Psychiatry, the Law, and Depravity: Profile of Michael Welner, M.D. Chairman, The Forensic Panel

Dr. Welner was once retained by the attorney of a New York man who had lost his insurance benefits on the suspicion that he was feigning a disability. The insurance company had conducted a sting operation, videotaping him intelligently conversing at a dinner, and had subsequently cut off his benefits. Welner, using standardized assessments, did find the man to be malingering. However, when he went to the man's apartment, where he lived with his wife, the extent of the examinee's impairment was overpowering.

While that man might be able to hold a cogent conversation and appear to be functional, his apartment was paved with four-foot piles of unopened mail and stacks of items that he had collected that made it nearly impossible to even walk through the dwelling. All that was available was a narrow channel from the front door to the bed, with a small opening into the kitchen and bathroom.

"It was oppressive," recalls Dr. Welner. "I had to get him out of there just to conduct the interview, because I couldn't take it." Welner advised the attorney to videotape the man's apartment. "It had to be seen to be believed."

Going to the scene of the crime, to the place of employment, to the home advantages many cases. Dr. Welner calls them "forensic house calls — you breathe and live the world on an examinee's terms. Life is very different for them at home versus in your office." Thanks to this probing psychiatric work, the man won the case against a large disability insurance company with impressive resources and opinions that had gone no further in their assessment than the man's dramatic manner. There was much more below the surface. Welner discovered it and the other experts should have done so as well.

"Discovering that someone is faking is only part of the story," cautions Dr. Welner. "You still need to clarify what, if anything, actually is going on with that examinee."

Psychiatrists have the power to make things better, such as helping workers adjust to their illnesses while maintaining employment. However, forensic psychiatrists also have the power to ruin a person's future when they deem someone to be at risk in the workplace. Yet they would be remiss if they did not warn a company of a truly dangerous employee, and the circumstances under which he might ignite.