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

Psychological Injury and Law

Volumn 4, Issue 3-4, 2011, Pages 187-216

  Worthen, Mark D ^a   Moering, Robert G ^a  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

Compensation and pension (C P) examination; Disability Benefits Questionnaire (DBQ); PTSD; Veterans Affairs (VA)

Indexed keywords

EID: 84856354874     PISSN: 1938971X     EISSN: 19389728     Source Type: Journal    
DOI: 10.1007/s12207-011-9115-2     Document Type: Review

References (112)

1. American Academy of Psychiatry and the Law (2008). AAPL practice guideline for the forensic evaluation of psychiatric disability. The Journal of the American Academy of Psychiatry and the Law, 36(4), S3-S50.
2. American Psychiatric Association (2000). Diagnostic and statistical manual for mental disorders (4, text revth ed.). Washington, DC: American Psychiatric Association.
3. American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073.
4. Andrews, L. B. (2008). The psychiatric interview and mental status examination. In R. E. Hales, S. C. Yudofsky & G. O. Gabbard (Eds.), The American psychiatric publishing textbook of psychiatry (5th ed.). Arlington, VA: American Psychiatric.
5. Arbisi, P. A. & Ben-Porath, Y. S. (1995). An MMPI-2 infrequent response scale for use with psychopathological populations: The infrequency psychopathology scale, F(p). Psychological Assessment, 7, 424-431. doi: 10. 1037/1040-3590. 7. 4. 424.
6. Arbisi, P. A., Ben-Porath, Y. S. & McNulty, J. (2006). The ability of the MMPI-2 to detect feigned PTSD within the context of compensation seeking. Psychological Services, 3(4), 249-261.
7. Arbisi, P. A., Murdoch, M., Fortier, L. & McNulty, J. (2004). MMPI-2 validity and award of service connection for PTSD during the VA compensation and pension evaluation. Psychological Services, 1(1), 56-67. doi: 10. 1037/1541-1559. 1. 1. 56.
8. Bellini, J., Bolton, B. & Neath, J. (1998). Rehabilitation counselors 'assessments of applicants' functional limitations as predictors of rehabilitation services provided. Rehabilitation Counseling Bulletin, 41(4), 242-258.
9. Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., et al (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8(1), 75-90. doi: 10. 1002/jts. 2490080106.
10. Bush, S. S., Connell, M. A. & Denney, R. L. (2006). Collection and review of information. In S. S. Bush, M. A. Connell & R. L. Denney (Eds.), Ethical practice in forensic psychology: A systematic model for decision making (pp. 49-57). Washington, DC: American Psychological Association. doi: 10. 1037/11469-003.
11. Calhoun, P., Earnst, K., Tucker, D., Kirby, A. & Beckham, J. (2000). Feigning combat-related posttraumatic stress disorder on the personality assessment inventory. Journal Of Personality Assessment, 75(2), 338-350.
12. Ciccone, J. & Jones, J. W. (2010). Personal injury litigation and forensic psychiatric assessment. In R. I. Simon & L. H. Gold (Eds.), The American psychiatric publishing textbook of forensic psychiatry (2nd ed., pp. 261-282). Arlington, VA: American Psychiatric.
13. Crewe, N. M., & Athelstan, G. T. (1984). Functional assessment inventory manual. Minneapolis, MN: University of Minnesota. Available at: http://library. ncrtm. org/pdf/189. 098B. pdf.
14. Dalton, J. E., Tom, A., Rosenblum, M. L., Garte, S. H. & Aubuchon, I. N. (1989). Faking on the Mississippi scale for combat-related posttraumatic stress disorder. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1(1), 56-57.
15. Dawes, R., Faust, D. & Meehl, P. (1989). Clinical versus actuarial judgment. Science, 243(4899), 1668-1674.
16. DeClue, G. (2011). Harry Potter and the structured interview of reported symptoms? Open Access Journal of Forensic Psychology, 3, 1-18. Published online only at: http://www. forensicpsychologyunbound. ws.
