danivon wrote:Neither of you are doctors, so I don't trust either of your assertions.
What do actual doctors say about the ease of faking conditions?
First of all, it's not merely an assertion. I posted a list of symptoms of Depression from the Mayo Clinic. Which of them
cannot be faked? Which of them
can be measured by an objective test?
And DF, are you suggesting that no-one with such conditions can be disabled?
No, no more than you are suggesting that everyone diagnosed with Depression is actually depressed, I'm sure.
I hope not. All very well wanting to crack down on fraud, but what about those who are genuine?
I enjoyed reading
this. Puts it in a nutshell.
One summer, before graduating, I sat for a week studying in my bedroom. It was swelteringly hot and I had to keep the window open. But I was incessantly interrupted by the neighbours' banter outside.
Laughing, joking, playing football, having rows; their entire social life was being played out in front of me. And then as I battled with the intricacies of the kidney, it occurred to me: I had the education, but wasn't I being the stupid one?
I was studying while they sunbathed, so I could be a doctor and heal them when they developed skin cancer, and I would pay taxes to ensure that they could continue their lifestyle. Outrageous!
What was even more galling was that their apparent illnesses didn't hinder their lives - they weren't incapacitated at all. I watched the sons, both of whom were around my age, as they kicked a ball around. Was this the best cure for their depression?
I can see the appeal - if it's possible to live for free, not having to work, then why not do it? But perhaps making people get a job would mean that they weren't so depressed. Have they not just fallen into a vicious circle?
In my work, I see people battling crippling, disabling illnesses who deserve help from the state, people who are unable to work and whose lives are blighted by their conditions.
Further restrictions on benefit applications that would make it more difficult for people to receive long-term sickness benefit might mean that a proportion of those who really deserved it were excluded, and that would be a tragedy. But can we continue to support legions of people for whom state assistance has become a lifestyle rather than a necessity?
Official figures last week showed that half a million people under the age of 35 are now claiming incapacity benefit, more than those claiming unemployment benefit.
There is another factor you may not be considering: doctors who gain a reputation for approving Depression claims--do you suppose their practice is likely to increase or decrease?
In other words, there is money to be made in approving questionable claims.
Now, back to faking Depression and "assertions." There are a lot of fakers out there.
A 2002 study in the Journal of Clinical and Experimental Neuropsychology examined about 10,000 neuropsychological assessments that involved patients who applied for or received compensation benefits or who were involved in injury litigation. Researchers found that 29% of personal injury and 30% of disability claim cases involved probable malingering and symptom exaggeration. Probable malingering was present in 8% of medical cases not related to litigation or compensation claims.
Of the 10,000 cases, 39% of mild head injury cases and 31% of chronic pain complaints resulted in probable malingering impressions.
In his 2007 book, Assessment of Malingered Neuropsychological Deficits, neuropsychologist Glenn J. Larrabee, PhD, said half of people involved in medical-legal claims exaggerate illnesses.
The problem is not limited to workers’ compensation and disability cases. Patients pretend to be sick or disabled to avoid work, stay out of legal trouble, obtain medication or receive special accommodations such as extra time on a collegiate exam.
Headlines in the past year illustrate how some patients fake illness for financial gain. For example, 10 New York railroad retirees were arrested in May for disability pension fraud. In 2012, women in Virginia, Arizona and California falsely claimed to have cancer and raised thousands of dollars in donations.
The bad economy is leading more people to pretend to be sick for money, said Donald Schroeder, MD, an Oregon-based orthopedic surgeon and past president of the Oregon Medical Assn. Consider that 55% of 500 fraud examiners said occupational fraud had risen, according to a 2009 survey by the Assn. of Certified Fraud Examiners. Intense financial pressure was listed as the largest contributing factor to the increase.
People “are losing their jobs and are desperate to find a way to support themselves,” said Dr. Schroeder, who conducts exams in personal injury and workers’ compensation cases. “They’ll file compensation claims, or they’ll go to court in personal [injury cases]. The problem is greater than ever.”
Difficulties in spotting malingerers
Physicians face myriad challenges in identifying malingering patients. One is time constraints of medical visits, said David Fleming, MD, chair of the American College of Physicians’ Ethics, Professionalism, and Human Rights Committee.
“We’re seeing so many patients [who] have chronic conditions, it’s difficult to pick up on the fact there may not be an objective reason to treat a particular patient,” he said. “We don’t really have the time to investigate. Oftentimes, it’s easier” just to treat them.
Lack of a long-term patient-physician relationship adds to the problem. If patients see many different physicians, that limits doctors getting to know and build trust with them, Dr. Fleming said.
Mental conditions that mirror the appearance of malingering can make spotting a fake troublesome, said Christopher Stewart-Patterson, MD, a fellow with the American College of Occupational and Environmental Medicine. Dr. Stewart-Patterson, who practices occupational medicine in Canada, co-wrote an article on malingering in the January/February issue of AMA Guides Newsletter, which is published by the American Medical Association.
. . .
Faking symptoms of common medical and psychiatric conditions is not difficult, according to Dr. Stewart-Patterson’s article in AMA Guides Newsletter. Ninety-seven percent of untrained people can correctly choose symptoms associated with major depressive disorder on subjective checklists, the article said. Sixty-three percent can identify at least five symptoms associated with a brain injury.
Patients easily can go online to learn the symptoms of nearly every disease, said Dr. Schouten. His book, Almost a Psychopath: Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy? details how doctors can detect manipulative behavior in patients.
“With the Internet and the availability of all sorts of medical information, you could come up with a list of symptoms,” Dr. Schouten said. “Then, when the physician says, ‘Do you have this,’ [a patient] has every symptom under the sun.”
A key barrier to pinpointing malingering is a doctor’s desire to be supportive of patients, say medical experts.
http://www.amednews.com/article/2012091 ... 9109942/4/
11 Apr 2013, 2:34 pm 
