We will meet via telehealth video for about 90 minutes (or in person if you are in Colorado and want to meet in person), and we will talk about your mental health concerns, your military service, and how mental health concerns are impacting your work life and personal life. You can expect me to be respectful, knowledgeable about military culture and military service, and specific in some of my questions so I can help provide a clear and thorough report to VA.

This is a common concern of veterans, and I know that talking about trauma at all, particularly with someone you don’t know well, can be an obstacle for many people.

The answer to this question is:

Not in any more detail than is absolutely necessary to gather the information for the evaluation, unless you want to provide more detail. With some veterans we talk about trauma in terms of “yes” or “no” questions. With others we talk in more depth. I’ll need to get some basic information about traumatic events, but we don’t need to spend a lot of time on this or get into much detail unless you want to. While talking about traumatic experiences in more detail can be helpful when doing PTSD treatment, these exams are not for treatment.

My goal is to strike a balance during these evaluations- to keep the experience as stress-free as possible while also being sure we don’t miss any important points, and to be sure that we gather enough information for VA to understand your experiences and their impacts on you.

I work with veterans all over the country, primarily through telehealth services. I am authorized to practice telepsychology under PSYPACT, which currently covers 43 states and is likely to expand. If you live in Colorado and want to meet in person, we can arrange that, but usually I meet with veterans via telehealth video meetings.

Here is my description of how VA assesses claims:

In simple terms, in order to make decisions about mental health disability benefits, VA has to answer the following 3 questions:

-Does this veteran have a diagnosable mental health condition?

Examples of these include PTSD, Insomnia Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, Adjustment Disorder, and others. If the answer to this question is “yes,” then the VA asks…

-Is the diagnosed condition, or are any of the diagnosed conditions, related to military service?

VA wants clear evidence that the mental health diagnosis did (or did not) start during military service, or is (or is not) directly caused by military service. This could mean that the symptoms started during service, that treatment started during service, that the experiences that led to the diagnosis happened during service, or that the symptoms developed secondary to another condition that started during service (such as depression due to back pain, as an example). So, as you can see, a diagnosis being ““related to military service” can mean several different things.

-How are mental health symptoms impacting the veteran’s social life and work life?

In other words, what functional impacts are the veteran’s mental health symptoms having?

Yes, if you would like your spouse to participate. This is totally up to you. I meet with most veterans individually, but it is quite common for spouses to join the meeting at the veteran’s request for some of the evaluation. It can be helpful to hear a spouse’s perspective on how mental health symptoms are impacting a veteran’s life, and it can provide some comfort and support during the evaluation.

I assess for the full range of possible mental health diagnoses. This includes PTSD, Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, Insomnia, Adjustment Disorder, Bipolar Disorder, Persistent Depressive Disorder, and more.

With regard to sleep problems- I can assess problems related to falling asleep, staying asleep, nightmares, sleep quality, pain impacting sleep, etc. I cannot assess for breathing related sleep problems such as sleep apnea- this requires a medical examination, and often a sleep study.

A note on TBI- I cannot formally diagnose TBI. According to VA regulations a TBI diagnosis requires a diagnosis by a psychiatrist, physiatrist, neurologist, or neurosurgeon. But I can assess for and diagnose memory and concentration problems stemming from TBI. If you have questions about this, please contact me.

I sometimes do brief formal memory testing to assess memory concerns, but formal memory testing is a separate type of examination that takes longer and is more involved than a standard VA disability benefits mental health examination.

I also find it important to ask about the mental health impacts of medical problems. Chronic pain, for example, can often impact a veteran’s quality of life, and can lead to significant depression or sleep problems. I assess for this type of connection between medical and mental health challenges.