Compensation and pension examinations (C&P exams) for psychological disorders, including PTSD exams, are unfair to veterans because of high false negative and false positive rates. I review the evidence for this high inaccuracy rate, while noting that the Department of Veterans Affairs bears the burden of proof to demonstrate the reliability and validity of their psychological claim exams. I offer recommendations to correct this problem, with an emphasis on developing a rigorous quality improvement program based on examiner peer review.
The paragraph above is an Abstract for a Wʜɪᴛᴇ Pᴀᴘᴇʀ I submitted to the Advisory Committee on Disability Compensation. If you wish to review the paper, click here to download Psych Exams Are Unfair to Veterans.
Here is a succinct summary of the paper:
VA C&P exams for PTSD and other mental disorders currently suffer from high rates of both false negative and false positive conclusions, which lead to a large number of faulty VBA disability determinations for Mental Health disability claims.1
If Secretary Shulkin understands the nature and extent of this problem, I believe he will take action. Such action will require VA leadership to:
• Invest the time necessary to fully understand the various causative factors that lead to poor quality Psychological C&P exams;
• Coordinate this Quality Improvement effort across silos, especially between VBA and VHA;
• Empower knowledgeable staff to work expeditiously, making changes to processes and procedures right away, knowing that everything will be tested to assess efficiency and accuracy.
The good news is that VA already possesses the talented people and technological resources necessary to make this happen, starting now.
1. Please see the Wʜɪᴛᴇ Pᴀᴘᴇʀ for a detailed discussion, including dozens of references.