17. Department of Veterans Affairs (2001). C&P clinicians guide. Washington, D. C.: Department of Veterans Affairs. Available at: http://www. dsjf. org/VA%20Files/Clinician%20Guide%20v2. pdf.
18. DeViva, J. C. & Bloem, W. D. (2003). Symptom exaggeration and compensation seeking among combat veterans with posttraumatic stress disorder. Journal of Traumatic Stress, 16, 503-507.
19. Eakin, D. E., Weathers, F. W., Benson, T. B., Anderson, C. F. & Funderburk, B. (2006). Detection of feigned posttraumatic stress disorder: A comparison of the MMPI-2 and PAI. Journal of Psychopathology and Behavioral Assessment, 28(3), 145-155.
20. Economic Systems Inc (2004). VA disability compensation program: Legislative history. Washington, DC: VA Office of Policy, Planning and, Preparedness.
21. Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview: The schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35(7), 837-844.
22. Erbes, C., Dikel, T., Eberly, R., Page, W. & Engdahl, B. (2006). A comparative study of posttraumatic stress disorder assessment under standard conditions and in the field. International Journal of Methods in Psychiatric Research, 15(2), 57-63.
23. First, M. B., Spitzer, R. L., Gibbon, M. & Williams, J. B. W. (2002). Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.
24. Foa, E. B. & Tolin, D. F. (2000). Comparison of the PTSD symptom scale-interview version and the clinician-administered PTSD scale. Journal of Traumatic Stress, 13, 181-191.
25. Foote, W. E. (2008). Evaluations of individuals for disability in insurance and Social Security contexts. In R. Jackson (Ed.), Learning forensic assessment (international perspectives on forensic mental health) (pp. 449-479). New York: Taylor & Francis Group.
26. Franklin, C., Repasky, S., Thompson, K., Shelton, S. & Uddo, M. (2002). Differentiating overreporting and extreme distress: MMPI-2 use with compensation-seeking veterans with PTSD. Journal Of Personality Assessment, 79(2), 274-285.
27. Freeman, T., Powell, M. & Kimbrell, T. (2008). Measuring symptom exaggeration in veterans with chronic posttraumatic stress disorder. Psychiatry Research, 158(3), 374-380.
28. Frisch, M. (1994). Quality of life inventory: Manual and treatment guide. San Antonio, TX: NCS Pearson.
29. Frisch, M. B., Clark, M. P., Rouse, S. V., Rudd, M. D., Paweleck, J. K., Greenstone, A. & Kopplin, D. A. (2005). Predictive and treatment validity of life satisfaction and the quality of life inventory. Assessment, 12, 66-78.
30. Frisch, M. B., Cornell, J., Villanueva, M. & Retzlaff, P. J. (1992). Clinical validation of the Quality of Life Inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment, 4(1), 92-101. doi: 10. 1037/1040-3590. 4. 1. 92.
31. Frueh, B., Buckley, T. C., Grubaugh, A. L. & Elhai, J. D. (2008). 'Military-related PTSD, current disability policies, and malingering': Reply. American Journal of Public Health, 98(5), 774-775. doi: 10. 2105/AJPH. 2007. 133512.
32. Frueh, B., Elhai, J., Gold, P., Monnier, J., Magruder, K., Keane, T. & Arana, G. (2003). Disability compensation seeking among veterans evaluated for posttraumatic stress disorder. Psychiatric Services, 54(1), 84-91.
33. Frueh, B. C., Gold, P. B. & de Arellano, M. A. (1997). Symptom overreporting in combat veterans evaluated for PTSD: Differentiation on the basis of compensation seeking status. Journal of Personality Assessment, 68, 369-384.
34. Frueh, B., Grubaugh, A., Elhai, J. & Buckley, T. (2007). US Department of Veterans Affairs disability policies for posttraumatic stress disorder: Administrative trends and implications for treatment, rehabilitation, and research. American Journal of Public Health, 97(12), 2143-2145.
