Intrusive HR paperwork for internship

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Im filling out the required paperwork for internship (VA medical center) and there's one form that's really bothering me. It's a medical history form, and no explanation is given as to why this information is needed, or what it will be used for. And it contains a long list of VERY personal medical conditions you may have experienced, many of which don't seem to be at all relevant to the workplace. Examples: painful urination, hernia, suicide plans, nervous trouble of any sort, eating disorder, car sickness, STDs, used tobacco, learning disability, and "have you ever been treated for a mental condition?".

Now, I already filled out a form listing conditions that are relevant to the workplace, like communicable diseases, immunixations, etc. I get that for the safety of the workplace, they do need to have some medical information about me. But this other form is really bugging me. Some of the conditions I listed apply to me, and some of them don't, but I don't think the VA is entitled to have very personal information about my mental and behavioral health history. And it's not even l Ike I'm mailing it directly to HR when I finish it - I was instructed to send it to my new department secretary.

I know there's no way around filling out this form. But in your honest opinions, how truthful would you be if you were I my shoes? Am I being over sensitive about this? Should I just fill it out and forget about it? How likely is it that it even matters, or that anyone will ever access it?

I've filled out that form. It is indeed pretty intrusive. I answered it all honestly -- I figured it's not worth getting caught up in a lie, and my guess was that it'd sit in a file cabinet in HR (ie, my bosses would never see it).

Tricky question, absolutely. There are a few things to consider here.

1. Could you possibly get into trouble or be found out if you weren't truthful about certain issues that you would rather not disclose?
2. Could you be stigmatized by disclosing certain information?
3. Is it possible that a supervisor or other person authorized to see the form could have some type of reaction, like fearing your incompetence or the possibility that you wouldn't be safe in certain situations (examples are eating disorders, anxiety disorders, past suicidality, etc...)

Is there any way you can contact someone about what the form is used for and go from there case-by-case? That way you can weight out your options in the event that it be possible that you could be found out for lying, or be stigmatized, or be put under closer watch for 'red flag' issues, etc.

Congrats on matching- remember that they liked you and probably have your interests at heart (somewhat or for the most part...)! Good luck!

Originally Posted by psychRA

Im filling out the required paperwork for internship (VA medical center) and there's one form that's really bothering me. It's a medical history form, and no explanation is given as to why this information is needed, or what it will be used for. And it contains a long list of VERY personal medical conditions you may have experienced, many of which don't seem to be at all relevant to the workplace. Examples: painful urination, hernia, suicide plans, nervous trouble of any sort, eating disorder, car sickness, STDs, used tobacco, learning disability, and "have you ever been treated for a mental condition?".

Now, I already filled out a form listing conditions that are relevant to the workplace, like communicable diseases, immunixations, etc. I get that for the safety of the workplace, they do need to have some medical information about me. But this other form is really bugging me. Some of the conditions I listed apply to me, and some of them don't, but I don't think the VA is entitled to have very personal information about my mental and behavioral health history. And it's not even l Ike I'm mailing it directly to HR when I finish it - I was instructed to send it to my new department secretary.

I know there's no way around filling out this form. But in your honest opinions, how truthful would you be if you were I my shoes? Am I being over sensitive about this? Should I just fill it out and forget about it? How likely is it that it even matters, or that anyone will ever access it?

That's federal employment for you. I'm not sure some of the conditions you think are not applicable to the workplace truly are. Things like suicidal ideation or learning disabilities can absolutely effect the job duties of a psychologist (or psychologist-in-training) and can also effect patients. Medical licensure boards also ask for disclosures of mental illness history for things like substance abuse and depression for similar reasons.

Some of these questions sound like ADA (disability disclosure violations), tbh...Even with medical licensing, you generally only have to report active or impairing conditions, not all medical and mental health history.

The only form I filled out like that for my VA internship went to the VA doctor who saw me for my courtesy physical. The only form that I filled out for HR related to medical conditions gave the option not to disclose, which I took advantage of.

I would definitely ask some questions of HR before submitting this form.

Originally Posted by psycscientist

I'm not sure some of the conditions you think are not applicable to the workplace truly are. Things like suicidal ideation or learning disabilities can absolutely effect the job duties of a psychologist (or psychologist-in-training) and can also effect patients.

I get that some conditions do potentially impact performance. But, really...STDs, car sickness, UTI, hemorrhoids, parent/sibling with cancer, bed wetting? No one is going to convince me that these things are related to the workplace. The fact that I haven't experienced them personally doesn't mean that this form doesn't totally freak me out.

And then there are some other things on the form that do apply to me, and if they weren't important enough to ask about during the application process, I don't see why I have to disclose them now. By signing the form, I'm authorizing the VA to obtain my medical records. I'm sure the forms probably go in a file cabinet somewhere, but falsifying them is apparently illegal, and I don't understand why they have the authority to compel this information.

So, is there any way to contact HR about this without making it seem like I have something to hide? I've worked for the VA before, and I get that there is no way to avoid filling out the paperwork, but I'd really like to know why they need this information.

I just wanna say that I empathize. I just got all the paperwork for my post-doc at an American AMC and it asks me all the same things. I am used to the whole criminal record check/immunization check side of things, but this is something entirely new for me. I mean, I get I have to do it, but I don't relish my employer knowing about my gastrointestinal symptoms, for instance.

FWIW, I'm doing my internship at a Canadian AMC, and I didn't have to do near anything of this level of disclosure to get started here. It definitely seems like a difference between the two countries.

Not sure why they have you give it to the dept. secretary. I just had mine and I gave it directly to the doc who did my physical. I'm not sure where it goes from there though.

I just heard that my VA postdoc would prefer a full copy of my physical (rather than a letter stating that it was performed and I was cleared). That seems unnecessarily intrusive to me, so they'll be getting a letter.

If you want to work in a healthcare setting, this is becoming more and more common. I had to have actual physicals for my internship and postdoc and provide similar information. Heck, they took fingerprints too.

From what I understand, you are supposed to have privacy from your direct supervisor. It should only be the HR people who see the information.

The only thing i have to add is that I work for a defence contractor and had to fill out similiarly intrusive security clearance forms. It is a federal crime to lie or withhold information on these types of forms.

I've never had a problem answering those questionnaires, I guess none of the physical issues I've ever had I've ever found to be particularly embarassing. And although I have had some personal therapy over the years (both as a requirement for my degree and also for personal issues), I've never answered in the affirmative that I've been treated for a "mental condition."

There's a couple of reasons for this. First, I've made sure to never have any of my therapy done through insurance, as I value my privacy and have never been comfortable with the idea of faceless insurance adjusters reading details about what I discuss in therapy. So, there's no insurance record of my consumption of psychotherapy services that's easily available (which is the way I like it).

Second, when psychotherapy is done on a private-pay basis, there's no requirement that the clinician offer a diagnosis, AFAIK. Certainly not for billing and probably not necessarily even as otherwise (legally, ethically). The form, as I recall, doesn't ask whether you've "ever had psychotherapy or psychiatric treatment for any reason," it just asks about whether you've had it for a "mental condition." I take that as asking whether you've ever been formally diagnosed (e.g., DSM, etc.) and treated for said diagnosis, and as far as I'm aware, that's never been the case for me (despite the fact I've received services from psychotherapists for various issues over the years).

Anyways, I don't think they really care otherwise unless you've ever been hospitalized or treated for things like suicidality, psychoses, or serious drug or alcohol issues, etc. (unless you're planning on working for the NSA or CIA, I suppose). If you fail to disclose that and have some issue in the future that impacts your job, your records could get pulled and I would imagine it's possible for such a thing to be used as a basis for firing you or worse.

Had some trouble wording this post properly. For anyone who might misconstrue my post here - don't lie on your HR paperwork, BTW. Seriously.

It is the standard medical form that the doc/nurse will review for your physical. I have had to complete the same forms for two other hospitals outside of the VA. I believe that past history of substance use/alcohol and mental health issues are protected under ADA. If you plan on working for the VA they will do extensive background check and may do credit checks if you plan on traveling to trainings. It is just part of the deal if you want to work for the federal government.

Originally Posted by DUintern

It is the standard medical form that the doc/nurse will review for your physical. I have had to complete the same forms for two other hospitals outside of the VA. I believe that past history of substance use/alcohol and mental health issues are protected under ADA. If you plan on working for the VA they will do extensive background check and may do credit checks if you plan on traveling to trainings. It is just part of the deal if you want to work for the federal government.

Different levels of background checks, BTW. The VA uses OMB (Office of Management and Budget) to do their background investigations. It's the least-intensive of background checks the feds tend to conduct. FBI, DoD, CIA, NSA do much more extensive stuff.

The practical question is, lets say you got psychotherapy five years ago because you had trouble in a marriage and had trouble sleeping and may have been drinking too much. Let's also say you never got hospitalized, you paid privately for five sessions with the therapist, and years later you're feeling much better and as far as you know you never got affixed a diagnosis of a "mental condition" as part of your psychotherapy.

So, in that case, should you answer "yes" on that form when they ask you if you've been "treated for a mental condition"? Should you only answer "yes" if you're aware of some specific mental condition that you were formally identified by a professional as having and got help with it, or should you answer "yes" because you sought help? Obviously we shouldn't diagnose ourselves, and I don't think the form asks you about what kind of "mental condition" you suspect you might have had based on some services you've received from a mental health professional in the past. It also doesn't ask just openly "have you ever sought treatment from a mental health professional for anything" (which would be a different question).

