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Found 38 results

  1. Hello, I was wondering if anyone could help... I was denied ptsd for 2009 mst claim for not enough evidence. I just found out in my old claim that my va records were "not available" they said that they had requested the info from me, but that was false I never received any paperwork other than my denial. In July 2013 the VA sent me a letter to reopen my case if I had any new material evidence. I found my VA treatment records myself from both Fl and NY sent that in and uploaded to ebene account. I also sent a letter from my current private psychiatrist. My questions are: 1. My new claim closed two days ago but I never had C&p exam? 2. On ebenes it only has private dr. Letter as new evidence and nothing has changed as far as VA letter benefits ab8 letter, I think they are going to deny me again and it is just tearing me apart that no one can give me any information on my file? What should I do next to help myself?? Thank you!!!!
  2. I am hoping that someone will have some great advice, insight, resource that I haven't been able to find. I am rated for mh. My psychiatrist of 10 years transferred. He and I had a very good working relationship, he knew that I understood when I was okay and when I need a med adjustment, to be seen etc. When he transferred I went 8 months seeing a pharmacist having my meds "bridged" then I got a new psychiatrist. She is awful. She has put me on klonopin for my anxiety and panic attacks because I don't sleep and have daily panic attacks. Neither have gotten better so every time I see her she changes my anti-depressant (which is noted in my charts not to do, because I am hyper sensitive to them) she then ups my dosage of klonopin so that I am now at zombie stage if I actually take the prescribed amount and am addicted to them because when I don't take them I am physically ill. I am increasingly more depressed and none of my anxiety/panic attacks are better except for when I am sleeping from said klonopin. I called today to ask to have my psychiatrist changed and was told that because I had been seeing her for under a year that it was highly unlikely to get a new one, but I could fill out a "form", I asked the VA form number so I could print it, of course there is no such VA form, it is their form. I have to go in and fill it out and justify why I want to switch my psychiatrist? The fact that she has gotten me addicted to benzos isn't enough? Is this normal? Is it really that hard to get switched to a new psychiatrist? The vet center here has no psychiatrist so I can't get teh meds I do need. I don't know where else to turn but I don't want to see this woman anymore. She puts notes in my records that are inconsistent at best then puts things like mst rule out ptsd, for months on end but never does anything to rule diagnosis me with ptsd or not? why put it in there at all? so she diagnoses me with bipolar 2(which i have had that diagnosis forever) then adds panic disorder with agoraphobia and general anxiety disorder, but don't those with the mst in my record and a suspicion of ptsd kinda spell it out? I am just tired of being drugged, not getting better and feeling like I am on a hamster wheel!
  3. I have a few questions that I hope this site can answer. Back in 2000 I joined the army national guard and was sent to AIT while there and living in the barracks we had what i guess is called hazing going on. I was the new guy who already had a unit patch, rank and a list of ribbons so i was already out of place in the barracks. At first stupid stuff like being called a FNG or a NUG and lifting my bunk off the ground while i was in it and slamming it to the ground, or a tossed bunk or my lock pooped and my locker tossed. Yes it pissed me off but nothing worth crying to the drill sergeants about. After a few weeks a couple of my class mates where standing around and laughing looking at pictures and one calls me over and ask me if i knew what Tea Bagging was i honestly had no clue and said making a cup of tea. Then the kids shows me a Polaroid picture of me asleep in my bunk and another male placing his private parts on my face. I was told that this had happened many times. I went down to the office and proceeded to inform our Senior drill sergeant/acting first sergeant who tell me he will look into it. I leave think of i reported shit is going to hit the fan. Instead the Senior Drill sergeant came upstairs into our bay and tells everyone to gather round. I was thinking her we go.. Instead he yells out that he understands some teas bagging on going on and that it was just gay to let another man put his bare nuts on your face and that he better not see any of that stuff going on. I was shocked and freaking out because I am not gay never was and never will be. After this i began getting threatened and call a blue falcon i was woken up one night to chem light being poured in my mouth and other night having actual pubic hair sprinkled over my face. Other times buckets of water would be thrown onto me in my bunk i was to hyper vigilant that if they could not get close enough to me to mess with me they would throw boots or other objects at me. I called and talked to my home unit PSNCO and told him what was going on and refereed me to contact our home SGM in charge of all training which i did. He told me to avoid them and he was making some calls. The next day i got called over to the base national Guard liaison SGM who proceeded to yell at me to suck it up and stop whining and that if i was such a xxxxx i never should have joined the Army. Again i reported it and WTF is going on. I left and called my home SGM and told him what had happened and he just said WTF and told me to keep my head down and avoid them at all cost that there was not much he could do from where he was. In the middle of all this i had slipped on some heavy ice and went down a flight of stairs and was on a profile and going through rehab for my knee and lower back. One mourning i got my Sick call slip signed before the battalion went on there run at 0400. The rule was no one is allowed up in the barracks during PT period which meant i had to go into the day room until my scheduled therapy time. I was the only on a profile at the time so it was just me. I screwed up and fell asleep and over slept (at this time i was barley sleeping so i crashed hard.) I woke up and saw the time was 0800 and freaked out ran up stairs changed uniforms and caught a cab to school. A few hours later one of our Drill Sergeants came and pulled me out of class and asked me why i missed my rehab appointment and i told him the truth. The next day at lunch time i was called into the office where the SR DS handed me a counseling statement and saying that i had forged a sick call slip to get out of PT. I said i never forged a slip and he said that i had filled out a slip and had them sign it and that i did not use the slip for it intended purpose and i was getting a AR15 i asked to see JAG and was told i would be taken within 3 days. 3 days went by and i asked one of the DS when i would be going to JAG and was told opps we forgot to schedule you. That afternoon i was called over to the SGM NGB Liaisons office again. Where he proceeded to yell at me for getting into trouble and pulled out another counseling statement and began writing that i had supposedly gotten 3 AR15's and that he was chaptering me out on a chapter 14. I said that i had not even received 1 yet that the only thing i got in trouble for i have not seen JAG for so 3 was impossible. At this point tons of yelling lots of curse words and a demand to shut the hell up and just sign the document i once again asked to see JAG and was told i would be scheduled. A few more days go by and i get called into the commanders office where he wants me to sign my chapter papers and i once again say i have not even seen JAG yet. He tells me it does not matter i am just being sent back to my unit with a Under Honorable Conditions and that as long as i do not get into any more trouble for 6 months it will convert to full Honorable. I get back to my unit and they place me on none reporting status and tell me to go to the VA for MH and to finish rehabbing my knee and back. I got turned away from the VA with them telling me that they had not received my medical files and that i did not have enough concurrent active duty time to qualify for services. I tell my unit and they hook me up with a civilian doc who ended up doing surgery on my knee less then a year later. During my recovery after surgery i get a letter in the mail that i was discharged from the National Guard and in the signature box just said soldier not available. I called my unit and they were just as shocked as i was and said that there was nothing they could do about it now. Years have gone by and i was diagnosed with severe anxiety and PTSD. This is the tricky part the Doctor who diagnosed me was a civilian i saw at his private practice but he also worked full time at a VA CBOC. I honestly tried to live in denial of what happend and began drinking and did some dumb things and that is all on me. I hit pretty low and began seeing a shrink who helped me quite drinking and helped me with some coping tools like caring a calendar around so i would stop forgetting stuff. About a year my counselor who was also a vet told me to apply to the VA for PTSD and i told him that i had tried back in 2002 and was denied because they could not locate any of my medical files or service files. I was told by a bunch of VFW guys that because i did not complete the training that i would never get approved anyway that i was technical never a soldier. MY counselor told me things have changed and to file again. So i did on my own we don't have and VSO's out where i live and they only come through once a month and they only alot 30 mins for you anyway. I am embarrassed that what happened to me did. I was supposed to be a soldier and stronger then that a defender to the weak how was i so weak that it happened to me. I chocked up my fear and filled out the 781 and sent it in. I submitted all my doctors and just last week got a letter in the mail telling me that what i wrote on my 781 was not enough they needed more. Also calling the 800 number they still can not find my medical file so that's a major problem. So i sit down a write out a 7 page explanation of before during and after and resubmit it. Can someone please tell me how this will work out and if denied then what. I was told that if they can not find proof they will not even give me a comp and penn appoint and just deny me. I do not know if i am strong enough to do a appeal and have to go tell my story in a court room... Can some please walk me through this process and help turn the crazy down in my brain a little bit please?
