title: Evaluating psychiatric disability: differences by forensic expertise.
abstract: The task of evaluating psychiatric disability poses several ethics-related and practical challenges for psychiatrists, especially when they are responding to a request from a third party for a disability evaluation on their own patient. This study sought to evaluate the differences in how forensic and nonforensic psychiatrists approach and view evaluations for Social Security disability benefits. Thirty-two forensic and 75 nonforensic psychiatrists were surveyed on their practice patterns and perceptions of role, objectivity, and dual agency in the disability evaluation process. Significant differences were found between forensic and nonforensic psychiatrists' perceptions of the dual-agency conflict, beliefs about who should perform evaluations, and beliefs about the weight given to different opinions when decisions of whether to award disability benefits are made. A minority of respondents in both groups reported having identified a patient as disabled, despite believing otherwise. The implications of these findings are discussed.
authors.affiliation: Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA. paul.christopher@umassmed.edu
authors.forename: Paul P
authors.initials: PP
authors.lastname: Christopher
authors.forename: Rasim
authors.initials: R
authors.lastname: Arikan
authors.forename: Debra A
authors.initials: DA
authors.lastname: Pinals
authors.forename: William H
authors.initials: WH
authors.lastname: Fisher
authors.forename: Paul S
authors.initials: PS
authors.lastname: Appelbaum
mesh_terms: D004185:Disability Evaluation; D005555:Forensic Psychiatry; D006801:Humans; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires