FACTS – Military Sexual Trauma – MST – PTSD

MILITARY SEXUAL TRAUMA
Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the
VA health care system, a 10-point hiring preference for federal employment and other important benefits. Ask your VA
representative or Veterans Service Organization representative about Disability Compensation, Pension, Health Care, Caregiver
Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors’ Benefits.
DISABILITY COMPENSATION FOR CONDITIONS RELATED TO
MILITARY SEXUAL TRAUMA (MST)
Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the VA health care system, a 10-point hiring preference for federal employment, and other important benefits. Ask your VA representative or Veterans Service
Organization representative about Disability Compensation, Pension, Health Care, Caregiver Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors Benefits. Some Veterans may have experienced sexual trauma while serving in the military. These kinds of experiences can affect Veterans’ mental and physical health, even many years later. Veterans can
apply for disability compensation for any current difficulties that are related to their service, including difficulties related to MST.

HOW DOES VA DEFINE MST?
MST is defined by Title 38 U.S. Code 1720D as “psychological trauma resulting from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is defined as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.”

ARE VETERANS GRANTED DISABILITY COMPENSATION FOR MST?
Veterans are not granted compensation for the traumatic event itself, but can be granted disability compensation for conditions that result from MST.  Compensation – April 2015
CAN YOU DEVELOP POSTTRAUMATIC STRESS DIS ORDER (PTSD) OR OTHE R MENTAL HEALTH DISORDERS AS A RESULT OF MST?
Yes. Exposure to any trauma can potentially result in PTSD or another mental health disorder. PTSD is the most common mental health diagnosis related to experiencing MST.
WHAT EVIDENCE CAN SU PPORT A DISABILITY C LAIM FOR PTSD AS A R ESULT OF MST?
Department of Defense forms used in reporting incidents of sexual assault or harassment, as well as investigative reports during military service are direct evidence to support these claims. However, VA knows that events involving sexual trauma are not always officially reported. Therefore, for PTSD claims related to MST VA has relaxed the evidentiary requirements and looks for “markers” (i.e., signs, events, or circumstances) that provide some indication that the traumatic event happened.
These include, but are not limited to:  Records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians Pregnancy tests or tests for sexually transmitted diseases Statements from family members, roommates, fellow Servicemembers, clergy members, or counselors Requests for transfer to another military duty assignment. Deterioration in work performance Substance abuse. Episodes of depression, panic attacks, or anxiety without an identifiable cause.  Unexplained economic or social behavioral changes Relationship issues, such as divorce Sexual dysfunction
VA RELAXED THE STAND ARDS OF EVIDENCE FOR COMBAT RELATED PTSD. ARE T HE STANDARDS OF EVIDENC E FOR MST – RELATED PTSD CLAIMS MORE STRINGENT THAN OTHER PTSD CLAIMS?
No. In fact, VA relaxed its evidentiary standard for disability claims related to MST in 2002 to ensure all available evidence supporting these claims is considered. Because military service records may lack corroborating evidence that a stressful event occurred, VA regulations make clear that evidence from non-military sources may be used to corroborate the Veteran’s account of the MST. Further, when direct evidence of an MST is not available, VA may request a medical opinion to consider a Veteran’s account and any “markers” to corroborate the occurrence of the MST event as related to current PTSD symptoms.

