Plaintiff presents with a wide array of physical, cognitive, and psychological problems, which have reportedly occurred secondary to the toxic exposure. Results of the current forensic toxicology evaluation are consistent with these reports, revealing significant areas of concerns and likely decline secondary to the toxic exposure, resultant hypoxic brain injury, and other resultant psychological and physical impairments.
Tests of neuropsychological functioning indicate mild to moderate impairments in executive functioning and memory. More specifically, plaintiff shows particular deficits in attention/concentration, impulsivity, complex planning/sequencing, and immediate memory. He also shows deficits with ongoing mental demands, as he seems to reach a cognitive threshold (which is atypically low) for processing/retaining new information. Testing also suggests (mild) deficits in long-term memory. Auditory and visual memory appear to be equally affected. Muscle strength is mildly impaired, as is fine motor speed/dexterity.
In terms of psychological functioning, results suggest that plaintiff is experiencing a very severe level of both depressive and anxiety symptoms. Anxiety symptoms include generalized symptoms as well as anxiety features specific to Posttraumatic Stress Disorder. Results on the PDS indicate that he is currently suffering from severe effects of PTSD. It is noted that he has experienced multiple traumatic events during his life, including having several highly traumatic experiences while he was serving overseas in the military as a young man. Having had a history of pre-exposure PTSD diagnosis (with significant behavioral/psychiatric sequelae) likely played a critical role in the severity of his current (and reportedly most distressing exposure-related) PTSD symptoms. After spending a substantial period of time talking specifically about pre- and post-exposure PTSD symptoms, I am confident that plaintiff’s current impairments are causally related to the toxic exposure that he suffered at work.
Results of plaintiff’s MMPI-2-RF show validity scales that do raise concerns about the possible impact of over-reporting and under-reporting, and these concerns have been considered. He generated a much larger than average number of infrequent responses to the MMPI-2-RF items. However, this level of infrequent responding may occur in individuals with genuine, substantial psychological and medical problems. Given the corroborating evidence of significant medical problems, I find plaintiff to be reporting credible symptoms. Interestingly, there is also evidence of possible under-reporting in his protocol. He presented himself in a very positive light by denying several minor faults and shortcomings that most people acknowledge.