There are several acceptable approaches for performance of these
evaluations including standardized methods such as Georgia Competency Test. 1. Source of referral In cases when the defendant is assessed by the evaluator as incompetent to
stand trial the issues of malingering (feigning the signs and symptoms of mental
disorder) and potential for restoration to The party making the referral is responsible for providing the necessary
collateral information for the preparation of the report.
*The evaluator retains the right to refuse to become involved in a case for
undisclosed reasons.
© 1999 - 2007 Mark I. Levy, MD, DFAPA Can be requested by the defense, the prosecution or the courts. 1. Source of referral The party making the referral is responsible for the provision of the
necessary collateral information for the preparation of the report.
*The evaluator retains the right to refuse to become involved in a case for
undisclosed reasons.
© 1999 - 2007 Mark I. Levy, MD, DFAPA
These evaluations are usually requested by the defense, and occasionally
by the prosecution for a "rebuttal", or to assure the objectivity of
the defense witness. 1. Source of referral The party making the referral is responsible for the provision of the
necessary collateral information for the preparation of the repot.
*The evaluator retains the right to refuse to become involved in a case for
undisclosed reasons.
© 1999 - 2007 Mark I. Levy, MD, DFAPA
Competency to stand trial evaluations can be ordered by the defense, the
prosecution, or the courts.
The party ordering evaluation should expect the evaluator to address the
pertinent issues in accordance with: Dusky v. U.S., 362 U.S. 402, 80 S.Ct.788
(1960); Drope v. Missouri, 420 U.S. 162, 95 S.Ct. 896 (1975); and Godinez v.
Moran, 509 U.S. 389, 113 S.Ct. 2680 (1993)., and the statutory requirements in a
given jurisdiction.
Competencies to waive constitutional rights, i.e. competency to plead guilty or
competency to waive the right to counsel are not offered as separate
evaluations, but are addressed in the context of competency to stand trial
report.
The reports will not contain any exculpatory or inculpatory statements by the
defendant.
The reports address the following areas in sufficient detail:
2. Date and Place of the Evaluation, and time spent for the preparation of the
report.
3. Statement of non-confidentiality.
4. List of reference materials and of interviews utilized in the preparation of
the report.
5. Case law or statutory requirements to meet the criteria for competency to
stand trial in a given jurisdiction.
6. Pertinent background information of the defendant.
7. Pertinent psychiatric, medical and substance abuse history.
8. Thorough Mental Status Exam and current level of functioning.
9. Evaluation of the defendant’s ability to understand the proceedings against
him.
Statements of the defendant that demonstrate the extent of his understanding of
relevant issues are provided in quotations. This part of the report would
provide answers as to whether the defendant has the ability to:
* understand his present charges,
*understand his overall legal situation,
*understand the roles of courtroom personnel
*distinguish between various pleas
*understand the range of possible verdicts
10. Assessment of the defendants ability to assist in his defense. This part of
the evaluation should reflect on defendants ability to:
*recount his behavior and whereabouts at the time of the alleged offense (*as
stated above, no exculpatory or inculpatory statements are included in the
report)
*effectively interact with his attorney
*behave in acceptable manner in the court room
11. Whether or not, and to what extent the defendant’s mental disorder (if
any) has affected his competency to stand trial. (The absence of mental disorder
usually precludes further evaluation)
competency will be discussed.
The party making the request should expect the report to address the following
areas:
2. Date and Place of the Evaluation, and time spent for the preparation of the
report.
3. Statement of non-confidentiality.
4. List of reference materials and of interviews utilized in the preparation of
the report.
5. Case law or statutory requirements to meet the criteria for an insanity
defense in a given jurisdiction.
6. Detailed background information of the defendant.
7. Past psychiatric history
8. Medical history
9. Substance abuse history.
10. Description of the offense in question by the defendant and by the
collateral sources.
11. Review of collateral information reconstructing the mental state of the
defendant at the time of the offense, and the time proximate to the offense.
