How the MMPI-3 Can Impact Your Long Term Disability Claim: Understanding Psychiatric Defensive Medical Examinations

If you’re filing or already receiving long term disability benefits for a mental health condition, you may be asked to attend a psychiatric “Independent Medical Examination” — which, in reality, is anything but independent.  These exams are more accurately called Defensive Medical Examinations (“DME”) because they’re arranged and paid for by your insurance company, often with the goal of cutting off or denying your benefits.  One tool insurers frequently rely on in psychiatric DMEs is the MMPI-3, a psychological test that can significantly influence the outcome of your claim.

Below we’ll answer common questions to help you understand what a psychiatric DME involves, how the MMPI-3 fits into the process, and how to protect your rights before and after the exam.  Whether you’re preparing for an upcoming DME or dealing with a claim denial based on one, it’s important to know what you’re up against—and how a long term disability attorney can help you push back.

What do I need to know about the psychiatric DME process?

When pursuing a long term disability claim due to psychiatric conditions, you may be required to undergo a psychiatric Defensive Medical Examination (“DME”).  This evaluation is conducted by a psychiatrist hired by your insurer, and the outcome of the examination can have serious ramifications for your benefits.

What is a psychiatric Defensive Medical Examination (“DME”)?

A psychiatric Defensive Medical Examination (“DME”) is an evaluation conducted by a psychiatrist hired by your long term disability insurer.  Despite being called an “independent” medical examination by insurers, these evaluations are not truly independent.  The psychiatrist is chosen and paid by the insurance company, which often results in a biased report that downplays or denies the severity of your condition.

During a psychiatric DME, the psychiatrist will typically:

• • Ask questions about your medical history, symptoms, and daily functioning;
  • Evaluate your mental state through conversation and observation; and
  • Administer psychological testing, such as the Minnesota Multiphasic Personality Inventory-3 (“MMPI-3”), which insurers often use to assess credibility and diagnose mental health conditions.

The insurance company uses the DME report to determine whether you meet the criteria for long term disability benefits.  Because these exams often favor the insurer, preparing properly and understanding your rights is crucial.

Why is my long term disability insurer requesting a psychiatric DME?

Your long term disability insurer is requesting a psychiatric DME to evaluate whether you still meet the criteria for disability benefits.  Insurers often use these exams as a way to justify reducing or terminating benefits, especially for mental health claims, which can be more subjective than physical conditions.

Common reasons an insurer may request a psychiatric DME include:

• • Verifying your diagnosis: Your insurance company may question whether your condition is as severe as your treating doctors say.
  • Assessing your credibility: Tests like the MMPI-3 are often used to suggest that claimants are exaggerating symptoms, even when they are not.
  • Looking for improvement: If you have been receiving benefits for an extended period, your insurer may use a DME to argue that your condition has improved enough for you to return to work.
  • Creating grounds to deny or terminate benefits: Because the psychiatrist conducting the DME is hired by the insurance company, their report may be biased in favor of your insurer’s financial interests, being used as justification to deny or terminate your long term disability claim.

If your insurer has scheduled a psychiatric DME, it’s important to approach it carefully.  These exams can significantly impact your claim, and preparing in advance can help protect your benefits.  A long term disability attorney can provide valuable guidance and make sure your rights are protected during the process.

What is the MMPI-3 test?

The MMPI-3 (Minnesota Multiphasic Personality Inventory-3) is a psychological test designed to assess personality traits, mental health conditions, and how a person perceives and responds to stress.  It consists of 335 true-or-false questions that evaluate a wide range of psychological symptoms, including depression, anxiety, and PTSD.

Insurance companies often use the MMPI-3 in psychiatric DMEs to assess credibility of your condition and symptoms.  The test includes built-in validity scales that insurers may use to argue that a claimant is exaggerating or faking symptoms.  Insurers look at the MMPI-3 results to assess whether your mental health condition is severe enough to prevent you from working.

Although the MMPI-3 is a widely used test, it is not perfect.  The way results are interpreted can be subjective, and insurance-hired psychiatrists may use them unfairly to downplay your condition.  That’s why it’s important to understand the role of this test in your disability claim and be prepared for how your insurer might use it against you.

How can the MMPI-3 impact my disability claim?

The MMPI-3 can have a significant impact on your long term disability claim because insurers use it to evaluate the severity and legitimacy of your mental health condition.  While the test is a recognized psychological tool, its results can be misinterpreted or misused by insurance-hired psychiatrists to deny or terminate benefits.

