Psychiatrist and psychologist - Who assesses what?
Perspective of a neuropsychologist
An assessment of the effects of brain damage is required within various legal areas of social security systems, in order to establish the nature and extent of brain function disorders and possible secondary mental disorders resulting from illnesses or injuries to the central nervous system. The clients are statutory accident insurance companies and the German Statutory Pension Insurance Scheme, private accident, public liability and disability insurance companies, care institutions and authorities and courts.
The questions relate to an illness- or accident-related reduction in ability to work, the extent of disability, the degree of incapacity and the results of damage or the capacity to work under civil service law. The effects of cognitive and affective disorders on occupational performance, general life management and activities and participation in various area of life are established in the basis of a nuanced neuropsychological examination using select diagnostic tools tailored to the individual case.
Exploration und behavioural observations and a scientifically founded validation of symptoms also form part of the assessment, as do the collation of performance-defining psychological parameters forming the basis of the person’s decision-making process. The psychometric objectivization - i.e. a classification of a person’s cognitive and emotional functional level based on statistical standards - allows the severity of functional impairments in areas such as perception, attentiveness, memory and executive functions to be identified and quantified.
The expert assessment must factor in the interplay between the health problems of a person and their general life background in accordance with a holistic approach under the
ICF system. Finally, questions can be answered regarding therapeutic or rehabilitative measures to maintain ability to work and/or concerning social, academic or professional reintegration and any relevant forecasts on further pathways and the permanence of impairments. The significance of neuropsychological assessments in interdisciplinary contexts is to be illustrated using four case histories from various areas of law.