  4. What is the best way to go if you do not want it to take forever to get a rating. I was looking at the DRO process and thought it was supposed to be the quickest way to go. After reading this, I see that it's not. I need the fastest results for someone I am helping who is currently homeless. Finally got PTSD diagnosis based on MST from VA doc and am in the process of filing a NOD. Seems like this may be a long route. Is requesting a relook the best way to go? Thanks.
  5. I would like to thank everyone on the PTSD and TDIU forums for helping me reach my 100% rating. My story began in 1975 when I was in AIT. I was the only female in my unit and my DI thought he could take advantage of that fact. I was sexually assaulted and tortured by this man for 8 weeks. I told no-one. The reason for mentioning these facts is to let other veterans suffering from MST know that there is hope no matter how many years have passed. I received my 100% award 41 years and 15 days after my assault began. I suffered with nightmares and flashbacks for all of those years. I worked and provided a decent living for myself until March of this year when I was finally forced to take a medical retirement. I am 63 and just had 2 more years to make it to retirement. In 2014 I joined a PTSD Support Group. For the first time I was able to tell my story. My peers encouraged me to file a claim and I finally did. My symptoms became much worse the more I opened up and I ended up losing my job. The reality is I would have lost my life if I had not have met these amazing women. My life is finally turning around and I am learning to control my anger and feel as though I deserve to live. I never believed that anyone would believe my story after all of those years. The person that investigated my claim uncovered some conversatIons that I had with a Chaplin. He had noted in my file that he thought I had been sexually assaulted even though I never said those words. I was amazed at how thorough this investigation was. Please forgive my rambling, I just want others to know that there are claims personnel that really work hard to give us the benefits we deserve. I spent hours reading the Had It forums to keep my self encouraged during the waiting time. Thank you all so much for the support!
  6. I was just printing out records off of myhealthyvet for my cp exam for some secondary stuff and my smc s cp on Wednesday and noticed that I have MST noted a few times in my records, is this something that would be bad for me? I am not claiming PTSD or MST. I am already rated for mh.
  7. Hello all, first of all thank you to all who share your stories and advice. While this is my first post, I've been stalking the forum for months as something to do during my insomnia as I wait for my decision. I have found both comfort and education here. I was hoping for some opinions, advice, or even encouragement. I realize I'm not in the worst shape compared to others, but this process has my anxiety through the roof. I am currently rated 30% SC PTSD-MST (total rating with other disabilities is 50%). My condition has progressively worsened, especially over the past few years. I submitted my FDC for PTSD increase and TDIU in May and it has been in Gathering of Evidence phase. All of my treatments have been with VA docs. My GAF scores average around 50. I obtained a favorable IMO to submit with my application. I haven't yet been scheduled for a C&P exam. Over the past several years I missed a lot of work, burned through my leave with sick days, was previously placed on both short and long term disability with my employer, all from my SC medical issues. I would appreciate based on your experience and thoughts on whether I might have a good case for increase, what my rating might be, whether I might get TDIU or P&T, how long it might take for VA to get my medical records from VA hospitals, if I will have to do a C&P exam (the thought almost triggers a panic attack), or any advice on what I can do to pass the time as I wait besides chronically check eBenefits and read every single thread on this forum. I realize I have a much longer wait ahead of me, so I figured I'd start engaging here. Thank you in advance for any help.
  8. Today both my PTSD due to MST and my Major Depression claims were denied. I had my C&P on 12/17/2015. I picked up my exam notes from the records department of my local CBOC where the exam had been held, and just a few minutes later my MST coordinator called to tell me of my denial. I checked e-Benefits and it has already been finalized with notification letter sent. The C&P examiner did several things I find fishy and that I was uncomfortable with during the exam, and then apparently diagnosed me as Borderline Personality Disorder and reported that I don't have PTSD. I had been diagnosed with PTSD by different (civilian)doctors in both 2006 and in 2014. I am very upset by this because in her report, she states that I meet all the criteria, but that she won't count the D and E criteria because she thinks it fits better with a BPD diagnosis. I have no idea how or why she made this determination. She said my symptoms were "long-standing." Well, yes, they were, because the stressor that caused my PTSD occured 17 years ago. This is what her notes said when she denied that I have PTSD. “The Veteran is reporting an alleged sexual assault during her time in the Army that would meet Criterion A and reporting symptoms consistent with criteria B, C, F, G, and H. However, her reported mood symptoms, anxiety, impulsivity, substance use, irritability and angry outbursts, risky behaviors, risky sexual behaviors, and social and occupational are better accounted for by her BPD diagnosis.” “The symptoms she is reporting that would meet PTSD criteria D & E are better accounted for by her BPD diagnosis, appear to be long-standing and more of a characterological nature.” I don't feel comfortable at this time sharing more of her C&P notes. It is still too fresh for me. I am trying to figure out what my next step will be...filing for an appeal or a reconsideration. Any advice or insight would be greatly appreciated.
  9. So I just read the notes from my first visit to the VA MST coordinator last Monday...Yeah let me tell you I am as angry as anyone could be but all that aside and knowing this could happen from what Ive been told before even going in it is a step that I have to take in the long process of things. here is a list of WTF's in the notes. 1. she Said I was late and claimed I said I got lost.... I was actually early and waited in a waiting room with my wife with me and just a phone in the reception area that said if I was there for more then 15 min to pick up phone. Not to mention my wife drove me there and actually works there so um getting lost defiantly did not happen. I wont even go into the fact that she cancelled my actual first visit because she called off or the fact that she called off again for my last appoint Thursday. 2. Stated presentation suggested significant paranoia and possible embellishment regarding negative events. Ok fair enough I can say to some extent I am paranoid it comes with the lay of the land of severe Anxiety and PTSD. But embellishment? I went in and told her about the incidences honestly as fast as I could get through them. There were a few things she paused me on and had me focus on and repeat several times because she could not keep up with me and she was writing. 3. She said I did not mention my suicide attempt in 2009 with my subsequent hospitalization. It was a 1 hour appointment and we never got that damn far in the time line before time was up. I kept trying to jump forward but she kept having me go back to build a history leading up to the big event so how in the hell did I even get the chance to tell her that shit. 4. Stressors: Interpersonal Loss/Disruption: veteran divorced in 2009... OK first i did not get divorced in 2009 and in fact the same women i married in 2006 is still the same women i am married to now... (yes i am a major xxxxxxx so this is a mirical in its own right.) i did get divorced in 2003 but was separated from my first wife in February 2002 less then 1 year after discharge and told her the divorce took so long because of the waiting period after separation and then months after separation she got pregnant with not my kid and its stalled the divorce even longer. 5. Says that some remote system search showed that in the past I had claimed to be "black ops" and that is why my DD214's are so messed up. First I was in the ARMY and we refer to things as spec ops or SF, Black ops are civilian contractors and do not have 214's. but that is not the point years ago when filing my first VA claim and they "lost my claim file for 2 years and had to rebuild it" and they could not find my damn STR's records or even my second enlistment. yes I did make a smart ass comment to the effect that "so your telling me some black op force came and erased all my records from your system. But I never once claimed to be any kind of spec ops I was FA and proud of that fact. 6. I get that there was a shit ton of information packed into that short hour and I know my damn timeline was off on some events. But considering she is claiming events that happened on my second enlistment happened during my first enlistment and is linking them to my first enlistment and has things all chewed up as far as the story goes. 7. that I stated I do not take showers because I claimed I was water boarded. OK first I did not claim to be water boarded. I said that several times I had buckets of water poured on me when I slept and I woke up choking from the water being thrown in my face. I also said that I do not take showers because the water splashing me in the face triggers a flash back to that time in service so I take shallow baths or use just a wash cloth to get clean. 8. Personality Disorder NOS, Depressive disorder NOS, Alcohol use disorder, in remission by history. I have been getting treatment for 8 going on 9 years and never once had someone say Personality disorder what in the actual F$#@ is this? I can agree with the other 2 diagnoses with Severe anxiety NOS but that one is just crap. She did not list it in active problems list just in her notes so maybe this is just a stepping stone I do not know but hell I am so sick of the VA dropping that bomb on people instead of admitting to PTSD. Yeah so paranoid I can def agree to and this crap is why. there is more but i wont make this any longer then it is. this stuff just gets me annoyed probably more then I should let it. it mostly sucks because I have to go through her to get to what I need so asking for someone else does not seem like a option right now. I do not know what to do to fix any of it without coming off as overly defensive or paranoid.
