Opinion ID: 3162189
Heading Depth: 3
Heading Rank: 1

Heading: Dr. Van Horn finds Michael unfit for duty

Text: In December 2009, the City referred Michael to Dr. Firoza Van Horn for a comprehensive neuropsychological evaluation to determine his fitness for duty. She examined him and reviewed both his past medical records and the City’s recruitment announcement for police officers. Taking his medical records and test results together, Dr. Van Horn concluded that Michael “has shown evidence of all of the symptoms and deficits” of deteriorating brain function. Specifically, Dr. Van Horn found that Michael demonstrated deficits in “switching mental set and handling more than one task at a time, visual memory, tactile perception, problem solving and new learning ability.” She also concluded that, because Michael was never previously referred for a comprehensive neuropsychological exam, he “has been led to believe that despite recurrent growth of a brain tumor that necessitated three surgeries, chemotherapy, No. 14-2478 Michael v. City of Troy Police Dep’t, et al. Page 9 radiation and anticonvulsant medication, he was able to return to a job that require[s] him to protect the public, enforce laws, assign areas, investigate and make arrests, direct and control traffic, write violation ticket[s], prepare reports, appear in court, provide service and assistance to [the] public, [and] protect himself among other responsibilities.” Dr. Van Horn’s ultimate conclusions were that “Officer Michael is not competent to handle his duties as a police officer” and that, “[g]iven his cognitive defects, he may be a threat to himself and others.” 2. Dr. Liethen disagrees with Dr. Van Horn’s conclusion On his own accord, Michael underwent a neuropsychological assessment by Dr. Philip Liethen in February 2010. Michael was referred to Dr. Liethen by Dr. Tom Mikkelsen, who had treated Michael since June 2000. In a December 2009 letter, Dr. Mikkelsen opined that “Michael’s medical condition in no way affects his ability to properly and adequately care for his children, and in no way affects his judgment or temperament.” Like Dr. Van Horn, Dr. Liethen interviewed Michael and conducted neuropsychological tests. He also reviewed Dr. Van Horn’s report and Dr. Mikkelsen’s letter. Dr. Liethen concluded that “Michael’s cognitive profile demonstrated all major neuropsychological domains to be well within, and generally above, normal expectation. No remarkable weaknesses were demonstrated, as was consistent with Mr. Michael’s presenting report of no remarkable ADL [average daily living] functional problems.” Dr. Liethen also noted that his overall findings were consistent with the data documented in Dr. Van Horn’s report, but that his ultimate conclusion nonetheless differed. “[T]he current findings do not indicate any functional incapacity or incompetency; the current findings do not indicate any basis for Mr. Michael not to return to duty as a police officer in the capacity in which he was serving premorbidly.” Dr. Liethen specifically noted that the limited data that were present in Dr. Van Horn’s report “suggest[] gross misinterpretation prejudiced toward finding incapacity/incompetency” because the objective data contradicted “at least most of” Dr. Van Horn’s findings. In particular, Michael’s purported “deficits” in switching mental set, visual memory, and new learning ability were all belied by Michael’s average or above-average test results in those areas. No. 14-2478 Michael v. City of Troy Police Dep’t, et al. Page 10 3. Dr. Daniel denies that Michael is entitled to disability-insurance benefits In June 2010, Dr. Morad Daniel reviewed Michael’s medical records and the reports of Drs. Van Horn and Liethen on behalf of the City’s long-term disability insurance carrier, Standard Insurance Company. Dr. Daniel concluded that Michael was fit for duty: “Based on the claimant’s essentially normal neurological examinations, his excellent seizure control with no seizure recurrence since 04/2009, and his most recent normal neuropsychological evaluation, there is no evidence of any active limitation that would preclude the claimant from performing his duties as a police officer on a regular basis.” He further explained that Michael did not have any “current physical or mental limitations or restrictions,” and that “Dr. Van Horn’s neuropsychological assessment concluded with several erroneous statements, which were not based on the claimant’s actual test performance data.” Rather, Michael’s “test results were within the normal range on all subtests administered.” 4. Dr. Sewick determines that Michael is unfit for duty Based on another referral by the City, Dr. Bradley Sewick evaluated Michael in August 2010. Dr. Sewick interviewed Michael for one-and-a-half hours, reviewed Dr. Van Horn’s report and raw data, Michael’s medical records, and the City’s records describing a police officer’s duties. He discussed some of his concerns regarding Michael’s test results and ultimately concluded that Michael was unfit for duty: “I cannot in good conscience indicate that [Michael] can safely return to the full duties required of a police officer because of concerns that I have related to the findings outlined above.” Later that same month, Dr. Sewick wrote an addendum report, explaining in greater detail why he felt that Michael was unfit for duty as a police officer: Based upon my review of the neuropsychological testing raw data forwarded to me by Firoza Van Horn, it is my opinion that because of his medical condition, Officer Michael presents with a combination of problems that I think may likely negatively impact his abilities to effectively perform the job functions of a police officer in some areas and under certain conditions. Dr. Sewick thus agreed with Dr. Van Horn’s conclusion. No. 14-2478 Michael v. City of Troy Police Dep’t, et al. Page 11 5. Dr. Benincasa denies that Michael is entitled to disability-insurance benefits In January 2011, Dr. Daniel Benincasa independently reviewed Michael’s medical records on behalf of Standard Insurance Company. He disagreed with Dr. Van Horn’s overall assessment that Michael was unfit for duty, calling Dr. Van Horn’s interpretation of the data “simply baffling” and saying that she “note[d] deficits where there are none.” “The neuropsychological data is essentially within normal limits, across all domains, with the exception of the Trail B test being mildly slower but not suggestive of any substantial impairment and the claimant’s tactile time being mildly slower. Neither of these weaknesses would preclude work capacity as [a] police office[r].” Dr. Benincasa instead agreed with Dr. Liethen’s opinion: “The data from Dr. Liethen notes all scores and domains tested to be within the average to high[-]average range[,] which would not be indicative of any restrictions or limitations in regard to the claimant’s work capacity as a police officer.” He also opined that “the neuropsychological data does not reach a level of significance as to preclude [Michael] from his work capacity as Police Officer.”