1. Purpose of This Document
This informed consent outlines the nature of counseling services I provide as a Licensed
Professional Counselor (LPC) in the State of Colorado, as well as additional
forensic/non-treatment services I may provide, including Independent Medical Opinions (IMOs)
or supporting documentation for Veterans filing claims with the U.S. Department of Veterans
Affairs (VA). Please read carefully and ask any questions you may have.
2. Counseling Services (Clinical/Treatment Services)
As your counselor, I provide mental health assessments, diagnoses, and therapy for treatment and
personal well-being. Colorado mental health statutes govern these services and require:
● An established clinical relationship
● Appropriate documentation
● Adherence to the state scope of practice
● Compliance with confidentiality laws (HIPAA and Colorado state law)
Clinical services are separate from any forensic or documentation services.
3. Independent Medical Opinions (IMOs) and Veteran Documentation
I may provide written statements, nexus letters, Disability Benefits Questionnaire (DBQ)
assistance, functional assessments, or other documentation intended solely for VA disability
claims. These services are considered forensic/non-treatment services, not clinical treatment.
IMOs Are Not Therapy
IMOs do not constitute a therapeutic diagnosis or ongoing treatment. They are professional
opinions based on:
● Review of relevant records
● Veteran self-report
● Mental health assessment tools
● My professional training and scope as an LPC
Licensing and State Boundaries
When providing IMOs:
● I am acting as a forensic evaluator, not a treating therapist.
● My Colorado license permits me to offer written professional opinions to individuals
located in other states as long as I am not providing therapy across state lines.
IMOs and VA Requirements
Veterans understand that:
● The VA determines the final disability rating.
● The VA may contact me for clarification.
● The VA may weigh IMOs differently depending on provider type (LPC, psychologist,
psychiatrist, etc.).
4. Distinction Between Treatment and Evaluation
It is essential to understand the difference between clinical services and an IMO:
Clinical/Therapeutic Services
● Focus on treatment, healing, and symptom reduction.
● Confidential under HIPAA and Colorado law.
● Based on a therapeutic alliance.
Forensic/Documentation Services (IMOs)
● Focus on producing an objective written opinion.
● May require disclosure of information to external agencies (e.g., VA).
● Not confidential in the same manner as therapy.
● May involve fees separate from therapy.
5. Limits of Confidentiality
When providing an IMO or written documentation for the VA:
● You consent to the release of relevant information in the document.
● The VA may request clarification or additional information.
● I will only release information necessary to complete your request and with your signed
written consent.
Standard confidentiality limits apply in cases of:
● Danger to self or others
● Suspected abuse of a child, elder, or at-risk adult
● Court order
6. Fees
IMOs and other forensic documents are billed separately from therapy.
Examples:
● Record review fees
● Report writing or IMO preparation
● Completion of VA forms (e.g., DBQs)
Fees will be disclosed in writing before any documentation service begins.
7. Record Review and Accuracy
Veterans requesting an IMO agree to:
● Provide complete and accurate records
● Disclose relevant history
● Understand that opinions will be based on available information
I reserve the right to decline writing an IMO if the evidence does not support the requested
conclusion.
8. Veteran Responsibilities
By requesting an IMO or documentation for the VA, the veteran acknowledges:
● The opinion is independent and may or may not support their claim.
● They understand the distinction between treatment and evaluation.
● They consent to the release of the written opinion to the VA or appropriate parties.
9. Risks and Benefits
Benefits
● Professional documentation to support a VA claim
● Clarity of symptoms and functional impact
Risks
● The opinion may not support your desired outcome
● The VA may request additional documentation
● IMOs may affect treatment dynamics if you are also a therapy client
10. Consent and Agreement
I have read and understand the information in this informed consent. I understand the differences between counseling services and Independent Medical Opinion services. I understand the fees, confidentiality limits, and my rights.