These usually include police reports, witness accounts, notes and discharge
summaries from recent hospitalizations, accounts of communications of the
defendant with others, etc.
12. Diagnostic Impression. (The absence of mental disorder usually precludes
further evaluation).
13. Detailed account as to how the given diagnosis was reached.
14. Description of the correlation between the defendants behavior at the time
of the offense with the symptoms of his/her mental illness. (In the case of
multiple legal charges,
each offense will be addressed separately)
15. Correlation of the defendant’s mental state and behavior with statutory
requirements for the insanity defense in a given jurisdiction.
16. Issue of malingering. (The reasons as to why the evaluator does or does not
believe that the defendant is not fabricating the symptoms of mental illness as
it relates to the offense in question).
The reports reflect local case law or statutory requirements and are performed
in accordance to the decisions in Coker v. GA, 428 U.S. 280 (1976); Locket v.
OH, 487 U.S. 586 (1978); Edmund v. FL, 458 U.S. 782 (1982); Ake v. OK, 470 U.S.
68, S.Ct. 1087 (1985); Thompson v. OK, 487 U.S. 815 (1988); Perry v. Lynaugh,
492 U.S. 302 (1989); Stanford v. Kentucky....
These evaluations require a considerable amount of time for interviewing the
defendant, reviewing collateral information and assisting the defense attorney
in preparation to the trial.
The reports can include, but are not limited to:
2. Dates and places of the evaluation, and time spent in the preparation of the
report.
3. Statement of non-confidentiality.
4. List of reference materials and of interviews utilized in the preparation of
the report.
5. Detailed background information of the defendant.
6. Past psychiatric history
7. Medical history
8. Substance abuse history.
9. Description of the offense in question by the defendant.
10. Review of collateral information to reconstruct the mental state of the
defendant at the time of the offense, and the time proximate to the offense.
These usually include police reports, witness accounts, notes and discharge
summaries from recent hospitalizations, accounts of communications of the
defendant with others, etc.
11. Diagnostic Impression
12. Detailed account as to how the given diagnosis has been reached.
13. Past Criminal History of the defendant
14. Whether or not the offence was committed under the influence of extreme
mental or emotional disturbance
15. To what extent if any the victim was a participant in the defendant’s
conduct or consented to the act.
16. Whether or not at the time of commission of the capital felony the defendant
had impaired capacity to appreciate the criminality of his conduct or to conform
his conduct to the requirements of the law.
17. Assessment of the risk factors of violent behavior.
18. Issue of malingering (feigning signs or symptoms of mental illness). The
evaluator should provide the basis to his conclusion.
19. Summary, integrating all pertinent mitigating and/or aggravating factors.
Independent
Medical Evaluations,..Disability Evaluations...
(courtesy of
Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)
1. Source of referral The party making the referral is responsible for providing the necessary
collateral information for the preparation of the report.
*The evaluator has the right to refuse to be retained for a case for
undisclosed reasons.
© 1999 - 2007 Mark I. Levy, MD, DFAPA These evaluations can be requested by the attorneys for plaintiff or
defense. The reports share many characteristics of other evaluations for torts
involving psychiatric issues. 1. Source of referral The party making the referral is responsible for providing the necessary
collateral information for the preparation of the report.
*The evaluator has the right to refuse to be retained for a case for
undisclosed reasons.
These evaluations are usually requested by Insurance Companies, but can also
be requested by defense attorneys.
The party making the request should expect the report to address the following
areas in sufficient detail:
2. Date and Place of the Evaluation, and time spent for the preparation of the
report.
3. Statement of non-confidentiality.
4. List of reference materials and of interviews utilized in the preparation of
the report.
5. Detailed background information of the client.
6. Past psychiatric history
7. Medical history
8. Substance abuse history.
9. Present Mental Status Exam
10. Description of the functioning of the client prior to becoming disabled
11. Description of the functioning of the client after becoming disabled
12. Review and summary of pertinent collateral information (medical and
psychiatric records, accounts of acquaintances, co-workers, etc.).
