130 lines
6.6 KiB
Mathematica
130 lines
6.6 KiB
Mathematica
DVBCWPD2 ;ALB/ESW PTSD WKS TEXT - 2 ; 10 Oct 2000
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;;2.7;AMIE;**34**;Apr 10, 1995
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TXT ;
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;;
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;;F. Assessment of PTSD
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;;
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;; * state whether or not the veteran meets the DSM-IV stressor criterion
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;; * identify behavioral, cognitive, social, affective, or somatic change
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;; veteran attributes to stress exposure
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;; * describe specific PTSD symptoms present (symptoms of trauma
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;; re-experiencing, avoidance/numbing, heightened physiological arousal,
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;; and associated features [e.g., disillusionment and demoralization])
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;; * specify onset, duration, typical frequency, and severity of symptoms
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;;
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;;G. Psychometric Testing Results
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;;
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;; * provide psychological testing if deemed necessary.
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;; * provide specific evaluation information required by the rating board or
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;; on a BVA Remand.
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;; * comment on validity of psychological test results
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;; * provide scores for PTSD psychometric assessments administered
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;; * state whether PTSD psychometric measures are consistent or inconsistent
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;; with a diagnosis of PTSD, based on normative data and established
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;; "cutting scores" (cutting scores that are consistent with or supportive
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;; of a PTSD diagnosis are as follows: PCL - not less than 50;
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;; Mississippi Scale - not less than 107; MMPI PTSD subscale a score
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;; greater than 28; MMPI code type: 2-8 or 2-7-8)
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;; * state degree of severity of PTSD symptoms based on psychometric data
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;; (mild, moderate, or severe)
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;; * describe findings from psychological tests measuring other than
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;; PTSD (MMPI, etc.)
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;;
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;;H. Diagnosis:
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;;
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;; 1. The Diagnosis must conform to DSM-IV and be supported by the findings
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;; on the examination report.
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;; 2. If there are multiple mental disorders, delineate to the extent possible
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;; the symptoms associated with each and a discussion of relationship.
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;; 3. Evaluation is based on the effects of the signs and symptoms on
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;; occupational and social functioning.
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;;
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;; NOTE: VA is prohibited by statute from paying compensation for a disability
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;; that is a result of the veteran's own ALCOHOL OR DRUG ABUSE, whether based
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;; on direct service connection, secondary service connection, or aggravation
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;; by a service-connected condition. Therefore, when alcohol or drug abuse
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;; accompanies or is associated with another mental disorder, separate,
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;; to the extent possible, the effects of the alcohol or drug abuse from
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;; the effects of the other mental disorder(s). If it is not possible
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;; to separate the effects, explain why.
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;;
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;;I. Diagnostic Status
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;;
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;; Axis I disorders
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;; Axis II disorders
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;; Axis III disorders
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;; Axis IV (psychosocial and environmental problems)
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;; Axis V (GAF score - current)
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;;
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;;J. Global Assessment or Functioning (GAF):
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;;
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;; NOTE: The complete multi-axial format as specified by DSM-IV may be required
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;; by BVA REMAND or specifically requested by the rating specialist. If so,
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;; include the GAF score and note whether it refers to current functioning.
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;; A BVA REMAND may also request, in addition to an overall GAF score,
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;; that a separate GAF score be provided for each mental disorder present when
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;; there are multiple Axis I or Axis II diagnoses and not all are service-
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;; connected. If separate GAF scores can be given, an explanation and
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;; discussion of the rationale is needed. If it is not possible, an explanation
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;; as to why not is needed. (See the above note pertaining to alcohol or drug
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;; abuse, the effects of which cannot be used to assess the effects of
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;; a service-connected condition.)
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;;
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;; DSM-IV is only for application from 11/7/96 on. Therefore, when applicable
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;; note whether the diagnosis of PTSD was supportable under DSM-III-R prior
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;; to that date.
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;;
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;;K. Competency:
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;;
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;; Competency, for benefits purposes, has a special meaning,
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;; and refers ONLY to veterans' ability to manage benefit payments in their own
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;; best interests without restriction, and not to any other subject. State
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;; whether the veteran is capable of managing his/her or her benefit payments
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;; in the individual's own best interests (a physical disability which prevents
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;; the veteran from attending to financial matters in person is not a proper
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;; basis for a finding of incompetency unless the veteran is, by reason of that
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;; disability, incapable of directing someone else in handling the individual's
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;; financial affairs).
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;;
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;;L. Other Opinion:
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;;
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;; Furnish any other specific opinion requested by the rating
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;; board or BVA remand (furnish the complete rationale and citation of medical
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;; texts or treatise supporting opinion, if medical literature review was
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;; undertaken). If the requested opinion is medically not ascertainable
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;; on exam or testing please state WHY. If the requested opinion can not be
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;; expressed without resorting to speculation or making improbable assumptions
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;; say so, and explain why. If the opinion asks "... is it at least as likely
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;; as not..", fully explain the clinical findings and rationale for the opinion.
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;;
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;;M. Integrated Summary and Conclusions
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;;
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;;- Describe changes in PSYCHOSOCIAL FUNCTIONAL STATUS and QUALITY of LIFE
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;; following trauma exposure (performance in employment or schooling, routine
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;; responsibilities of self care, family role functioning, physical health,
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;; social/interpersonal relationships, recreation/leisure pursuits)
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;;- Describe linkage between PTSD symptoms and aforementioned changes in
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;; impairment in functional status and quality of life.
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;; Particularly in cases where a veteran is unemployed, specific details about
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;; the effects of PTSD and its symptoms on employment are especially
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;; important.
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;;- If possible, describe extent to which disorders other than PTSD
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;; (e.g., substance use disorders) are independently responsible for impairment
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;; in psychosocial adjustment and quality of life. If this is not possible,
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;; explain why (e.g., substance use had onset after PTSD and clearly is a means
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;; of coping with PTSD symptoms).
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;;- If possible, describe pre-trauma risk factors or characteristics that may
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;; have rendered the veteran vulnerable to developing PTSD subsequent to trauma
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;; exposure.
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;;- If possible, state prognosis for improvement of psychiatric condition
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;; and impairments in functional status.
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;;- Comment on whether veteran should be rated as competent for VA purposes
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;; in terms of being capable of managing his/her benefit payments in his/her
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;; own best interest.
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;;
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;;
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;;Signature: Date:
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;;END
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