CAN PREVIOUSLY DENIE D MST RELATED P TSD DISABILITY CLAIM S BE RE – EVALUATED?
Yes. Increased awareness of MST issues resulted in special training beginning in December 2011 for all VA regional office personnel who process MST-related claims and the mental health clinicians conducting the examinations related to these claims. This ongoing training focuses on discovering “marker” evidence to support the claim. VA wants all Veterans who filed MST-related PTSD claims before December 2011 to receive the benefits of this nationwide training. If your claim was submitted before that date and denied, you can request a re-evaluation from your local VA regional office.
WHAT DO VETERANS NEE D TO DO TO GET A PRE VIOUSLY DENIED MST- RELATED PTSD DISABILITY CLAIM RE – EVALUATED?
Veterans who want VA to review their previously denied MST-related PTSD claim can start by contacting their regional office, calling 1-800-827-1000 or logging into their free eBenefits account at www.eBenefits.va.gov.
CAN VETERANS PROVIDE NEW INFORMATION FOR A RE-EVALUATION OF A PREVIOUSLY DENIED MSTRELATED PTSD DISABILITY CLAIM?
Yes. VBA will accept new evidence to be reviewed when a claim is re-evaluated. It’s best to send any new evidence at the same time as you request a re-evaluation. Veterans Service Organizations, as well as MST specialists and/or Women Veterans Coordinators available at every VA regional office, can help you determine what type of information is best to submit.
DO I NEED TO BE SERVICE CONNECTED FOR MY CONDITIONS RELATED TO MST TO GET TREATMENT?
No. VA provides free health care for physical and mental health conditions related to experiences of MST. No documentation of the MST experiences or disability compensation rating is required. Some Veterans may be able to receive this free MST-related health care even if they are not eligible for other VA care.
HOW CAN YOU APPLY FOR DISABILITY COMPENSATION?
You can apply for disability compensation by completing VA Form 21-526, Veteran’s Application for Compensation and/or Pension. You may also apply online at www.ebenefits.va.gov, or you can appoint an accredited Veterans Service Officer (VSO) to assist you. Male and female MST coordinators are available at every VA regional office to assist Veterans filing claims related to personal assault or MST. You can call 1-800-827-1000, and VA will put you in touch with an MST coordinator, or you can email the MST coordinator at your local regional office from the list of Compensation – April 2015 coordinators located at http://www.benefits.va.gov/benefits/mstcoordinators.asp . For informationabout MST-related treatment, visit ww.mentalhealth.va.gov/msthome.asp.

 

Overview

Female deep in thought.

Military sexual trauma (MST) is the term that the Department of Veterans Affairs uses to refer to sexual assault or repeated, threatening sexual harassment that occurred while the Veteran was in the military. It includes any sexual activity in which one is involved against one’s will – he or she may have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be sexually cooperative or with implied faster promotions or better treatment in exchange for sex), may have been unable to consent to sexual activities (for example, when intoxicated), or may have been physically forced into sexual activities. Other experiences that fall into the category of MST include unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s body or sexual activities; and/or threatening or unwelcome sexual advances.

Male deep in thought.Both women and men can experience MST during their service. All Veterans seen at Veterans Health Administration facilities are asked about experiences of sexual trauma because we know that any type of trauma can affect a person’s physical and mental health, even many years later. We also know that people can recover from trauma. VA has free services to help Veterans do this. You do not need to have a VA disability rating (i.e., “service connected”) to receive these services and may be able to receive services even if you are not eligible for other VA care. You do not need to have reported the incident(s) when they happened or have other documentation that they occurred.

This website has information about the health care services that VA has available for Veterans who experienced MST.  For information about VA disability compensation for conditions related to MST, please view this fact sheet about Disability Compensation for Personal Assault or Military Sexual Trauma.

Veterans Disability – Case Law

Case Law


VA is not requried to obtain a Vocational Expert Testimony or Industiral Survey to Deny Total Disability Individual Unemployement (TDIU) to deny a Veteran Individual Unemployment. But they must use the Vocational Experts findings in thier opinion!

This is a major difference between VA Adjudication and Social Security ODAR Adjudication. Social Security has to use a Vocational Expert at Step 4 and Step 5.

 


 

Smith v. Shinseki, 2010 U.S. App. Vet. Claims LEXIS 1470 (U.S. App. Vet. Cl., Aug. 11, 2010)
OVERVIEW: The veteran had a combined service-connected disability rating of 80 percent. Although the Board found that his 80 percent combined rating (with at least one disability rated at 40 percent) met the threshold requirements for a TDIU claim, it denied his claim after taking into account his work history, his educational background, and reports from VA medical examiners. While the medical examiners did not suggest that he could perform his previous employment as a laborer in the coal mines or a carpenter, they concluded that he was not prevented from performing light or sedentary jobs. The court rejected the veteran’s argument that VA was required to obtain an industrial survey from a vocational expert to evaluate his claim. Given that a TDIU determination under § 4.16 did not require any analysis of the actual opportunities available in the job market, the court declined to conclude that an industrial survey was “necessary” for that purpose in connection with TDIU claims. Because job market information was not required, the duty to assist under 38 U.S.C.S. § 5103A did not require the VA to provide such information through an industrial survey.

 This is why you need a ∞ TDIU Vocational Evaluation  performed by a Vocational Expert so that the court will have the inforation assessed for them, unlike Social Security which has to use Vocational Experts, 

The VA doesnt, BUT must apply the Vocational Experts opinion to the VA’s Decision.

The Court was left scratching its head as to what jobs this disabled veteran could obtain and work since VA did not address that:In a later case in July 2014 the Appeals Court for Veterans Claims reasoned in McClain v. Gibson that VA must provide a detailed explanation when it decides that a severely disabled veteran is ’employable’ as opposed to unemployable.

 

Evan McLain, Appellant, v. Sloan D. Gibson, Acting Secretary of Veterans Affairs, Appellee.
No. 13-2264
UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

2014 U.S. App. Vet. Claims LEXIS 1235   July 17, 2014, Decided

“McClain [Veteran] argues that the Board provided an inadequate statement of reasons or bases for its denial of TDIU. To show entitlement to TDIU, the evidence must demonstrate an inability to undertake substantially gainful employment as a result of a service-connected disability or disabilities. 38 C.F.R. § 4.16(a) (2014) (TDIU is awarded when a disabled person is”unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities”). The Board “may not reject [a claim for TDIU] without producing evidence, as distinguished from mere conjecture, that the veteran can perform work that would produce sufficient income to be other than marginal.”Beaty v. Brown, 6 Vet.App. 532, 537 (1994). Although the Board need not find that  [*2] a particular job exists in the economy, Smith v.Shinseki, 647 F.3d 1380, 1385 (Fed. Cir. 2011), the Board’s statement regarding employability must do more than “merely allude to educational and occupational history, attempt in no way to relate these factors to the disabilities of the appellant, and conclude that some form of employment is available.” Gleicher v. Derwinski, 2 Vet. App. 26, 28 (1991). Moreover, the Board’s explanation for its determination must be understandable to the claimant and facilitate judicial review. Allday v. Brown, 7 Vet.App. 517, 527 (1995) (Board’s statement “must be adequate to enable a claimant to understand the precise basis for the Board’s decision, as well as to facilitate review in this Court”).

Mr. McLain argues that the Board inadequately explained its TDIU determination because it did not address how difficult it would be for him to find employment given the limitations noted by medical examiners. The May 2010 and January 2012 examinations relied on by the Board found that Mr. McLain’s disabilities did not preclude him from employment in a loosely supervised setting, with minimal social interaction, where there was little background noise or phone  [*3] communication, and where alarms and exact communication would not be needed. Record (R.) at 36, 48-49. Although the Board relied on these examiners’ ultimate conclusions that Mr. McLain could be employed in some kinds of jobs, the Board did not address the limitations noted by the examiners, nor did it attempt to relate these limitations to Mr. McLain’s educational and occupational history or explain what kinds of jobs Mr. McLain could obtain. See Beaty andGleicher, both supra. The Board’s failure to do so renders its statement of reasons or bases inadequate and warrants remand.1Allday,supra; see also Tucker v. West, 11 Vet.App. 369, 374 (1998) (remand is appropriate where the Board has, inter alia, failed to provide an adequate statement of reasons or bases).”

