Personal Injury and Disability

Abstract

Forensic mental health evaluations in personal injury and disability cases require an assessment of changes in the examinee’s functioning over time. This task requires the incorporation of multiple sources of data to obtain an accurate picture of the examinee. Social networking site (SNS) data, as a form of collateral data, may be useful in providing information about the examinee’s functioning over time and may help to corroborate or disconfirm aspects of the examinee’s self-report. SNS data, however, is subject to certain limitations and vulnerabilities, including issues with authenticity, context, representativeness, and relevance. These challenges are considered within the legal contours of civil litigation. The chapter concludes with recommendations for the effective use of social media data in personal injury and disability cases.

Appendices

Case Profile 1

8.1.1 Type of Evaluation

Personal Injury

8.1.2 Case Context

Roseanne Martin, a 41-year-old aide at a state high-security mental health facility, filed a law suit against her employer alleging that she was repeatedly sexually harassed by her supervisor over a three-year period. She claimed that as a result, she developed severe anxiety, was unable to leave her house, and was unable to sustain an intimate relationship with her significant other. This evaluation was requested by her attorney to determine the nature and extent of any emotional injury Ms. Martin suffered as a result of her employer’s actions.

8.1.3 Sources of Information

• 1. Clinical interview

• 2. Mental status examination

• 3. Psychological testing:

  • a. Minnesota Multiphasic Personality Inventory second Edition Restructured Form (MMPI-2-RF)

  • b. Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)

• 4. Mental health treatment records

• 5. Memoranda from employer

• 6. Screenshots of images from Ms. Martin’s Facebook account

8.1.4 Relevant Background

Ms. Martin, a single mother of four children, had been employed as a mental health worker at a State Hospital for 17 years. This is a high-security facility where individuals who have been found not criminally responsible for violent crimes and who have been adjudicated to be a danger to themselves or others are housed. Ms. Martin worked the night shift which began at 11:00 PM and ended at 7:00 AM. Ms. Martin reported that she enjoyed her job. She preferred working at night because she found it quieter and it allowed her to spend time with her children, who range in age from 13 to 21. Ms. Martin, who has never been married, reported she has always been the sole source of financial support for her family. She was proud of the fact that she had always been able to provide for her children. She had one long-term romantic relationship lasting 12 years. This relationship ended about two years ago.

Ms. Martin reported that about 3.5 years ago, a new supervisor, Gordon Everett was assigned to her unit. According to Ms. Martin, Mr. Everett began making suggestive remarks to her indicating he wished to have a sexual relationship with her. On one occasion he called her into his office, locked the door, and told Ms. Martin it was “just a matter of time until I get you into bed.” She said she was shocked by this and was “speechless.” She told him that she would not sleep with him. When she attempted to leave, Mr. Everett stood between her and the door and told her she could not leave until she kissed him. Ms. Martin reported she felt terrified and was afraid to resist. Ms. Martin then went back to her unit. She said she barely made it through her shift. She did not tell anyone about this incident. She hoped he would leave her alone since she did not encourage him.

However, according to Ms. Martin, Mr. Everett continued to press her for sexual favors. She attempted to avoid him whenever possible. Eventually, Mr. Everett became more insistent. He told her that if she did not start being more “friendly” to him, that she would be sorry and made reference to how one of the patients had recently attacked and seriously injured another staff member. Mr. Everett allegedly told Ms. Martin, “It would be a shame if something like that happened to a nice-looking woman like you.”

Ms. Martin then reported Mr. Everett’s behavior to the human resources department. Although they promised to investigate the allegations, Ms. Martin said that nothing changed. A few weeks later, Ms. Martin said that one of the patients on the unit told her that he had heard that other patients had been approached by someone on staff who offered them $50 to “mess her (Ms. Martin) up.” The following week, Ms. Martin said that she was in a supply room looking for towels when Mr. Everett came into the room behind her and shut the door. She said that he verbally berated her for “snitching” on him. He then told her he “knew what [she] really wanted.” He pushed her against the shelves, forcibly kissed her on the mouth, and groped her breasts. He told her there was “more to come,” and warned her to cooperate or start watching her back.

