The medical expert cannot express an opinion about the ultimate question to the trier of fact:  how much is the plaintiff’s emotional distress (emotional injury) worth in dollars?  Yet when the question of these monetary damages is put to a jury, their deliberations are better-served if considered in the context of a Forensic Psychiatrist‘s knowledgeable…

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Violence or the threat of violence at the workplace cannot be ignored by an employer. A threat of violence can include bullying, harassment, threats, implied threats. Employers can do something about a potentially violent employee or employee at risk. The employer has a duty to maintain a safe workplace (which is anywhere the job is…

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There are distinctions to be drawn when evaluating individuals for occupational problems, psychopathology, disability, creation of a hostile work environment, workplace stress, retaliation, discrimination, risk of violence, and fitness for duty. The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is more than 900 pages long and describes in detail most…

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Fitness for Duty Psychiatric Examinations are conducted by a psychiatrist trained and experienced specifically to conduct a Fitness for Duty, to assess if an employee is mentally fit to perform the essential functions of the job. The following is adapted from a transcribed spoken presentation to Kaiser Permanente’s In-House Counsel about Fitness for Duty. I…

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Undue Influence? Abuse of Trust?  Elder Abuse?  Increasingly, caregivers are taking a central role in the lives of parents and spouses when there aren’t enough hands to go around.  See also Dr. Raffle’s Undue Influence in the Making of Bequests companion article. What are the indicators which may point to a caregiver raiding a patient’s assets? …

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Reasons the Treating Psychotherapist Should Not Be the Expert Witness In civil cases where emotional distress is alleged, it often occurs that the plaintiff’s attorney designates the treater as his expert. Usually the argument is that the plaintiff’s own therapist (“the treater”) has spent many more hours with the plaintiff than the defense expert and therefore…

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All psychiatric reports evaluate something, but not always the same thing. For example, eligibility for benefits, or fitness to do a job (e.g., in HR arenas, as well as wrongful termination and discrimination lawsuits). To make sense of the report, the reader must determine what is being evaluated and how it is being done. Psychiatric…

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It is not possible to discuss Diminished Capacity (Diminished Responsibility) without first understanding the legal concept of insanity since both are joined at their ideological hip by mens rea. Diminished Capacity, like insanity, is a legal concept not a medical diagnosis. The overarching principle of diminished capacity is that an accused’s level of responsibility for…

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I believe the courtroom is a unique place with special rules that must be understood in order for the most effective presentation of the technical data to occur. The process is adversarial, which is generally contrary to the experience of academicians or people who practice a profession but do not testify as a forensic expert….

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The clinical aspects of pain and psychiatric consequences have occupied my attention for many years. As a psychiatrist I was Assistant Clinical Professor of Orthopedics at University of California San Francisco Medical School for 15 years. I focused my work in that Department on the assessment and treatment of chronic pain and psychopathology. The mind-body…

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