  10. Morning, Just got my result from a MST please tell me what do you all think? Opinion: It is as likely as not (50% likelihood) that the current symptoms of the patients diagnosed PTSD and depressive disorder are the result of an in service MST-related event. Rationale: Markers of symptoms in the patient's medical history (Statement in Support of Claim and MAP-D Development letter) would/could fall in line as MST markers with her claimed stressor and substantiate that stress. Exam utilized DSM-5 diagnostic criteria.
  11. Hello, I have a few questions. I just received a letter from the VA. I was not expecting anything. I opened the letter and they did a review under the special initiative. First off I do not know what that means anyway. It was just more in depth than the letter i received when they first denied my claim in September 2015. I read through it and basically what they are saying as to why they denied me was because they state that I had a substance abuse problem before I joined. I am not sure how they came up with that. I was 18 when I joined right out of high school. I am trying to think why they would say that. Anyway it should not even be part of the decision. I enclosed the letter I received . It also stated that my timeline is off and i am contradicting myself in my statements. First off the incident happened in 1995 and I did not say anything about it until July of 2014. I now believe because so much time has passed they don't believe me and the want to blame it on something else. I believe the statements they say I contradict myself are probably the one where I did not disclose yet and I tried to get benefit from the VA without disclosing it. Now i feel like theirs no path forward for me to get approved May 23, 2016 Dear Mr. DEPARTMENT OF VETERANS AFFAIRS ?. A special review of your file was mandated on January 6, 2016. Enclosed is the decision that finalizes the previous provisional evaluation completed on your claim under. The special initiative discussed in our letters dated August 29, 2013, September 9, 2015, and January 21, 2016. Please see the attached finalized decision and appeal rights provided with this letter. You submitted Notices of Disagreement on September 10, 2013, September 25, 2015, and December 4, 2015. These Notices of Disagreement were received premature as you were not properly notified of the decision which finalized the rating decisions. This letter tells you about what we decided. It includes a copy of our rating decision that gives the evidence used and reasons for our decision. We have also included information about additional benefits, what to do if you disagree with our decision, and who to contact if you have questions or need assistance. What We Decided We dete1mined that the following conditions were not related to your military service, so service connection couldn’t be granted: Medical Description Right shoulder rotator cuff tear (claimed as right shoulder condition) Lurnbosacral strain (claimed as back condition) Cervical intervertebral disc syndrome (claimed as neck strain) Anxiety disorder Posttraumatic stress disorder (PTSD) Bipolar disorder Deoression to include alcohol abuse We determined that the following service connected condition hasn't changed: Medical Description Percent (%) Assigned Left shoulder strain with rotator cuff tear 20% We have enclosed a copy of your Rating Decision for your review. It provides a detailed explanation of our decision, the evidence considered, and the reasons for our decision. Your Rating Decision and this letter constitute our decision based on a special review of your claim mandated on January 6, 2016. We enclosed a VA Form 21-8764, "Disability Compensation Award Attachment-Important Information," which explains certain factors concerning your benefits. Are You Entitled to Additional Benefits? If you served overseas in support of a combat operation you may be eligible for mental health counseling at no cost to you at the Veteran's Resource Center. For more information on this benefit please visit http://www.myhealth.va.gov/mhv-portal-web/. You may be eligible for medical care by the VA health care system for any service connected disability. You may apply for medical care or treatment at the nearest medical facility. If you apply in person, present a copy of this letter to the Patient Registration/Eligibility Section. If you apply by writing a letter, include your VA file number and a copy of this letter. You should contact yom State ofiice of Veteran's affairs for information on any tax, license, or fee-related benefits for which you may be eligible as a Veteran (or surviving dependent of a Veteran). State offices of Veteran's affairs are available at http://www.va.gov/statedva.htm. The VA provides Blind Rehabilitation services to eligible blind, low vision, or visually impaired Veterans to help them regain their independence and quality of life. The Veteran's blindness, low vision, or vision impairment does NOT have to be related or caused by military service. If you need help with yam vision loss, please contact yam nearest Visual Impairment Services Team Coordinator (VIST) at the eye clinic at yam nearest VA Medical Center. For more information, go to http://www.rehab.va.gov/blindrehab/. What You Should Do If You Disagree With Our Decision If you do not agree with our decision, you must complete and retmn to us the enclosed VA Form 21-0958, "Notice of Disagreement" in order to initiate your appeal. You have one year from the date of this letter to appeal the decision. The enclosed VA Form 4107, "Your Rights to Appeal Our Decision, " explains yam right to appeal. What Is eBenefits? eBenefits provides electronic resomces in a self-service environment to Servicemembers, Veterans, and their families. Use of these resomces often helps us serve you faster! Through the eBenefits website you can: • Submit claims for benefits and/or upload documents directly to the VA • Request to add or change yam dependents • Update yam contact and direct deposit information and view payment history • Request a Veterans Service Officer to represent you • Track the status of yom claim or appeal • Obtain verification of yom military service, civil service preference, or VA benefits • And much more! Enrolling in eBenefits is easy. Just visit www.eBenefits.va.gov for more information. Ifyou submit a claim in the future, consider filing through eBenefits. Filing electrortically, especially if you participate in om fully developed claim program, may result in faster decision than if you submit yom claim through the mail. If You Have Questions or Need Assistance Ifyou have any questions, you may contact us by telephone, e-mail, or letter. If vou Here is what to do. Telephone Call us at l-800-827-1000. If you use a Telecommunications Device for the Deaf (TDD), the Federal number is 711. Use the Internet Send electronic inquiries through the Internet at httos://iris.va.gov. Write VA now uses a centralized mail system. For all written communications, put your full name and VA file number on the letter. Please mail or fax all written correspondence to the appropriate address listed on the attached Where to Send Your Written Corresoondence. Inall cases, be sure to refer to your VA file numbe..-.. If you are looking for general information about benefits and eligibility, you should visit our website at https://www.va.gov, or search the Frequently Asked Questions (FAQs) at https://iris.va.gov. We sent a copy of this letter to your representative, California Department of Veterans Affairs, whom you can also contact if you have questions or need assistance. Sincerely yours, Director VA Regional Office Enclosures: Where to Send Your Written Correspondence Rating Decision VA Form 21-8764 VA Form 4107 VA Form 21-0958 cc: CA DVA 21/144 jsl079:ng DEPARTMENT OF VETERANS AFFAIRS Veterans Benefits Administration Regional Office Represented By: CALIFORNIA DEPARTMENT OF VETERANS AFFAIRS Rating Decision 05/20/2016 · INTRODUCTION The records reflect that you are a veteran of the Gulf War Era. You served in the Army from January 18, 1994 to May 21, 1996. A special review of your file was mandated on January 6, 2016. Enclosed is the decision that finalizes the previous provisional evaluation completed on your claim under the special initiative discussed in our letter dated August 29, 2013, September 9; 2015, and January 21, 2016. You submitted Notices of Disagreement on September 10, 2013, September 25, 2015, and December 4, 2015. These notices of disagreement were received premature as you were not properly notified of the decision which finalized the rating decisions. Please see the attached finalized decision and appeal rights provided with this letter. Based on the review and the evidence listed below, we have made the following decision(s). 2 of 10 DECISION 1. Evaluation of left shoulder strain with rotator cuff tear, which is currently 20 percent disabling, is continued. 2. Service connection for cervical intervertebral disc syndrome (claimed as neck strain) is denied. 3. Service connection for right shoulder rotator cuff tear (claimed as right shoulder condition) is denied. 4. Service connection for lumbosacral strain (claimed as back condition) is denied. 5. Service connection for posttraumatic stress disorder is denied. 6. Service connection for anxiety disorder is denied. 7. Service connection for bipolar disorder is denied. 