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

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. The article alerts examiners to the possibility that they might face resistance from VA officials if they screen for and assess symptom exaggeration or feigning and that they could encounter VA-imposed restrictions on time allotted for exams. Specific suggestions are made for different types of exams: Initial Post-traumatic Stress Disorder (PTSD), PTSD Review, Initial Mental Disorder, and Mental Disorder Review.