Cost of malingering mild traumatic brain injury-related cognitive deficits during compensation and pension evaluations in the veterans benefits administration

ABSTRACT

Given the high rates of exaggeration in those claiming long-term cognitive deficits as a result of mild traumatic brain injury (mTBI), the aim of this study was to evaluate the rates of malingering in those seeking disability through the Veterans Benefits Administration and estimate the financial burden of disability payments for those receiving compensation despite exaggerated mTBI-related cognitive deficits. Retrospective review included 74 veterans seen for Compensation and Pension evaluations for mTBI. Rates of malingering were based on failure of the Medical Symptom Validity Test (MSVT) and/or the Test of Memory Malingering (TOMM) trial 1 ≤ 40. Total estimated compensation was based on the level of disability awarded and the number of individuals found to be malingering cognitive deficits. Overall, 33–52% of the sample was found to be malingering mTBI-related cognitive deficits. The malingering groups were receiving approximately $71,000–$121,000/year ($6,390–$7,063 per year, per veteran on average). Estimated nationwide disability payments for those possibly malingering mTBI-related cognitive deficits would be $136–$235 million/year (projected costs from 2015–2020 = $700 million–$1.2 billion). It is critical that providers and administrative officials identify those exaggerating disability claims attributed to mTBI. The cost of malingering impacts society in general as well as veterans themselves, as it diverts needed funds/resources away from those legitimately impaired by their military service.

KEYWORDS:

• Malingering
• medical symptom validity test
• neuropsychology
• test of memory malingering
• traumatic brain injury
• veterans

Acknowledgments

No conflict of interests were reported. The views and opinions contained in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of Veteran Affairs.

Additional information

Funding

This work was supported by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs, and the Mid-Atlantic MIRECC.