Forensic Psychology

Forensic Psychology

Civil Evaluations

Please click on the topics below for a description of Dr. Ernst’s approach to conducting various evaluations in civil proceedings:

The central question of a personal injury evaluation is not the extent of current psychiatric impairment that exists, but the degree to which the plaintiff’s psychological functioning prior to an alleged trauma has worsened as a result of the traumatic event. When conducting personal injury evaluations, Dr. Ernst establishes pre-injury psychological functioning through a careful review of records, interviews with individuals in the plaintiff’s life, and a detailed clinical interview investigating significant life events or mental conditions that occurred prior to the alleged trauma. Dr. Ernst next assesses present psychological impairment utilizing objective psychological testing, including malingering measures. Finally, in a causation analysis, Dr. Ernst determines whether any changes in psychological functioning were proximately caused by the alleged trauma. Such a causation analysis includes consideration of the base rates of relevant symptoms and disorders, an analysis of whether the plaintiff’s change in psychological functioning occurred temporally close to the alleged trauma, and a consideration of co-occurring stressors, including the psychological impact of litigation. In cases in which a plaintiff is alleging psychological damages from a minor trauma, Dr. Ernst carefully distinguishes between an “eggshell plaintiff” (e.g. a plaintiff whose limited pre-injury coping capacities left him vulnerable to the impact of a trauma) and a “crumbling skull plaintiff” (e.g. a plaintiff whose psychological functioning would have deteriorated regardless of whether he was exposed to an alleged trauma.) Dr. Ernst has extensive experience evaluating an array of traumatic events including, but not limited to, military trauma, childhood physical and sexual abuse, domestic violence, sexual harassment, auto and airplane accidents, sexual assault, natural disasters, and exposure to community violence.
Evaluations of civil competency may be required in diverse legal situations related to guardianship, testamentary capacity, contractual capacity, the capacity to consent to treatment, or involuntary civil commitment. While various legal standards govern these evaluations, Dr. Ernst’s competency evaluations are guided by a similar assessment structure. First, the legal standard or competency question is translated into functional capacities. For example, competency to make a medical determination may be translated into the capacity to understand relevant information about treatment options and to consider potential costs and benefits of treatment. Second, Dr. Ernst assesses the presence or absence of relevant functional capacities through the use of psychological testing and a detailed clinical interview. Third, Dr. Ernst determines the cause(s) of any deficits in functional capacities. For instance, the inability of a patient to understand relevant information about her treatment options may result from neuropsychological impairment, poor insight into mental illness, or psychotic symptoms. Dr. Ernst’s ultimate opinion of whether an individual is competent is based upon an analysis of the degree of congruity or incongruity between the relevant capacities the examinee has, and what will be demanded of her in the specific situation in which her competency is being questioned. Thus, an opinion about competency is context-specific. While a cognitively impaired individual may be competent to consent to a simplistic medical procedure, the same individual may be incompetent to consent to a more complex medical procedure which requires a greater cognitive capacity to understand.
A fitness for duty evaluation requires a careful analysis of whether an employee has the current capacity to perform his core job duties, and whether interventions, including psychiatric treatment, may allow the employee to safely return to work in the future. Dr. Ernst begins by translating the employee’s job description into measurable psychological capacities. For instance, a transit operator’s job description may be translated into the capacity to focus while driving, maintain emotional composure, and operate complex machinery. The employee’s ability to perform these psychological capacities is then assessed through a detailed clinical interview, records review, and objective psychological testing. In fitness for duty evaluations, the focus is on the present work capacity, and privacy concerns sometimes necessitate that protected health information, including past mental health conditions, not be included in reports. Thus, Dr. Ernst begins all fitness for duty evaluations with a clear conversation with the referral source about the specific scope of the evaluation. He limits the content of his reports to only the information that is needed by the employer to make a sound decision regarding the employee’s work capacity.
During a workplace threat assessment, Dr. Ernst provides an opinion of the degree of risk an employee presents in the workplace, which individuals are most likely to be injured by the threatening employee, and situations in which the employee is most likely to exhibit dangerous behavior. Dr. Ernst’s opinions are informed by a careful analysis of the employee’s history of threatening behavior, psychological factors driving the employee’s threatening behavior, and the presence or absence of empirically derived risk factors which are associated with an increased risk of workplace aggression. Dr. Ernst utilizes well-established psychological tests, such as the WAVR-21, when conducting workplace threat assessments.
Dr. Ernst routinely conducts QME and AME evaluations in the California Workers Compensation System. In such evaluations, he provides an opinion of whether an applicant has developed a psychological condition, whether the psychological condition was caused predominantly or substantially by the actual events of employment, the degree of psychological impairment that exists, and the extent to which treatment could improve psychological functioning. Dr. Ernst’s QME and AME evaluations are informed by a thorough understanding of the impact of chronic pain and trauma on psychological functioning and work capacity. He is adept at identifying examinees who are engaging in malingering, and able to distinguish malingering individuals from those whose symptoms may erroneously appear exaggerated due to a psychosomatic disorder. Dr. Ernst has completed over 100 QME and AME evaluations over the course of his career, and was selected as a subject matter expert for the QME pre-test panel.

