Varma Penumetcha, MD, FAPA Cascade Forensic Psychiatry

Resources

CLE presentations, publications, and background for attorneys new to psychiatric experts

For Attorneys New to Psychiatric Experts

A forensic psychiatric evaluation answers a specific legal question — competency, criminal responsibility, disability, risk — not a general diagnostic one. The evaluation begins after a conflict check and a signed retention agreement. Records review, examination, and a written report follow, with deposition and testimony as the matter requires. If you are weighing whether a case has a psychiatric dimension worth evaluating, that is what the initial inquiry call is for.

Presentations for Attorneys (CLE)

Dr. Penumetcha presents continuing legal education programs to bar associations and attorney organizations. Current topics are listed below. To discuss a presentation for your organization, use the inquiry form.

Competency Restoration from the Inside

What happens between a finding of incompetency and a return to court. Built from years of direct clinical work inside the competency-restoration process — what restores, what doesn't, and what a well-supported restoration opinion looks like.

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Guilty Except for Insanity: What the Evaluation Can and Cannot Tell You

How a mental-state-at-the-time-of-offense opinion is constructed, where its limits are, and how to examine one critically. For both prosecution and defense audiences.

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The Weight of the Consultative Examination in Disability Claims

How much evidentiary weight a one-hour consultative examination deserves against a longitudinal treatment record. Based on his published analysis of this question.

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AAPL Practice Resource for the Forensic Psychiatric Evaluation of Competence to Stand Trial

Journal of the American Academy of Psychiatry and the Law, 2018;46(3):373.

The American Academy of Psychiatry and the Law's practice resource on competency evaluation — how the evaluation is structured, what it examines, and the reasoning behind a competency opinion. A useful orientation for attorneys who want to understand what a well-constructed evaluation looks like from the inside.

Read at JAAPL →

AAPL Practice Guideline for Forensic Psychiatric Evaluation of Defendants Raising the Insanity Defense

Journal of the American Academy of Psychiatry and the Law, 2014;42(4 Suppl):S3.

The Academy's practice guideline for insanity-defense evaluations — how an evaluator reconstructs mental state at the time of the offense and reasons from the record to an opinion. Background for the criminal responsibility work described under Areas of Practice.

Read at JAAPL →

AAPL Practice Resource for the Forensic Evaluation of Psychiatric Disability

Journal of the American Academy of Psychiatry and the Law, 2018;46(1 Suppl):S2.

The Academy's practice resource on psychiatric disability evaluation — the distinction between diagnosis and functional impairment, and how an evaluation connects one to the other against the applicable standard.

Read at JAAPL →

Selected Presentations and Testimony

  • Expert witness for attorney deposition-skills training, Institute of Continuing Legal Education, University of Michigan (2013, 2014, 2015). Served as the psychiatric expert witness while attorneys practiced direct and cross-examination.
  • Written testimony in support of SB 1546 (chatbots and youth mental health), Oregon House Behavioral Health Committee, February 2026. Submitted on behalf of the Oregon Psychiatric Physicians Association Legislative Committee.
  • Scientific presentations at annual and regional meetings of the American Psychiatric Association, the American Academy of Forensic Sciences, and the World Psychiatric Association.

Selected Publications

Selected peer-reviewed articles, professional reports, and book chapters.

  • Penumetcha V, Kapoor R. The weight of a consultative psychological evaluation in disability claims. Journal of the American Academy of Psychiatry and the Law. 2017;45(1):109.
  • Janofsky JS (Chair), Alampay M, Bonnie R, Buchanan A, Champion M, Ford E, Gandhi T, Hoge SK, Penumetcha V, Pinals DA; APA Council on Psychiatry and Law. Position statement on weapons use in hospitals and patient safety. American Psychiatric Association; July 2018.
  • Merlo G, Porter-Stransky KA, Sugden SG, … Penumetcha V, … Baron D. American Psychiatric Association Lifestyle Psychiatry Presidential Workgroup report. American Journal of Psychiatry. 2025;182(9):885–887.
  • Roy K, Balon R, Penumetcha V, Levine BH. Psychosis and seizure disorder: challenges in diagnosis and treatment. Current Psychiatry Reports. 2014;16(11):509.
  • Shah A, Penumetcha V, Tampi RR, Ahmed M, Mansoor R, Marwaha R, Young J. Diagnostic procedures. Psychiatry Board Review. 2017;42:25.
  • Gupta N, Shah A, Roy K, Penumetcha V, Oldham M. Clinical aspects of psychiatric disorders. Psychiatry Board Review. 2017.

Frequently Asked Questions for Attorneys

What does a competency evaluation actually examine?

Competency to stand trial asks whether a defendant has a rational and factual understanding of the proceedings and the capacity to consult with counsel — the standard set out in Dusky v. United States. It's tied to the specific deficits at issue in a given case, not a general judgment about whether someone has a mental illness, and it addresses restorability where the legal question calls for it.

Does Dr. Penumetcha only evaluate competency to stand trial, or other kinds of capacity too?

Competency evaluations aren't limited to trial competency. Related capacity questions include competency to waive Miranda rights, confession voluntariness, testamentary capacity (capacity to make a valid will), and contractual capacity.

How does retention and conflict screening work?

The process begins with a conflict check, which requires the names of the parties and counsel involved on both sides. Once that's clear, a signed retention agreement is in place before any evaluation work begins.

Is a forensic evaluation the same as a psychiatric evaluation for treatment?

No. A forensic evaluation is not treatment, and it does not create a physician-patient relationship. It answers a specific legal or administrative question for the retaining party or the court — it is not a course of care, and it doesn't substitute for one.

Does a forensic evaluation come with any patient confidentiality protections, like HIPAA?

Because no physician-patient relationship is formed, a forensic evaluation doesn't work like a treatment record. What's discoverable or protected depends on how the evaluation was ordered and by whom — that's worth discussing case by case rather than assuming either way.

Does Dr. Penumetcha testify, and where?

Yes — deposition and trial testimony are part of the forensic work, as the matter requires. The practice is Oregon-based and evaluates matters within Oregon.

Is a forensic evaluation's outcome shaped by who retained the expert?

No. The findings reflect the evaluation itself, not the retaining party's position. That independence is what makes the opinion useful to the court in the first place.

How do I start the process?

Submit the inquiry form. Scope and retention are settled on a scheduling call after the conflict check clears.

What materials are typically needed to begin?

It depends on the evaluation type, but collateral records and prior documentation are usually central — particularly for evaluations that reconstruct a person's state at an earlier point in time, where direct examination alone can't answer the question.

Can an attorney retain Dr. Penumetcha for a record review without a full evaluation?

Yes. Attorneys may retain him for record review and an assessment of whether psychiatric issues are likely relevant to a matter, without requiring a full evaluation.