8. Service connection for depression to include alcohol abuse is denied. EVIDENCE VA Form 21-526, Veterans Application for Compensation and/or Pension received August 12, 2012 • 5103 Notice Letter dated December 12, 2012 • Martinez VAMC reports (in VVA) VA compensation examination conducted April 17, 2013 VA Form 21-4138, Statement in Support of Claim received May 27, 2013 • VA rating decision dated August 23, 2013 VA letter dated August 29, 2013 VA Form 21-0958, Notice of Disagreement received September 10, 2013 Correspondence from the veteran received September 10, 2013 VA Form 21-078la, Statement in Support of Claim for Service Connection for Post­ Traumatic Stress Disorder (PTSD) Secondary to Personal Assault received August 21, 2014 VA Form 21-526ez, Application for Disability Compensation and Related Compensation Benefits received August 21, 2014 • Service treatment reports from 11/1992 to 3/2000 Kaiser Permanente records from 1/2004 to March 2006 Sacramento County Mental Health records 3/2007 UC Davis records 1/2006 to 1/2010 Contra Costa records 9/2005 to 9/2014 John Miur Health records 1/2005 Request for VA treatment reports from Long Beach, Sacramento VAMCs dated October 9, 2014 • DPRIS reply received October 9, 2014, and October 17, 2014, indicating no service personnel Records are available • VA Form 21-0820, Report of General Information dated October 20, 2014 • Service personnel records from November 1993 to May 1996 VA Form 21-0820, Report of General Information dated January 31, 2015 VA Form 21-0820, Report of General Information dated April 2, 2015, from MST coordinator VA compensation examination conducted July 2015 VA letter dated August 5, 2015 • Statement from Shawn received August 22, 2015 • VA Form 21-0781a, Statement in Support of Claim for Service Connection for Post­ Traumatic Stress Disorder (PTSD) Secondary to Personal Assault received August 22, 2015 VA rating decision dated September 8, 2015 VA letter dated September 9, 2015 • Notice of disagreement received September 25, 2015 (Premature Notice of disagreement) • Long Beach VAMC/Anaheim CBOC reports 3/2014 to 9/2015 VA Form 21-526ez, Application for Disability Compensation and Related Compensation Benefits received October 1, 2015 • VA Form 21-0958, Notice of Disagreement received December 4, 2015 (premahrre NOD) VA Form 21-0820, Report of General Information dated January 5, 2016 • Fax request dated January 5, 2016 to Martinez VAMC • Compensation examinations conducted November 2015 Martinez VAMC 9/1997 to 6/1999 VA rating decision dated January 19,, 2016 VA letter dated January 21, 2016 REASONS FOR DECISION 1. Evaluation of left shoulder strain with rotator cuff tear currently evaluated as 20 percent disabling. The evaluation of left shoulder strain with rotator cuff tear is continued as 20 percent disabling. (38 CFR §3.32l(a); 38 CFR §3.32l(b)(l)} We have assigned a 20 percent evaluation for your left shoulder strain with rotator cuff tear based on: • Limited motion of the arm at shoulder level Additional symptom(s) include: • Painful motion of the shoulder The provisions of38 CFR §4.40 and §4.45 concerning functional loss due to pain, fatigue, weakness, or lack of endurance, in coordination, and flare-ups, as cited in DeLuca v. Brown and Mitchell v. Shinseki, have been considered and are not warranted. Although there was additional loss of range of motion with repetitive movements, these changes did not rise to the next higher level of disability. A higher evaluation of 30 percent is not warranted for limitation of motion of the arm unless the evidence shows: • Limited motion of the arm to 25 degrees from the side. 2. Service connection for cervical intervertebral disc syndrome (claimed as neck strain). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for cervical intervertebral disc syndrome (claimed as neck strain secondary to left shoulder) is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA medical opinion found no link between your diagnosed medical condition and military service. Your service treatment reports from November 1993 to May I 996 show no complaints of or diagnosis of cervical spine, neck condition. You were provided a VA compensation examination in November 2015. The examiner reviewed the claims file, including service treatment reports, private medical reports, the history and the evidence presented at the examination. The examiner opined the neck condition is less likely than not due to the service connected left shoulder strain. The examiner indicated the neck condition is more likely due to left cervical radiculopathy 3. Service connection for right shoulder rotator cuff tear (claimed as right shoulder condition). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for right shoulder rotator cuff tear (claimed as right shoulder condition secondary to left shoulder strain) is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA medical opinion found no link between your diagnosed medical condition and military service. Your service treatment reports from November 1993 to May 1996 show no complaints of or diagnQsis of a right shoulder disability. You were provided a VA compensation examination in November 2015. The examiner reviewed the claims file, including service treatment reports, private medical reports, the history and the evidence presented at the examination. The examiner opined the right shoulder condition is less likely than not due to the service connected left shoulder strain. The examiner indicated the condition may be right shoulder weakness and pains may also be secondary to a cervical radiculopathy and/or an undiagnosed rotator cuff tendinopathy. 4. Service connection for lumbosacral strain (claimed as back condition). Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for lumbosacral strain (claimed as back condition secondary to left shoulder strain) is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA medical opinion found no link between your diagnosed medical condition and military service. Your service treatment reports from November 1993 to May 1996 show no complaints of or diagnosis of a low back disability. You were provided VA compensation in November 2015. The examiner reviewed the claims file, the service treatment reports, the post service treatment reports, the history and the evidence from the VA examination. The examiner opined it is less likely than not the lumbar spine condition is secondary to left shoulder strain. As a result of the claimant's inability to lift heavy objects with either his left or right shoulder it would ·be highly unlikely for the claimant's unilateral or bilateral shoulder condition to cause a lumbar strain since the claimant is unable to lift heavy objects that would strain his lumbar spine. Also, since the claimant’s post-service Medical records have not established a baseline back condition because his post-service medical records have been silent for post-service back condition; there is no evidence of aggravation. 5. Service connection for posttraumatic stress disorder. Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with 38 CFR 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. A diagnosis of posttraumatic stress disorder must meet all diagnostic criteria as stated in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. The evidence does not show a confirmed diagnosis of posttraumatic stress disorder which would permit a finding of service connection. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. You submitted a lay statement to Support your claim. A credible lay statement may establish what was seen, heard, and directly experienced. The lay evidence was found not to be competent and sufficient in this case to establish a diagnosis of your condition or to show that a diagnosis had been made by a medical professional. You submitted a lay statement to support your claim. A credible lay statement may establish what was seen, heard, and directly experienced. The lay evidence was found not to be competent or credible evidence of the symptoms of your claimed condition. Although, some evidence supports your claim, we found other medical evidence more persuasive because it is supported by an accurate account of the medical history and/or it is the most detailed and reliable depiction of your medical condition. While some evidence supports your claim, we found other medical evidence more persuasive because it is supported by your relevant military And/or personal history. The VA medical opinion found no link between your diagnosed medical condition and military service. You submitted lay evidence that your claimed disability is 7 -=-r- of 10 Related to events or treatment in service. We have determined that the service treatment records and post service evidence contradict your statement(s) of a connection between your service and your claimed condition, and find the other evidence is more credible when considered in light of all the evidence. November 1993 service entrance examination shows a history of substance abuse before service. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were.promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. You have provided statements in August 2014 and August 2015, regarding you’re claimed in­ service event. The time frame you identified is not consistent with the timing of the onset of the substance abuse counseling. The time line indicates onset over one year after your release from active duty. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. InJanuary 2005 you are diagnosed with bipolar disorder. The correspondence frodocumenting his recollection of the history has been reviewed. Because we were able to identify a marker in your service treatment reports you were scheduled for a VA compensation examination which was conducted in July 2015. The examiner indicated you do not have a diagnosis of posttraumatic stress disorder. The examiner did not diagnose posttraumatic stress disorder. 6. Service connection for anxiety disorder. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for anxiety disorder is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no 3lr 8 of 10 Continuity of symptoms from service to the present. The VA medical opinion found no link between your diagnosed medical condition and military service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The VA medical opinion found no link between your diagnosed medical condition and military service. November 1993 service entrance examination shows a history of substance abuse before service. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. You have provided statements in August 2014 and August 2015, regarding your claimed in­ service event. The time frame you identified is not consistent with the timing of the onset of the substance abuse counseling. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. In January 2005 you are diagnosed with bipolar disorder. The correspondence from documenting his recollection of the history has been reviewed. Because we were able to identify a marker in your service treatment reports you were scheduled for a VA compensation examination which was conducted in July 2015. The examiner diagnosed major depressive disorder and other specified anxiety disorder. The examiner indicated it is at least as likely as not the stressor occurred. However the examiner indicated The series of experiences you found to be distressing, you reported antagonistic harassment by superiors related to alcohol rehabilitation contributed to his distress. The examiner indicated it cannot be said with confidence that his depression or anxieties are solely attributed to the claimed in service event. Your depressive symptoms are reported to be related to significant negative views of self and guilt/shame over past alcohol abuse and its sequelae including domestic violence, Dills, impact on his military career, and current alienation from wife and child. 7. Service connection for bipolar disorder. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. 9 of 10 Service connection for bipolar disorder is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. Although, some evidence supports your claim, we found other medical evidence more persuasive because it is supported by an accurate account of the medical history and/or it is the most detailed and reliable depiction of your medical condition. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. In January 2005 you are diagnosed with bipolar disorder. 8. Service connection for depression to include alcohol abuse. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. Service connection for depression, dysthmic disorder to include alcohol abuse is denied since this condition neither occurred in nor was caused by service. The evidence does not show an event, disease or injury in service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. There was no continuity of symptoms from service to the present. The VA medical opinion found no link between your diagnosed medical condition and military service. November 1993 service entrance examination shows a history of substance abuse before service. Service records show you were recognized for outstanding performance in December 1994. In January 1995 you were promoted. Your enrollment in counseling is noted as command directed in August 1995. Discharge action was initiated in January 1996. March 1996 service separation examination shows no complaints of or diagnosis of the record from November 1993 to May 1996. You have provided statements in August 2014 and August 2015, regarding you’re claimed in­ service event. The time frame you identified is not consistent with the timing of the onset of the substance abuse counseling. Kaiser Permanente treatment reports show treatment for mental health symptoms beginning in 2004. InJanuary 2005 you are diagnosed with bipolar disorder. JASON SIPES 552 35 1079 10 of 1O The correspondence fro, documenting his recollection of the history has been reviewed. Because we were able to identify a marker in your service treatment reports you were scheduled for a VA compensation examination which was conducted in July 2015. The examiner diagnosed major depressive disorder and other specified anxiety disorder. The examiner indicated it is at least as likely as not the" stressor occurred. However the examiner indicated The series of experiences you found to be distressing, you reported antagonistic harassment by superiors related to alcohol rehabilitation contributed to his distress. The examiner indicated it cannot be said with confidence that his depression or anxieties are solely attributed to the claimed inservice event. Your depressive symptoms are reported to be related to significant negative views of self and guilt/shame over past alcohol abuse and its sequelae including domestic violence, Dills, impact on his military career, and current alienation from wife and child. REFERENCES: Title 38 of the Code of Federal Regulations, Pensions, Bonuses and Veterans' Relief contains the regulations of the Department of Veterans Affairs which govern entitlement to all veteran benefits. For additional information regarding applicable laws and regulations, please consult your local library, or visit us at our web site, www.va.gov.
  12. I have been 100% perm and total since 2003, before that i was 70%. I just got an appointment for a C and P exam to reevaluate. WHY! Has anyone ever heard of this? Has anyone ever had one after being perm and total? What is going on?
  13. hi everyone, if anyone has any insight on the results of my C&P exam it would be greatly appreciated. i was sexually assaulted while AD AF, my claim was quick start filed 5 months ago, i had the exams over a month ago and things seemed to be going well, it went to pending decision approval two weeks ago and then all of a sudden dropped back to gathering of evidence and a pending appointment request. my AMVETS lady never answers me and when she does she says she will get back to me... and never does. my PTSD is at an all time high not knowing what all of this means. i also have a few other claims in for chronic pain and chronic gastritis (gastritis c&p stated that it was more likely psych related) 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: 309.81 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD ICD code: 309.81 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Chronic Pain 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 [X] No [ ] 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 deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood 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: [X] Military service treatment records [X] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [X] Department of Defense Form 214 Separation Documents [ ] 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 [X] Other: VBMS, CPRS 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): The veteran was raised in ________by her biological parents. She described her childhood as "really good, compared to people I served with and hearing where they came from I was definitely blessed." She described her relationship with her parents as "normal" and indicated that they did not get along while she was an adolescent, but are now "best friends." She denied any experiences of abuse growing up. The veteran is currently living in ________ with her husband who is currently active duty in the military. She has no children and no other marriages. The veteran reports that they were married just 2 weeks prior to her sexual assault which occurred while they were stationed at separate bases. She indicated that although she is living with him now, they are estranged because of her ongoing symptoms since the assault. She plans to move in with her parents as soon as they have room for her to do so. She indicated that her husband says she's not the same person he married and that he doesn't know her anymore even though they've been together for 6 years. They have not been physically intimate since her assault. The veteran indicated that they plan to proceed with a divorce once she has addressed her medical and military issues. The veteran indicated that at present she is engaged in very few activities and spends the majority of her time at home. She indicated that she tries to take care of chores around the house or go grocery shopping, but she finds even those tasks to be challenging and her husband often has to remind her to do them. She indicated that she has few friends and that "I don't like people, I don't like talking to people, social settings." Prior to her sexual assault she describes herself as being a "social butterfly." Now, she spends a lot of time watching shows on Netflix. She typically would enjoy going to the gym, but has been unable to because of a back injury. b. Relevant Occupational and Educational history (pre-military, military, and post-military): The veteran's highest level of education is a high school diploma. She The veteran is currently unemployed both due to physical limitations (she has difficulty standing for long periods of time due to a back injury) as well as mental health issues (she is afraid of people). She has no income and her husband is currently supporting her financially. She was never deployed to an area where she received hazardous duty pay. Her Veteran received an honorable discharge due to "Hardship; Service Member Initiated Due to Dependency." The veteran reports that prior to her sexual assault she loved the work she did in the military and got along with her coworkers; she was "really happy and really proud." After the assault she reports that she was "emotionally checked out" at work and was reprimanded for insubordination by a superior officer. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): The veteran reported receiving sporadic mental health treatment through the Air Force following her sexual assault. Her medical records in VBMS reflect this. She was prescribed medication to assist with sleep and mood including melatonin, biotin, prozac, flexaril, and trazodone. She indicated that prior to this she was also seen for evaluation and treatment for ADD and was prescribed ritalin. The veteran indicated that since discharging she has run out of her medications and has not been on anything for several weeks. The veteran described symptoms including intrusive thoughts, flashbacks, nightmares, emotional and physical distress at trauma cues, avoidance of trauma related memories/feelings/conversations and situations, gaps in her memory of the event, emotional numbness, disconnection from others, negative change in beliefs about herself/others/world, persistent negative emotional state, anhedonia, irritability, difficulty sleeping, poor concentration, hypervigilance. She also reported having panic attacks daily (with increased heart rate, throat swelling, difficulty breathing, face flushed, feeling out of control, shakiness, uncontrollable tears) and feeling depressed. The veteran described feeling like she's on a "roller coaster." She indicated that she has nightmares of her assault nightly and finds herself triggered by other people who she now fears may be similarly harmful to her. Additional triggers include hearing the "Law-and-Order SVU" theme song and hearing about Bill Cosby in the news. She has not been back to base despite being able to get free healthcare there (because her husband is active duty), in order to avoid being triggered to remember what happened. She has a sense of "impending doom" and always feels that she needs to keep her guard up because something might happen. The perpetrator's family is involved in illegal activity and she worries that they might come after her, or that he will once he is released from prison. She has been sleeping in a separate bedroom from her husband and keeps the door to her room locked at night. On one occasion he heard her screaming and crying in the middle of the night and entered her room, and she punched him before she was fully aware of what was happening. She has difficulty sleeping at night because at the time of her assault she was sleeping next to someone she trusted, so now even sleep does not feel safe. She reported that when she was still working at ________, she would often miss work because her sleep medication would "knock me out for half the day." She indicated that she has been unable to relate to/open up to anyone and feels that she can't connect with others, even friends from childhood. She is embarrased about what happened and doesn't want others to know. She indicated that whereas she used to enjoy fashion and getting dressed-up, she now makes an effort to look unattractive; she does not shave her legs or wear make-up anymore. She goes days without showering and only does so when her husband directs her to. She reports that she often will not leave her house for days at a time. She spends a great deal of time watching Netflix and cooking in order to avoid memories of the event. She indicated that she has to force herself to eat, but that she often throws up what she's eaten. She has chronic gastritis and she indicated that the stress of the assault caused it to "flare-up." The veteran indicated that immediately after the assault she considered suicide, but got support from a friend and did not take any action. Since then she has had suicidal ideation, but no plan or intent. She reports that she last had thoughts of suicide at the end of January 2016. She continues to feel hopeless and has thoughts such as "I don't know what the point of all of this is," but has had no recent active suicidal ideation. She denied current or past self-injurious behavior. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): The veteran denied any current or past legal problems with the exception of the case related to her military sexual assault. e. Relevant Substance abuse history (pre-military, military, and post-military): The veteran reported that she typically drinks one bottle of wine per month. She reported that for a week after the sexual assault she was binge drinking, roughly one bottle of wine daily every day of that week. She indicated that she stopped because she was having difficulty functioning at work and did not want to be sent for substance abuse treatment. She denied any history of drug use or experimentation. f. Other, if any: The veteran reported that 2 weeks following her marriage she was sexually assaulted by a friend. A court martial was pursued against her assailant, and the veteran, along with other victims testified against the perpetrator. The perpetrator was sentenced to time in prison, loss of rank, and dishonorable discharge. Please see documentation in VBMS for additional details. The veteran reported that the period between the report of her assault, and the completion of the court martial has been very difficult. She indicated that she feels her case was mishandled by the military for several reasons. First, she reports that she was encouraged to drop the charges initially which was "the biggest slap in the face." She also reports that at one point her supervisor addressed her in front of her peers about the incident. She indicated that once others became aware of what had happened she was ostracized. Male friends gave her the "cold-shoulder" because they worried she would "call rape" on them. She indicated that she was further harassed by another supervisor who interrogated her about what happened and then slapped her on her behind and called her "fake tits." The veteran reports that she continued to have negative experiences even after she was transferred to a different unit. She was told that she was insubordinate by a supervisor and people continued to ostracize her. 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: Sexual Assault 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? [ ] Yes [X] No If no, explain: Related to military sexual trauma that occurred stateside Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. Sexual assault case was brought to trial in the military and the veteran's assailant was sentenced to time in prison, dishonorable discharge, and loss of rank. Veteran's symptoms began to emerge shortly after the assault and medical records show that she was seen for mental health treatment at that time and received medication. 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) 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] Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) 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] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Hypervigilance. [X] Problems with concentration. [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 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 more than once a week [X] Chronic sleep impairment [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 [X] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene 6. Behavioral Observations -------------------------- The veteran presented for the evaluation on time, appropriately dressed and groomed, and appearing her stated a ge. She wore an oversized sweatshirt. The veteran was alert throughout the evaluation, and was oriented to person, place, and time. Speech was normal in rhythm, rate, tone, and volume. Content was coherent and goal directed. Affect was full range and appropriate, and her mood appeared to be anxious and depressed. There was no evidence of hallucinations or delusions. Cognitive functioning was grossly intact. Insight and judgment were fair. The veteran denied current suicidal and homicidal ideation, plan, and intent. 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 currently meets DSM-V criteria for a diagnosis of PTSD stemming from her military sexual trauma. Her symptoms fall within the severe range and have had a significant impact on her functioning in all domains since the incident. Please see above for a full accounting of the veteran's symptoms and their impact, as well as a detailed account of the assault and its aftermath. With appropriate treatment, veteran's symptoms may improve over time. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.
  14. So i got a call from the rater who is handling my claim with the VA...Let me tell you informative and getting pissed off is a understatement. For years i have been battling the VA on my complete second enlistment records just out right missing no where to be found... and when i say no where to be found i mean every conceivable location known to man and a few only known to critters who only come out at dark and unicorns. I was told that honestly considering what happened to me it is not uncommon for my records to have just been thrown away. I have been fighting for my knee problems and sinusitis and tinnitus for over 10 years but have been up against the lost file wall. I never filed for PTSD until last year because of My new VSO recommendation to. I original VSO who did my first claims did not file for the PTSD from the start because he said he wanted me to get my foot in the door first. Plus prior to 2009 he was worried that my lack of going to CID would be a problem. I am frustrated and angry and honestly i am tired of fighting this battle. I just want help for the things that are broken nothing more. I just do not know what to do anymore. All my faith in the system that i once loved is gone even though some bad shit happened to me i still loved the service and missed it. now im even angrier then i was before and after talking to this vso and him showing me information from the base i was at he said i was one of the lucky ones. He showed me reports and news paper articals and told me most of the ones that were targeted like i was usually left that base either drooling from psychoses or in a body bag. I just dont know what to do at this point.
  15. C&P Exam PTSD:MST Eating Disorder.pdf ^^^^^^Well the attached report indicates to me a 10% PTSD rating. I am currently 30% and I do not understand how this happened but I might be in for a reduction. I thought the exam went well. I had a PTSD and Eating Disorder C&P. Regarding the occupational/social impairment she checked the one that resembles 10% and for "b" she marks YES and goes on to say my trauma impacts my occupational/social impairment. Look at the symptoms she notes: Anxiety; Panic Attacks more than once a week; Chronic sleep impairment; difficulty in establishing and maintaining effective work and social relationships She even stated in the exam that I was BDD (Body Dysmorphic Disorder) but her reports indicates while I have BDD characteristics I don't warrant the BDD rating. She states for the VA established diagnosis of SPECIFIED TRAUMA AND STRESSOR RELATED DISORDER, there is NO CHANGE in the diagnosis. At this time the claimant's condition is active. Does this Exam mean I am going to be reduced or would I fall under the below??? 3.344 Stabilization of disability evaluations. (a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind. (b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, §3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made. (c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.
