Forensic Services
Independent Neuropsychological & Psychological Evaluations (IMEs)
Independent Neuropsychological & Psychological Evaluations (IMEs)
Independent Neuropsychological/Psychological Evaluations (IMEs) involve an assessment of cognitive abilities and/or psychological status. The purpose of an IME is to conduct an objective, non-biased and comprehensive evaluation on an individual claiming impairment secondary to an illness, injury, or exposure to an event(s). IME is the gold-standard for answering complex questions regarding the nature of cognitive and/or psychological functioning, determining the presence of cognitive change and/or psychological symptoms, and the influence of these changes or symptoms on functioning (e.g., daily, social, occupational).
IMEs are often utilized in disability, worker’s compensation, or personal injury claims. As such, IMEs are considered forensic evaluations. Unlike a clinical assessment that assumes a patient’s complaint(s) to be accurate, a forensic evaluation involves a comprehensive records review, extensive testing (including formal measures of performance and symptom validity), personality assessment, the gathering of collateral information (when necessary), and verification of symptoms. The goal of an evaluation is to tease apart complex issues inherent to these cases, including causality, exacerbating factors, confounding variables, non-clinical influences, and motivational issues. Although all individuals are treated respectfully, it is not the role of the IME provider to establish a doctor-patient relationship, provide feedback or treatment based on the findings.
Neuropsychological/Psychological IMEs are utilized to address:
- Establishing bona fide cognitive loss secondary to a traumatic brain injury resulting from accidents, falls, blast injuries, or repeated concussions
- Determining the presence of memory impairment secondary to anoxic injury/illness or medical condition (e.g., chronic pain, CVA, fibromyalgia) and its impact on occupational functioning
- Assessing the presence and severity of psychological conditions (e.g., Depression, Anxiety, Post-traumatic Stress Disorder) and its impact on daily and occupational functioning
- Ruling in or out non-clinical factors to claims of impairment, including fabrication, malingering, embellishment, economic factors, retaliation, convenience, Factitious disorder, personality traits, or unconscious needs (e.g., Somatic Symptom disorder)
- Making recommendations regarding occupational restrictions or limitations secondary to impairment
- Monitoring claimant level of impairment/emotional distress, response to treatment, proximity to Maximum Medical Improvement (MMI), and/or other variables influencing a protracted recovery
Dr. Luis, as a board-certified Clinical Neuropsychologist, has been conducting IMEs for over a decade. These evaluations may be performed at her practice location in Sarasota, FL, or a second office in the Fort Lauderdale, FL area. Arrangement can also be made at a location in closer proximity to a claimant. Please contact (954) 559-5073 for additional information, to schedule an IME or for a fee schedule.
Dr. Luis follows standards established by The American Academy of Clinical Neuropsychology and The National Academy of Neuropsychology and does not allow third party observers or audio or videotaping of testing.
Dr. Luis has performed IMEs for a number of Insurance companies, including Prudential, Northwestern Mutual, Mass Mutual, Guardian, Berkshire Life, CNA, and AIG. She also serves as a consultant for Independent Claims Consultants Network, LLC, and Independent Medical Consultants Inc.
Record Reviews & Peer-to-Peer Consultations
Record Reviews
Record reviews involve a comprehensive analysis of medical records and summary reports. These reviews are performed by a professional with expertise in a claimant’s condition and are utilized to identify questions that need to be addressed, additional information that needs to be obtained, or as a means of highlighting specific challenges (i.e., non-compliance with treatment, co-morbid conditions, secondary gain factors) that need to be clarified during an IME. In some cases, a comprehensive peer review may serve to synthesize issues in complex cases where multiple assessments have taken place, treatment providers are involved, and/or co-morbid conditions exist. On occasion, record reviews may be sufficient and serve to avoid the high costs of an IME.
Peer-to-Peer Consultations
A peer-to-peer consultation involves a productive dialog with a claimant’s treatment provider. These consultations are often performed in conjunction with a record review. The goal is to establish a reciprocal discussion to better understand a claimant’s neuropsychological or psychological issues, ongoing symptoms, response to treatment, current functional status, potential impediments to treatment/recovery, motivational issues, and other influential factors. A properly conducted peer-to-peer consultation may serve to expedite a satisfactory solution in complex and/or intractable cases.
Peer-to-peer consultations also involve collegial discussion with a treatment provider following an IME in order to discuss findings of an independent evaluation, engage in a discourse regarding a claimant’s status toward Maximum Medical Improvement (MMI), and/or to facilitate a smooth transition back to occupational functioning.
Dr. Luis has over a decade of experience completing professional record reviews and peer-to-peer consultations for disability claims, worker’s compensation claims, and, on occasion, personal injury claims. Her expertise involves record reviews and peer-to-peer consultations of cases entailing neuropsychological or psychological issues. The process often includes reviewing neuropsychological/psychological evaluation reports, raw test data, interpretive strategies performed by colleagues, and evaluating the therapeutic process and techniques used by treatment providers.
Capacity Evaluations
Capacity Evaluations
Capacity reflects the legal assumption that an individual is presumed to have the physical and/or mental ability to make or execute sound decisions.
Although there are several legal standards of diminished capacity, neuropsychologists are often involved in “civil” capacity evaluations involving individuals with cognitive impairment. This is a growing area given the changing demography of our country involving an increased number of adults over the age of 85. Individuals at advanced age levels carry the greatest risk for dementia and have the highest rates of cognitive decline.
Dr. Luis has been involved with the neuropsychological assessment of older adults with or without cognitive decline in medical, long-term care, and private-practice settings for over two decades. Capacity evaluations with this population and in these settings focus on:
An individual’s ability to provide medical consent to treatment
An individual’s ability to deny or refuse medical treatment
An individual’s ability to make financial decisions
An individual’s ability to execute health care advanced directives
An individual’s ability to implement legal contract (e.g., will, POAs)
An individual’s ability to live independently
An individual’s ability to provide testamentary capacity
Dr. Luis is not available to perform capacity evaluations in criminal matters (e.g., ability to stand trail).