Who We Are
Experience
As a former VA C&P Psychologist, Dr. Garbelman has completed medical opinions in over 250 veteran mental health Dependency and Indemnity Compensation cases and over 1,500 mental health Compensation and Pension cases. Dr. Garbelman helped develop training programs to advance the understanding of mental health staff conducting C&P examinations at several VA facilities and was selected as a forensic expert to assist raters at a local regional office by offering medical opinions in cases across a 12 state area.
Certifications
Dr. Garbelman holds certifications through the Veteran Health Administration DEMO/DMA to conduct all manner of veteran benefit mental health claims: Aggravation Opinions, General Certification, Medical Opinions, Mental Health Opinions, Military Sexual Trauma, PTSD, Telehealth Training and Webex Demo, and Telehealth Project Overview.
Dr. Garbelman is a licensed psychologist in his state of practice and has completed the American Association of Suicidology Certified Psychological Autopsy Examiner (PACT).
Expertise
Dr. Garbelman has published two peer-reviewed journal articles on mental health assessment and veteran benefits in the Journal of Psychological Injury and the Law:
Independent Medical Opinions (IME) and DBQ Mental Health
Independent Medical Opinions or IME’s are impartial psychological assessments focusing on diagnosis, psychosocial impairment, and the nexus between mental illness and service. IME can be completed in person or via the internet using tele-health technologies.
An IME can be used to complete DBQ mental health forms or submitted as evidence as a part of a veteran’s claim.
All IME utilize evidence-based assessment and interviewing. I am certified in the Clinician Administered PTSD Scale (CAPS) which is well regarded as the ‘gold-standard’ in PTSD assessment. My semi-structured interview was developed based upon trainings and recommendations available through the National Center for PTSD regarding the assessment and understanding of the unique psychosocial impact of mental illness with the veteran population.
All IME provide an evidence-based narrative across all areas of psychosocial functioning focusing on functionality and impairment. All IME include a detailed multi-sectioned rationale allowing the rating authorities to assign the IME full probative value and weight.
IME can address a myriad of veteran mental health issues associated with veteran benefits. These can include but are not limited to:
- Establishing Service Connection
- Increases in Service Connection
- Individual Unemployability
- Character of Discharge/Insanity Exemption
- Establishing Service Connection
Establishing service connection for mental health requires an understanding of differential diagnosis but also the federal regulations governing the establishment of a nexus between mental illness and service. After years of working as a full-time C&P Psychologist and working directly with rating officers at a regional office facility we have learned how to review records and interview veterans to ensure they are represented accurately. Our semi-structured interview provides a clear narrative for the rating authorities regarding the onset of mental illness and the relationship to service. It ensures the right questions are asked across all aspects of potential impairment in each critical domain of psychosocial functioning (mental health, occupational/academic, social, AODA, legal etc).
This narrative is further supported by a clear detailed rationale section written in the language of the rating authorities and in manner consistent with federal regulations governing veteran benefit determinations.
- Increases in Service Connection
Claims for an increased service connection rating require a detailed psychosocial impairment evaluation in order to ensure the claimant's impairment is documented and consistent with governing regulations. Service connection increases require a purposeful examination process, a detailed file review, and a thorough rationale explaining the match between the veteran's impairment and the standards associated with various degrees of service connection.
- Individual Unemployability
Assisting a veteran with claims of individual unemployability requires more than asking the veteran about work. It requires a detailed understanding of the standards and language the rating authorities use based upon federal regulations and training. A purposeful review of records, assistance with Statements in Support of Claim, a detailed examination, and thorough rationale are essential in order to assist the rating officer how the veteran's impairment impacts attendance, performance, and their ability to interact with others in a work setting.
- Character of Discharge/Insanity Exemption
Less common but of critical importance to former service members are requests to changes in character of discharge to allow the claimant to become eligible for veteran status and benefits. In cases in which willful misconduct or other behaviors resulted in an unfavorable character of discharge but were in fact due to mental illness, the insanity exemption is a means to establish a character of discharge allowing for veteran status.
Independent Medical Opinions (IMO) and Nexus Letters
Independent Medical Opinions or 'Nexus Letters'
IMO or 'nexus letters' are forensic evaluations based upon a complete and through review of the veteran's military and treatment records. Unlike an IME, a IMO does not include a face-to-face examination of the veteran. IMO or 'nexus letters' can provide powerful evidence in support of a veteran's claim before scheduled VA C&P examinations or as a part of an appeals process.
IMO or 'nexus letters' can address a myriad of veteran mental health issues associated with veteran benefits. These can include but are not limited to:
- Establishing Service Connection
- Increases in Service Connection
- Individual Unemployability
- Character of Discharge/Insanity Exemption
Dependency and Indemnity Compensation
Dependency and Indemnity Compensation (DIC) claims are complicated given the death of a veteran. We have extensive experience with these claims and can help the families of these deceased veterans seeking benefits.
Dr. Garbelman has provided medical opinions in over 250 DIC cases in his past role as a medical expert at a local regional office. He also attained certification through the American Association of Suicidology in the science of psychological autopsy which is the field of reconstruction of the relationship between mental illness, manner of death (accidental, natural, suicide) and the immediate cause of death.
Resources for Veterans
We have written several guidelines for veterans writing Statements in Support of Claim to ensure they are properly informed and given detailed guidance on how to match their experiences to the needs of the rating authorities. We give numerous examples, descriptions, and also discuss the importance of statements from family, employers, and medical providers, offering additional guidance and recommendations for the completion of these supplemental statements as well.
For copies of these guidelines or for copies of Dr. Garbelman's published works in the area of mental health veteran benefit determinations, please contact us.
Other on-line resources:
The national Center for PTSD is a clearinghouse for all aspects of PTSD: for veterans, family, friends, and mental health professionals. It provides training, resources, and support.
Veteran Benefit Administration
The Veterans Benefits Administration (VBA) provides a variety of benefits and services to Service members, Veterans, and their families.
When a veteran needs help, the Veteran Crisis Line is there. It is an excellent site to become familiar with so when you need it, you are familiar and can get the help you need.