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FORENSIC BOARDS > Psychiatric Disability > Flashcards

Psychiatric Disability Flashcards

1
Q

Rate of Malingering in Disability Evals

A

20-30%

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2
Q

Significant Point About Disability Defs

A

Vary - need to know def being used

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3
Q

AMA Impairment

A

“significant deviation, loss, or loss of use of any body structure of function”

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4
Q

AMA Disability

A

Activity limitations and/or participation restrictions

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5
Q

Impairment Rating

A

% est loss of activity and limitations of ADLs

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6
Q

Maximum Medical Improvement

A

Status were person to get “as good as he gets” from available tx, and date from which further recovery/deterioration no longer anticipated

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7
Q

AMA Guides 4 Essential Questions of both Provider and Rater

A
  1. What is the clinical problem/dx?
  2. What difficulty does the pt report (sx, functional loss)?
  3. What are the exam findings?
  4. What are the results of clinical studies?
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8
Q

Physical D/o w/ Mental D/o

A

Mental d/o included in physical impairment rating, so MH chapter not used

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9
Q

AMA Guides 3 Types of D/o Allowed

A

Mood, Anxiety, and Psychotic D/os (so pain-related, somatization, PDs, dissociative, substance-related, etc not allowed)

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10
Q

AMA Guides Psych Limitation

A

50% of whole person

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11
Q

SSDI vs SSI

A

SSDI - pays benefits to workers who have become disabled
SSI - social welfare proram to provide income support for people who have become disabled regardless whether they have ever worked

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12
Q

SSI Eligibility

A

Means-tested: dependent on meeting needs test against income, not work hx or contribution to fund / provides minimum income for indigent disabled

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13
Q

SS Disability Gen Def + 3 Reqs

A

“Inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment
- can’t do work they did before
- can’t adjust to other work bc of condition
- expected to result or death or last > 12 months

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14
Q

SS Medically Determinable Impairment (Gen def (2) and add’l req)

A
  • results from anatomical, physiological, or psychological abn
  • can be shown by medically acceptable clinical and laboratory diagnostic techniques
  • Must be established by medical evidence other than self-report
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15
Q

SSA 11 Qualifying Categories of Mental D/o

A
  1. NCDs
  2. Schiz-spectrum/psychotic
  3. Depressive, BP, and related d/o
  4. ID
  5. Anxiety and OCDs
  6. Somatic sx and related d/o
  7. Personality and impulse-ctrl d/o
  8. ASD
  9. Neurodevelopmental d/o
  10. ED
  11. Trauma- and stressor-related d/os
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16
Q

SSA Add’l Qualifying D/o Category for Children

A

Developmental d/o in infants and toddlers

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17
Q

SS SUDs

A
  • Don’t qualify, but independent d/os caused by substance use do
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18
Q

SSA Paragraphs

A

Combo of “paragraphs” established for each dx to meet their guidelines

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19
Q

SS Paragraph A

A
  • Objective medical evidence to establish d/o (might be med recs, testing, collateral)
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20
Q

SS Paragraph B

A

Functional criteria, w/ rating scale, to evaluate how d/o limits functioning

21
Q

SS Paragraph B 4 Areas of Mental Functioning

A
  1. Understand, remember, or apply information
  2. Interact w/ others
  3. Concentrate, persist, or maintain pace
  4. Adapt or manage oneself
22
Q

SS Paragraph C

A
  • D/o must be “serious & persist”
23
Q

SS Paragraph C Duration and 2 Subcriterion

A

Must have medically documented period > 2 years
C1: Individual relies (ongoing) on medical tx, MH therapy, psychosocial supports, or highly structured setting
C2: Despite diminished sx/signs, have achieved on marginal adjustmentS

24
Q

SS Residual Function Capacity

A
  • If doesn’t meet all listing criteria, can consider all impairment-related physical/mental limitations, such as sfx to medications
25
Q

Private Disability Purpose & Consideration

A

Provide benefits purchased by insured in addition to Workers’ Comp or SSA
- Need to know their def of disability and extent of context affected (same job, any occupation, etc)

26
Q

Rehabilitation Act 1973 Historical Significance

A

First act in world to prevent employer discrimination against disabled

27
Q

Rehab Act 1973 Jurisdiction

A

Only certain elements of fed, Postal Service, and Fed contractors/subcontractors

28
Q

Rehab Act 1973 “Handicapped Individual Def” (3)

A
  1. Has physical/mental impairment which substantially limits 1+ major life activities OR
  2. Has a record of such impairment
    OR
  3. Is regarded as having such impairment by employer
29
Q

School Board of Nassau County FL v. Arline (SCOTUS 1987) (FOTC, Issue)

A

Arline fired from teaching job after TB relapse
Issue: Is contagious ds “physical impairment” thereby qualifying her for protection under Rehab Act 1973?