 

NOTE: McClain is an unpublished opinion and not to be cited as precedent.  However I believe its teachings and principles are important to grasp in the area of TDIU claims.

Neurological Disorders Veterans TDIU


 

There are many Veterans Suffering From Neurological Disorders

The pain experienced by veterans suffering from neurological disorders is unlike anything else. It can affect every part of veterans’ lives, from the ability to spend time with family to the ability to work or participate in the activities that they once enjoyed.

Veteran’s often are unable to maintain employment or obtain employment due to disabilities and vocational limitations related to their neurological disorders, including compression neuropathies, like carpal tunnel syndrome or ulnar neuropathy, and amyotrophic lateral sclerosis (ALS) or “Lou Gehrig’s Disease.”

Peripheral Neuropathy

Peripheral neuropathy is a problem with the peripheral nervous system — the nerves that carry information to and from the brain and spinal cord. The problem produces pain, loss of sensation and movement difficulties. There can be many service-related accidents or injuries that cause peripheral neuropathy. This can inhibit your hand-eye coordination, manual dexterity, finger dexterity, reaching, handling, walking and other limitations that can affect your employability. If you are unable to maintain employment and need to have a TDIU Assessment to show how this affects your ability to maintain and obtain employment you should consider a TDIU Vocational Evaluation.

Amyotrophic Lateral Sclerosis or Lou Gehrig’s Disease

Amyotrophic lateral sclerosis — often referred to as Lou Gehrig’s Disease — is a serious and progressive disease that affects nerve cells in the brain and the spinal cord. A veteran with ALS may experience deterioration of the motor neurons that limits his or her ability to control movement. Eventually, it may lead to paralysis or death.

All veterans who develop ALS at any time after serving in the military may be eligible for compensation for that disability.

Neurological Disorders in Gulf War Veterans

Many veterans who were deployed to the Persian Gulf for Operations Desert Shield and Desert Storm were exposed to a dangerous mix of different chemicals and vaccines. They returned with special health problems. These problems include numbness, loss of muscle strength, loss of control of bowel or bladder, muscle pain, weakness, headache, brain damage, memory loss, sleep disorders and gastrointestinal problems. While they were not taken seriously at first, they eventually became known as Gulf War Syndrome.

Radiculopathy

Radiculopathy is not a specific condition, but a problem that affects the nerves and causes them not to work properly. The result is pain, weakness, numbness and lack of muscle control. If you have been diagnosed, you may be eligible for veterans disability benefits under TDIU if you can how Expert proof on how this limitation affects your unemployability.

VA Vocational Rehabilitation and Employment

EDUCATION AND CAREER COUNSELING
Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the
VA health care system, a 10-point hiring preference for federal employment and other important benefits. Ask your VA
representative or Veterans Service Organization representative about Disability Compensation, Pension, Health Care, Caregiver
Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors’ Benefits.
WHAT IS THE EDUCATION AND CAREER COUSELING PROGRAM?
The Department of Veterans Affairs (VA) Education and Career Counseling program (Title 38 U.S.C. Chapter 36) offers a great opportunity for transitioning Servicemembers and Veterans to get personalized counseling and support to guide their career paths, ensure most effective use of their VA benefits, and achieve their goals.
ELIGIBILITY
• Transitioning Servicemembers within six months prior to discharge from active duty
• Veterans within one year following discharge from active duty
• Any Servicemember/Veteran eligible for a VA education benefit
• All current VA education beneficiaries
SERVICES INCLUDE ASS ISTI NG SERVICEMEMBERS/VE TERANS WITH
• Career Choice – understand the best career options based on your interests and capabilities
• Benefits Coaching – guidance on the effective use of VA benefits and/or other resources to achieve education and career goals
• Personalized Support – Academic or adjustment counseling and personalized support to help remove any barriers to success
APPLICATION PROCESS
To connect with a VA counselor and receive this personalized assistance, apply here http://www.vba.va.gov/pubs/forms/VBA-28-8832-ARE.pdf. After we receive your application, we will contact you to schedule a time to meet with one of our counselors. For additional questions or help, contact VA by calling the nationwide toll free number, 1-800-827-
1000. For hearing impaired, dial 1-800-829-4833.

