VistA-WorldVistAEHR/r/AUTOMATED_MED_INFO_EXCHANGE.../DVBCWPE5.m

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DVBCWPE5 ;BP-CIOFO/MM - REVIEW PTSD WORKSHEET TEXT ;3/27/2002
;;2.7;AMIE;**43**;Apr 10, 1995
;
;
TXT ;
;;E. Assessment of PTSD
;;
;; 1. state whether or not the veteran meets the DSM-IV stressor criterion
;; 2. identify behavioral, cognitive, social, affective, or somatic symptoms
;; veteran attributes to PTSD
;; 3. describe specific PTSD symptoms present (symptoms of trauma
;; re-experiencing, avoidance/numbing, heightened physiological arousal,
;; and associated features [e.g., disillusionment and demoralization])
;; 4. specify typical frequency, and severity of symptoms
;;TOF
;;F. Psychometric Testing Results
;;
;; 1. provide psychological testing if deemed necessary.
;; 2. provide specific evaluation information required by the rating board or
;; on a BVA Remand.
;; 3. comment on validity of psychological test results
;; 4. provide scores for PTSD psychometric assessments administered
;; 5. state whether PTSD psychometric measures are consistent or inconsistent
;; with a diagnosis of PTSD, based on normative data and established
;; "cutting scores" (cutting scores that are consistent with or supportive
;; of a PTSD diagnosis are as follows: PCL - not less than 50;
;; Mississippi Scale - not less than 107; MMPI PTSD subscale a score
;; greater than 28; MMPI code type: 2-8 or 2-7-8)
;; 6. state degree of severity of PTSD symptoms based on psychometric data
;; (mild, moderate, or severe)
;; 7. describe findings from psychological tests measuring other than
;; PTSD (MMPI, etc.)
;;
;;G. Diagnosis:
;;
;; 1. The Diagnosis must conform to DSM-IV and be supported by the findings
;; on the examination report.
;; 2. If there are multiple mental disorders, delineate to the extent possible
;; the symptoms associated with each and a discussion of relationship.
;; 3. Evaluation is based on the effects of the signs and symptoms on
;; occupational and social functioning.
;;
;;NOTE: VA is prohibited by statute, 38 U.S.C. 1110, from paying compensation
;;for a disability that is a result of the veteran's own ALCOHOL OR DRUG ABUSE.
;;However, when a veteran's alcohol or drug abuse disability is secondary to
;;or is caused or aggravated by a primary service-connected disorder, the
;;veteran may be entitled to compensation. See Allen v. Principi, 237 F.3d
;;1368, 1381 (Fed. Cir. 2001). Therefore, it is important to determine the
;;relationship, if any, between a service-connected disorder and a disability
;;resulting from the veteran's alcohol or drug abuse. Unless alcohol or drug
;;abuse is secondary to or is caused or aggravated by another mental disorder,
;;you should separate, to the extent possible, the effects of the alcohol or
;;drug abuse from the effects of the other mental disorder(s). If it is not
;;possible to separate the effects in such cases, please explain why.
;;
;;H. Diagnostic Status
;;
;; Axis I disorders
;; Axis II disorders
;; Axis III disorders
;; Axis IV (psychosocial and environmental problems)
;; Axis V (GAF score - current)
;;
;;TOF
;;I. Global Assessment of Functioning (GAF):
;;
;; NOTE: The complete multi-axial format as specified by DSM-IV may be required
;; by BVA REMAND or specifically requested by the rating specialist. If so,
;; include the GAF score and note whether it refers to current functioning.
;; A BVA REMAND may also request, in addition to an overall GAF score,
;; that a separate GAF score be provided for each mental disorder present when
;; there are multiple Axis I or Axis II diagnoses and not all are service-
;; connected. If separate GAF scores can be given, an explanation and
;; discussion of the rationale is needed. If it is not possible, an explanation
;; as to why not is needed. (See the above note pertaining to alcohol or drug
;; abuse.)
;;
;;J. Competency:
;;
;; Competency, for benefits purposes, has a special meaning,
;; and refers ONLY to veterans' ability to manage benefit payments in their own
;; best interests without restriction, and not to any other subject. State
;; whether the veteran is capable of managing his/her or her benefit payments
;; in the individual's own best interests (a physical disability which prevents
;; the veteran from attending to financial matters in person is not a proper
;; basis for a finding of incompetency unless the veteran is, by reason of that
;; disability, incapable of directing someone else in handling the individual's
;; financial affairs).
;;
;;K. Other Opinion:
;;
;; Furnish any other specific opinion requested by the rating
;; board or BVA remand (i.e., furnish the complete rationale and citation of
;; medical texts or treatise supporting opinion, if medical literature review
;; was undertaken). If the requested opinion is medically not ascertainable
;; on exam or testing please state WHY. If the requested opinion can not be
;; expressed without resorting to speculation or making improbable assumptions
;; say so, and explain why. If the opinion asks "... is it at least as likely
;; as not..", fully explain the clinical findings and rationale for the opinion.
;;
;;L. Integrated Summary and Conclusions
;;
;; 1. Describe changes in PSYCHOSOCIAL FUNCTIONAL STATUS and QUALITY of LIFE
;; since the last exam (performance in employment or schooling, routine
;; responsibilities of self care, family role functioning, physical health,
;; social/interpersonal relationships, recreation/leisure pursuits)
;; 2. Describe linkage between PTSD symptoms and aforementioned changes in
;; impairment in functional status and quality of life.
;; Particularly in cases where a veteran is unemployed, specific details
;; about the effects of PTSD and its symptoms on employment are especially
;; important.
;;TOF
;; 3. If possible, describe extent to which disorders other than PTSD
;; (e.g., substance use disorders) are independently responsible for
;; impairment in psychosocial adjustment and quality of life. If this is not
;; possible, explain why (e.g., substance use had onset after PTSD
;; and clearly is a means of coping with PTSD symptoms).
;; 4. If possible, state prognosis for improvement of psychiatric condition
;; and impairments in functional status.
;; 5. Comment on whether veteran should be rated as competent for VA purposes
;; in terms of being capable of managing his/her benefit payments in his/her
;; own best interest.
;;
;;
;;Signature: Date:
;;END