Civil Evaluations

Please click on a topic below for a description of Dr. Ernst’s approach to conducting various evaluations in civil proceedings:

The central question of a personal injury evaluation is not the extent of current psychiatric impairment that exists, but the degree to which the plaintiff’s psychological functioning prior to an alleged trauma has worsened as a result of the traumatic event. When conducting personal injury evaluations, Dr. Ernst establishes pre-injury psychological functioning through a careful review of records, interviews with individuals in the plaintiff’s life, and a detailed clinical interview investigating significant life events or mental conditions that occurred prior to the alleged trauma. Dr. Ernst next assesses present psychological impairment utilizing objective psychological testing, including malingering measures. Finally, in a causation analysis, Dr. Ernst determines whether any changes in psychological functioning were proximately caused by the alleged trauma. Such a causation analysis includes consideration of the base rates of relevant symptoms and disorders, an analysis of whether the plaintiff’s change in psychological functioning occurred temporally close to the alleged trauma, and a consideration of co-occurring stressors, including the psychological impact of litigation. In cases in which a plaintiff is alleging psychological damages from a minor trauma, Dr. Ernst carefully distinguishes between an “eggshell plaintiff” (e.g. a plaintiff whose limited pre-injury coping capacities left him vulnerable to the impact of a trauma) and a “crumbling skull plaintiff” (e.g. a plaintiff whose psychological functioning would have deteriorated regardless of whether he was exposed to an alleged trauma.) Dr. Ernst has extensive experience evaluating an array of traumatic events including, but not limited to, military trauma, childhood physical and sexual abuse, domestic violence, sexual harassment, auto and airplane accidents, sexual assault, natural disasters, and exposure to community violence.
Evaluations of civil competency may be required in diverse legal situations related to guardianship, testamentary capacity, contractual capacity, the capacity to consent to treatment, or involuntary civil commitment. While various legal standards govern these evaluations, Dr. Ernst’s competency evaluations are guided by a similar assessment structure. First, the legal standard or competency question is translated into functional capacities. For example, competency to make a medical determination may be translated into the capacity to understand relevant information about treatment options and to consider potential costs and benefits of treatment. Second, Dr. Ernst assesses the presence or absence of relevant functional capacities through the use of psychological testing and a detailed clinical interview. Third, Dr. Ernst determines the cause(s) of any deficits in functional capacities. For instance, the inability of a patient to understand relevant information about her treatment options may result from neuropsychological impairment, poor insight into mental illness, or psychotic symptoms. Dr. Ernst’s ultimate opinion of whether an individual is competent is based upon an analysis of the degree of congruity or incongruity between the relevant capacities the examinee has, and what will be demanded of her in the specific situation in which her competency is being questioned. Thus, an opinion about competency is context-specific. While a cognitively impaired individual may be competent to consent to a simplistic medical procedure, the same individual may be incompetent to consent to a more complex medical procedure which requires a greater cognitive capacity to understand.
A fitness for duty evaluation requires a careful analysis of whether an employee has the current capacity to perform his core job duties, and whether interventions, including psychiatric treatment, may allow the employee to safely return to work in the future. Dr. Ernst begins by translating the employee’s job description into measurable psychological capacities. For instance, a transit operator’s job description may be translated into the capacity to focus while driving, maintain emotional composure, and operate complex machinery. The employee’s ability to perform these psychological capacities is then assessed through a detailed clinical interview, records review, and objective psychological testing. In fitness for duty evaluations, the focus is on the present work capacity, and privacy concerns sometimes necessitate that protected health information, including past mental health conditions, not be included in reports. Thus, Dr. Ernst begins all fitness for duty evaluations with a clear conversation with the referral source about the specific scope of the evaluation. He limits the content of his reports to only the information that is needed by the employer to make a sound decision regarding the employee’s work capacity.
During a workplace threat assessment, Dr. Ernst provides an opinion of the degree of risk an employee presents in the workplace, which individuals are most likely to be injured by the threatening employee, and situations in which the employee is most likely to exhibit dangerous behavior. Dr. Ernst’s opinions are informed by a careful analysis of the employee’s history of threatening behavior, psychological factors driving the employee’s threatening behavior, and the presence or absence of empirically derived risk factors which are associated with an increased risk of workplace aggression. Dr. Ernst utilizes well-established psychological tests, such as the WAVR-21, when conducting workplace threat assessments.
Dr. Ernst routinely conducts QME and AME evaluations in the California Workers Compensation System. In such evaluations, he provides an opinion of whether an applicant has developed a psychological condition, whether the psychological condition was caused predominantly or substantially by the actual events of employment, the degree of psychological impairment that exists, and the extent to which treatment could improve psychological functioning. Dr. Ernst’s QME and AME evaluations are informed by a thorough understanding of the impact of chronic pain and trauma on psychological functioning and work capacity. He is adept at identifying examinees who are engaging in malingering, and able to distinguish malingering individuals from those whose symptoms may erroneously appear exaggerated due to a psychosomatic disorder. Dr. Ernst has completed over 100 QME and AME evaluations over the course of his career, and was selected as a subject matter expert for the QME pre-test panel.