35. Frueh, B. C., Hamner, M. B., Cahill, S. P., Gold, P. B. & Hamlin, K. L. (2000). Apparent symptom overreporting in combat veterans evaluated for PTSD. Clinical Psychology Review, 20(7), 853-885.
36. Gilbert v. Derwinski, 1 Vet. App. 49 (1990).
37. Ginzburg, K., Ein-Dor, T. & Solomon, Z. (2010). Comorbidity of posttraumatic stress disorder, anxiety and depression: A 20-year longitudinal study of war veterans. Journal of Affective Disorders, 123(1-3), 249-257.
38. Gough, H. G. (1950). The F minus K dissimulation index for the Minnesota Multiphasic Personality Inventory. Journal of Consulting Psychology, 14, 408-413. doi: 10. 1037/h0054506.
39. Gough, H. (1954). Some common misconceptions about neuroticism. Journal of Consulting Psychology, 18(4), 287-292.
40. Graham, J. R. (2006). MMPI-2: Assessing personality and psychopathology (4th ed.). New York: Oxford University Press.
41. Green v. Derwinksi, 1 Vet. App. 121 (1991).
42. Green, D. & Rosenfeld, B. (2011). Evaluating the gold standard: A review and meta-analysis of the Structured Interview of Reported Symptoms. Psychological Assessment, 23(1), 95-107.
43. Greenberg, S. A. & Shuman, D. W. (1997). Irreconcilable conflict between therapeutic and forensic roles. Professional Psychology: Research and Practice, 28, 50-57.
44. Greenberg, S. A. & Shuman, D. W. (2007). When worlds collide: Therapeutic and forensic roles. Professional Psychology: Research and Practice, 38(2), 129-132.
45. Greene, R. L. (2008). Malingering and defensiveness on the MMPI-2. In R. Rogers (Ed.), Clinical assessment of malingering and deception (3rd ed., pp. 159-181). New York: Guildford Press.
46. Gros, D., Simms, L. & Acierno, R. (2010). Specificity of posttraumatic stress disorder symptoms: An investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans. The Journal of Nervous and Mental Disease, 198(12), 885-890.
47. Guriel, J. & Fremouw, W. (2003). Assessing malingered posttraumatic stress disorder: A critical review. Clinical Psychology Review, 23(7), 881-904.
48. Guy, L. S., Kwartner, P. P. & Miller, H. A. (2006). Investigating the M-FAST: Psychometric properties and utility to detect diagnostic specific malingering. Behavioral Sciences & the Law, 24(5), 687-702.
49. Hall, R. C. W. & Hall, R. C. W. (2006). Malingering of PTSD: Forensic and diagnostic considerations, characteristics of malingerers and clinical presentations. General Hospital Psychiatry, 28, 525-535.
50. Hall, R. & Hall, R. (2007). Detection of malingered PTSD: An overview of clinical, psychometric, and physiological assessment: Where do we stand? Journal of Forensic Sciences, 52(3), 717-725.
51. Hodge v. West, 155 F. 3d 1356, 1362 (Fed. Cir. 1998).
52. Hyer, L., Boudewyns, P., Harrison, W. R., O'Leary, W. C., Bruno, R. D., Saucer, R. T. & Blount, J. B. (1988). Vietnam veterans: Overreporting versus acceptable reporting of symptoms. Journal of Personality Assessment, 52, 475-486.
53. IOM (Institute of Medicine) and NRC (National Research Council). (2007). PTSD compensation and military service. Washington, DC: The National Academies Press.
54. Jones v. Shinseki, 23 Vet. App. 382 (2010).
55. Knoll, J. & Resnick, P. (2006). The detection of malingered post-traumatic stress disorder. The Psychiatric Clinics of North America, 29(3), 629-647.
56. Lange, R., Sullivan, K. & Scott, C. (2010). Comparison of MMPI-2 and PAI validity indicators to detect feigned depression and PTSD symptom reporting. Psychiatry Research, 176(2-3), 229-235.
