Veteran Mental Health Exam with Dr. Belanger: What to Expect

I know how much you are dreading your Mental Health Evaluation. Please know that that’s normal. I understand that these are stressful and emotional. You don’t need to act like they aren’t. It will be perfectly normal for you to be anxious, sad, angry, dazed, etc. And yes, it will be perfectly normal and acceptable for you to cry. Also, any time during the exam, please ask me if you have any questions and/or tell me if you need to pause for a minute. 

I have two main priorities when doing these evaluations: to cause you the least amount of stress possible, and to provide the VA with the information they need to make the most accurate rating possible.  I can’t take away your stress, but I’m hoping to decrease your anxiety a little bit by letting you know what to expect with me. 

Whether you were assigned to me for your VA Compensation & Pension Exam or you chose to schedule an Independent Medical Examination (IME) with me, my overall approach in our telehealth appointment will be the same.

These exams aren’t for treatment; they are for assessment. That distinction is important, because treatment and assessment have different purposes. The purpose of treatment is to increase your quality of life. To do that, I would gather in-depth information about different aspects of your life, because that would help me understand you better and therefore provide more effective treatment.

The ultimate purpose of these exams is to provide the VA with the information it needs to make an accurate decision on your disability claim. I have completed thousands of these exams. I know what information the VA needs to make their decision. With that in mind, I have streamlined the questions I ask.

And I will ask you the questions that are necessary for an accurate rating. I believe that it is my responsibility to use my professional expertise to ensure that you are accurately represented. I think it’s unreasonable to expect veterans to know what we need to know and/or to remember to say it.

Please do not worry about remembering to say this or that. You don’t need notes or a list of anything. I will guide you through the exam, and I will make sure that I find out what I need to know. I won’t let you accidentally screw yourself over by forgetting to tell me something or by downplaying your symptoms.

A little orientation about how the exams (or DBQs) are set up… The majority of the exams fall under two categories: PTSD or Mental Disorders (that don’t include PTSD).

Both types of exams cover the same information in the beginning and in the end. The only difference is that the PTSD exams also include a PTSD-specific section in the middle.

Part 1: Your History
The beginning of both types of exams are the same: examiners are gathering background information on five areas: social/interpersonal, educational/occupational, mental health, legal history, and substance abuse. Each of those five sections is divided into pre-military, military, and post-military. If it is your first PTSD or Mental Disorders Exam, I’ll ask you about each of those topics. If you are having a Review PTSD or Mental Disorders Exam, we only need to provide updates about the time since your last exam.

Part 2: PTSD Symptoms (only for PTSD exams)
On your first PTSD exam (Initial-PTSD or I-PTSD), I will need to fill out a section that describes your traumatic stressor(s). I think that I approach that section differently than some other examiners. If you have already provided enough written information for me to understand if and how a traumatic stressor meets the criteria for PTSD, I will not make you re-tell that information. Since this is not treatment, I don’t think that serves our purpose. If I don’t have information to make an accurate assessment, I’ll ask you enough questions to better understand what happened.

When you are doing a Review-PTSD (R-PTSD) exam, your traumatic stressor will have already been documented in a previous exam. For those exams, you should not have to re-describe your traumatic stressor with me or any other examiner.

The other part of the PTSD section is a checklist of possible symptoms related to PTSD. I will specifically ask you about those symptoms, so I can better determine if your symptoms should be diagnosed as PTSD.

Part 3: Symptom Checklist
Finally, there is a checklist of possible mental health symptoms you may be experiencing. Again, When we get to the symptom list, I will specifically ask you about any symptoms we haven’t already addressed. That helps me ensure that I am providing the VA with accurate information that reflects your level of impairment.

After we go through the symptom list, you’ll be done. 

It will be stressful, but it won’t be as bad as you’re envisioning. And, we will get through it together.