PTSD Exams Updates

May 08, 2022

MST Compensation and Pension Exam

MST compensation and pension exam recommendations for psychologists and psychiatrists

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Apr 04, 2022

MST-based Claims Still Difficult without a PTSD Diagnosis

After Congress passed a new law in December 2020, I thought that henceforth claims based on MST, whether based on a PTSD diagnosis or not, i.e., they could be based on another covered mental health condition, would be treated in the same manner as PTSD claims, which are governed by 38 C.F.R. § 3.304(f)(5).

But that has not happened. I therefore must conclude that either I misunderstood the new law or perhaps the first bill did not conform to proper statutory construction. For more on this topic, see:

MST that Causes Depressive, Anxiety, & Other Mental Disorders Should Be Covered ... and

VA Standard of Proof for non-PTSD, MST-related Disability Claims

My (Revised) Comment on Proposed Changes to VA Mental Health Ratings

On 15 Feb 2022, the Department of Veterans Affairs published a proposed rule to update the VA Schedule for Rating Disabilities (VASRD), which includes the General Rating Formula for Mental Disorders.

I submitted my comment, a 12-page document, on 8 Mar 2022. I have since revised it (3 Apr 2022), clarifying a couple of points and correcting some minor errors. It's on this page:

VA Mental Health Ratings 

Update: Correct VA Medical Records

I recently updated my article: How to Correct VA Medical Records. 

Thanks to veteran Mark Yelton, who asked a question in the Comments section (near the bottom of the page), I clarified recommendations for sending a letter to your local VAMC requesting a correction to your medical records.

And I added a CHECKLIST for Requesting a Correction, available online or as a PDF you can download.

See also 7 Reasons to Review Your VA Medical Records.

In brief ...

Navy Veteran Defrauds VA & SSA for Over $1 Million in Disability Benefits

Are You a Veteran with Law Enforcement Experience?

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Mar 12, 2022

VA Mental Health Ratings

VA mental health ratings will change in 2022 or 2023.

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Mar 07, 2022

Is VBA Defying Congress?

The Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 seemed to indicated that Military Sexual Trauma (MST) that causes depressive, anxiety, & other mental disorders should be adjudicated like PTSD under 38 C.F.R. § 3.304(f)(5), but VBA apparently disagrees.

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Aug 26, 2021

Wounding Warriors

Wounding Warriors: How Bad Policy Is Making Veterans Sicker and Poorer - New book by LTC Daniel Gade PhD (US Army Ret.) & journalist Dan Xing Huang

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Aug 23, 2021

Expanded Review of June 2021 Advisory Committee Meeting

I expanded my review of the June 2021 Advisory Committee on Disability Compensation meeting so that it now includes:

* Positive Aspects of the June 2021 ACDC Meeting

* Positive Aspect: VASRD Mental Disorders Update

* Concerning Aspect of the June 2021 ACDC Meeting

* Committee Wants More Info on VBA Quality Assurance Program

* VA Office of Inspector General also takes issue with VBA's claim that they measure disability claims outcome

* VA Office of Inspector General reports about VBA's quality assurance program

* My Letter to the Committee re: VA's Misleading "Accuracy" Metric

* VA's Misleading "Accuracy" Metric (5-page PDF document)

* Board of Veterans Appeals also publishes a misleading "accuracy" statistic

Continue reading "Expanded Review of June 2021 Advisory Committee Meeting"

Aug 14, 2021

Review of the June 2021 Meeting of the Advisory Committee on Disability Compensation

* Positive aspects of the meeting.

* More info re: the update to the VA Schedule of Rating Disabilities (VASRD) for Mental Disorders.

* Concerning aspect of the meeting: Erroneous information given by VBA officials.

* New document: VA's Misleading "Accuracy" Metric.

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Jun 28, 2021

Life Events Checklist: Reliable & Valid Scoring Methods

The Life Events Checklist (LEC) is a widely used self-report measure of trauma history that categorizes events by the proximity of trauma exposure; however, the field has published multiple scoring methods for the LEC.