Here’s how the MMPI-3 can affect your claim:

• • Questioning your credibility: The test includes validity scales that assess whether your answers are consistent.  If the psychiatrist claims your results show exaggeration or malingering, your insurer may use that as a reason to deny your claim.
  • Challenging your diagnosis: If the MMPI-3 results do not align with your treating doctor’s diagnosis, your insurer may argue that your condition is not as severe as reported.
  • Minimizing your limitations: Your insurance company may use the test results to suggest that your mental health condition does not impede you from performing your occupational duties, even if your treating doctors say otherwise.

Because the MMPI-3 is just one piece of the evaluation, it should not be the sole factor in determining your eligibility for long term disability benefits.  If a psychiatric DME report misrepresents your condition based on MMPI-3 results, you may need to challenge it with additional medical evidence.  It’s always recommended that you consult with a long term disability attorney.  An experienced attorney can review the report, refute your insurer’s attempt to downplay your condition, and help you appeal the decision should your insurer deny or terminate your benefits.

Can I refuse to take the MMPI-3 or undergo a psychiatric DME?

Whether you can refuse to take the MMPI-3 or undergo a psychiatric DME depends on the terms of your long term disability policy.  Most policies require claimants to attend medical examinations requested by the insurer, including psychiatric DMEs.  If you outright refuse, your insurance company may use that as a reason to deny or terminate your benefits.

However, there are limits to what the insurer can demand:

• • The exam must be reasonable and necessary to evaluate your claim;
  • The insurer cannot require invasive procedures or testing unrelated to your condition; and
  • The psychiatrist conducting the DME should have relevant qualifications for evaluating your specific diagnosis.

If you are concerned about taking the MMPI-3, you may be able to challenge its use, especially if your treating doctors believe it is unnecessary.  You may also have the right to request reasonable conditions, such as having the exam recorded or asking for an observer to be present.

Before refusing or challenging a psychiatric DME, it’s best to consult with a long term disability attorney to avoid giving your insurer an excuse to deny your claim.

How do I prepare for a psychiatric DME with MMPI-3?

Preparing for a psychiatric DME with MMPI-3 is essential, as these exams are often used by insurance companies to justify denying or terminating long term disability benefits.  Knowing what to expect and how to approach both the interview and the psychological testing can help protect your claim.

How should I prepare for a psychiatric DME?

Preparing for a psychiatric DME is crucial because the insurance-hired psychiatrist may look for reasons to downplay your condition or question your credibility.

Before the exam, take time to review your medical history, including your diagnosis, symptoms, treatments, and medications.  Make sure you are consistent with what you have reported to your treating doctors and your insurance company.  While honesty is important, it’s best to keep your answers direct and to the point.  Overexplaining or trying to “prove” your disability could be misinterpreted as exaggeration.

During the evaluation, be mindful of how you present yourself.  The psychiatrist will observe not just what you say, but also your behavior, mood, and body language.  If you struggle with certain tasks in daily life, do not minimize your difficulties, but also avoid overstating them.

It’s helpful to write down key details about your condition before the exam so you don’t forget anything important.  If possible, consider requesting that the exam be recorded or bringing an observer, as this can help ensure an accurate account of what happens.  Consulting with a long term disability attorney before the DME can also provide guidance on what to expect and how to protect your rights.

What should I expect during the MMPI-3 test?

The MMPI-3 is a self-administered questionnaire consisting of 335 true-or-false statements designed to assess personality traits, emotional functioning, and mental health conditions.  Insurance companies use it in psychiatric DMEs to evaluate the severity of your condition and, in some cases, to challenge the credibility of your symptoms.

During the test, you will answer a wide range of statements about your thoughts, feelings, behaviors, and experiences.  Some questions may seem repetitive or unrelated to your condition, but they are designed to measure consistency in your responses.  The test also includes validity scales, which insurers may use to argue that a claimant is exaggerating symptoms, even if that is not the case.

Here’s what to expect during the MMPI-3:

• • The test is typically taken on a computer or paper in a quiet setting;
  • It takes about 35 to 50 minutes to complete;
  • The psychiatrist administering the DME may not review your responses with you immediately. Instead, they will score the test and interpret the results in their report; and
  • The MMPI-3 is just one part of the psychiatric DME, which may also include an interview and clinical observations.

Since your insurer may try to use the MMPI-3 results against you, it’s important to answer honestly without overthinking.  Trying to downplay or exaggerate symptoms can work against you, as the test is designed to detect inconsistent responses.  If you have concerns about how your insurer might interpret your results, consulting with a long term disability attorney before the exam can help you prepare and protect your claim.