Ms. Martin left work after her shift and put in for sick leave. She has not returned to work since. She reported she has experienced significant distress, including trouble eating, sleeping, and concentrating; as well as anxiety, panic attacks, and fatigue. She has become increasingly withdrawn and spends most of her time alone in her room. She lost interest in sex and this contributed to the breakdown of her relationship with her significant other. They eventually broke up after more than 12 years together.

Ms. Martin sought mental health treatment from a psychiatrist and a counselor. Despite this, she reported she has had little improvement in her symptoms. She continues to be socially isolated, anxious, fearful, and unable to sleep. She reported suddenly becoming overwhelmed with fear and panic in the grocery store and having to run out of the store, leaving her groceries behind. She said she sometimes has to pull over to the side of the road while driving due to her heart racing and having difficulty catching her breath. She finds herself being irritable and cranky with her children. She is jumpy at home and startles easily. She has lost interest in social activities that she formerly enjoyed. She has not returned to work.

8.1.5 Behavioral Observations and Mental Status

Ms. Martin was accompanied to the evaluation by her adult daughter who remained in the waiting room during the evaluation. Ms. Martin was appropriately dressed in clean, casual attire, with an acceptable level of grooming. She described her mood as “miserable.” She appeared to be quite sad. Her eyes were downcast. Her overt emotional expression was generally flat, although she became tearful when discussing her interactions with Mr. Everett. She moved slowly and appeared tired. She was responsive to all questions and produced coherent, although at times, very lengthy responses. There were no obvious problems with memory or concentration. She appeared to be of roughly average intelligence. She cooperated with all examination procedures.

8.1.6 Summary of Test Results

The MMPI-2-RF was used to obtain additional information about Ms. Martin’s psychological and emotional functioning. The MMPI-2-RF is a 338-item self-report instrument used to assess psychopathology and personality. This test also contains scales to assess under- or over-reporting of symptoms and other ways of responding that compromise validity.

Ms. Martin produced a valid profile. She appeared to understand the content of the questions and responded in a consistent fashion. She reported more symptoms than was typical in the normative sample, but this appeared to reflect a high level of distress rather than an attempt to exaggerate her symptoms. She appeared to be responding frankly to the test items and did not attempt to present herself in an unrealistically positive light.

Ms. Martin’s responses suggest she may be experiencing a high level of anxiety, marked by fear, worry, irritability, and a sense of dread. The degree of anxiety she is experiencing appears to be interfering with her daily activities. In addition to subjective feelings of worry and dread, her anxiety appears to manifest as somatic symptoms including gastrointestinal distress, headaches, tingling and numbness in her limbs, and an overall sense of weakness and exhaustion. She expresses great difficulty trusting other people and reports feeling that others may be intentionally trying to harm her.

The CAPS is a 30-item structured interview that corresponds to the DSM-5 criteria for diagnosing PTSD. In addition to assessing the twenty DSM-5 PTSD symptoms, questions target the onset and duration of symptoms, subjective distress, the impact of symptoms on social and occupational functioning, overall response validity, overall PTSD severity, and specifications for the dissociative subtype (depersonalization and derealization).

A diagnosis of PTSD requires that all criteria A through G are met. Ms. Martin’s responses to the CAPS indicate that the nature of the trauma she described meets Criterion A; she reported four intrusive symptoms, including intrusive memories, distressing dreams, and psychological and physiological reactions related to the trauma (Criterion B); one avoidance symptom—i.e., avoidance of memories associated with the trauma (Criterion C); five cognitive and mood symptoms including exaggerated negative beliefs or expectations, distorted cognitions leading to blame, a persistent negative emotional state, diminished interest or participation in activities, and attachment or estrangement from others (Criterion D); four arousal and reactivity symptoms including irritability, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbance (Criterion E); the duration of her symptoms has been for more than two years with no delayed onset (Criterion F); and she has experienced subjective distress as well as impairment in her social and occupational functioning (Criterion G).

