Course Title: Non-Organic Physical Signs: Are tests for “Fakers” credible? + Fundamentals and mechanics of the neurological examination

Course Instructor: Joseph S. Ferezy, DC

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CEU: One (1) CE Classroom Hour

Class Description:

People often present to health care providers following motor vehicle collisions and work incidents.  The party responsible for payment of related health care costs, both in the short and long term, often becomes a legal issue.  A part of the decision regarding payment is often based upon the expert opinion of a so called “Independent” (often referred to as “Adverse”) examiner of the patient.  The examination typically incorporates standard orthopedic tests with other tests for “Non-organic physical signs”.  These tests claim to be able to distinguish between organic or “real” damage from the alleged injury, from non-organic or “fake” damage, which may be due issues unrelated to the injury, from overt lying for a financial settlement (which is a crime), or from mental issues such as depression. This brief talk will discus the concept of organic vs. non organic disease.  “Waddell’s Sign’s” 8 signs, as well as another 6 tests for non organic physical signs will be described and critically examined. This brief class will review the fundamental mechanics of the neurological/ physical examination.  A format for examining the patient while the patient is standing, sitting, supine, and prone, will be presented. 

Class Objectives:

Contrast and compare the physical neurological examination with the physical examination of other body systems.

Perform a neurological examination in a logical, physical sequence from sitting to standing, supine and prone.

Describe and perform “Waddell’s Tests and six other special tests described in the literature to detect complaints without a physical basis.

Itemize pitfalls and critically review special tests described in the literature to detect complaints without a physical basis.