When a veteran attends a psychiatric assessment for a DVA claim, the psychiatrist's task is clinical: to assess the condition thoroughly and to document the diagnosis, its relationship to service and its effect on daily life in the detail DVA requires. DVA delegates then apply the Guide to the Assessment of Rates of Veterans' Pensions (GARP M for claims under the MRCA) to that report. The outcome of a claim is decided by DVA, not by the assessing psychiatrist.
This article explains what GARP M is, how DVA uses it, and what a comprehensive psychiatric assessment involves.
What DVA Needs from the Report
Under the Military Rehabilitation and Compensation Act (MRCA), DVA assesses permanent impairment by combining two ratings: a medical impairment rating (expressed in impairment points) and a lifestyle rating (how the accepted conditions affect daily functioning).
Both ratings are derived from the clinical evidence in the psychiatric report. The report therefore needs to describe the diagnosis, the severity and persistence of symptoms, the treatment required, and the effect of the condition on recreation and community activities, employment and domestic activities, personal relationships, and mobility. As a point of reference, DVA's published rules provide a Gold Card at 60 or more impairment points.
The psychiatrist's role is to document the clinical picture accurately and completely. The rating itself is made by the DVA delegate.
Understanding GARP: How Impairment Points Are Calculated
The Guide to the Assessment of Rates of Veterans’ Pensions (GARP) is the legislative instrument DVA uses to calculate permanent impairment. There are two versions: GARP V for claims under the Veterans’ Entitlements Act (VEA), and GARP M for claims under MRCA. Both use substantially similar assessment tables for psychiatric conditions.
How Psychiatric Impairment Is Assessed Under GARP
GARP contains specific tables for rating psychiatric impairment. The assessment considers two main components:
- Medical Impairment: The degree of psychiatric impairment based on clinical findings. This includes the severity and persistence of symptoms, the impact on cognitive and emotional functioning, and the level of treatment required.
- Lifestyle Effects: How your accepted conditions affect four key areas of your life:
- Recreation and community activities: Your ability to participate in social and leisure activities
- Employment and domestic activities: Your capacity to work and manage household responsibilities
- Personal relationships: Your ability to maintain social, sexual, and interpersonal relationships
- Mobility: Your ability to move about effectively in carrying out ordinary activities
The psychiatric assessment must provide sufficient detail for a delegate to rate each of these areas. The report therefore describes functional impact in each of these areas.
Psychometric Testing: The Objective Foundation
Psychometric testing provides standardised, validated measures of symptom severity that support clinical observations. These tools have been extensively researched in veteran populations and provide objective data that supports the clinical opinion.
Key Instruments Used in DVA Assessments
- PCL-5 (PTSD Checklist for DSM-5): The gold standard self-report measure for PTSD symptoms. Research in veteran populations has established its strong psychometric properties.
- PHQ-9 (Patient Health Questionnaire-9): A validated measure of depression severity with established thresholds for mild, moderate, and severe depression.
- GAD-7 (Generalised Anxiety Disorder-7): A measure of anxiety severity specifically validated in veteran populations.
- AUDIT (Alcohol Use Disorders Identification Test): Screens for hazardous or harmful alcohol consumption, which commonly co-occurs with PTSD.
Why Testing Takes Time
Completing psychometric measures properly requires time.
A comprehensive battery of psychometric tests, combined with proper scoring and interpretation, typically takes 30-45 minutes. This is in addition to the clinical interview and mental state examination.
Components of a Comprehensive DVA Psychiatric Assessment
DVA’s guidelines, developed in consultation with the Royal Australian and New Zealand College of Psychiatrists (RANZCP), outline specific requirements for psychiatric reports. A thorough assessment includes:
Detailed Clinical Interview (60-90 minutes)
- Personal history: Background, childhood, education, and pre-service functioning
- Military service history: Roles, deployments, operational experiences, and identified stressors
- Symptom development: When symptoms began, how they’ve progressed, and their relationship to service
- Treatment history: Previous and current treatments, response to treatment, and compliance
- Functional impact: How symptoms affect work, relationships, social activities, and daily functioning
- Risk assessment: Current risk of self-harm or harm to others
Mental State Examination (MSE)
The MSE is a structured clinical assessment of your current psychological functioning. It provides an objective snapshot of your mental state at the time of assessment, covering appearance, speech, mood, thought process, perception, cognition, and insight.
Documentation Review
A thorough assessment includes review of relevant documentation, such as service records, previous medical reports, and incident reports. This helps verify the service connection and provides context for the clinical presentation.
DVA-Compliant Report
The final report must address specific DVA requirements, including:
- DSM-5 diagnoses with supporting criteria
- Clear connection between conditions and military service
- Compliance with Statements of Principles (SOPs) timeframes
- Clinical findings described in the terms DVA uses for its impairment and lifestyle ratings
- Detailed documentation of lifestyle effects
- Prognosis and treatment recommendations
How Long a Comprehensive Assessment Takes
A comprehensive DVA psychiatric assessment at March Ahead typically takes two to three hours. That allows for the clinical interview, the mental state examination, psychometric measures where clinically appropriate, and a discussion of the veteran's circumstances. The time is set by what has to be covered clinically, not by the claim.
What a Comprehensive Assessment Includes
A psychiatric assessment prepared for DVA should include:
- a structured clinical interview;
- a review of the available service, medical and treatment records;
- standardised measures where clinically appropriate (for example the PCL-5, PHQ-9 and GAD-7);
- a diagnosis made against DSM-5 criteria;
- an opinion on the relationship between the condition and service, with reference to the relevant Statements of Principles;
- a description of functional impact across the areas DVA considers.
March Ahead's psychiatrists prepare reports to these requirements as a matter of clinical practice. The assessment is independent: the opinion rests on the clinical findings and the evidence, and the outcome of the claim is a matter for DVA.
Frequently Asked Questions
Can I use my treating psychiatrist for a DVA assessment?
Your treating psychiatrist can provide reports for DVA, and this evidence is valuable. An independent assessment by a psychiatrist who is not involved in your treatment can complement treating clinician reports, particularly for permanent impairment claims. At March Ahead the treating and independent roles are never combined for the same veteran.
Can I have a new assessment if my condition has changed?
A new assessment can be requested where there has been a change. For permanent impairment claims, DVA allows a reassessment when a condition has worsened (an increase of at least 5 impairment points). For initial liability claims that were rejected, new evidence from a comprehensive assessment may support an appeal to the Veterans Review Board.
Do psychometric test scores directly determine my impairment points?
Psychometric scores don't directly translate to impairment points. They provide objective evidence of symptom severity that supports the clinical assessment. The psychiatrist integrates test results with clinical observations, history, and functional assessment to form an opinion on impairment. DVA delegates then use the complete report to assign ratings under GARP.
How do I know if a psychiatrist is experienced with DVA claims?
Ask about their experience with DVA reports, their understanding of Statements of Principles and GARP, and their typical assessment duration. A psychiatrist who regularly prepares DVA reports will be familiar with these terms and can explain how they structure their assessments to meet DVA requirements.
Crisis Support
If you or someone you know is experiencing a mental health crisis:
- Emergency: 000
- Open Arms – Veterans & Families Counselling: 1800 011 046 (24/7)
- Lifeline: 13 11 14
- Safe Zone Support: 1800 142 072