8.1.7 Diagnostic Conclusions

There is considerable consistency among Ms. Martin’s self-report, the records of her mental health treatment, her performance on psychological testing, and her observed behavior during this examination—all suggesting that Ms. Martin is experiencing an extremely high degree of psychological distress. She is anxious, panicked, hypervigilant, depressed, and withdrawn. She has extremely disrupted sleep resulting in an exacerbation of her subjective distress, as well as physical fatigue and poor concentration.

Diagnostically, Ms. Martin’s symptoms best fit a diagnosis of PTSD. As indicated on the CAPS, she meets every diagnostic criterion and endorsed 14 out of a possible 20 symptoms. Ms. Martin’s daily functioning has been significantly compromised as a result of the stress she has experienced. She has felt unable to function at work. She is irritable with her children. She is avoiding social interaction and broke up with her long-time significant other. She struggles to complete relatively common activities, such as driving and grocery shopping, as a result of her symptoms.

8.1.8 Summary of Data Relevant to Psycho-Legal Question

Mental Health Treatment Records

Records from Ms. Martin’s psychiatrist and counselor indicate she has been in treatment for 2.5 years. During her initial psychiatric evaluation, she complained of “persistent feelings of depression and anxiety that interfere with her ability to function and interact with others.” She reported that she had sought help from human resources in dealing with “multiple frequent episodes of sexual harassment…Prior to her complaint and conflicts on the job, the patient enjoyed her place of employment and looked forward to going to work,” but Ms. Martin now “fear[s] for [her] safety and her job.” Ms. Martin’s symptoms included depressed mood, tearfulness, irritability, fatigue, decreased concentration, loss of interest, and social isolation. She reported severe sleep disturbance and was taking up to six Benadryl capsules to sleep. The psychiatrist prescribed Vyvanse, Xanax, Trazodone, and Neurontin. Subsequently, Neurontin and Trazodone were discontinued and Klonopin and Seroquel were added.

Ms. Martin also met with a therapist on a weekly basis. Notes from these sessions indicate Ms. Martin was often agitated and fearful. She reported feeling paralyzed mentally and physically. She complained of poor sleep and loss of interest in activities including socializing and having sexual relations with her significant other.

Memoranda from Employer

A memorandum from Ms. Martin’s employer confirmed that Ms. Martin had lodged a complaint against her supervisor alleging that he had engaged in a pattern of sexual improprieties, unwanted physical contact, physical restraint, and threats of physical harm. Another memorandum described an interview with Mr. Everett about these allegations. According to this memorandum, Mr. Everett acknowledged some “flirtatious behavior” may have transpired. He identified Ms. Martin as the instigator of this contact and reported that she had become angry with him when he told her he was married and was not willing to become involved with her. The memorandum indicated that Mr. Everett should be formally chastised for engaging in flirtatious behavior with one of his subordinates.

Facebook Images

During the deposition of the evaluator, the defense counsel presented the evaluator with three pages of images allegedly obtained from Ms. Martin’s Facebook account. These images depicted Ms. Martin wearing a tight-fitting, low cut, short dress and high heels. The defense counsel asked the examiner how she could assert that Ms. Martin had lost interest in sex given that these “provocative” photos were posted on her Facebook account. The examiner responded that without more information and context, that she could not form any opinion about these images and their relationship, if any, to Ms. Martin’s interest in sex.

Ms. Martin’s Account of the Facebook Images

After the deposition, the examiner spoke to Ms. Martin’s lawyer and asked him if she could meet with Ms. Martin to discuss these images with her. At this meeting, Ms. Martin identified the images as being of her and acknowledged the images were posted to her Facebook account. She clarified that she had posted the photos approximately three years ago. At that time, her relationship with her significant other was starting to deteriorate due to her anxiety and to her waning interest in having sexual relations. She reported that she was “pushing” herself to try harder with him because she loved him and did not want to lose the relationship. She stated, “I would try to get dressed up like this because he loved it and I thought it would make me feel better about myself. And it did, for a little while, but I just couldn’t keep it up and I couldn’t follow through.” She reported that the photos in question were taken at a New Year’s Eve party. She indicated that there were several other photos posted to Facebook that were taken that same night of her with her significant other and with other guests at the party which she showed the examiner. The other female guests were dressed in a similar fashion.

