NADE newsletter comments on malingering

JOA · Joined: 13 May 2004 Posts: 1703

CT Hall has put up an interesting link, to the Spring 2008 newsletter for the National Association of Disability Examiners. What’s interesting about it, at least from my point of view, is what's at the end of the newsletter. Titled an “independent response,” it’s really a kind of op ed piece. This op ed piece criticizes “a recent policy clarification” from SSA as getting in the way of using what the op ed piece presents as recent neuropsychological research that has validated several test instruments for detecting malingering.

Here, read the op ed piece for yourself:

http://www.nade.org/Spring_2008.pdf

Did you notice the list of references? Twelve of them, no less, culminating with something asserted to be titled “do tests of malingering have any value for SSA evaluation,” cited as DI 24515.066.

It’s hard to make much sense of this without knowing what the op ed piece is reacting to. It’s not reacting to DI 24515.066. The thing that titled, “do tests of malingering have any value for SSA evaluation” is something called a “National Question and Answer.” This Q&A has its own internal identification. This internal identification is not DI 24515.066. Q&A’s are identified instead by their year and order of publication. DI 24516.066 is only the POMS cross-reference at the end of the Q&A.

All of what I’m going to say next would mean more if you had had a chance to read the Q&A, which I don’t intend to publish on my own. But if you did in fact have an opportunity to read it, there are a couple of things I think will jump out at you:

1. The op ed piece refers to the policy clarification as having come from a “writer.” Sure enough, someone had to write it. But the component responsible for this particular policy statement is the Office of Disability Programs.

2. If we turn this “writer” stuff around, it sure seems plain to me that whoever wrote the op ed piece is unlikely to have read DI 24516.066. Or if he did, then it's unlikely he knows where it comes from. DI 24515.066 happens to be the POMS restatement of 20 CFR 404.1529 and SSR 96-7p. Against the background of this published regulatory standard for symptom evaluation, there’s really no surprise that as the op ed piece quotes, the O&A states that tests for malingering are not dispositive--are not a "gold standard"--and in fact are not even “programatically useful.”

3. On top of this, there is considerable possibility that the Q&A and the op ed piece are not talking about the same things. The Q&A is broadly about symptom evaluation, particularly in the context of consulltative psychological examinations, while the op ed piece seems to be aimed more narrowly at the validity of neurocognitive testing—meaning IQ scores. Validty of scores happens to alraedy be one of SSA's embedded princiiples for evaluatting intellectual functioning.

Again, I’m not going to publish the contents of the Q&A that is the subject of the NADE op ed piece. Insiders who want to read it can quickly find it by going to PolicyNet, selecting “Q&A’s,” and then doing a keyword search for “malingering.”

Or if you are an insider who has my .gov address, send me an e-mail and I’ll send you an InTRAnet link.

MikeWalters · Joined: 13 May 2004 Posts: 1138 Location: Cincinnati OH

I would also add that the last reference cited in the piece, mentioned by JOA, indicates that the author has not yet received word that SSA is no longer a part of HHS