57. Lopez, C., Antoni, M., Penedo, F., Weiss, D., Cruess, S., Segotas, M.,... Fletcher, M. (2011). A pilot study of cognitive behavioral stress management effects on stress, quality of life, and symptoms in persons with chronic fatigue syndrome. Journal of Psychosomatic Research, 70(4), 328-334.
58. Marx, B. P., Miller, M. W., Sloan, D. M., Litz, B. T., Kaloupek, D. G. & Keane, T. M. (2008). Military-related PTSD, current disability policies, and malingering. American Journal of Public Health, 98(5), 773-774. doi: 10. 2105/AJPH. 2007. 133223.
59. McAlinden, N. & Oei, T. (2006). Validation of the Quality of Life Inventory for patients with anxiety and depression. Comprehensive Psychiatry, 47(4), 307-314.
60. McLennan, S., Mathias, J., Brennan, L., Russell, M. & Stewart, S. (2010). Cognitive impairment predicts functional capacity in dementia-free patients with cardiovascular disease. The Journal Of Cardiovascular Nursing, 25(5), 390-397.
61. McNally, R. J. (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology, 5(4), 229-252.
62. Messer, J. M. & Fremouw, W. J. (2007). Detecting malingered posttraumatic stress disorder using the Morel Emotional Numbing Test-Revised (MENT-R) and the Miller Forensic Assessment of Symptoms Test (M-FAST). Journal of Forensic Psychology Practice, 7(3), 33-57.
63. Meyer, G. J., Finn, S. E., Eyde, L. D., Kay, G. G., Moreland, K. L., Dies, R. R.,... Reed, G. M. (2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist, 56(2), 128-165.
64. Miller, H. A. (2001). M-FAST: Miller Forensic Assessment of Symptoms Test and professional manual. Odessa, FL: Psychological Assessment Resources.
65. Miller, P. R., Dasher, R., Collins, R., Griffiths, P. & Brown, F. (2001). Inpatient diagnostic assessments: 1. Accuracy of structured vs. unstructured interviews. Psychiatry Research, 105(3), 255-264. doi: 10. 1016/S0165-1781(01)00317-1.
66. Miller, M., Wolf, E., Martin, E., Kaloupek, D. & Keane, T. (2008). Structural equation modeling of associations among combat exposure, PTSD symptom factors, and global assessment of functioning. Journal of Rehabilitation Research and Development, 45(3), 359-369.
67. Moering, R. (2011). Military service records: Searching for the truth. Psychological Injury and Law, 4(3), (in this issue).
68. Moos, R. H., McCoy, L. & Moos, B. S. (2000). Global assessment of functioning (GAF) ratings: Determinants and role as predictors of one-year treatment outcomes. Journal of Clinical Psychology, 56(4), 449-461.
69. Morel, K. & Shepherd, B. (2008a). Developing a symptom validity test for posttraumatic stress disorder: Application of the binomial distribution. Journal of Anxiety Disorders, 22(8), 1297-1302.
70. Morel, K. R. & Shepherd, B. E. (2008b). Meta-analysis of the Morel Emotional Numbing Test for PTSD: Comment on Singh, Avasthi, and Grover. German Journal of Psychiatry, 11(3), 128-131.
71. Mossman, D. (1994). At the VA, it pays to be sick. The Public Interest, 114, 35-47.
72. Mueller, T. I., Leon, A. C., Keller, M. B., Solomon, D. A., Endicott, J., Coryell, W.,... Maser, J. D. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. The American Journal of Psychiatry, 156, 1000-1006.
73. Murdoch, M., Sayer, N., Spoont, M., Rosenheck, R., Noorbaloochi, S., Griffin, J.,... Hagel, E. (2011). Long-term outcomes of disability benefits in US veterans with posttraumatic stress disorder. Archives Of General Psychiatry, 68(10), 1072-1080.
