Assessing Veteran Symptom Validity

Abstract

The accurate assessment of veteran symptom validity is a type of disciplined and reasoned inquiry towards the truth. This inquiry includes a two-part recognition (1) that assessing veteran truthfulness is properly part of accurately assessing veteran symptoms and (2) that the institutional environment must allow such inquiries to proceed unimpeded. This article identifies the institutional and veteran-based threats to the accurate assessment of veteran truthfulness, with suggestions on managing the former and discerning the latter. Starting with a description of the conflicting ethical-moral and utilitarian-political forces inherent in the Department of Veteran Affairs (VA), this article describes how these forces act to undermine the accurate assessment of veteran symptoms via both institution-wide systemic practices and local medical center-specific pressures towards collusive lying. It then details a strategy for accurately assessing and responsibly reporting the validity of veteran symptoms using Lonergan's fourfold method for conducting an inquiry towards the truth. Finally, it illustrates how responsibly assessing veteran symptom validity within VA is fundamentally a matter of personal integrity since there is no judicial overview and few external consequences. It argues that the assessment report is a moral action that constitutes examiners as conscientious to the degree that they attend or fail to attend to the data of experience, are intelligent or obtuse in forming insights, are reasonable or unreasonable in their judgments, and are responsible or irresponsible in their actions. © 2014 Springer Science+Business Media New York (outside the USA).