Lynch Ryan's weblog about workers' compensation, risk management, business insurance, workplace health & safety, occupational medicine, injured workers, insurance webtools & technology and related topics

March 5, 2008

Bullshit as Science: A Test for Malingerers

Paul Lees-Haley, PhD, is a psychologist who has come up with a 43 question test to separate the truly disabled from malingerers. Lees-Haley is either a genius or a pompous fraud right out of Mark Twain. Read on and decide for yourself. (This posting is based upon an article by David Armstrong in the Wall Street Journal, which limits access to subscribers.)

Lees-Haley studied the Minnesota Multiphasic Personality Inventory (MMPI), a standard tool for determining personality characteristics. He isolated 43 questions that he believes, taken together, clearly separate the truly disabled from malingerers and frauds. Lees-Haley's brainchild, dubbed the "Fake Bad Scale" test, was developed in 1991 and is finding its way into courtrooms around the country. Lees-Haley is available to testify in person on behalf of insurance companies as an expert witness. He charges $3,500 to evaluate a claimant and $600 per hour for depositions and testimony. Worth every penny, I'm sure, if his testimony results in the denial of benefits to a claimant.

Testing the Test
Below you will find a sample of questions from the test, requiring a "True" or False" response. A "T" before the question indicates a "true" response is indicative of malingering. Likewise for "false."
F My sex life is satisfactory.
T I have nightmares every few nights.
F I have very few headaches.
F I have few or no pains.
T I have more trouble concentrating than others seem to have.
T I feel tired a good deal of the time.
F I am not feeling much pressure or stress these days.

You don't need a PhD in psychology to identify the ambiguity and unfairness in these questions, which are typical of the test as a whole. In the aftermath of an injury, someone might well feel stressed out, have difficulty concentrating, be tired much of the time and have frequent headaches. These responses do not necessarily indicate malingering. They can just as easily be valid indicators of post-traumatic response to injury. The "Fake Bad Scale" fails to account for anything that might have happened in the real world. Using this corrupt measure, every survivor of the 9/11 attacks would be deemed a "malingerer."

Fortunately, the validity of the test has come under fire. A number of courts have thrown it out. That's the good news. The bad news is that untold numbers of people who have answered these questions honestly have ended up being labeled (and libeled) as "malingerers." Shame on the attorneys who rely on this phony science, and shame on the insurance carriers who retain them. And double shame to the originators of the MMPI, who have formally given their stamp of approval to this inept tool. To be sure, we all know that there are malingerers out there: but the "Fake Bad Scale" is no help whatsoever in singling them out.

Revised March 10, 2008.

Posted by Jon Coppelman at 12:13 PM Link to, Comment (10), or E-mail this post

Thank you for posting this so quickly.

PTSD cases not connected with physical injuries under the DBA Workmans compensation must first be litigated to prove the person has PTSD before any treatment will be paid for.

Very few of these employees have access to medical care or competent lawyers while the insurance company can hire the likes of
Paul Lees-Haley and Dr Griffin to disprove PTSD before an employee ever has the chance to see a psychiatrist of their choice.

The dangers of untreated PTSD go well beyond the welfare of the employee him or herself.

Posted by: Marcie Hascall Clark at March 5, 2008 1:28 PM

The test is a win/ win for the defense/ insurance company, here is why...

Here is how the FBS is scored.

If the plaintiff answers NO to any of the questions it can be used against him to claim he does not have ptsd.

If he answers yes to any of the questions, he gets points towards malingering.

So again, what is the test for?

The only scientific facts we have that has ever been proven that works is a Lie Detector test, and no Dr. through any test can read someone's mind. Sad part is, is in the Thompson case that doctor also said he had no brian damage, without an MRI or any test given. Word on street is that he finally did get one after his hearing and the MRI shows major brian damage and volume loss of the frontal lobes. Again, what are these test really being use for? ? ?

Posted by: queenbee at March 5, 2008 6:44 PM

I am a healthy, happy, semi-retired, yet still employed college prof. I took the test; rembering back when I fell down and bumped my head. I had a concussion. It took about 3 or 4 weeks to get well.

As a result of the answers, I must conclude that having a brain injury (concussion) actually CAUSED me to be a malingerer. I never knew before that character traits (malingering-ness) could be changed by an injury. (sarcasm).

This test is worse than bogus. It is designed to deny benefits needed by injured workers to aid in their healing process.

Posted by: Daniel Ashley, Ph.D. at March 6, 2008 3:25 PM

It was interesting reading the article by Coppelman. In his emotionally charged reponse to the Fake-Bad Scale, he seems to imply that the construct of malingering is beyond the understanding and measurement by psychologists. It is not, and the scale when administered properly and with the controls that are recommended for its administration, it can be useful in suggesting the probability of deception. Our recent studies with work comp patients in chronic pain using a similar but more complex test shows patients are very capable of lying and endorse items similar to the Fake-Bad Scale.

Blake H. Tearnan, Ph.D.

