The Role of Culture in Advocating for Accurate Diagnosis and Rating of Veterans’ Psychological Disabilities

Abstract

A lawyer assisting a veteran with a psychological disability claim will be a better advocate if she is first aware of the veteran’s cultural background and identity and how it might impact the way the veteran communicates with the gatekeepers in the system, most importantly medical examiners. Her awareness will make her a more effective advocate for the veteran at all stages of the disability claim and appeal process; it will enable her to identify ways she can make her client’s cultural background and identity a part of the record and a part of the diagnostic and rating procedures. Lawyers who appreciate cultural background and identity in their veteran clients and themselves will be agents of positive change in the VA disability system, moving it toward more culturally-sensitive and appropriate assessment, treatment, and compensation of all veterans.We have steadily advanced in our understanding of culturally competent approaches to lawyering. This article builds on our ever-increasing understanding by focusing on the specific context of advocating for veterans who have psychological disability claims in the VA disability system, a context in which cultural competence can be of critical importance to the outcome of a veteran’s claim and future livelihood. To do this, I first provide a brief overview of psychological disability claims in the Department of Veterans Affairs Compensation and Pension system, and second explore how culture interacts with mental health and the implications of this interaction on psychological diagnosis and treatment. Then I identify points in the VA disability claims process where veterans’ advocates who are aware of and educated in their clients’ cultural background and identity may advocate for culturally-sensitive psychological diagnosis, disability rating, and treatment. Finally, I consider questions we should more fully explore to advance our understanding of culturally-competent lawyering in the VA claims process.