  16. I have submitted a claim for PTSD-MST back in November of last year. Should I also claim SMC-K for ED now or wait until the original PTSD gets decided and rated (if any) I have been prescribed Viagra for ED for many of the years I have been service connected with my hearing loss. However in my records it just says its for ED Do I need to speak to my VA doctor to see if they believe it is the result of me getting raped in the army. I also took Viagra as a civilian post military, but I could not afford it as it is extremely expensive. The medicins I now take for PTSD make it absolutely and completely impossible to have sexual relations with my wife or even myself. It doesnot work at all any more... :( Lexipro 20mg - Mood maximum amount Thorazine 25 mg 2 X per day PANIC ATTACKS OMG this stuff helps Prasosine 1 or 2 MG nightmares / sleep Trazadone 50 mg nightmares / sleep Ambien 10MG Sleep (after I wake up at midnight) Simvastatin 20 MG High Cholesterol (I am not heavy and used to be athletic) , but have high Cholesterol and strange blood pressure 150/119 is common, so is 90/60 depending om my anxiety. On last thing, what is the difference between a hand written, signed and dated statement form my mother, father and sister vs a SWORN statement? Thanks
  17. I was recently an inpatient a VA medical center BH-ICU lock down unit for Suicidal Ideation with multiple actionable plans and means to complete. Based on my non service connected (yet) but currently VA treated PTSD- Military Sexual Trauma for 7 full days. During this inpatient visit, I was given at least 6 individual pills per, day ranging from panic, sleep, mood, more different panic, different sleep ect..ect... each day until they found the best fit for me. Currently I am service connected for 20% hearing loss & 10% tinnitus = 30%. That makes me a a priority group 2 and I pay $8.00 per prescription (from 30 day supply down to 1 pill). $ 8 bucks. Pretty simple. Based on my inpatient BH-ICU stay, that would total up to (6pills per day $8 each = $56 cost per day X 7 Days = $392). I have not worked since Jan 4th 2016 and am burning thru my savings and retirement money to support my family of four. Since getting VA treatment for PTSD-MTS in November of last year 2015 and filing a claim shortly afterwards with a VSO, I have paid for all of my medical co-pays at $8 which were significant but nothing like the 7 day inpatient amount will be. However, I did see this article on a VA website: Basic Business Rule No extended care copayment when income is below pension single rate threshold. *Copayment Free Care and Medication for treatment of Service-Connected (SC) disabilities, SC 50% or more, former POWs, Catastrophically Disabled Veterans, VA pensioners, and those under Special Authorities (e.g. PG 6, military sexual trauma, nasopharyngeal radium irradiation) Since getting treatment for PTSD-MTS in November of last year 2015 and filing a claim shortly afterwards with a VSO, I have paid for all of my medical co-pays and am waiting for the big bill from inpatient medications & maybe hospital care as well? What is my best option at this point...... I am a wreck emotionally and am having trouble sorting thru thius mess? I am grateful for the care I get and the support of the forum members. Especially TBird.Mark Combat Medic 1983-1986 30 Hearing loss SC PTSD-MTS pending VA RO
  18. Hello everyone, I've been reading this page on and off for awhile and thought I'd try to get some advice. I served in the Navy as Air traffic controller from 2007-2012 In 2009 I was raped and I reported it Transferred duty stations Immediately began treatment on board my new ship with the ship board Psychologist After some time she diagnosed me with PTSD Prescribed Trazadone I was demoted in job responsibilities My flight status for controlling was grounded due to the meds and diagnosis I started a claim in 01/10/2014 for PTSD due to MST Went to two separate mental health exams On 01/15/2015 I received my denial letter from the VA stating it is as least likely as not that my PTSD existed prior to my military service. And it is less likely than not the MST aggravated and worsened the PTSD pass its normal progression. There is no evidence that an in service stressor occurred. I don't understand how the examiners and the VA can say my PTSD is from my sister getting sexually abused during childhood and me witnessing it. <<<I never stated ever in my life that I witnessed what my sister went through. I was never affected by it because it did not happen to me, which explains my proof of having an active, positive childhood. I held jobs, good grades, good attendance and was apart of Track and field, ROTC and softball until my graduation from high school. Also, mental health plays a major part in the job I had in the Navy. If I were suffering from any mental health issues including PTSD, ATC would not have been a job option for me and I would have never completed the training or received my FAA card, but I did. There is an in service stressor, I reported it, I had a rep from a rape advocate group on board the ship, NCIS was involved, I transferred, and my personal work habits declined and is evident in the periodic evaluations we had. I have already filed a NOD requesting the DRO review my file. I have contacted a handful of Florida politicians and a newspaper. I requested the NVLSP assistance, but I haven't received a response saying they'll take my case, so I also contacted the American Legion. I have also requested my entry Physical into the Navy along with the treatment records from in service. I was able to contact my old divisional officer who over saw my transfer and knows exactly what happened to me that night and he agreed to write a statement for me. My mom also agreed to write a statement regarding the VA accusing me of witnessing my sisters abuse and accusing me of having PTSD then. I don't know if i'll need those things. I can't imagine what else I need to prove what happened to me in the Navy...I feel like I could gather all of the hard evidence in the world that I was raped and have ptsd, but the VA has zero sympathy for that and refuse to admit or acknowledge what went on. If anyone has any advice it would greatly appreciated.
  19. Forgive the first effort, injuries have a way of making things difficult..... Twenty-four years of dealing with the VA, and the difficulties at hand ensure negative results..... These are the copies of a C and P recently done at the VA, and leaves me to doubt this system is capable of conducting themselves in an ethical manner. Enjoy the insanity, this veteran is tired of paying the piper; Eighteen Years were Enough !!!! (Remand posted earlier.) Still waiting to address attorney with the results of this remand and the Shabby, Disrespectful, and unethical way in which this Veteran has been treated at the VA hands...... Document 1.pdf ... Comments, opinions, and suggestion greatly needed and appreciated.... Sincerely, Mark Document 38.pdf Document 37.pdf Document 36.pdf Document 35.pdf Document 39.pdf Document 40.pdf Document 41.pdf Document 42.pdf Document 43.pdf Document 44.pdf Document 45.pdf Document 46.pdf Document 2.pdf Document 3.pdf Document 4.pdf Document 5.pdf Document 6.pdf Document 7.pdf Document 8.pdf Document 9.pdf Document 10.pdf Document 11.pdf Document 12.pdf Document 13.pdf Document 14.pdf Document 15.pdf Document 16.pdf Document 17.pdf Document 18.pdf Document 19.pdf Document 20.pdf Document 21.pdf Document 22.pdf Document 23.pdf Document 24.pdf Document 25.pdf Document 26.pdf Document 27.pdf Document 28.pdf Document 29.pdf Document 30.pdf Document 31.pdf Document 32.pdf Document 33.pdf Document 34.pdf
  20. It's been awhile since I'be been on this site but I need some guidance and knew this was the place to get it. HADIT helped me so much with helping me to win my claim. I am 100% for MST and was also in the Navy and female. I received TDUI due to my symptoms and I don't know how to handle it. At first I was elated, now it's been awhile and I have guilt about getting 100% when so many people are fighting the system. I guess it's winner's guilt? But here's my real problem with all of this. Because I'm 100% I have Disabled Vet plates and I don't work. People ask what do I do and some closer friends know that I am on disability and some are ex military. I served in Hawaii and was in the Navy and was a female. How do you handle telling friends and relatives that your a disabled vet under my circumstances? They probably think I'm scamming the system because I don't have an answer for them. How can somebody who was on shore duty, a yeoman, in the Navy and a female possibly be 100% disabled. It would be so much easier if it was a back injury or something like that. I guess I'm ashamed of getting disability for PTSD and if I told them it was for PTSD there's no way that they would understand. And the ex military people would probably figure out it was MST and that is my worst fear. How can I tell people why I'm disabled? I feel like I should hide the fact that I'm disabled because I know they are thinking "how could I get TDUI". I'm just really at a lost about all of this and would like any advice you can give me. It's been bothering me for awhile and it's getting to the point where I have to tell my close friends and family something. I can't avoid it much longer. How have others handled telling people close you have PTSD? It's one thing if I would have served overseas then there wouldn't be an issue, people would be more likely to understand, or at least it would make sense to them. Anyhow I am starting to ramble...any advice would help...thanks.
  21. Hello! I'd like to thank my buddies in the MST forum for the support and help fighting this uphill battle with the VA. I originally filed 12/2011 for this disability and the VA closed my case without notifying me at all, about 45 days later. They said they "tried" to advise me of this case being closed but my phone was disconnected and that i sent their letters back to them unopened. Both of those things are simply not true. I waited for 4 years like a fool thinking this claim was in the backlog but come to find out they closed it. I had it reopened, but the "new" effective date was 2/2015, over 4 years after the original claim was opened. It took me months to re-gather evidence and get expert opinions and my nexus letter from a therapist 10/2015 I turned in all the evidence I had. (Nexus, buddy letter, statements of evidence, statement of MST) 12/2015 I had C&P with a civilian provider. 1/2016 I am rated 100% with housebound SMC for this disability alone. Although I included a statement requesting the original effective date and provided evidence that my phone was not disconnected and that I was in constant reliable communication with the VA at the time they closed my case, they denied my request. In fact, they overlooked my upload of this info so it seems. SO the fight continues, and I'll fight to my last breath for this. 4 years of 100% back pay is a lot and I will not turn my back on this. I am filling out my NOD and sending it in this week. I'll update you guys in like 8 years when this is settled. lmao. My best advice to win your MST case is to have your therapist write a very specific letter. In fact, ask if you can work on it with them. If they are not familiar with the VA's behavioral markers, look it up and provide them with the information. Also, I received lots of good information here, but I also received a lot of discouraging opinions on here as well. Once i uploaded my nexus letter to get opinions and got all kinds of flack for it. My therapist wasn't high enough of a medical pro, the wording was all wrong, the VA was "NEVER going to accept it.." bla bla bla. It really had me discouraged and triggered a really dark depression episode for me. Please take the opinions on here as well-intended suggestions, not as written in stone expert opinions or harsh criticisms. People on these forums DO know a lot, though. So take things with a grain of salt, arm yourself with knowledge, ask questions, but ultimately you are the one thats going to make some important decisions regarding your fight with the VA. I'd also like to note that PTSD for personal trauma (MST) is handled differently than combat PTSD. The burden of proof is different. The forms are different. Use the MST board if you need help and use the resources listed on there for guidance in understanding what is needed for a successful claim. Its what I did. Here is the link to the post that followed me on this journey. FIGHT! Keep fighting! Never give up!