What are some common tactics used by insurance-appointed psychiatrists during a DME?

Insurance-appointed psychiatrists often use subtle tactics during a psychiatric DME to minimize your symptoms or cast doubt on your credibility.  Since they are hired by your insurance company, their goal is often to find reasons to justify reducing or denying your long term disability benefits.

Some common tactics include:

• • Asking misleading or repetitive questions: They may ask the same question in different ways to see if you give inconsistent answers, which they could use to argue that you are exaggerating or unreliable.
  • Downplaying your symptoms: If you are polite, cooperative, or well-groomed, they might claim that you don’t “appear” disabled, even if you struggle significantly in daily life.
  • Observing you outside of the formal evaluation: They may watch how you walk into the office, sit, or interact with staff to look for signs that contradict your reported limitations.
  • Suggesting improvement or exaggeration: If you hesitate when answering questions or show any uncertainty, they may use that to suggest you are not being truthful about your condition.
  • Using the MMPI-3 validity scales against you: If the test results indicate distress, they might say you are exaggerating.  If they don’t, they could argue that you are not as impaired as you claim.

Since psychiatric DMEs are rarely in your favor, preparing in advance is crucial.  Being aware of these tactics can help you stay consistent, honest, and focused on your actual limitations.  If you are concerned about how the exam might affect your claim, consulting a long term disability attorney beforehand can help you protect your rights.

Can I bring someone with me to the psychiatric DME?

Bringing someone with you to a psychiatric DME can be an important way to protect yourself, but insurers and DME psychiatrists often push back against this.  Having a witness ensures there is an objective account of what happened during the exam, which can be useful if the psychiatrist misrepresents your statements or behavior in their report.

There are professional services that allow you to bring a nurse or medical observer to the DME.  These individuals are trained to take detailed notes on what was said and done during the exam.  Afterward, they can provide an official written statement about the psychiatrist’s conduct, the types of questions asked, and whether anything seemed inappropriate or biased.  Having this documentation can be valuable if you need to dispute the DME findings later.

Even if you cannot bring a professional observer, having a family member, friend, or caregiver with you can still be helpful.  They may not be allowed inside the actual evaluation, but they can document how long the exam lasted, what they observed before and after, and any concerning behavior from the psychiatrist.

Insurers and DME examiners often resist allowing a witness, claiming it is unnecessary or against policy.  However, having an attorney involved can help push back against these objections.  Your lawyer may be able to negotiate with your insurer to allow a witness or even request that the exam be recorded.  If your insurer refuses, this can be noted as part of a legal challenge if the DME report is later used unfairly against you.

Is my claim going to be denied if I attend a psychiatric DME?

Attending a psychiatric DME doesn’t automatically mean your long term disability claim will be denied—but it is a common step insurers take when they’re looking for a reason to cut your benefits.  Understanding the purpose behind the exam can help you prepare and respond strategically if the results are used unfairly.

Do psychiatric DMEs always favor the insurance company?

Psychiatric DMEs are often referred to as “Independent Medical Examinations” by insurers.  However, they are not truly independent and often favor your insurance company.  The psychiatrist conducting the exam is hired and paid by your insurer, which creates a financial incentive to produce reports that justify denying or terminating benefits.  While not every psychiatrist conducting a DME is biased, the system is designed in a way that tends to work against claimants.

Psychiatrists performing DMEs have a number of tactics they use to downplay the severity of your mental health condition.  For example, the psychiatrist may claim you appear “well-adjusted” or “not in significant distress” during the exam, even if your symptoms severely impact your daily life.  The psychiatrist may also ignore your medical history, choosing to focus only on the short time they spent with you rather than considering long-term treatment records from your actual providers.

Because psychiatric DMEs are designed to benefit your insurer, it’s important to prepare carefully, be mindful of their tactics, and seek legal guidance if you believe the report is biased.  A long term disability attorney can help you challenge an unfair DME report and present stronger medical evidence to support your claim.

How can my responses on the MMPI-3 be used against me?

The MMPI-3 is often used in psychiatric DMEs to evaluate your mental health, but your insurer may manipulate the results to challenge your credibility or downplay your condition.  Since the test includes validity scales, your insurer may argue that your responses suggest exaggeration or inconsistency, even when that isn’t the case.

