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23.1.1 Psychiatric assessments and unverified allegations re employment
Psychiatric and psychological examinations involve the client discussing their personal and employment history, and including his or her perceptions of circumstances relating to the origins of their symptoms. This means that the psychiatrist is often reliant only on the client's version of the circumstances, i.e. those prevailing prior to and up to the time of the development of the mental illness. In some cases, the client's recall of the circumstances cannot be confirmed by others or by available documentation and may even be seriously at odds with those available records.
Thus there is in some cases, potential for the psychiatrist's report on the origin of the illness to be based on fantasies generated by that illness itself.
Delegates should of course provide the examining psychiatrist with all evidence relating to the known circumstances, and if necessary incorporate this into a summarised 'briefing' on the case. Nevertheless, many psychologists and psychiatrists are guided by their clinical training to regard their patient's 'version of reality' as the critical issue for professional interaction and treatment. A report prepared from that professional standpoint may ignore or down-play what is independently known about alleged events or conditions. However, while this clinical approach may be helpful in professional psychiatric terms – i.e. coming to grips with the client's subjective distress and in facilitating treatment – this is not helpful for the purposes of determining liability. Liability can only be awarded on the basis of actual rather than perceived injuries.
Delegates should therefore read psychiatric reports with some care, to ensure that the account of circumstances relied upon by the psychologist is consistent with what has been independently verified, and if not, decide whether this is critical to the outcome.
Delegates need not accept medical reports based on false or unverifiable premises.
The Repatriation Commission (RC) has issued Guidelines for diagnosing, investigating, determining and assessing compensation claims for psychiatric conditions. The Commission Guideline is available in the Reference Library.
The fee schedule for Psychiatrists for the preparation of reports for compensation claims is available on the internet at http://www.dva.gov.au/service_providers/Fee_schedules/Pages/psych.aspx