Veterans Disability Issues

lf Veterans of the first Gulf War are defined by the Department of Veterans Affairs as men and women who served in Saudi Arabia, Iraq, Kuwait and other countries in the Persian Gulf. Approximately 697,000 troops were deployed to the region in the years 1990-1991.

Gulf War vets have many of the same issues and disabilities as veterans of other wars. But They frequently experience problems that are unique to military personnel who fought in the region. Many believe it was due to some type of toxin exposure.

In particular, Gulf War vets are affected by a medically unexplained illness popularly called Gulf War Syndrome. Symptoms of Gulf War Syndrome can include fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems.

Despite the frequent use of the phrase Gulf War Syndrome in civilian media, the VA prefers not to use that term and uses phrases such as “undiagnosed illness” and medically unexplained chronic multisymptom illnesses.” Because the symptoms of the illness vary enormously from vet to vet, the condition does not fit the formal definition of the term “syndrome,” according to the VA.

Presumptive Gulf War Conditions

The VA presumes that certain chronic illnesses that persist for more than six months in this cohort of veterans are related to service in the Gulf region. They include:

• Chronic fatigue syndrome

• Fibromyalgia

• Gastrointestinal disorders

• Undiagnosed illness that includes symptoms such as abnormal weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders and sleep disturbances, popularly called Gulf War Syndrome

• Infectious diseases that include malaria, brucellosis, campylobacter jejuni, Q fever, mycobacterium tuberculosis, non-typhoid salmonella, shigella, visceral leishmaniasis, and West Nile virus

• Amyotrophic lateral sclerosis (ALS)

The VA continues to conduct research into these and other conditions associated with service in the Gulf War during 1990-1991. Of particular interest is the source of so-called Gulf War Syndrome, and numerous causes have been suggested.

Possible Causes of Gulf War Syndrome

Possible causes of this medically elusive illness include:

• Vaccinations, especially vaccinations for anthrax and botulism

• Oil well fires, petroleum and smoke

• Pesticides

• Pyriostigmine bromide, used as a re-treatment against militarized nerve agents

• Biological and chemical weapons

• Sand, dust and particles

• Depleted uranium

• Toxic embedded fragments (shrapnel)

• Noise

•Occupational hazards, such as chemicals, paint and machinery

•Heat

If you have a service connected disability and are unemployed and believe that your disability is the cause you should consider a TDIU Vocational Evaluation.

When a Veterans Representatives & Attorneys need an objective Vocational Assessment of a claimant’s Past Relevant Work, & Current Vocational Capabilities, they turn to us for Answers.

We have been providing Forensic Vocational Expert Services and Occupational assessments for over 17 years. We have also served as an unbiased expert for the U.S. Federal Government in more than 500  cases. We have performed over 3,000 assessments and have a specializations in brain injury (TBI), and Mental Health/Psychological issues.

 

Forensic Vocational Expert

Veterans Having a Hard time Finding Employment

Never Drop your Standards. Many Armed Forces at the time of leaving thier post, have tend to have the highest standards of thier life! Many times upon leaving they tend to let old habits creep in and before they are aware of it, thier daily routine to maintain physical stability is lost. Returning to civilian life after years of active military service should be a joyous occasion for veterans. However, many returning soldiers have a difficult time adjusting to life outside the armed forces, which may contribute to veteran unemployment rates well above the national average.

 VETS STRUGGLING TO FIND JOBS

Veterans who served after the September 11 attacks have an unemployment rate of about 10%, compared to the national average of 7.3%. While this is down from a peak veteran unemployment rate of 13.1% in December of 2011, this still means that 246,000 veterans who have served in the past 13 years are without work.