8.1.9 Clinical Forensic Opinion

There were no indications that Ms. Martin experienced symptoms of PTSD prior to the alleged events in her workplace. Prior to these events, she was a well-functioning single parent who was able to care for her family both emotionally and financially. Ms. Martin had no history of mental health treatment prior to the alleged events. She had no history of substance abuse. The onset of Ms. Martin’s symptoms and the decrease in her functional capacity appear to be directly related to the events in her workplace. The evaluation of Ms. Martin and review of her medical records did not identify any other life circumstances or potential causative factors unrelated to the alleged sexual harassment and retaliation that could explain the decline in Ms. Martin’s mental health and functional capacity.

8.1.10 Recommendations

No specific recommendations were offered as part of this evaluation.

8.1.11 How Did Social Media Impact This Case?

After the discussion with Ms. Martin, the examiner determined that the Facebook postings did not change her opinion regarding Ms. Martin’s loss of interest in sex as a result of the alleged sexual harassment at her workplace. The reasons for this are as follows. First, the context of the images had not been disclosed by the defense attorney. Placed in the context of a New Year’s Eve party, Ms. Martin’s attire was not unusual. Second, the photos had been posted three years prior to the evaluation. At that time, the alleged sexual harassment had just begun, and Ms. Martin was still able to function at work. Finally, there is no evidence that a person’s attire is dispositive of their interest in sex. It cannot be inferred from Ms. Martin’s clothing that she did or did not have decreased interest in engaging in sexual relations with her significant other.

Case Profile 2

8.1.1 Type of Evaluation

Disability

8.1.2 Case Context

Jason Anderson, a 24-year-old bank employee, claimed to be totally disabled from his job after a motor vehicle accident in which he sustained minor physical injuries. According to Mr. Anderson, as a result of this accident he became unable to work due to anxiety about driving, poor concentration, and an inability to work with numbers. The disability insurance company requested an independent evaluation of Mr. Anderson’s work capacity.

8.1.3 Sources of Information

• 1. Clinical interview

• 2. Mental status examination

• 3. Psychological testing:

  • a. Minnesota Multiphasic Personality Inventory, second Edition (MMPI-2)

  • b. Validity Indicator Profile, verbal subtest (VIP)

  • c. Wechsler Adult Intelligence Scale, fourth Edition (WAIS-IV)

• 4. Academic records

• 5. Performance evaluations

• 6. Emergency medical service records

• 7. City Hospital records

• 8. Mental health treatment records

• 9. Print out of Mr. Anderson’s Twitter postings

8.1.4 Relevant Background

Mr. Anderson, a single 24-year-old man, had been employed by a local bank as a teller for nine months. He has lived with his father continuously since his parents divorced when Mr. Anderson was 13 years old. He has a high school diploma and completed one year at a community college majoring in general studies. He was previously employed as a cashier at a supermarket. He reported he took the job at the bank with the hopes of eventually becoming a financial analyst. He stated that he had planned to finish college and then obtain an MBA via online classes while continuing to work at the bank.

Mr. Anderson reported that he was involved in a motor vehicle accident when he was driving home from work. He was struck from behind while stopped at a traffic light. He opined that he must have “blacked out” for a minute. He woke up, touched his face and realized he was bleeding. The airbags had deployed. Paramedics arrived. They told him he had been in an accident. He reported he could not remember his name, phone number, whether there had been anyone else in his car, or where he was coming from. He was taken to the emergency department of City Hospital by ambulance. He was examined and given a CT scan which was read as normal. He had facial lacerations which were treated and some bruising on his chest from the airbag. He was given medication for pain and was told to follow up with his primary care physician. He was discharged from the emergency department after approximately three hours when his father arrived to pick him up.

Mr. Anderson reported he stayed in bed for the rest of the day and just slept. The following day he reported he felt stiff and sore. He had his father call the bank to explain what had happened and to tell them he needed to take some sick time. After about one week, his lacerations had healed and he reported his pain had significantly decreased, but he still “wasn’t myself.” He did not feel able to return to work and took short-term disability.

Over the next several months, Mr. Anderson reported he felt very emotional and anxious. He also noticed he was having trouble remembering numbers and would invert digits. He said he was having difficulty concentrating, was working more slowly, and having trouble completing tasks. He was very uncomfortable driving or even riding in a car. He reported he had very limited social interactions. “My father is my only friend.” He reported he sought treatment from Dr. Rivera, the psychiatrist his father had been seeing. Based on Mr. Anderson’s description of the accident and his difficulties, Dr. Rivera diagnosed Mr. Anderson with a traumatic brain injury. No neuropsychological testing was done. Mr. Anderson then applied for long term disability.

Mr. Anderson reported he will never be able to return to his job at the bank and will be unable to complete his education or become a financial analyst as he had planned. “The biggest thing is my inability to deal with numbers. How can I work in a bank and analyze investments if I can’t work with numbers? I just can’t focus for long periods of time and the idea of driving to work gives me a panic attack. I just can’t do it anymore.”

8.1.5 Behavioral Observations and Mental Status

Mr. Anderson arrived early for the evaluation. He was unaccompanied and reported he had driven himself to the office which he stated was 20 min from his home. Mr. Anderson was appropriately attired in casual clothing consisting of a sweatshirt and jeans. He displayed adequate grooming. He was responsive to all questions and was cooperative throughout the evaluation, although he expressed anger and resentment about having to participate in the evaluation. He described his mood as “annoyed.” His overt display of emotions was variable and appropriate to the content of the discussion. He maintained intermittent eye contact. His responses to questions were logical and cogent, although he reported having difficulty recalling some dates and names. For example, he reported he could not recall the month in which the accident had occurred. Mr. Anderson appeared to be of average intelligence. He displayed no difficulty in maintaining his concentration during the 5.5-hour evaluation and took only one brief break after about 3.5 hours.

8.1.6 Summary of Test Results

Validity Indicator Profile—Verbal Subtest (VIP)

The VIP Verbal subtest was utilized to assess effort and motivation. Mr. Anderson produced an invalid/inconsistent profile. Although he generallyv responded correctly to easier items, he became less engaged with the task and did not make a consistent effort as the items became more difficult.

Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV)

The WAIS-IV is an individually administered assessment of cognitive abilities designed for adults ages 16–69. The subtests on the WAIS-IV are used to calculate a Full Scale IQ (FSIQ) and four composite scores, each of which assesses a different aspect of cognitive functioning: Verbal Comprehension Index (VCI) which assesses verbal reasoning, Perceptual Reasoning Index (PRI) which assesses nonverbal reasoning, Working Memory Index (WMI) which assesses immediate memory, and Processing Speed Index (PSI) which assesses the speed of cognitive processing.

Mr. Anderson’s full scale IQ was at the lower end of the average range (25th percentile). Likewise, all four index scores were in the low average or average ranges. There were no significant differences among these scores. Consistent with his performance on the VIP, Mr. Anderson tended to give up quickly on more difficult tasks. He responded “I don’t know” to a number of items and even with encouragement, he was not willing to guess at an answer.

Minnesota Multiphasic Personality Inventory, 2nd Edition (MMPI-2)

The MMPI-2 was used to obtain additional information about Mr. Anderson’s psychological and emotional functioning. The MMPI-2 is a 567-item self-report instrument used to assess psychopathology and personality. This test also contains scales to assess under- or over-reporting of symptoms and other ways of responding that compromise validity.