74. Nasreddine, Z., Phillips, N., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I.,... Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695-699.
75. Neath, J., Bellini, J. & Bolton, B. (1997). Dimensions of the functional assessment inventory for five disability groups. Rehabilitation Psychology, 42(3), 183-207.
76. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).
77. Niv, N., Cohen, A., Sullivan, G. & Young, A. (2007). The MIRECC version of the global assessment of functioning scale: Reliability and validity. Psychiatric Services, 58(4), 529-535.
78. Petry, N., Alessi, S. & Hanson, T. (2007). Contingency management improves abstinence and quality of life in cocaine abusers. Journal of Consulting and Clinical Psychology, 75(2), 307-315.
79. Pietrzak, R., Goldstein, M., Malley, J., Johnson, D. & Southwick, S. (2009). Subsyndromal posttraumatic stress disorder is associated with health and psychosocial difficulties in veterans of operations enduring freedom and Iraqi freedom. Depression and Anxiety, 26(8), 739-744.
80. Poyner, G. (2010). Psychological evaluations of veterans claiming PTSD disability with the Department of Veterans Affairs: A clinician's viewpoint. Psychological Injury and Law, 3, 130-132. doi: 10. 1007/s12207-010-9076-x.
81. Resnick, P. J. (1997). Malingering of posttraumatic disorders. In R. Rogers (Ed.), Clinical assessment of malingering and deception (2nd ed., pp. 130-152). New York: Guilford Press.
82. Resnick, P. J., West, S. & Payne, J. W. (2008). Malingering of posttraumatic disorders. In R. Rogers (Ed.), Clinical assessment of malingering and deception (3rd ed., pp. 109-127). New York: Guilford Press.
83. Ridgway, J. D. (2011). The splendid isolation revisited: Lessons from the history of veterans benefits before judicial review. Veterans Law Review, 3, 135-219.
84. Rogers, R. (2001). Handbook of diagnostic and structured interviewing. New York: Guilford Press.
85. Rogers, R. (Ed.). (2008). Clinical assessment of malingering and deception (3rd ed.). New York: Guilford Press.
86. Rogers, R., Bagby, R. M. & Dickens, S. E. (1992). Structured interview of reported symptoms professional manual. Odessa, FL: Psychological Assessment Resources.
87. Rogers, R., Payne, J. W., Berry, D. T. R. & Granacher, R. P. (2009a). Use of the SIRS in compensation cases: An examination of its validity and generalizability. Law and Human Behavior, 33, 213-224. doi: 10. 1007/s10979-008-9145-9.
88. Rogers, R., Payne, J. W., Correa, A. A., Gillard, N. D. & Ross, C. A. (2009b). A study of the SIRS with severely traumatized patients. Journal of Personality Assessment, 91(5), 429-438. doi: 10. 1080/00223890903087745.
89. Rogers, R., Sewell, K. W. & Gillard, N. D. (2010). Structured interview of reported symptoms, 2nd edition, professional manual. Lutz, FL: Psychological Assessment Resources.
90. Rosales, G. A. (2011, June 9). Re: Interviewing collaterals: Separate or with the veteran? [Electronic mailing list message]. Retrieved from AVAPL (Association of VA Psychology Leaders) Comp & Pen electronic mailing list (no URL available).
91. Roy-Byrne, P., Dagadakis, C., Unutzer, J. & Ries, R. (1996). Evidence for limited validity of the revised global assessment of functioning scale. Psychiatric Services, 47(8), 864-866.
92. Rubenzer, S. (2009). Posttraumatic stress disorder: Assessing response style and malingering. Psychological Injury And Law, 2(2), 114-142. doi: 10. 1007/s12207-009-9045-4.
93. Satel, S. (2011). PTSD's diagnostic trap. Policy Review, 165, 41-54.
94. Simon, R. (Ed.). (2003). Posttraumatic stress disorder in litigation: Guidelines for forensic assessment (2nd ed.). Washington, DC: American Psychiatric Press.