Here are some ways your MMPI-3 responses could be used against you:

• • Claiming you are exaggerating symptoms: If your responses indicate high levels of distress, the psychiatrist may say the results suggest malingering or symptom magnification.
  • Arguing you are not as impaired as you claim: The test includes questions about feelings like sadness or worry.  If your answers don’t reflect extreme distress, your insurer may claim you are functioning well enough to return to work, even if you still struggle with daily tasks.
  • Ignoring real-world limitations: The MMPI-3 only measures psychological traits based on a questionnaire.  It doesn’t account for how your condition affects your ability to work, but your insurer may treat it as definitive proof of your functional abilities.

Because MMPI-3 results can be subjective, your insurer may use them selectively to justify a claim denial.  If a psychiatric DME report misrepresents your condition based on MMPI-3 results, a long term disability attorney can help challenge the findings and provide stronger medical evidence to support your claim.

What are some red flags that suggest the DME psychiatrist is biased?

Since your insurance company hires and pays the DME psychiatrist, there is often a built-in bias against claimants.  While not every psychiatrist will be overtly unfair, certain red flags can indicate that the examiner is more focused on helping the insurer deny or terminate benefits rather than conducting a truly neutral evaluation.

Some common signs of bias include:

• • Rushing through the exam: If the psychiatrist spends very little time with you, asks only a few questions, or skips important details, they may not be conducting a thorough or fair evaluation.
  • Ignoring your medical records: A fair evaluation should consider your treatment history and records from your treating doctors.  If the psychiatrist seems uninterested in reviewing your medical background, it could indicate bias.
  • Focusing on how you “appear” rather than your symptoms: Some biased psychiatrists will note that you are “well-groomed,” “polite,” or “cooperative” as a way to suggest that your condition is not severe, even though mental illness is not always outwardly visible.
  • Misrepresenting your statements: If the psychiatrist twists your words, minimizes your symptoms, or claims you said things you didn’t, they may be shaping the report to favor your insurer.
  • Over-reliance on MMPI-3 validity scales: If the report emphasizes that your test results indicate exaggeration or malingering, even when your treating doctors support your claim, the psychiatrist may be unfairly discrediting you.
  • Failing to explain findings: A biased psychiatrist may make sweeping conclusions about your ability to work without fully explaining how they reached those conclusions.
  • Using boilerplate language: If the report sounds generic or similar to reports from other cases, the psychiatrist may be using standard wording designed to favor the insurance company rather than assessing your condition individually.

If you notice any of these red flags, it’s important to push back.  A long term disability attorney can help challenge a biased DME report by gathering additional medical evidence, cross-referencing inconsistencies, and refuting unfair conclusions that do not reflect your true condition and symptoms.

What should I do if I feel the psychiatrist misrepresented my responses or diagnosis?

If you believe the DME psychiatrist misrepresented your responses or diagnosis, it’s important to act quickly to correct the record and protect your long term disability claim.  Insurance companies often rely heavily on DME reports to deny or terminate benefits, so challenging inaccuracies is critical.

Here’s what you can do:

• • Request a copy of the DME report: You may have the right to review what the psychiatrist wrote about your exam, though sometimes insurers will only provide this after a claim denial or termination.  If your insurer denies access, an attorney may be able to help you obtain it.
  • Compare the report to your actual experience: Take notes on what happened during the exam and compare them to the psychiatrist’s findings.  Look for misstatements, omissions, or exaggerated conclusions.
  • Get a statement from a witness: If you brought someone with you or hired a professional observer, their notes can help counter any false claims in the report.
  • Ask your treating doctors for a rebuttal: Your psychiatrist or therapist can provide a written statement refuting any incorrect conclusions and reaffirming your diagnosis and limitations.
  • Submit a formal response: If the DME report is inaccurate, you can submit a detailed response to the insurer pointing out errors and providing supporting medical evidence.
  • Consult a long term disability attorney: An experienced lawyer can help challenge a biased DME report, ensure your insurer considers all relevant medical evidence, and fight back if your claim is unfairly denied.

DME psychiatrists hired by insurers do not have the final say in your disability claim.  If their report is misleading or unfair, taking immediate action can help protect your right to benefits.

How do I protect my rights after the psychiatric DME?

After a psychiatric DME, it’s important to take steps to protect your rights and ensure your long term disability insurer doesn’t misuse the exam results to deny your benefits.  Even if the psychiatrist’s report is biased or inaccurate, you have the ability to respond and challenge it.

What should I do if my claim is denied after a psychiatric DME?

If your long term disability claim is denied after a psychiatric DME, you still have options to fight back.  Insurance companies often rely on biased or inaccurate DME reports to justify denials, but a strong appeal can challenge these findings and protect your right to benefits.

