A Practical Guide to Conducting VA Compensation and Pension Exams for PTSD and Other Mental Disorders

Abstract

Despite being one of the most common forensic mental health evaluations, no article has ever appeared in a peer-reviewed journal describing how to conduct US Department of Veterans Affairs (VA) mental health compensation and pension examinations. This article rectifies that paucity of information. We outline the legal framework, ethical considerations, and administrative challenges inherent in these evaluations. We provide separate guidelines for private practice clinicians and VA staff or contractors. We pay special attention to the multiple sources of collateral information available for these exams and how to access relevant records.

Mental Health Service Utilization before and after Receipt of a Service‐Connected Disability Award for PTSD: Findings from a National Sample

“…For example, the compensation and pension evaluation are often perceived to be a stressful process (Sayer, Spoont, and Murdoch ). It is a forensic evaluation, and so is not designed to be therapeutic in the same way as a mental health treatment service (Worthen and Moering ). Consequently, the evaluation can occasionally be perceived as adversarial (Meshberg‐Cohen, DeViva, and Rosen ).…”

Subjective cognitive complaints and neuropsychological test performance following military-related traumatic brain injury

“…Another possibility is deliberate misrepresentation. This is an issue in all cases in which there may be external incentives to look worse than one is objectively [34] and certainly an issue in military and Department of Veterans Affairs (VA) cases [35]. In our sample, we do not have data on external incentives.…”

Descriptive Profiles of the MMPI-2-Restructured Form (MMPI-2-RF) across a National Sample of Four Veteran Affairs Treatment Settings

“…This need for the monitoring of response style is particularly pronounced within the VA (Ray 2017;Russo 2013). Between 33% to 53% of veterans undergo the forensically-intermingled compensation evaluation process (DeViva and Bloem 2003;Freeman et al 2008) and those evaluations can incorporate historic testing data from the veteran's record (Worthen and Moering 2011) that may not reflect symptom presentation accurately if not screened for patterns of invalid responding. Thus, broadband measures offer a level of utility not available with brief symptom inventories and are well-suited to the task of aiding VA measurement-based care.…”