95. Smith, D. W. & Frueh, B. C. (1996). Compensation seeking, comorbidity, and apparent symptom exaggeration of PTSD symptoms among Vietnam combat veterans. Psychological Assessment, 8, 3-6.
96. Solomon, D. A., Keller, M. B., Leon, A. C., Mueller, T. I., Lavori, P. W., Shea, M. T.,... Endicott, J. (2000). Multiple recurrences of major depressive disorder. The American Journal of Psychiatry, 157, 229-233.
97. Sparr, L. & Pankratz, L. D. (1983). Factitious posttraumatic stress disorder. The American Journal of Psychiatry, 140(8), 1016-1019.
98. Stecker, T., Fortney, J., Owen, R., McGovern, M. P. & Williams, S. (2010). Co-occurring medical, psychiatric, and alcohol-related disorders among veterans returning from Iraq and Afghanistan. Psychosomatics, 51, 503-507.
99. Stender, W. W. & Walker, E. (1974). The National Personnel Records Center fire: A study in disaster. The American Archivist, 37(4), 521-549.
100. Strasburger, L. G., Gutheil, T. G. & Brodsky, A. (1997). On wearing two hats: Role conflict in serving as both psychotherapist and expert witness. The American Journal Of Psychiatry, 154(4), 448-456.
101. Taylor, S., Frueh, B. & Asmundson, G. (2007). Detection and management of malingering in people presenting for treatment of posttraumatic stress disorder: Methods, obstacles, and recommendations. Journal of Anxiety Disorders, 21(1), 22-41.
102. Thomas, M., Skilbeck, C. & Slatyer, M. (2009). Pre-injury estimates of subjective quality of life following traumatic brain injury. Brain Injury, 23(6), 516-527.
103. Tolin, D., Steenkamp, M., Marx, B. & Litz, B. (2010). Detecting symptom exaggeration in combat veterans using the MMPI-2 symptom validity scales: A mixed group validation. Psychological Assessment, 22(4), 729-736.
104. Ustün, T., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J.,... Pull, C. (2010). Developing the world health organization disability assessment schedule 2. 0. Bulletin of the World Health Organization, 88(11), 815-823.
105. Veterans Benefit Administration (2010). Annual benefits report: Fiscal year 2010. Washington, DC: Department of Veterans Affairs.
106. Weathers, F. W., Keane, T. M. & Davidson, J. R. (2001). Clinician-administered PTSD scale: A review of the first ten years of research. Depression and Anxiety, 13(3), 132-156.
107. Weathers, F. W., Ruscio, A. M. & Keane, T. M. (1999). Psychometric properties of nine scoring rules for the clinician-administered posttraumatic stress disorder scale. Psychological Assessment, 11(2), 124-133.
108. Weiss, D. S. (2004). Structured clinical interview techniques for PTSD. In J. P. Wilson, T. M. Keane, J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (2nd ed., pp. 103-121). New York: Guilford Press.
109. Wetter, M. W., Baer, R. A., Berry, D. T. R., Robison, L. H. & Sumpter, J. (1993). MMPI-2 profiles of motivated fakers given specific symptom information: A comparison to matched patients. Psychological Assessment, 5(3), 317-323.
110. Widows, M. R. & Smith, G. P. (2005). Structured inventory of malingered symptomatology, professional manual. Lutz, FL: Psychological Assessment Resources.
111. Wisdom, N., Callahan, J. & Shaw, T. (2010). Diagnostic utility of the structured inventory of malingered symptomatology to detect malingering in a forensic sample. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 25(2), 118-125.
112. Yarvis, J., Bordnick, P., Spivey, C. & Pedlar, D. (2009). Subthreshold PTSD: A comparison of alcohol, depression, and health problems in Canadian peacekeepers with different levels of traumatic stress. In B. E. Bride & S. A. MacMaster (Eds.), Stress, trauma and substance use (pp. 117-135). New York: Routledge/Taylor & Francis Group.