Note that in this context, "proximity" means "how close to the trauma were you?" For example did a person experience the trauma directly? Observe the trauma? Or did they hear about the trauma?

The authors of this research study propose a novel scoring procedure in which total scores are weighted according to the proximity of trauma. The Weighted Score method assigns relative "weights" to three types of traumatic experiences.

Directly experienced trauma = 3

Observed traumatic event = 2

Heard about traumatic event = 1

For psychologists and psychiatrists who wish to ascertain the overall "trauma load", or "trauma burden", experienced by an examinee or patient, understanding the pros and cons of different LEC scoring methods should prove useful.

Continue reading "Life Events Checklist: Reliable & Valid Scoring Methods"

Jun 28, 2021

Detecting Feigned TBI Using Pupillometry

Pupil dilation patterns are outside of conscious control and provide information regarding neuropsychological processes related to deception and cognitive effort, and familiarity.

This study examined the incremental utility of pupillometry on the Test of Memory Malingering (TOMM) in classifying individuals with verified traumatic brain injury (TBI), individuals simulating TBI, and healthy comparisons.

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Jun 06, 2021

Senator Wicker Asks Important Questions About PTSD C&P Exam Quality - VA Responds with Eloquent Obscurantism

Senator Wicker asked the VA to:

"Describe how the VA conducts quality control of PTSD C&P exam results, and C&P examiner performances."

This article critiques the VA's answer to Senator Wicker's questions and covers the following topics:

VA's Response to Senator Wicker

Analysis of VA's Response

Problem: Misleading

Problem: Limited Relevance

Problem: The Audit Review Tool does not measure the quality of a C&P examination.

FY2020 Audit Review Criteria (screenshot; you can also download the actual criteria in PDF format)

Analysis of Audit Review Criteria

What is obscurantism?

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May 21, 2021

Normal Cognitive Test Scores Cannot Be Interpreted as Accurate with Failed PVT

While use of performance validity tests (PVTs) has become a standard of practice in neuropsychology, there are differing opinions regarding whether to interpret cognitive test data when standard scores fall within normal limits despite PVTs being failed.

This study is the first to empirically determine whether normal cognitive test scores underrepresent functioning when PVTs are failed.

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May 19, 2021

Advisory Committee on Disability Compensation, June 23-24 Meeting

The next meeting of the VA Advisory Committee on Disability Compensation is June 22-23, 2021 from 0900 to 1200 EDT. This post contains:

* Meeting Agenda

* NEW Call-in Number to listen to the meeting

* How to send the Committee a public comment

* Time Zone chart to find the meeting start time in your location

Click the link below to read this post.

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May 13, 2021

SIMS - Structured Inventory of Malingered Symptomatology

SIMS cut score: What is the best cut score for the Structured Inventory of Malingered Symptomatology (SIMS)?

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May 12, 2021

Service Members Seeking Disability Compensation Did Not Progress in Intensive Outpatient Treatment for PTSD

These results provide preliminary data indicating that participation in disability separation may attenuate the effect of PTSD treatment ...

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May 12, 2021

PTSD: Comorbid Mental Disorders, Chronic Pain, and Medical Conditions

Post-traumatic stress disorder (PTSD) is an often disabling mental disorder whose management typically focuses on reducing PTSD symptoms. Chronic pain and other comorbidities that commonly accompany PTSD symptoms may also be independently associated with disability.

...

Common comorbidities thus significantly influence disability associated with PTSD, often more strongly than PTSD symptoms.

...

If you conduct a Review PTSD exam, and you determine that one or more comorbid psychiatric, medical, or chronic pain disorders are secondary to PTSD, but the veteran did not file a secondary condition claim, consider either

(i) writing an Opinion and Rationale about the secondary conditions anyway; or

(ii) include a sentence or two indicating the possibility of PTSD-related secondary conditions.

Continue reading "PTSD: Comorbid Mental Disorders, Chronic Pain, and Medical Conditions"