Mr. Anderson completed this test in approximately one hour, which is at the low end of the typical completion time of 60 to 90 min. However, he responded to the test questions in an inconsistent and contradictory manner, yielding a profile of questionable validity. Other validity indicators suggest that there was some tendency to present himself in a negative light. This suggests that the following test results may not be reliable indicators of Mr. Anderson’s actual functioning.

If taken at face value, Mr. Anderson’s responses suggested he was experiencing mild to moderate emotional distress characterized by a sad mood, worrying, a lack of enjoyment in life, and hostility and anger towards others. However, given the variability of his responses, this interpretation may be inaccurate.

8.1.7 Diagnostic Conclusions

Due to Mr. Anderson’s inconsistent effort during this evaluation and evidence from other sources that contradicted aspects of his self-report, firm diagnostic conclusions could not be reached.

8.1.8 Summary of Data Relevant to Psycho-Legal Question

Academic Records

Mr. Anderson’s high school transcript indicated he graduated with a final grade point average of 2.8. Notably, he failed one semester of Algebra and finished this class with a grade of C-. His final grade in Geometry was D. He did not take Algebra II.

Mr. Anderson’s community college transcript indicated he failed the math placement test and was enrolled in a pre-college algebra course in his first semester. He earned a grade of C in this class. In his first semester he also took an introductory sociology course in which he earned a grade of B- and a music appreciation class in which he earned a grade of C+. In his second semester, Mr. Anderson enrolled in a college algebra course. He dropped this class at the midterm with a failing grade. He did successfully complete courses in English composition (B-) and an introductory course in world history (C).

Work Performance Evaluations

During his nine months of employment at the bank, Mr. Anderson received two performance evaluations—one after three months of employment and another after six months of employment. Both evaluations rated Mr. Anderson in the average range. Strengths were listed as “friendly” and “liked by customers.” Areas needing further development included “complete tasks on time,” “pay attention to details,” and “motivation.”

Emergency Medical Service Records

The first contact with Mr. Anderson was at 5:59 PM, approximately five minutes after the accident. Records indicated he provided his name, date of birth, and a list of medications and allergies. He reported that his chest hurt. He was described as alert and oriented with a normal neurological status. He told emergency responders that he was unsure if he had lost consciousness. His Glasgow Coma Score was 15 (Note: this is the highest possible score, indicating he was completely conscious).

City Hospital Records

Mr. Anderson was admitted to the emergency department at 6:39 PM on the date of the accident having been brought in by emergency medical services. His injuries were listed as blunt force trauma and lacerations. There was a question of loss of consciousness as Mr. Anderson reported that he did not remember the accident. He was experiencing moderate pain in his chest, neck, and head. He was alert and oriented. At 7:02 PM he was observed talking to his mother on the phone. A CT scan was performed. The results were “normal.” No mass, fractures, intracranial hemorrhage or hydrocephalus was found. A CT scan of the cervical spine was normal. The abdomen was “largely unremarkable.” His lacerations were sutured. He was given pain medication. He verbalized understanding of the discharge instructions. He was discharged to his home at 9:43 PM.

Mental Health Treatment Records

Mr. Anderson was seen by Dr. Rivera for an initial evaluation having been referred by another patient (his father). Mr. Anderson reported he had been in an accident six months earlier. He reported he had lost consciousness for “six or seven hours” after the accident and had been kept in the hospital overnight. Dr. Rivera indicated that he did not believe Mr. Anderson met the diagnostic criteria for PTSD and suspected he might have sustained a head injury. Dr. Rivera told Mr. Anderson and his father, “I’m not an expert in head injury, but that was my take.” Dr. Rivera noted a provisional diagnosis of 293.83 (mood disorder secondary to a general medical condition).

Twitter Postings

A print out of Mr. Anderson’s Twitter postings (tweets) was provided. This consisted of 1258 tweets posted by Mr. Anderson beginning a month before he was hired by the Bank and ending three weeks before this evaluation. Most (i.e. over 900) of these tweets referred to playing blackjack at a casino in a neighboring state and were marked with a hashtag naming this casino. Some included photos of Mr. Anderson holding chips or cash. The content of these tweets typically referred to his success and winnings or losses at blackjack. There were several references to him participating in blackjack tournaments. The frequency and content of these tweets did not change over time—that is he was posting just as often after the accident as he had before the accident. Based on these tweets, it appeared that Mr. Anderson was visiting this casino, located about 60 miles from his home, about three times each week.

