M1A2Tanker

Thank you for correspondence. It's been most helpful.

Thank you all for your thoughts. To clearify I have 60% on my back, 70% PTSD, 10% tinnitus for a Total of 90%. This definitely helps to understand my options better. I have never heard of SMC(S)? What exactly is that and how does that work?

Hello, I could really use ya'lls help. This is only second post and I'm reaching for help as I have a few questions I can't seem to find and when I call the VA no one knows how for me to proceed. First, I am OEF veteran and rated 60% for my back (2 back surgeries after deployments) and 70% for PTSD, 10% tinnitus. I am currently working full time and I'm struggling y'all. I am having major insomnia and I'm dealing with chronic back pain from sciatic nerve throbbing down my left leg. Most days, it's grit your teeth and soldier on. I'm not getting any better over the last 15 years and I decided tonight I have to put in a new claim. It's got to be done. I don't know how to proceed with my claim with everything I have going on right now? Currently, I'm seeing a psychiatrist at the VA for PTSD. I don't know if I should file secondary claim to my back for chronic pain syndrome, or depression or insomnia? How are these linked to PTSD, but they are also coming from my chronic condition with my back. I can't get comfortable at night to even get to sleep, and no sleep/ work is building depression that I know is coming from pain and no sleep and not able to function. I know I have chronic pain with my back but I don't know how to proceed with all these. I'm supporting my family working I can't quit to do a TDIU claim? How do I move forward? I know you can only claim one MH but does that also include counting for a secondary for a chronic condition, as well? THANK YOU all in advance. I GENUINELY appreciate your thoughts.

Thank you both for your thoughts. Claim was started in March 2015, and FDC completed in Sep. Hoping to hear back soon. Is there a place I can look when it's finalized before their mail goes out? Thanks again. Merry Christmas.

Hello Veterans, I'd like to thank everyone here for your service. This is my first posting I've ever done here. I've followed here closely and want to thank everyone for their discussions. I finished my C&P exam and was wanting to see what everyone thought my outcome may be. It's been a long road as I'm sure it's been for most. This site has been such a help to so many veterans. Id really appreciate your thoughts. Thank you. SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [X] Yes [ ] No ICD code: F43.10 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Post Traumatic Stress Disorder ICD code: F43.10 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Chronic back pain from military injury ICD code: See medical books 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes [X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [ ] No [X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes [ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [ ] Yes [X] No 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Pre-Military: Military: b. Relevant Occupational and Educational history (pre-military, military, and post-military): Pre-Military: Military: d. Relevant Legal and Behavioral history (pre-military, military, and post-military): Pre-Military: None Military: None Post-Military: None e. Relevant Substance abuse history (pre-military, military, and post-military): Pre-Military: None Military: Drank alcohol, but no problems with alcohol. Post-Military: Doesn't drink alcohol at all; no illicit drug use. f. Other, if any: No response provided. 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No b. Stressor #2: Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No c. Stressor #3: Please See Section II.2. (3), Mental Health, Military Section for additional stressors. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criteria A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) [X] Witnessing, in person, the traumatic event(s) as they occurred to others [X] Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic events(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Hypervigilance. [X] Exaggerated startle response. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1 [X] Stressor #2 [X] Stressor #3 [X] Other, please indicate stressor number (i.e., Stressor #4, #5, etc.) as indicated above: 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Panic attacks that occur weekly or less often [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Suicidal ideation [X] Neglect of personal appearance and hygiene 6. Behavioral Observations -------------------------- The Veteran was on time for the scheduled appointment, and he was cooperative and very pleasant throughout the interview. His grooming and hygiene were good, and he was dressed in casual attire, which was appropriate for the setting. The veteran's mood appeared to be mildly dysthymnic. His affect was mood congruent. His psychomotor activity level was within normal limits. His receptive and expressive language were within normal limits. His thought processes appeared to be logical and goal directed. His reality testing was good. He denied having delusions or hallucinations. His intellectual functioning appeared to be within the above-average range. His insight seemed to be good. His judgment seemed to be good. He denied having suicidal or homicidal ideations, and there were no safety concerns present at the time of this interview. 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, (including any testing results) if any -------------------------------------------------- The Veteran DOES meet DSM-5 diagnostic criteria for Post Traumatic Stress Disorder. It is more likely than not (greater than 75%) his PTSD is due to his military service (please see the Military section of Section II.2.3 for a list of traumatic experiences the Veteran had while in Kuwait). Veteran, as stated earlier, he had numeroud stressors that qualify as trauma according to DSM-5 and which indeed are realted to his PTSD diagnosis. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.