Financial Capacity Assessment for Adults in California

Financial capacity assessment can be confusing for older adults and their families, and finding a psychologist skilled in capacity evals is not always easy.  Here is some helpful information about financial capacity, and where a psychological capacity assessment comes into the picture.

Understanding Financial Capacity

Financial capacity is a person’s ability to manage money and make financial decisions.  This is a right that all adults have, but in some situations, questions about a person’s ability to manage their own money can arise. 

There are two typical types of cases when this happens:

• For older adults who are diagnosed with a neurodegenerative disorder, like dementia  

• When an adult becomes disabled in a way that impacts their brain and thinking, like after a traumatic brain injury or stroke

To be very clear, just because a person has a disability, dementia, or is of a certain age, does not mean they lack financial capacity.  Financial capacity usually comes into question when a person:

• Demonstrates difficulty making financial decisions

• Shows very poor judgment about their own finances

• Is financially manipulated by another person

• Can’t keep up with managing their money 

In addition to having a brain change that impacts overall judgment, these types of situations could raise questions about financial capacity. It’s very serious to consider limiting someone’s right to make their own decisions, so in cases that are not clear-cut, it is necessary to seek a financial capacity assessment with a clinical psychologist.

Financial Capacity Assessment With a Psychologist

A psychologist with expertise in the financial capacity assessment will do a few things as part of a comprehensive financial capacity evaluation:

• A thorough interview with the adult in question

• Testing to evaluate their 

• understanding of financial concepts

• judgment and decision-making

• practical money skills (like writing a check or counting change)

• Possibly also interviews with family members, partners, caregivers, or other people closely involved in the person’s life

• A review of financial and medical records

The psychologist will often write a report with the results and recommendations.  When there is a question about financial capacity, the psychologist’s aim is always to balance protection (recommending support and additional help when someone truly needs it) and autonomy (respecting and supporting the person’s right to make their own decisions).  This is a tightrope walk in some situations, and hiring a psychologist with expertise in this area can lead to the best possible outcome for the vulnerable adult being evaluated.

The Results of a Financial Capacity Assessment

After a financial capacity assessment is complete, the results may be used in a few different ways: 

• To aid in appointing a financial representative (sometimes called an agent, Power of Attorney, or POA)

• To make recommendations about what support a person might need to maintain as much financial autonomy as possible (e.g., help setting up autopay for monthly bills)

•  To appoint a conservator of a person’s estate (also called a limited conservatorship, in which the conservator only handles financial matters for the person)

• To do nothing (e.g., when someone demonstrates financial capacity, and no change is needed)

• To protect a vulnerable person from being exploited for their money or property

Receive A Capacity Assessment in Los Angeles, CA

Receiving a financial capacity assessment can help you better understand what is best for your family. Dr. Reger provides capacity assessments at several locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for your financial capacity assessment

3. Balance protection and autonomy today

OTHER COUNSELING SERVICES OFFERED BY Dr. REGER in Los Angeles, ca

I know you may experience a number of mental health concerns. This is why I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations.

How to Make the Most of a Psych Eval, Part I: Finding the Right Psychologist

A psychodiagnostic or neuropsychological evaluation is an investment of time and money, and if you are seeking a psych eval, you want to make the most of your investment.  In this series, I’ll share some tips for how to do that.

Expect to Share a Lot About Yourself During a Psych Eval

I encourage potential patients (both for therapy and neuropsych testing) to look for a good fit.  During a psych eval, you will be spending essentially an entire day with your psychologist, and telling them a lot of personal information.  A clinical interview includes questions about:

• Social history (family, relationships, partners, marriages, children)

• Medical history

• Any history of abuse

• Mental health symptoms, diagnoses, and treatment

• Drug and alcohol use, past and present

• Problems you are having in your day-to-day life

These interviews can feel very vulnerable, and working with a psychologist who you feel comfortable with makes the process easier.  During testing, it’s even more important to feel at ease, because anxiety can impact your test results!

Don’t Be Afraid to Ask Questions When Seeking a Psych Eval

In addition to feeling comfortable during your psych eval, it’s also important to find a psychologist who is qualified and experienced in the type of evaluation you need.  For example, some psychologists primarily do psych testing for children, others work only with adults.  There are also usually practical things to consider, like cost, location, and timeframe.  Here are some questions you can ask as you seek a psychologist for a psychodiagnostic evaluation:

• Where is your office?  (Some psychologists, like myself, see testing patients at several offices around Los Angeles and Orange County)

• How often do you test patients for (adult ADHD, dementia, autism, traumatic brain injury, capacity, or whatever else you specifically need from testing)?

• How much have you worked with (ADHD, dementia, capacity, TBI, cancer, etc)?

• What is your specialty?

• What do you charge for this type of psych eval?

• Are there ever additional costs beyond this?

• Do you have a wait for psych testing?  If so, how long is the wait?

• How do you accept payment for psychological assessments?

• When can I expect a report after psych testing is complete?

• Do you offer a feedback session after testing?  

These questions can help you learn practical things, but the psychologist’s answers should also give you an idea of their style and how you feel talking to them. 

Green and Red Flags to Keep In Mind When Finding a Psychologist for a Psych Eval

I would love to believe that anyone out there promoting him or herself as a qualified assessment psychologist is being honest.  But, the truth is that becoming competent in psychological assessment takes many years of education, supervised training, and experience, and not all psych evals are the same.  Here are some markers of quality in a psych eval, and some red flags to watch out for.