What if you got anxiolytics or antidepressants from your GP for three months after your mom died? What if you went to a 12 step program for many years for a very serious alcohol problem but never saw a mental health professional, period (and you're now sober and have been for years)? Are these situations "treatment" of a "specific mental condition" (the former looks to me like treatment, not sure whether bereavement qualifies as a "mental condition," and the latter looks to me like it's not formal treatment, and absent any formal diagnosis, it's an open question as to how much the form wants you to speculate about what "mental condition" you might have, or have had).

I'm getting caught up openly in semantics here, but this just doesn't seem like a straightforward question that's being asked here, and I don't think the question is designed to be open-ended either.

From NAMI's website:
Does the ADA forbid blanket inquiries into your medical and psychiatric history during the hiring process?

Yes. However, an employer may ask you objective questions that help the employer decide whether you can perform essential duties of a job. An employer may ask you about your ability to meet the physical standards for jobs involving physical labor, your ability to get along with people, or your ability to finish tasks on time and to come to work every day.

Originally Posted by serendipity2

From NAMI's website:
Does the ADA forbid blanket inquiries into your medical and psychiatric history during the hiring process?

Yes. However, an employer may ask you objective questions that help the employer decide whether you can perform essential duties of a job. An employer may ask you about your ability to meet the physical standards for jobs involving physical labor, your ability to get along with people, or your ability to finish tasks on time and to come to work every day.

Spot on, I think, and explains why the question doesn't simply just ask "have you ever gotten help for any emotional problems in your life"?

It's unfair for them to ask that and they aren't (and shouldn't) be interested in that. For the most part, at least as far as the VA is concerned, they want to know if you're schizophrenic, or bipolar, or seriously drug addicted, or have some history of problems with emotional stability that have required you to be seen formally by a mental health professional over an extended period, or have require acute treatment for.

They don't care about the details of what you've seen shrinks for over the years, or whether you have ADD/ADHD, or whether you've wet the bed, and they aren't supposed to care anyways.

From the form itself:

"Have you ever been treated for a mental condition? (If yes, specify when, where, and give details.)"

To me, this is not a specific question about fitness for duty. This is a blanket inquiry into mental health history.

I get that this is how the VA works. I've worked for them before. What bothers me is:

1. I am being required to disclose protected health information, and to authorize the VA to access my medical records, as a condition of employment.

2. I have no idea why some of this info is necessary, or how this information is being used. I don't have any current red flags. I do have some historical issues that have been addressed, years in the past. If I happen to see a doctor who isn't informed about these issues, are they going to revoke my internship? And if my internship offer is contingent on this employee physical, why wasn't this done BEFORE I went through the application, interview, match process, and preparations to move my entire life?

And if none of this matters, and it's just going to be locked in a file cabinet forever, then why am I having to do it in the first place?

Originally Posted by psychRA

From the form itself:

"Have you ever been treated for a mental condition? (If yes, specify when, where, and give details.)"

To me, this is not a specific question about fitness for duty. This is a blanket inquiry into mental health history.

Well, my question is - have you been informed somehow (verbally or in writing) by a treating professional that you have a mental condition (which appears to be synonymous with psychiatric diagnosis) for which you're being treated or have been treated?

Here's what I think this question is not. First, it's not a blanket question as to whether you've had psychiatric or psychotherapeutic treatment in the past. Second, it's also not a blanket question as to whether you have ever been identified as having a specific mental condition, absent treatment for it. Third, it's also not asking you to play doctor on yourself and guess as to what mental condition you might have or have had based on what treatment you might have received in the past.

What it's asking you is whether you've received formal psychiatric or psychological treatment, and whether you know (not suspect, not guess, not hypothesize) whether it was for a "mental condition." People can see psychotherapists or their doctors for general stress, life problems, and etc., doesn't mean they have a "mental condition" unless they were told they did.

Anyways, I'm going to step back, the OCD part of my brain is getting much too involved in this question. And no, I don't have OCD (at least, no one has told me I have).

Originally Posted by JeyRo

What it's asking you is whether you've received formal psychiatric or psychological treatment, and whether you know (not suspect, not guess, not hypothesize) whether it was for a "mental condition."

Ah, I think I see what you're saying here. And I think I understand why we're perceiving this question differently. There are lots of reasons why someone might seek situation-specific therapy (grief, marital/family issues, etc.) that have nothing to do with actual diagnoses. If you happen to fall into that category, you could make an argument for answering "no" to that question. In that sense, it's not a blanket question about ever getting any kind of treatment.

