Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-22-6 - Psychological Examination Guidelines6.1. Purpose - The purpose of the psychological assessment is to obtain a current view of the claimant's emotional and cognitive functioning, interpersonal relationships and approach to tasks. Symptoms and behaviors must be sampled through interview techniques, checklists, and standardized psychological measurements. Long term personality traits and dysfunctions should be identified. Inferences should be made regarding motivation and dissimulation (faking). It is assumed that psychological assessments are" comprehensive and not limited to the presentation of psychometric data. Even when part of an interdisciplinary team, the psychologist retains responsibility for recommending additional evaluations and interventions by other health care professionals as deemed necessary.6.2. Guidelines - The following are guidelines for psychologists to use when performing psychological evaluations for the Division of Workers' Compensation. It is assumed that all psychologists providing services for the Division of Workers' Compensation adhere to all relevant standards for practice as set forth by the American Psychological Association (Ethical Principles, Standards for Providers of Psychological Services, and Specialty Guidelines).6.3. Initial evaluation: a. Intelligence testing - During the initial evaluation, a standard intelligence test, such as the Wechsler Adult Intelligence Scale-Revised, should be administered. An intelligence screen should not be used during the initial evaluation. Behavioral observations of an individual in a structured testing environment is as important as the claimant's level of intellectual functioning. Therefore, such clinical observations should be provided. Also, all subtest scores as well as Verbal, Performance, and Full Scale IQ scores should be reported. This allows comparison of test results from one administration to another over time.b. Achievement testing - Achievement testing, such as the Wide Range Achievement Test-Revised or the Peabody Individual Achievement Test, should be administered during the .. initial evaluation. Such tests are used to demonstrate that the claimant has the requisite reading skills to understand and reliably respond to objective measures of personality. They are also used to help determine whether the claimant might have a diagnosis of. Learning Disability for rehabilitation purposes.c. Personality assessment - The type of personality instrument(s) to be used depends upon the claimant's intellectual capacities and reading level. Taped versions are acceptable when a claimant has an appropriate intellectual level but limited reading abilities. At a minimum, personality assessment should include tests that address not only acute and chronic symptoms of emotional disorders, but also longstanding personality characteristics. A- measure of dissimulation should be included in the evaluation, unless clinically contraindicated. For example, low intellectual functioning may preclude the administration of tests which provide a measure of dissimulation (eg., MMPI-2). Personality assessment may include objective/projective personality measures, symptom checklists, and other instruments that meet accepted professional standards. Psychologists should also report a summary of raw data from objective personality testing. For example, a copy of the MMPI-2 profile sheet or Welsh Code can be extremely helpful when other psychologists are comparing test results over time.d. Neuropsychological screen - If a clinician wishes to address the issue of presence or absence of organic dysfunction in a claimant, then a neuropsychological screen is in order. If a screening is determined to be necessary, evaluate at a minimum, the following: attention and concentration, memory, judgment, language skills, and visual/spatial abilities.e. Comprehensive neuropsychological evaluations - When sufficient information is indicated by the results of a neuropsychological screen or by the claimant's history, a comprehensive neuropsychological evaluation consisting of accepted evaluation procedures should be used by a psychologist qualified and trained in neuropsychology. A psychologist qualified to interpret neuropsychological evaluations should document at least 500 hours of intensive training in administration and interpretation supervised by a qualified neuropsychologist. Current " national standards for such supervising neuropsychologists suggest either intensive graduate course work and practice in assessment of brain function and extensive clinical supervision of such clinical activities, or a graduate degree of psychology and two years of full-time post-graduate supervised training in neuropsychology in a program specifically designated for such training.
f. Integration of findings - A detailed report integrating all the data from observations, test responses and their interpretation, results of previous assessments and any other. relevant data such as school records, rehabilitation reports, and medical findings should be prepared. Address any inconsistencies noted between behavioral observations and test responses or previous assessments.6.4.a. Reevaluations - The examining psychologist should attempt to determine whether the claimant's level of intellectual functioning has previously been assessed. The same test battery for intellectual functioning (eg., WAIS-R) should not be administered to a given claimant more than once in a six month period, unless otherwise justified. An example would be when the clinician judges that the previous intellectual assessment was of questionable validity due to other identifiable factors, such as severe depression, psychosis, or the influence of drugs or alcohol. The report of the intellectual results should address the potential effects of previous administrations of the same test upon the observed outcome of the current assessment. For instance, the literature suggests there is a learning effect for taking Standardized intellectual tests which can increase the measured level of intellectual functioning.