Glossary

This page provides definitions of common terms used when discussing VA disability benefits for PTSD and other mental disorders.

Links to Definitions on this page:

CAPS
DSM
Feign
IME Companies
Malinger
Military Sexual Trauma (MST)
SADS
SCID
Secretary of Veterans Affairs
Sense of Congress
VHA

Terms Defined:

CAPSClinician-Administered PTSD Scale. The VA’s National Center for PTSD publishes this structured diagnostic interview for posttraumatic stress disorder (PTSD). The new version keyed to DSM-5 PTSD diagnostic criteria is called the CAPS-5.

DSMDiagnostic and Statistical Manual for Mental Disorders. The American Psychiatric Association has published the DSM since 1952. The current edition is DSM-5, published in 2013. The Veterans Health Administration (VHA) requires that C&P examiners (psychologists and psychiatrists) use DSM-5 for compensation and pension examinations (C&P exams), and VA regulations regarding veterans disability benefits for mental disorders frequently reference the DSM.

Feign – “pretend to be affected by (a feeling, state, or injury).” [Google] In contrast to malinger, which implies knowledge of the intent of a person’s feigning, to state that an evaluee “feigned psychiatric symptoms” indicates fabrication, but does not imply a reason for the falsehood.

IME Companies – An Independent Medical Examination (IME) is a medical evaluation conducted by physicians or other health professionals in personal injury litigation, workers compensation claims, and private disability insurance cases. The term is also used by companies that conduct C&P exams with veterans, under contract with the Department of Veterans Affairs.

Psychologists sometimes use the term Independent Psychological Examination (IPE) so that they are not accused of presenting themselves as physicians, although in the VA, the word ‘medical’ is used to describe expert witness opinions, evaluations, etc., whether the examiner is a physician, psychologist, audiologist, nurse practitioner, social worker, or physician assistant.

The VA currently contracts with IME companies to conduct C&P exams. Two such companies are QTC and Veterans Evaluation Services (VES).

Malinger – To feign illness and/or exaggerate symptoms in order to achieve a specific objective, e.g., to forestall military service, avoid incarceration for a crime, or to receive undeserved disability benefits. To list “malingering” (Z76.5) in a diagnostic formulation, the psychiatrist or psychologist must possess good evidence that the individual feigned and/or exaggerated symptoms in order to achieve some secondary gain.

Military Sexual Trauma – Defined in 38 U.S.C.  § 1720D(a)(1) as “…psychological trauma, which in the judgment of a mental health professional employed by the Department, resulted 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 or active duty for training.”

SADSSchedule for Affective Disorders and Schizophrenia. The New York State Psychiatric Institute, Biometrics Research division (Columbia University, College of Physicians and Surgeons), developed this structured diagnostic interview in the 1970s. Although not keyed to current DSM nosology, the SADS possesses very good reliability and has a strong research base.1

Secretary of Veterans Affairs – (from Wikipedia) The United States Secretary of Veterans Affairs is the head of the U.S. Department of Veterans Affairs, the department concerned with veterans’ benefits, health care, and national veterans’ memorials and cemeteries. The Secretary is a member of the Cabinet and second to last at 16th in the line of succession to the presidency. The current Secretary is Robert A. McDonald.

SCIDStructured Clinical Interview for DSM. The New York State Psychiatric Institute, Biometrics Research division, (Columbia University, College of Physicians and Surgeons), developed this structured clinical interview based on Diagnostic and Statistical Manual (DSM) nosology. The most recent version is Structured Clinical Interview for DSM-5 (SCID-5).

Sense of Congress – A resolution passed by a simple majority vote by either chamber of Congress or jointly by the House and Senate. These resolutions do not create new law, but they can influence public opinion and thereby put pressure on the Executive branch to change regulations in line with the Sense of Congress resolution. About.com has an informative article on the topic.

VHAVeterans Health Administration. The U.S. Department of Veterans Affairs is divided into three administrations, Veterans Benefits Administration (VBA), Veterans Health Administration (VHA), and National Cemetery Administration (NCA). The Veterans Health Administration is America’s largest integrated health care system with over 1,700 sites of care, e.g., Medical Centers and Community-Based Outpatient Centers, serving 8.76 million Veterans each year.


Footnotes
1. Endicott, J., & Spitzer, R. L. (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35(7), 837–844.

3 Responses

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