13. Diagnostic Impression/Severity of Impairment.
14. Reasoning as to how the diagnostic impression has been reached.
15. Relationship of present impairment to client’s ability to work (in
specific occupation and general or related fields).
16. Client’s historical interest in the specific occupation.
17. Personality, psycho-social, and other factors contributing to disability.
18. Issue of malingering (feigning signs and symptoms of mental illness).
19. Summary of previous treatment and an opinion as to whether or not
adequate/optimal treatment was received by client.
20. Prognosis/Need for additional treatment.
*Requests for forensic evaluations for individuals involved in the treatment (
i.e in the capacity of doctor-patient relationship) with the evaluator
(presently or in the past) will not be accepted.
However, if this evaluator is subpoenaed for testimony for patients involved in
treatment (i.e. in cases where doctor-patient relationship has been established)
it must be done with the waiver by the patient of testimonial privilege, and
with understanding that such testimony inherently cannot be qualified as
impartial or as a substitute for an objective forensic evaluation. In such cases
no opinions will be provided regarding prognosis, need for future treatment and
associated costs.
The party making the request for independent medical evaluation should expect
the report to address the following areas:
2. Date and Place of the Evaluation, and time spent for the preparation of the
report.
3. Statement of non-confidentiality.
4. List of reference materials and of interviews utilized in the preparation of
the report.
5. Detailed background information of the client.
6. Past psychiatric history
7. Medical history
8. Substance abuse history.
9. Present Mental Status Exam
10. Description of the triggering event by the plaintiff
11. Description of the triggering event by the collateral sources
12. Issues of duty, dereliction of duty, negligence and resulting harm
13. Description of the functioning of the client prior to becoming disabled
14. Description of the functioning of the client after becoming disabled
15. Review and summary of pertinent collateral information (medical and
psychiatric records, accounts of acquaintances, co-workers, etc.).
16. Diagnostic Impression/Severity of Impairment.
17. Reasoning as to how the diagnostic impression has been reached.
18. Relationship of present impairment to client’s ability to work (in
specific occupation and general or related fields).
19. Personality, psycho-social, and other factors contributing to disability.
20. Issue of malingering (feigning signs and symptoms of mental illness).
21. Summary of previous treatment and an opinion as to whether or not
adequate/optimal treatment was received by client.
22. Prognosis/Need for additional treatment/Related costs.
© 1999 - 2007 Mark I. Levy, MD, DFAPA
PSYCHIATRIC MALPRACTICE, STANDARDS OF CARE (courtesy of Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)These evaluations can be requested by the defense or the plaintiff.
The reports reflect local jurisdictional standards and address the issues of
duty, breach of duty, causation and resulting damages in relation to the
specific form(s) of psychiatric malpractice in question, i.e.
- Failure to obtain information
- Failure to appropriately diagnose
- Failure to treat
- Negligent use of psycho-pharmacologic agents or of psychotherapy
- Negligent failure to prevent patients from harming themselves or others
- Sexual misconduct
- Failure to obtain informed consent
- Negligent mishandling of the Therapeutic Transference
- Violations of civil rights; false imprisonment/restraints and seclusion
- Breach of confidentiality
- Abandonment
- Negligence in supervision, etc.
The format of the report will vary in relation to the form(s) of malpractice
in question.
The party making the request for the evaluation is responsible for providing the
necessary collateral information. (These include and are not limited to complete
medical and psychiatric records, copies of non-abbreviated versions of
depositions, policies, procedures and/or practice guidelines of an
institution/entity involved in the litigation, local jurisdictional standard for
determination of malpractice, etc.)
*The evaluator has the right to refuse to be retained for a case for undisclosed reasons.
© 1999 - 2007 Mark I. Levy, MD, DFAPA