The Role of the Defense Psychiatrist in Workmen's Compensation Cases

Abstract

Tomorrow's psychiatrist should be more cognizant, competent, and comfortable in forensic science matters. Psychiatric cases are increasingly the subjects of litigation, but justice in the courts depends on able advocacy by all parties. Advocacy for patient-plaintiffs is more similar to customary clinical roles than is advocacy for defendant insurance companies, which nevertheless are as needful of competent psychiatric experts as patient-plaintiffs if justice is to be done. Ironically, defense psychiatrists can do much to help patient-plaintiffs if they understand their roles correctly. Since legal systems are designed to produce justice, not therapy, the forensic competence of future psychiatrists will help to make litigation more therapeutic and just for patients. This paper describes the peculiarities of psychiatric work in litigated workmen's compensation cases, focusing on the role of the defense psychiatrist. We will highlight the constructive and therapeutically gratifying potentials of this work. Greater familiarity with the process will help to enlist the interest and participation of psychiatrists in workmen's compensation cases for the ultimate benefit of the patients and improvement of the legal system.

Substantiating psychological injury under the federal employees' compensation act

“…Other writers have provided guidelines to assist the professional in determining causality. Parlour and Jones (1980) suggest that various sources of information, including extended interviews with the claimant, family and friends, prior physicians, employers, and other associates; review of medical, military, scholastic, and employment records; observation of the claimant outside the office setting; and results from a trial of treatment be considered when developing a theory as to causality. Leavitt (1980), in turn, recommends that the following factors be evaluated in arriving at an opinion as to causality: (1) workplace stressors, including concurrent interpersonal employment context, preparedness for trauma, job performance requirements, and epidemiological considerations; (2) 'linkage events' that can be assumed to mediate between the occurrence of the stressor and the disabling condition, such as emotional or psychophysiological reactions to the stressor, as well as psychological mechanisms that can be proposed to account for the clinical condition; and (3) susceptibility to the workplace stressor, in terms of past history or psychological mechanisms.…”