A case of malingering by proxy in a Social Security disability psychological consultative examination

The term "malingered neurocognitive dysfunction by proxy" was discussed by Slick, Sherman, and Iverson (1999) as part of the differential for defining malingering when a patient is responding to directions or pressure from others. In Chafetz (2008), rates of symptom validity failure in children whose parents are seeking Social Security Disability (SSD) on their behalf were presented and showed 20% to 26% symptom validity test failure rates at chance or below-chance levels. The objective of the current case study was to determine whether the requirements of malingering were met in a 9-year-old whose parent was seeking SSD on his behalf. A retrospective approach was employed using an archived case from one of the author's records. This case shows a practical application of a symptom validity scale for low-functioning individuals (Chafetz, Abrahams, & Kohlmaier, 2007), which was designed initially for use with adult and child SSD claimants. The egregious nature of symptom validity failure, coupled with SSD seeking for the whole family, along with conduct disorder symptoms provided a strong suggestion of malingering by proxy. The present results are discussed with respect to low-functioning claimants.