Department of

Veterans Affairs Memorandum

JUN 26-
Dale:

From:
Deputy Under Secretary of Health for Operations and Management (1 ON)

Subj: VHA Guidance for Mental Health Compensation & Pension (C&P) Examinations

To: VISN Directors, VAMC Directors

1. The C&P program is one of VA's most important missions, especially in the
eyes of disabled veterans and their families. A thorough, complete C&P
examination is a critical component to the fair, timely award of compensation or
pension to deserving veterans. I ask that each C&P examiner continue to
exercise their usual, good judgment in conducting a thorough and complete
examination.

2. As a reminder, complex conditions such as Post Traumatic Stress Disorder

(PTSD) cannot be adequately documented or ruled out without obtaining a
detailed military history and reviewing the claims folder. This means that initial
review of the folder prior to examination, the history, and examination itself, and
the dictation for an examination initially establishing PTSD will often require more
time than examinations of other disorders.

3. Quality indicators for the Initial PTSD exam include documentation of the
following: frequency, severity and duration of the symptoms, specific stressors
during service and the link to current condition, post-military stressors and
description of the psychosocial consequences, presence of problematic alcohol
or substance abuse, effects on employment functioning, impairment of thought
process or communication, the diagnosis is consistent with DSM-IV and
supported by the exam findings, description of multiple mental disorders and
symptoms, and the veterans ability to manage VA benefits.

4. A thorough examination adheres to these quality indicators. These indicators

can be accessed and reviewed at
http://vaww . epep. va . gov Ipi I guali tystandards. aspx Please be sure you
have allocated enough time to these examinations to ensure each veteran gets
the thorough, thoughtful examination he or she deserves.

5. For any questions please contact the DoD Coordination Office at

(202) 461-6082.

tJ~~
FA~E
William F. Feeley, MSW,

VAFORM
MAR 1989
2105