impairments caused by mood, thought, and post-traumatic disorders from those cased by personality traits, developmental or adjustment problems, symptom misattribution, exaggeration, lack of motivation, primary or secondary gain, faking, or malingering.
Dr. Bursztajn teaches and consults nationally to psychiatrists and other mental health professional, as well as to physicians across the primary and specialty medical care spectrum. He has served as faculty for the Harvard Medical School Psychiatric Intensive Diagnostic Interviewing Preparatory Course for the Board of Psychiatry & Neurology certification examinations, cofounded the Harvard Medical School Program in Psychiatry and the Law at the Beth Israel Deaconess Hospital, and his many clinical and teaching distinctions include being recognized as a practicing "doctor's doctor" by being named Principal Mentor at Harvard Medical School and being awarded the A. Clifford Barger Excellence in Mentoring Award as well as being the first physician/forensic psychiatrist in Harvard Medical School's history to be appointed as the representative of the Harvard Medical School Alumni Board of Directors to the Harvard University Alumni Board. He continues to publish and present workshops nationally and internationally on a variety of special interest topics in medicine and in general and forensic neuropsychiatry.
Tuition
The $395 tuition includes a continental breakfast, breaks, lunch with faculty, a detailed manual which can be retained as a bookshelf reference, and a dynamic learning experience.
Click here for registration information.
Continuing Education Information
Case Managers: 6.5 contact hours of continuing education for Case Managers have been applied for from the Commission for Case Manager Certification, Rolling Meadows, Illinois. Disability Specialists: 6.5 contact hours of continuing education for Disability Specialists have been applied for from the Commission for Disability Management Specialists Commission, Rolling Meadows, Illinois. Human Resource Professionals: This program has been approved for 7 recertification credit hours toward PHR, SPHR and GPHR recertification through the Human Resource Certification Institute (HRCI). Nurses: To successfully complete a program and receive contact hours you must: 1) register in, 2) be present for the period of time you are awarded contact hours, 3) complete the evaluation. Occupational Health Nurses: 6.6 60-minute contact hours of continuing education in nursing have been applied for through the American Association of Occupational Health Nurses, Inc (AAOHN). AAOHN is an accredited approver of continuing education by the American Nurses Credentialing Center's Commission on Accreditation. (ANCC is the educational department under the ANA.) Physical Therapists: Continuing Physical Therapy credits vary by state, and will only be applied for if requested in writing on the conference registration form. Physicians: SEAK, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. SEAK, Inc. designates this educational activity for a maximum of 7 AMA PRA Category 1- Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. Rehabilitation Counselors: 6.5 contact hours of continuing education hours for Rehabilitation Counselors have been applied for from the Commission on Rehabilitation Counselor Certification, Rolling Meadows, Illinois. Rehabilitation Nurses: This program will be accepted for 6.6 contact hours of credit for ARN certification. Submit certificate.
Schedule
Monday, July 20, 2009
7:00-8:00Continental Breakfast & Exhibits
8:00-8:15Introduction
Familiarizing health care professionals with the elements of forensic psychiatric evaluation of claims where malingering and misattributing is suspected. Questions & Answers.
8:15-9:30Frameworks for Evaluation
Attendees will be presented with the key frameworks for evaluations: Clark's threshold model for malingering in the presence of Antisocial Personality Disorder, or sociopathy, DSM-IV-TR and ICD-10 diagnostic criteria for Antisocial Personality Disorder, Malingering, and Factitious Disorder, and going beyond the DSM to identify misattributers who use a work related event as a passive and convenient focus. Questions & Answers.
9:30-10:45What to Look For: Key Data to be Identified
Attendees will learn the key data to look for and elicit from claimants which can be critical in unmasking the sophisticated malingerer. Faculty will review and discuss:
- History of litigiousness or other manipulative behavior,
- Psychological testing consistent with malingering,
- Data consistent with fabrication or exaggeration of disability - e.g. concentration and stamina shown when filling out test instruments,
- Preexisting medical or psychiatric disorders and impairments,
- Longstanding personality traits (e.g., antisocial, borderline, immature, dependent, histrionic) and/or adjustment problems,
- Longstanding or concurrent life stresses or crises to which the claimed damages can be reasonably attributed,
- Displacement of responsibility and externalizing of blame,
- Data consistent with seeking primary or secondary gain from litigation, and
- Specific factual claims uncorroborated or contradicted by reliable data. Questions & Answers.
10:45-11:00BREAK, EXHIBITS & NETWORKING OPPORTUNITY
11:00-12:00Case Examples and Opportunities for Case Related Informal Consultation
Specific cases of malingering and misattributing that have been unmarked will be explored. Attendees will be encouraged to be actively involved in the diagnostic and forensic process and to present challenging cases for informal consultation. Questions & Answers.
12:00-1:00LUNCH PROVIDED WITH FACULTY
1:00-2:00Bringing the Psychiatric Interview to Life
The faculty, with the use of video, will illustrate principles of indirect interviewing of sophisticated malingerers and misattributers (in contrast to state-managing or hostile interrogation) to create an alliance that fosters open disclosure while enabling the examiner to observe and document data contradicting the interviewee's claims. Questions & Answers.
2:00-3:00Psychological Testing
Faculty will discuss and demonstrate the proper use of psychological testing in the suspected malingerer and misattributer. Included in the discussion are the MMPI-2, PAI, P3, and other validity tests. Questions & Answers.
3:00-3:15BREAK, EXHIBITS & NETWORKING OPPORTUNITY
3:15-4:15Supplementary Data Collection
Faculty will discuss and explain the benefits and drawbacks of supplementary data collection (e.g., video surveillance, formal instruments, laboratory tests, brain imaging). Questions & Answers.
4:15-4:30Wrap up