Female veterans have had consistently higher rates of unemployment than male veterans. This may partially be due to the fact that many female veterans are mothers who choose to stay outside of the workforce and focus on child rearing after their deployments. However, people who study employment statistics have also pointed to fewer available services for female vets, and a tendency to not self-identify as a veteran, which may affect their participation in preferential hiring efforts.

VETERAN HIRING INCENTIVES  DO WORK TO CHANGE THE TREND

The federal government has stepped up efforts to increase veteran hiring, and has created incentives for employers who give preference to veterans. These incentives include reimbursement for veterans’ salaries and training, as well as tax credits for employers who hire veterans.

Additionally, the government has created a website (https://www.ebenefits.va.gov/ebenefits/jobs) to specifically assist veterans in finding employment, job training, or resources to continue their education. The website also offers a feature where veterans can enter their branch of service, military pay grade, and military occupation code in order to see what career areas may be a fit for their particular skills.

Many veterans who are willing to work are simply unable to do so on account of service-related injuries or disabilities. For these veterans, applying for disability benefits may provide the extra income needed to support themselves and their families.

TDIU – DIAGNOSING PTSD

PTSD is a result of a person experiencing a traumatic event. Any number of situations can trigger PTSD for service members, as they are routinely exposed to stressful and traumatic occurrences.

Some of the Common Symptoms of PTSD may include:

  • Panic Attacks
  • Generalized Anxiety
  • Reliving the event, or flashbacks
  • Feelings of detachment, emotional numbness or depression
  • Avoiding situations that are reminiscent of the traumatic event
  • Not talking about the traumatic event
  • Living in a constant state of alertness or readiness for danger
  • Loss of interest in normal daily activities

Veterans experiencing these symptoms should contact a health care professional to determine whether they are suffering from PTSD.

There are many combat Veterans who have developed post-traumatic stress disorder (PTSD) as a result of military service are eligible to receive disability compensation for their condition. PTSD is a serious disorder that requires ongoing treatment which may not be possible if the veteran is not awarded an adequate amount from the VA.


 

The VA, Veterans Disability and what is needed to get a PTSD Disability Rating:

In the past, the VA has maintained strict requirements for claiming PTSD disability but in recent years these have become less stringent. Since 2010, veterans are no longer required to prove that the PTSD-triggering event actually occurred. This applies to combat veterans and any veteran who experienced fear of hostile terrorist activity.

The way to create  A DIRECT SERVICE CONNECTION FOR PTSD, VETERANS MUST HAVE:

  • A current PTSD diagnosis
  • A statement about the event that caused their trauma
  • Consistency between the veteran’s statement and the conditions of their service
  • A medical opinion that the stressor had a sufficient enough impact on them to cause PTSD

FAQ Forensic Mental Health Evaluations

Why do people/lawyers/courts seek forensic mental health evaluations?

People need forensic mental health services for varying reasons. Some need to  comply with court orders while others need evaluations for employment reasons.  Mental health evaluations can be used in criminal court cases or to enhance a civil case currently under litigation. They can also be required for probation/parole purposes. Sometimes individuals may chose to seek a mental health evaluation as a “second opinion.” Sometimes people may need mental health evaluations for prior to medical surgery. Mental Health Evaluations are completed by a neutral professional with extensive training in mental health and forensics.

What can I expect in a forensic evaluation?

A mental health evaluation can take up to 8 hours to complete the testing and interview portion (for one adult).  When a custody evaluation is conducted it is a more involved process and usually takes between 30 to 60 days depending on the case.  At times, you may be asked to take certain actions outside of the interview, such as collecting information or keeping records.  You will be required to pay for evaluations in advance. At your appointment the reason for evaluation, role of evaluator, confidentiality issues (or lack of confidentiality) will be discussed. Your evaluation will include a detailed personal history, answering questions, and verbally participating with the evaluator. Most times you be given tests to complete. The tests do not have a “right” or “wrong” answer but are designed to assess your personality, level of mood, etc. Your evaluation may take one visit or more than one visit, depending on your situation. There are no right or wrong answers to give when talking to the evaluator. It is important to be honest and “be yourself.” Plan to spend three hours at your first appointment.