Posted by: Blake H. Tearnan, Ph.D. at March 6, 2008 9:24 PM

I have not read the WSJ article but can tell you this about the test. This test was developed for use in personal injury cases where there is little or no objective evidence of injury. It asesses physical and pyschological symptoms often overreported in PI cases as well as denial of mild antisocial beliefs most people would admit to at some level if they are being honest with themselves. In other words, persons who obtain a high scores are reporting a high number of physical and/or psychological symoptoms (without verified conditions to support them)and claiming to be unrealistically virtuous and honest. Empirical studies show scores above 23 suggest exageration and above 28 very likely. HOWEVER, if you are evaluating a patient where the symptoms they endorse fit with their objectively verified medical or psychological condition, those items should not be counted toward the score. The test is not for assessing malingering of PTSD, there is the Fptsd scale for that. The scales should also not be used without the full MMPI-2 including all other 'valdity' scales. Like all tests, medical and psychological, it must be used as one part of a broader forensic asssessment and not by itself as the sole determinant of malingering. False positives can occur as with any test. It should be used by psychologists with full training in the development and interpretation of such tests. Misuse of a test does not mean the test lacks utility.

Posted by: K.B., Ph.D. at March 6, 2008 9:58 PM

Based on my experience of more than three decades of using junk science as an insurance defense attorney, of course these “lie detector/malingerer” test are phoney and tend to favor the defense. Who pays for their development and use? Certainly not the plaintiff’s side unless they think they have real legitimate case! Most plaintiff’s lawyers would love a tool that enabled them to weed out the flakes and fakes before having to invest substantially in their litigation. (Plaintiff's lawyers tend to get paid only if they prevail - which they can't do without a good case if there is competent defense counsel on the matter.)

Rather, it is mainly us defense lawyers who use these tests as a means of intimidating claimants into dismissing their case or settling for next to nothing. If a plaintiff weathers all the “tests” (typically a day of testing in a psychologist's office followed by an Independent Medical Exam [IME] by a “defense psychiatrist” hired for the purpose of selling a “pre-determined” conclusion to a jury), and still pursues the case, then the defense lawyer knows he/she has more work to do. In that event, the following sub-rosa investigation is what actually reveals “truth” as to the pain and limitations on the claimant’s abilities as revealed by the plaintiff’s real life situation(s). In this sense, I suppose you could say that these tests are useful tools in getting at the truth, but as a direct source of insight, they are just junk science used for a devious purpose.

If we were to address the issue of “justice” (not to be confused with winning!), on the basis of their probative value as opposed to their prejudicial effect, such tests would never be allowed in a court of law.

Posted by: RETIRED defense lawyer at March 7, 2008 5:50 PM

IME'S for a class action suit against a KY workers comp dotor who is paid to go against oaths to help companys get by with no compensation,keeping them in this COMMONWEALTH KY state, with many competent doctors IME'S CT'S ect, prove the unethical practice

Posted by: at March 10, 2008 11:09 PM

no surprise, worked for 25 yrs., got hurt at work, first time in my life, the employer has the insurance and the funds to buy their answer and you don't.

Posted by: Kathleen at March 12, 2008 8:20 PM

As a patient myself, I find it back-stabbing to all these corporations who are out to screw a human-beings health, when an employee becomes total disabled.

I am a true witness of this horrible experience. All of these phony tests are lies. Many Patients like myself, could have all the supported medical documentation that shows all facts, and we are still being harrassed and questioned over, and over and over and over, like freaking broken record.

Being an injuried indivisual with a TOTAL Disability can put a toll, Strain, and Stress on that person which becomes emotionally distress. Not to mention, the complications on a reqular day to day living.

No one knows the stress and depression affect on a persons life unless they are living in a that permanant shell. In my case I am a single mother with 2 kids and I have a son with 4 major disablities, to which I am struggling to help him with because of my permanant disability. My disability is affecting my family because i am not able to do the things that use to do.

It's really sad to see how your long term job turns on you after you put in so many years and long hours of hard work. I still can't believe all the hate and fakeness that my job and their insurance companies have put me through.

The IME's are fake ass liers.

Oh my gosh!!! I had a witness in the room with me and video taping the entire appointment and this Lying ass IME stated in his report, even though he visually evaluated me and saw my disablitiy that I was fine and okay.

These IME's are getting paid to lie!!!!!! Now if this isn't fair.... I don't know what is!!!! Oh let me guess! A stupid IQ Test that is pointless and a violation to me and any other patient who is Total disabled.

I think all the bullshit should stop after we/the patients can choose to have a judge do a reverse test on all the IME'S and their Bullshit lies. These tests are bogus and are not true.... They need to stop bullshiting patients and read the facts on all medical test reports.


Posted by: PATIENT at May 10, 2008 12:18 PM

I am commenting to your post, Patient at May 10, 2008. I know exactly what you are saying I am going through workmans comp at this time, I have already been drug threw the mill I have a depressive disorder from my job constinly playing games to push me out because they claim they can no longer accomadate my disabilities. The fact is I would not be in this situation if it had not been for the disrespect the company shows for the individuals. When the company found out I had asteo arthritis and was recieving injections in my fingers from from the work I was doing exasterbating my condition. The only thing they have been focused on is getting me out, believe me I have been so depressed its been over a year and I am now just being able to do my dishes with out crying, my knees are just as bad now for my work place forcing me to do a job no one eles was required to do for 40 hours a day. I just went through taking Lees-Haleys test for depression that was recognised for maligering and all my depression is said to be from my past history. Hah! What bull!
I am 3mo's or better behind on all my bills and am getting ready to loose my as long as I can still see no matter how much pain I am in I am still able to work... which I would probably go crazy if I don't. But I know what you are going through believe me!

Posted by: R. Hill at June 1, 2008 8:38 PM
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