Green Flags (Signs that Point to a Quality Psych Eval):

• The psychologist is open about his or her experience, training, specialty, and other questions you ask.

• He or she seems knowledgeable about the concern you have

• They are able to explain what to expect from testing and a clear timeframe for receiving a report.

• They include recommendations in their report.

• A feedback session is included as part of testing (this means the psychologist will go over the report and results with you).

Red Flags (Signs that Raise Questions About Quality)

• The provider is not a psychologist.  Only psychologists are trained and licensed to provide psychological and neuropsychological assessments.  No one in mental health with a Master’s Degree (LMFT, LPCC, LCSW), or in another field (nursing, physician, occupational therapy) is qualified to do a comprehensive psychological assessment to diagnose a mental health or neurological disorder.  If they are advertising this way, move on!

• The psychologist is defensive or vague when you ask about their training, education, or specialty area.

• They won’t give you a clear idea of cost.  Sometimes the cost changes because of differences in time required, for example, if there are a lot of school and medical records to be reviewed, or because once testing starts, it becomes clear there is a need for additional tests. But in general, the psychologist should be able to tell you a specific number (e.g., $350 per hour, and about how many hours are expected, OR a flat rate, like $5,000 for the psych eval).  

• They do not offer a feedback session.  This is an essential part of psych testing and gives you both the opportunity to fully understand your results and to ask questions about anything you don’t understand in the report.

Begin Working With A Psychological Evaluator in Los Angeles, CA

Finding the right evaluator can take time, but it is vital in receiving the best support possible. Dr. Reger provides psychological evaluations at several locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for your QME psychological evaluation

3. Get answers that you need to continue with your work comp claim

OTHER COUNSELING SERVICES OFFERED BY Dr. REGER in los angeles, ca

I know you may experience a number of mental health concerns. This is why I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations.

What to Look For in a Work Comp Psych Evaluator

If you are an attorney or a worker in need of a work-related psychological evaluation, you have two options through the California Division of Workers’ Compensation (DWC).  The first is a panel Qualified Medical Evaluator (QME), and the second is an Agreed Medical Evaluator (AME).  I’ll discuss the differences and similarities, as well as my thoughts on what to look for in a work comp psych evaluator.

Psych Eval for Work Comp in Los Angeles: Qme vs. Ame

All psychologists who conduct workers’ comp psych evaluations in the entire state of California have a few things in common:

• Doctoral level education in psychology (a PhD or PsyD)

• License to practice psychology in California

From there, a QME and an AME can vary quite a bit.  A psych QME:

• Is certified by the state, by passing a test

• Has at least five years of clinical experience after licensure

• Is selected from a panel of three possible evaluators that is randomly generated by the state

• Is chosen based on location – nearness to the worker’s home address, usually

In contrast, a psych AME:

• Can be certified as a QME, but does not have to be

• Is only available to workers who have hired an attorney to represent them for their work comp claim

• Is agreed upon by the attorney for the worker and the attorney for the employer

• May or may not be located close to the worker’s home

If you have an attorney and opt to be evaluated by an AME, you waive your option to have a panel QME.  The major benefit of going with a psych AME instead of a psych panel QME is that AMEs are often well-established within the workers’ comp world, and have a lot of experience doing work comp psych evals.  Typically, if both sides can agree on an AME, it is because that psychologist has done high quality work that the attorneys are aware of, and they both trust the AME will come to evidence-based and balanced opinions that reflect the reality of the work injury.

Does This Mean a Psych Qme Work Comp Eval Isn’t as Good?

Not at all!  Many psychologists are certified QMEs and available as AMEs as well, and there are many well-trained psychologists starting out as QMEs who simply aren’t yet well-known to attorneys.  There are plenty of psych QMEs doing excellent work comp evals.

Markers of a Good Psych Qme or Psych Ame Eval

Regardless of whether you end up in a work comp psych eval with a QME or an AME, there are a few components that will be part of any thorough psych evaluation:

• A clinical interview.  You will be asked about your personal, educational, occupational, and medical history.  These invasive questions all help the psychologist in evaluating your work comp injury

• Psychological testing.  You will have to take several psych tests for a work comp eval.  These can be brief, or very long.  Just know they are providing evidence to support your psych QME or psych AME in reaching medical opinions about your work-related injury.

• A record review.  Your work comp psych evaluator will review records provided by the attorneys.  These may include medical records from an incident related to work, and general health records, sometimes dating back years.

• A report.  Whether you see a psych QME or a psych AME, that psychologist will write an integrated report that includes all of the information they gathered throughout testing, interview, and record review.  They will include opinions about a diagnosis, the cause of any diagnosis or symptoms, and appropriate treatment.  They will also comment on work restrictions if there are any.

Begin Working With A Psychological Evaluator in Los Angeles

Finding the right evaluator for a work comp eval can take time, but is worth it in the end. Dr. Reger provides psychological evaluations at several locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with an LA Psychologist for your QME psychological evaluation

3. Get answers that you need to continue with your work comp claim

Other Counseling Services Offered BY Dr. Reger in los angeles, ca

I know you may experience a number of mental health concerns. This is why I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations.