. "Appendix C Automated Medical Information Exchange (AMIE) Worksheets for Initial and Review Examinations for PTSD." PTSD Compensation and Military Service. Washington, DC: The National Academies Press, 2007.
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PTSD Compensation and Military Service
INITIAL EVALUATION FOR POST-TRAUMATICSTRESS DISORDER (PTSD)
# 0910 Worksheet
Date of Exam:
Place of Exam:
The following health care providers can perform initial examinations forPTSD.
a board-certified or board “eligible” psychiatrist;
a licensed doctorate-level psychologist;
a doctorate-level mental health provider under the close supervision of aboard-certified or board eligible psychiatrist or licensed doctorate-levelpsychologist
a psychiatry resident under close supervision of a board certified or boardeligible psychiatrist or licensed doctorate-level psychologist; or
a clinical or counseling psychologist completing a one-year internship orresidency (for purposes of a doctorate-level degree) under close supervisionof a board-certified or board eligible psychiatrist or licensed doctorate-levelpsychologist.
A. Identifying Information:
era of military service
reason for referral (original exam to establish PTSD diagnosis and related psychosocial impairment; re-evaluation of status of existing service-connected PTSD condition)
B. Sources of Information:
records reviewed (C-file, DD-214, medical records, other documentation)
review of social-industrial survey completed by social worker
statements from collaterals
administration of psychometric tests and questionnaires (identify here)