Competency to Stand Trial,... Competency to Waive Constitutional Rights, Competency to Plead Guilty... (courtesy of Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)

There are several acceptable approaches for performance of these evaluations including standardized methods such as Georgia Competency Test.
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:

1. Source of referral
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)

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
competency will be discussed.

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.

For further information, please contact
Mark I. Levy, MD
Tel: 415-388-8040  Fax: 415-388-1225
e-mail: mark@levymd.com

© 1999 - 2007 Mark I. Levy, MD, DFAPA

Insanity Defense, Criminal Responsibility (courtesy of Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)

Can be requested by the defense, the prosecution or the courts.
The party making the request should expect the report to address the following areas:

1. Source of referral
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 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.

For further information, please contact
Mark I. Levy, MD
Tel: 415-388-8040  Fax: 415-388-1225
e-mail: mark@levymd.com

© 1999 - 2007 Mark I. Levy, MD, DFAPA

CAPITAL SENTENCING, CAPITAL MITIGATION... (courtesy of Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)

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.
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:

1. Source of referral
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.

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.

For further information, please contact
Mark I. Levy, MD
Tel: 415-388-8040  Fax: 415-388-1225
e-mail: mark@levymd.com

© 1999 - 2007 Mark I. Levy, MD, DFAPA

Independent Medical Evaluations,..Disability Evaluations... (courtesy of Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)


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:

1. Source of referral
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.

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.

For further information, please contact
Mark I. Levy, MD
Tel: 415-388-8040  Fax: 415-388-1225
e-mail: mark@levymd.com

© 1999 - 2007 Mark I. Levy, MD, DFAPA

PERSONAL INJURY, PSYCHIATRIC HARM, EMOTIONAL DISTRESS, MENTAL INJURY, PAIN AND SUFFERING, MENTAL ANGUISH,..... (courtesy of Pogos H. Voskanian, M.D, http://www.forensic-psychiatrist.com/)

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.
*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:

1. Source of referral
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.

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.

For further information, please contact
Mark I. Levy, MD
Tel: 415-388-8040  Fax: 415-388-1225
e-mail: mark@levymd.com

© 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.

For further information, please contact
Mark I. Levy, MD
Tel: 415-388-8040  Fax: 415-388-1225
e-mail: mark@levymd.com

© 1999 - 2007 Mark I. Levy, MD, DFAPA