What benefits can I expect from working with a certified forensic evaluator/mental health professional?

A number of benefits are available from having your forensic evaluation completed by a mental health professional. Many people and/or attorneys find that working with a mental health professional to be a tremendous asset to managing difficult aspects of their case.   Some of the benefits available from forensic mental health services include:

  • Having a professional explain to a jury or judge your situation, possible diagnosis or lack of diagnosis
  • Finding resolution to the issues or concerns that led you to seek forensic services
  • Improving your chances for successful jury selection
  • Refuting testimony of other opposing expert witness that could be potentially damaging to your case

Why do Mental Health Evaluations cost so much?

Evaluations are conducted by professional mental health evaluators who have a minimum of a Masters degree (six years of college). The evaluator also has many hours of post-Masters training and experience. The Evaluation is a lengthy process and includes the ability to assess, diagnose, provide comprehensive reports, and sometimes testify in court. Child Custody Evaluations are much more involved and take specialized training to conduct. They take many more hours to complete and include the ability to work well with children and adults. Often there is interaction with many people and other professionals.

Why do I have to pay for my evaluation in advance?

It is necessary to provide funds in advance of appointments, because the evaluator attempts to avoid being vulnerable to allegations of bias. It is helpful, in assuring both parties of objectivity, to be free to render one’s opinion or recommendation without fear of difficulty collecting fees.

What can I expect from a preoperative bariatric evaluation?

This office will conduct a mental status exam, psychosocial history, clinical intwerview and administer the MMPI2 test.

Here is a good article about this question:
by Anthony N Fabricatore, Canice E Crerand, Thomas A Wadden, David B Sarwer and Jennifer L Krasucki, Published online: 01 May 2006

Background: The prevalence of extreme obesity and the popularity of bariatric surgery have increased dramatically in recent years. Many surgery programs require that candidates undergo a preoperative psychological evaluation, but no consensus exists for guiding mental health professionals in the conduct of these evaluations. Method: A survey was sent to bariatric surgeons, who were asked to distribute the surveys to the mental health professionals to whom they refer surgery candidates for preoperative evaluations. 194 respondents provided information on the assessment methods they use, which psychosocial domains are the focus of their evaluations, and what they consider to be contraindications to surgery. Responses to open-ended questions were coded for content. Results: Most respondents reported using clinical interviews (98.5%), symptom inventories (68.6%), and objective personality/psychopathology tests (63.4%). A minority used tests of cognitive function (38.1%) and projective personality tests (3.6%). Over 90% of respondents listed mental health issues among the most important areas to assess. Similarly, 92.3% listed psychiatric issues as “clear contraindications” to surgery, but no specific disorder was listed by a majority of respondents. Issues related to informed consent and treatment adherence were the non-psychiatric domains most frequently listed as important areas to assess and as contraindications to surgery.

Conclusion: The assessment practices of mental health professionals who evaluate bariatric surgery candidates vary widely. No consensus is likely to emerge until large long-term studies identify consistent psychosocial predictors of poor postoperative outcomes.

Are Forensic Evaluations Confidential?

In general, the law protects the confidentiality of all communications between a client and a psychotherapist/Forensic Evaluator. Information is not disclosed without written permission. However, there are number of exceptions to this rule. Exceptions include:

  • Suspected child abuse or dependent adult or elder abuse. The Mental Health Professional is required by law to report this to the appropriate authorities immediately.
  • If a client is threatening serious bodily harm to another person(s) The Mental Health Professional must notify the police and inform the intended victim.
  • If a client intends to harm himself or herself. The Mental Health Professional will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, further measures may be taken without their permission in order to ensure their safety.
  • Court evaluations.  The forensic evaluator can explain areas of confidentiality in each case.  Generally speaking the evaluator is hired to give the court recommendations so confidentially may be limited.