30
Q

School Board of Nassau County FL v. Arline (SCOTUS 1987) H & R

A

H: Yes, protected. Remanded to determine actual threat.
R: School argued was to protect others rather than inability, SCOTUS wrote society’s myths/fears about disability/ds are as handicapping as the actual physical limitations

31
Q

School Board of Nassau County FL v. Arline (SCOTUS 1987) Historical Sig

A

Laid foundations for protections of HIV+

32
Q

ADA Gen

A

Enacted 1990 to prohibit discrimination against persons w/ disabilities in all aspects of employment (hiring, training, comp, benefits, etc)

33
Q

ADA Employer Req (& 2 caveats)

A

Reasonable accommodation to perform essential job functions
- Unless would cause undue hardship or if employee is a direct threat

34
Q

ADA “Disability” (3)

A

Same as Rehab Act
1. Physical/mental impairment that substantially limits 1+ major life activities of such individual
2. “Record of impairment”
3. “Regarded as” having impairment

35
Q

“Regarded as” having impairment

A

Doesn’t actually have to have, just show that they were regarded as to have one and discriminated against as such

36
Q

ADA (EEOC) Physical or Mental Impairment Def

A

1) An physiological d/o or condition, cosmetic disfigurement, or anatomical loss affecting 1+ body systems, such as …
2) Any mental or psychotical d/o, such as ID, organic brain syndrome, emotional or mentail illness, and specific learning disabilities (Specifically mentions all the big ones)

37
Q

ADA Excluded Dx (6)

A
  • Transvestism/transgender/GID
  • Pedophilia/exhibition/voyeurism/other sexual behavior d/os
  • Compulsive gambling
  • Kleptomania
  • Pyromania
  • Current psychoactive susbtance abuse d/os related to illegal drug use
38
Q

ADA Other Code Listings Not Included (2)

A

Phase of life problems or parent-child problems

39
Q

ADA Drugs (2)

A
  • Not protected. Denies coverage of any employee/applicant currently (recently enough that reasonable belief ongoing problem) engaging in illegal use of drugs
  • Protected only if in tx/completed program + not currently using
40
Q

ADA ETOH

A

ETOH dependence protected by ADA

41
Q

ADA Drugs/ETOH Additional Exclusion

A

If condition poses direct threat of harm to others or (arguably) selves

42
Q

ADA PDs

A

Do count. Personality traits don’t

43
Q

ADA Corrected Disabilities

A

Do qualify

44
Q

ADA Amendments Act of 2008

A

Says that impairments must be examined in unmitigated state w/ only exception of ordinary eyeglasses or contact lenses

45
Q

ADA “Substantially Limits” Considerations (5)

A
  • Construed broadly in favor of expansive coverage
  • Limits MLA compared to gen pop
  • Don’t consider mitigating effects
  • Episodic/remission count, if limits when active
  • < 6mo can count
46
Q

ADA Major Life Activities Gen Def

A
  • Basic activities that the average person in gen pop can perform with limited or no difficulty2
47
Q

2 Gen Categories of ADA MLAs

A
  1. General activities
  2. Major bodily functions
48
Q

ADA Reasonable Accommodation Def

A

A modification or adjustment of the “way things are customarily done”

49
Q

PA DOC v. Yeskey (SCOTUS 1999) Summ + Main Point

A
  • Excluded from prison boot camp option instead of sentence bc PMH HTN. Sued under ADA T II.
  • H: Prisoners covered entities, ADA applies to inmates in state prisons and can sue if excluded from programs due to disability (except dirt threat)

FORENSIC BOARDS (34 decks)

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