Here are some steps you can take if your claim is denied or terminated after undergoing a psychiatric DME:

• • Request a copy of the denial letter and DME report: Your insurer must explain why your claim was denied.  Carefully review the letter and the psychiatrist’s report for errors, misrepresentations, or inconsistencies.
  • Gather supporting medical evidence: Ask your treating doctors to provide updated medical records, letters, or reports that reaffirm your diagnosis and explain how your condition prevents you from working.
  • Obtain a rebuttal from your treating psychiatrist or therapist: If the DME psychiatrist misrepresented your condition, a statement from your own mental health provider can help refute those conclusions.
  • Consider additional expert evaluations: If necessary, you may be able to undergo an independent psychiatric evaluation from a neutral doctor to counter the insurance company’s findings.
  • Consult a long term disability attorney: An attorney experienced in disability insurance claims can help build a strong appeal, ensure the insurer considers all evidence, and take legal action if necessary.

Most long term disability policies allow you to appeal the denial.  Your appeal should point out flaws in the DME report, highlight supporting medical evidence, and explain why you still qualify for benefits.  It is always recommended to engage a long term disability attorney before filing an appeal on your own.  An experienced attorney will understand the best strategy to secure your benefits, help you obtain additional evidence proving your disability, and prepare a detailed appeal letter rebutting your insurer’s reasons for denial.

Can I challenge the results of the MMPI-3 or the DME report?

Yes, you can and should challenge the results of the MMPI-3 or the psychiatric DME report if they misrepresent your condition or unfairly suggest you are not disabled.  Insurance companies often use these reports to justify denying or terminating benefits, but they are not the final word on your claim.

If you believe the MMPI-3 results or the psychiatrist’s conclusions are inaccurate, here’s how you can push back:

• • Look for errors or bias: Some DME psychiatrists misinterpret MMPI-3 results, exaggerate claims of malingering, or ignore other medical evidence.  Take note of anything that seems misleading or incomplete.
  • Get a rebuttal from your treating doctor or therapist: A statement from your own mental health provider can clarify how the MMPI-3 should be interpreted in the context of your full medical history and why the DME report is flawed.
  • Obtain an independent evaluation: If necessary, you can undergo an evaluation by a neutral psychiatrist or psychologist to provide an unbiased assessment of your condition.
  • Consult a long term disability attorney: A lawyer can help challenge your insurer’s reliance on a flawed MMPI-3 interpretation or biased DME report and ensure that your appeal presents strong, well-documented medical evidence.

The MMPI-3 is just one test, and the DME psychiatrist’s opinion is not the only medical evidence that matters.  If your insurer is using flawed conclusions to deny your claim, taking immediate action can help protect your benefits.

How can a long term disability attorney help me handle a psychiatric DME?

A long term disability attorney can be a valuable advocate when dealing with a psychiatric DME, especially since these exams are often biased in favor of the insurance company.  Insurers use DMEs to justify denying or terminating benefits, so having legal support can help you protect your rights and ensure a fair process.

Here’s how an attorney can help:

• • Pushing back on unfair DME requests: If your insurer’s request for a psychiatric DME is excessive, unnecessary, or conducted by an unqualified doctor, an attorney may be able to challenge or limit it.
  • Negotiating conditions for the exam: Attorneys can request reasonable accommodations, such as allowing a witness, having the exam recorded, or ensuring the psychiatrist has relevant experience with your condition.
  • Preparing you for the exam: A lawyer can help you understand what to expect, identify common tactics used by DME psychiatrists, and advise you on how to respond to questions without unintentionally harming your claim.
  • Reviewing the DME report for inaccuracies: If the psychiatrist misrepresents your statements, ignores key medical evidence, or misinterprets MMPI-3 results, your attorney can help identify those flaws.
  • Gathering medical evidence to counter a biased report: An attorney can work with your treating doctors to obtain medical records, statements, or additional evaluations that support your claim.
  • Filing an appeal or lawsuit if necessary: If your benefits are denied based on a flawed psychiatric DME, a lawyer can build a strong appeal or take legal action against the insurer.

Insurance companies count on claimants being unprepared for psychiatric DMEs, but having an attorney involved ensures that you are not navigating the process alone.  With legal support, you can challenge unfair tactics, protect your benefits, and push back against biased DME findings.

If you’re looking to file a long term disability insurance claim for lung cancer, appeal a wrongful claim denial, or litigate your insurer, Riemer Hess can help. Contact us today at (212) 297-0700 or click the button below for a consultation on your disability case.