What it is, however, is a blanket question about whether you've ever been treated for a mental condition of any kind, and that's what bothers me. Without going into details, I have had treatment for at least one Axis I disorder, years ago, which has been clearly documented in my medical records. They're requiring me to state whether I've ever had any kind of treatment for any kind of mental health diagnosis, regardless of whether my diagnosis has any current bearing on my job. And I don't think that's okay. It's a violation of privacy, for one. And it's grounded in the assumption that anyone who's ever had a mental condition is automatically at risk for poorer job performance, which is untrue.

If they were asking specific questions about current symptoms or diagnoses that would directly impact my job performance (active substance abuse, recent suicidality, psychosis, etc.), that would be one thing. But they're not.

I think that NAMI may have some more resources for this, as even diagnoses such as schizophrenia are stigmatized when in fact many people recover from these conditions and go on to lead productive and satisfying careers (and lives)... For a system such as the VA that is embracing recovery-oriented service provision, this isn't a recovery-oriented process.

There are many examples of psychologists with diagnosable mental health disorders that did not disclose this at certain times due to stigma (see Marsha Linehan, Patricia Deegan...). Think about all the disorders that would count in this! Anxiety disorders, traumatic reactions/ disorders (ASD, PTSD...), ADHD, disordered eating (many people get EDNOS when not meeting other criteria, rather than not receiving a diagnosis...) Its not very helpful to discuss not meeting clinical significance when so many people DO in the above categories and beyond, that if treated may not even be relevant in a person's life at the time of Internship!

I am sure that there is a way to advocate against filling out this form, you may just need to do your homework to find out where and how you want to respectfully approach it. The apprehension this is causing can't be setting you up for a positive start to the internship...

JeyRo, thanks for clearing up the confusion around security checks. I am already well aware of the difference in security levels within the federal system. The question pertains to the VA and the point is that at the end of the day you will be pretty much telling them everything about yourself. My guess is that if you have a raging alcohol/drug problem they will likely find this out when they contact every neighbor you have had for the past 5 years.

Originally Posted by serendipity2

From NAMI's website:
Does the ADA forbid blanket inquiries into your medical and psychiatric history during the hiring process?

Yes. However, an employer may ask you objective questions that help the employer decide whether you can perform essential duties of a job. An employer may ask you about your ability to meet the physical standards for jobs involving physical labor, your ability to get along with people, or your ability to finish tasks on time and to come to work every day.

This is allowed. Blatant, specific questions about specific conditions (I think HIV, TB, and Hepatitis are exceptions, due to contagion factor) aren't. This includes both mental and physical conditions. That doesn't mean that people don't ask them all the time (illegally) when you have a noticeable disability, but I'm shocked the VA is allowed to access for such a specific health history for a non-security clearance position. It's especially ironic/odd as the federal government actively recruits people with disabilities as employees.

My understanding from working at the VA awhile back, is that if something happens to you while at work, the VA is required to take care of you, free. That's why they have guards in the front of the VA-- to keep out people who are seeking free medical care. Basically, if someone needs medical care while in the VA hospital, federal government requires they get full care. So if you do pass out while at work or something happens to you, they will have your medical file on record. I don't think you need to disclose anything you don't think it would be important for a doctor to know if you did need medical care and couldn't communicate for some reason. That's just my opinion, though.

Originally Posted by zoistaffy

My understanding from working at the VA awhile back, is that if something happens to you while at work, the VA is required to take care of you, free. That's why they have guards in the front of the VA-- to keep out people who are seeking free medical care. Basically, if someone needs medical care while in the VA hospital, federal government requires they get full care. So if you do pass out while at work or something happens to you, they will have your medical file on record. I don't think you need to disclose anything you don't think it would be important for a doctor to know if you did need medical care and couldn't communicate for some reason. That's just my opinion, though.

That could definitely factor into it, I'm sure, and is why hospitals in general can have fairly "intrusive" hiring questionnaires compared with some other employers. In some ways, it's a CYA move on your own part--the better able you are to establish what medical conditions you did, and did not, have prior to employment, the stronger your case if you're exposed to something while on the job. Then again, I honestly don't remember how intrusive the paperwork was at the last hospital I worked at compared with the VA, but my gut instinct is telling me they weren't horribly far apart (e.g., seem to remember them asking about immunization records, and I think at least a few "nervous condition"-type questions were included).

Originally Posted by DUintern

My guess is that if you have a raging alcohol/drug problem they will likely find this out when they contact every neighbor you have had for the past 5 years.

Just to clarify, the VA doesn't do that kind of background check - remember, this is an Office of Management and Budget (OMB) security clearance, about as low-level as it gets in the Federal government. If this was a DoD security clearance, maybe.