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This year, over 700,000 Americans will suffer a heart attack. Many of these will occur in the workplace. Work related stress can play a significant contributing role in these events. Unfortunately, emotional stress is very subjective and often difficult to quantify. Everyone knows “stress is bad for your heart,” but we now have a large body of scientific literature showing a very strong association between job strain and cardiovascular events. The cardiovascular risk from job strain appears to occur independently of other stressors in one’s life. A careful and thorough review of an individual’s work-related duties allows a better understanding of this risk, and is vital to making recommendations for worker’s compensation benefits, disability claims, and returning to work.

For more information on how Dr. Friedel or our other experts can serve your expert witness needs, please contact us at 412-433-0200.

An ever­ increasing number of plaintiffs are claiming post-­traumatic stress disorder. Why such a sudden, marked increase in litigation of this form?

Post­-traumatic stress disorder (PTSD) was first described in the sixth century B.C. The symptoms associated with the illness have not changed, though the name of the condition itself has, naturally, changed. In World War I the disorder was labeled “shell shock,” linking the condition to the close lines between battling armies and the continuous firing of munitions. In World War II, the condition came to be called “combat neurosis.” The term “post­-traumatic stress disorder” entered the psychiatric nomenclature with the 1980
publication of the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition.

The Vietnam conflict heightened the lay public’s awareness of this condition, through frequent articles in the press, movies, and books depicting the invisible wounds caused by combat. Symptoms of the disorder include rapid hyperarousal which frequently leads to aggressive acts. These behavioral changes often lead to the loss of family and employment. In addition, associated alcohol and/or drug abuse as self ­medication of the
symptoms is frequent. Finally, in severe and usually untreated cases, suicide can occur.

The Iraq and Afghanistan wars have once again brought these combat ­related symptoms to the fore, and nowadays there is more awareness of issues surrounding civilian PTSD. According to studies in civilian populations,accidents causing significant injuries, medical malpractice disability, or discrimination and the associated harassment are often
root causes of the disorder. Rape is the incident most predictive of PTSD.

This increased awareness of PTSD is but one reason for the increase in lawsuits involving the disorder. Additionally, according to studies, those who claim to have PTSD win markedly higher legal settlements. Both of these factors incentivize some individuals to simply learn the symptoms and behaviors associated with PTSD, and act them out—especially when there will likely be a sympathetic group of jurors. Lawyers are increasingly aware of such fraudulent claims, and they now place greater emphasis on the full constellation of symptoms that characterize PTSD.

The newest criteria for diagnosis of PTSD include a severely traumatic event, as well as having flashbacks, dreams, and frequent sleep disturbance related to the event. Patients will also often withdraw from environmental stimuli that remind them of the traumatic event.

In all sufferers of PTSD, there is a marked decrease in functional level. The success of civil litigation involving PTSD often depends on the attitudes of jurors and judges toward this psychiatric disorder. Meanwhile, as the amounts awarded to sufferers of PTSD continue to rise, less­ than­ honest lawyers have taken to coaching clients in the art of passing as psychologically traumatized.

Disagreement between psychiatric expert witnesses on the defense and plaintiff sides is common. The witness’ credentials and experience in working with post­-traumatic stress disorder—in both military and civilian populations—frequently determines whether the defense or plaintiff is successful.

Lawyers should always carry out thorough background checks to verify a particular psychiatrist’s professional experiences and background in litigation. Deserving clients will be most appreciative.

Dr. Burton Singerman is a nationally respected psychiatrist who is presently accepting work as an expert witness for both plaintiffs and defendants. 

Neuropsychiatrists are the experts best equipped to handle litigation cases involving brain injury. They have undergone specialized training and have developed clinical expertise that allows them to describe the long-term implications of brain injury, as well as the psychological and psychiatric effects of brain injury. In addition, the cognitive deficits associated with brain injury are best evaluated by a neuropsychiatrist. Recent studies have shown a high correlation between brain injury and significant psychiatric disorder and suicide: At least three-quarters of patients with a brain injury have been shown to develop significant psychiatric conditions within five years of the injury, and suicide is not an infrequent outcome.

Lawyers frequently take on cases in which a major component of the settlement and the jury award is based on an evaluation of the long-term effects of a brain injury, whether caused by work injuries, physical altercations, car accident or countless other circumstances. This is not a minor area in the legal arena. Two percent of the American population suffers from a disability related to brain injury, predominantly trauma-based. Brain injury can, of course, occur at any age. A significant percentage of such cases have lifelong implications. This is crucial in determining how much income the victim has lost and will lose, as well as the pain and suffering caused by the psychiatric disorders associated with the injury.

As a psychiatrist with specialized experience in neuropsychiatry, I can argue cases for lawyers representing brain injury victims, presenting the information most appropriate to help them obtain the maximum possible awards for their clients.

In addition Burt Singerman, M.D is available and sits on our panel of experts. His extensive background working with our military as a national expert in soldiers with brain injuries—through his research with the Pentagon and the Department of Defense—has proved beneficial in some of the largest cases we have undertaken.

Please write to info@trustexpertresources.com or contact me directly at dnpistone@outlook.com to discuss any cases in which you feel my expertise could be of benefit. We can discuss whether I would be the best representative for your case. If not, we can recommend other expert witnesses in our group who would be a more appropriate choice.

In 2015 the World Health Organization reported that depression is the number one cause of disability world wide. Patients with major depression may continue to function suboptimally: at least 50% of these have cognitive complaints affecting functioning in areas including the workplace. In the elderly, depression may actually mimic dementia.  However, in terms of disability, a test like the CNSVS by a psychiatrist that knows how to interpret it may be crucial to making your case regarding return to work issues.  The CNSVS test is often so useful it prevents the need to resort to the much more comprehensive batteries of tests by neuropsychologists which are lengthy and expensive. As opposed to neuropsychological testing, CNSVS testing can be administered to monitor cognition over time and determine if the patient is ready to return to work, needs to go on disability, or requires job accommodations.

When utilized in the proper setting by a skilled and experienced psychiatrist, CNSVS can be an effective tool in determining the extent of cognitive deficits such as dementia and depression, and can save time and money in having to hire additional experts, such as neuropsychologists, and unnecessarily complicating your case. For more information about how Dr. Pistone or any of our other trusted experts can assist you on your next case contact us at 412-433-0200. Or, fill out the service request for below and we will contact you shortly.

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