Veterans Disability

Don’t Let the VA Employees be the only one to decide a Veterans Disability & Employability.  There are some claims, a veteran establishes that he is unable to return to his former employment because of his service-connected disability.  However that is not the only issue involved in individual unemployability (TDIU), the question then becomes whether the veteran has the education, work experience, transferrable skills and adequate physical or mental ability to secure and maintain Other Work. The VA often relies on their VA physicians or Social Workers’ to answer this question. But, in fact, vocational experts are the only ones who are qualified to provide an opinion on this issue.

Vocational experts can evaluate the opportunities in the contemporary labor market against the veteran’s peculiar circumstances, offering an opinion as to the veteran’s potential for obtaining another job.

When the VA obtains there opinion its often in a report known as Social & Industrial Survey , to support a veteran’s claim of unemployability due to service-connected disabilities. However, the person the VA has completing this form rarely has training, education, or experience in vocational issues, vocational limitations, nor medical and psychological aspects of disability. This is a true Veterans Disability Assessment.

The United States Department of Veteran’s Affairs (VA) is a government run military benefit system that is responsible for administering programs for veterans’ benefits, their families, and survivors. Veterans Disability- VA regulations state that “all veterans who are unable to secure and follow a “substantial gainful occupation” by reason of a service-connected disability shall be rated totally disabled.” (38 C.F. R. Sect 4.16).

you can get 100% Veterans Disability through “Individual Unemployability” or IU is a way for the VA to compensate veterans at the 100 percent rate who are unable to work because of their service connected disability. This is the fasted-growing part of the disability compensation program.

Entitlement to 100% Veterans Disability due to TDIU requires evidence of unemployment due to the disability in question and medical evidence that a veteran’s service-connected disability renders him or her totally disabled and unemployable. A Vocational Expert report can assist in documenting Total Disability.

The recent US Court of Appeals case of Smith v. Shinski (No 2010-7145) using Social Security case law indicates the Veteran’s Administration does not have to use Vocational Experts in TDIU (Total Disability, Individual Unemployability) cases but that the VA adjudicator must consider a report documenting the Veteran’s unemployability. It is clear from this decision that the ultimate question is the employability of the Veteran, not the availability of jobs they can perform.

Specifically, 38 C.F.R. § 4.16 states in part, that if a veteran is unable to secure or follow a substantially gainful occupation as a result of service-connected disabilities, he or she may be assigned a TDIU rating.  Of course there are other requirements for IU benefits, but even if those requirements are met, if a veteran is still able to secure or follow a substantially gainful occupation, then IU will be denied.

A quality Veterans Disability Assessment needs to be done by a vocational expert to document the vocational aspects of the veterans disability issues that a doctor cannot do.

Vocational Expert Resource Links

Commission on Rehabilitation Counselor Certification

http://www.crccertification.com/

 

 

International Association of Rehabilitation Professionals

http://www.rehabpro.org/

 

 

The American Counseling Association

http://www.counseling.org/

 

 


The American Rehabilitation Counseling Association

http://www.arcaweb.org/

 

 


The Society for Human Resource Management

http://www.shrm.org/Pages/default.aspx

 

 

Other useful links:

The Dictionary of Occupational Titles http://www.oalj.dol.gov/libdot.htm

 

The Bureau of Labor Statistics http://www.bls.gov/

 

O-net Online http://www.onetonline.org/

 

The Social Security Administration http://www.ssa.gov/

 

The Job Accommodation Network http://askjan.org/

Job Search and Labor Market Information

Government Agencies

School Information

Professional Organizations and Certifying Bodies