Mr. Anderson’s Account of Twitter Postings

Mr. Anderson acknowledged that he visited this casino regularly to play blackjack. He reported he has been doing so for years. These visits typically take place at night. He usually arrives around 9:00 PM and stays until around 3:00 AM. His father often goes with him, but he does go alone if his father is unable to accompany him. He stated that driving there is difficult, but “I’m trying to push myself to get better.” When asked how he is able to play blackjack, given his reported inability to work with numbers, Mr. Anderson replied, “I’ve been doing it so long, it’s muscle memory.” He denied that playing blackjack (even in tournaments) requires facility with numbers or concentration.

8.1.9 Clinical Forensic Opinion

Disability is conceptualized as an interaction between personal capabilities and situational demands. When situational demands exceed the individual’s capabilities, a disability exists. Therefore, disability analysis involves defining the relevant contextual demands as well as determining the individual’s capabilities. Disability also implies a change in functional capacity—that is, the individual’s capabilities have decreased as a result of an illness or injury. The examinee’s current functional capacity is compared to his functional capacity prior to the injury. The questions to address are: (1) what could the examinee do before the injury that he can no longer do; and (2) are these changes significant enough to prevent him from working as a bank teller?

According to Mr. Anderson, prior to the accident, he was functioning very well and was on his way to achieving his goal of becoming a financial analyst. He claimed that as a result of the accident he is no longer able to work as a bank teller because he is unable to work with numbers, has decreased concentration, and has difficulty driving. However, the findings of this evaluation do not support these claims. A review of Mr. Anderson’s academic records indicates that he never had strong numeric skills. He struggled with high school math, failed the placement test at the community college, and had to withdraw from the only college-level math class he took due to failing grades. In addition, his continuing to play blackjack at a casino argues against an inability to work with numbers, sustain concentration, and to drive long distances.

It is beyond the scope of this evaluation to determine if Mr. Anderson did sustain a brain injury in the motor vehicle accident. However, the existing evidence argues against this possibility. The only medical professional to support that diagnosis was Dr. Rivera, who did not have access to medical records or neuropsychological testing, admitted he lacked expertise in brain injury, and based his diagnosis on Mr. Anderson’s inaccurate self-report in which he claimed to have been unconscious for six or seven hours and had been kept in the hospital overnight. Records from emergency medical services and from the hospital contradict these assertions. Additionally, intellectual testing, despite Mr. Anderson’s variable effort, yielded scores that were likely consistent with his premorbid intellectual functioning.

In short, there was no convincing evidence that Mr. Anderson’s functional capacity has declined in any significant way following the motor vehicle accident. He remains as capable as he ever was of working as a bank teller.

8.1.10 Recommendations

No specific recommendations were offered as part of this evaluation.

8.1.11 How Did Social Media Impact This Case?

Mr. Anderson’s Twitter postings provided information about his daily activities that he had not previously disclosed in the examination. When confronted with his tweets, Mr. Anderson acknowledged their authenticity and confirmed the context. He admitted that he traveled to a casino 60 miles from his home several times a week in order to play blackjack for up to six hours.

This information did have direct relevance to the forensic issue in this case in that it provided evidence that Mr. Anderson was routinely engaging in activities that were inconsistent with his claimed impairments. The fact that he continued to play blackjack in tournaments contradicted his claim of being unable to work with numbers or to sustain concentration. His ability to drive to the casino, located 60 miles from his home, undermined his report of being unable to drive to work. Mr. Anderson’s tweets also corroborated the information obtained from other sources of data, including the psychological testing, that suggested inconsistent effort and possible exaggeration of symptoms, and his academic and work records that argued against a decline in his functional capacity.