  22. I accidentally deleted my original posts and apologize for that. I was trying to respond to rwoods 4? who had a question about the timeline of how long it took my claim to be finalized. I will retype my original posts real quick. My apologies. My claim was for PTSD, Anxiety, Depression, Insomnia caused my MST and the VA combined all of these under PTSD. My rating came back service connected at 70%. I'm satisfied with this rating and now I'm on continuing on the road to recovery which has been a very rough ride the last 10 years. In my original post my advice was to make sure that you track down all of the records and information for the VA to have as that is what I did because I wanted to make sure they got all of the records and background information that they needed. It was a lot of work and I had to keep calling prior therapists, hospitals, and previous bases to get the right information which made me learn patience. Also, the C&P exam was a very huge trigger for me. I had and have had many panic attacks and unfortunately it's been a huge challenge. I have had a hard time overcoming going over specific details, but I know they have to have all of the information available to do their jobs and know how it affects me now. My only other advice is to make sure you try and stick to the questions that the examiner asks and very much be yourself. I couldn't be anything but myself as my anxiety and lack of focus took over the entire exam. My exam was done over the holidays and was completed around the second week of January of this year. I hope this helps and thanks all that responded previously with congrats and well wishes to recieve the proper therapy that will help me be happy in life. Thank you all for your service, continued service to veterans or one another, and God BLess. P.S. How do you like someone elses post? LOL I couldn't find out how to do that?
  23. I promised myself that I would talk about my experience navigating through the VA bureaucracy because it has been such a long, arduous, insulting, and ridiculous ride so far....and I haven't even had my C&P yet! I know that I am a regular person and that my experience with the VA (and the department of the Navy) is likely a very typical one. That thought both saddens and enrages me because I know if this happened to me, this and WORSE has happened to so many other people. This morning I uploaded my "package" including all evidence I could obtain (took me the better part of a year to obtain what little evidence I got), a nexus letter from my doctor, a buddy statement, my statement in support of claim for MST, and my information release forms. I feel weird that this is out of my hands yet again, and I only hope that things get better from this point on. Here's a timeline of my events to give you an idea of what I've gone through so far. I'll update this as things progress for me. 2009-MST incident occurred. I was found by Navy MA's (military police) and it was quite obvious what occurred to me given my condition, where they found me, and complete lack of clothes. I was too afraid to admit what happened for fear of reprimand and ridicule, so when questioned by NCIS and the Sexual Assault Victims Advocate I simply said I didnt know what happened to me. I was treated on base, given emergency contraception, and sent on my way. 2009-all ptsd/mst "markers" present themselves. I was forced into inpatient psych treatment by my CoC, causing me to lose my job (air traffic controllers are bound by flight status and ongoing psych problems/meds are disqualifying). I was dxed with "adjustment disorder" which is basically the most vague psych diagnosis you can get. 2010- I left the Navy. 2010- Rated 10% for depressive disorder 2011- Began MST Claim, faxed in evidence. 2011-2015 "I know there's a backlog, but holy sh!t, what happened to my claim???" Early 2015- VA says they closed my claim. I was never notified in any way, shape, or form. They say "oops! Our bad!" My claim is deferred then reopened. None of my evidence was received by them (rolls eyes) and I no longer have the original paperwork (discharge paperwork from medical, ncis paperwork with agent's name, card of the sexual assault victims advocate lady) or fax transmittal sheet i originally submitted due to a flood. Mid 2015- I began requesting documentation through FOIA Mid 2015- I receive responses. No records were kept by base police, NCIS, SA Victims Advocacy, or even Branch Medical. The only thing noted was that I was treated for "alcohol intoxication" with no mention of medications given, provider, or even date of treatment. I receive ONE 2 page treatment record from a counseling intake that briefly mentions the assault (score!). Summer 2015- I begin working on getting a Nexus letter from my provider. I was very clear with her that I was seeking her out not only because of how ptsd from mst presents itself in my everyday life, but because I have this burden of proof to meet so the VA can acknowledge this as service connected. Summer 2015- I am notified that the VA will "entertain" evidence in this claim, but that the effective date will be 8/31/2015 instead of 11/2011. The VA claims they tried calling me to notify me of my claim being closed back in 2011 but my phone was disconnected and the letters they sent me were returned to sender. Neither of these statements are true. My phone has NEVER been disconnected, and I in fact still have VA letters dated within days of the supposed letters they sent me (those letters pertained to other things appointments,education stuff). To top it off, the lady who called me says she's the one who tried calling me in 2011 personally and that she personally was the one that closed out my claim because she "couldn't find me." I told her I would be happy to provide evidence that my phone was never disconnected and that i was receiving their letters at the contended address at the contended time. She took offense to this and i could tell. They (in turn) audited my VA payments (out of nowhere). I feel like because I openly said that the VA was wrong and could be proven wrong, they took me to collections over $00.39 of overpayment. Yes. 39 cents. No, i can't just pay 39 cents. No they can't just withhold the 39 cents. Its a whole long process and its terrible and its almost more than I can handle at this point. Fall 2015- I finally have everything submitted. At this point I'm waiting on a C&P. Again, I'm putting this out there in hopes that it will help someone keep fighting the battle. Its hard. It sucks. Its re-victimizing. Its a terrible thing to deal with when you are already fighting daily battles as a result of MST. Its hard to ask for help because its hard to trust anyone, which is why I never sought the help of a VSO.
  24. I have the results of my C and P exam. I am hoping for some feedback. In particular the references to work. It does note I left my Federal job from anxiety from working with men. However, they state I have been self-employed for 20 years. That is true but as a way for me to feel like I am making some contribution. My average income from the business is $1500 per year. If you have advice on what to do with that information it would be appreciated. I really want to put all this behind me and get on with life. C AND P RESULTS (Personal information has been removed. The went back to the examiner for additional information which is included.) Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire SECTION I: 1. Diagnostic Summary This section should be completed based on the current examination and clinical findings. Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? X Yes 0 No If no diagnosis of PTSD, check all that apply: O Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria 0 Veteran does not have a mental disorder that conforms with DSM-5 criteria 0 Veteran has another Mental Disorder diagnosis. Continue to complete this Questionnaire and/or the Eating Disorders Questionnaire. 2. Current Diagnoses a.Mental Disorder Diagnosis #1: 309.81 Post Traumatic Stress Disorder Comments, if any: __ Mental Disorder Diagnosis #2: 305.00 Alcohol Abuse, in remission Comments, if any: _ _ Mental Disorder Diagnosis #3: _ _ Comments, if any: __ Mental Disorder Diagnosis #4: _ _ Comments, if anv: Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or OoO Use Only* If additional diagnoses, describe (using above format): __ b. Medical diagnoses relevant to the understanding or management of the Mental Health disorder (to include TBI): __ Comments, if any: __ 3. Differentiation of symptoms a. Does the Veteran have more than one Mental disorder diagnosed? X Yes 0 No If yes, complete the following question (3b): b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? X Yes 0 No 0 Not applicable (NIA) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: __ If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: All symptoms are related to PTSD. The alcohol abuse is in remission and was related to coping with anxiety associated with MST. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? 0 Yes X No 0 Not shown in records reviewed Comments, if any: __ If yes, complete the following question (3d): d. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? 0 Yes 0 No X Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis: __ If yes, list which symptoms are attributable to each diagnosis: __ 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) 0 No mental disorder diagnosis 0 A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication X Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication 0 Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation 0 Occupational and social impairment with reduced reliability and productivity 0 Occupational and social impairment with deficiencies in most areas, such as work, school , family relations, judgment, thinking and/or mood 0 Total occupational and social impairment 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 bv each mental disorder? Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only* X Yes 0 No 0 No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: __ If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: The social and occupational impairment is related to PTSD. The alcohol abuse is in remission and was related to coping with anxiety associated with MST. 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? 0 Yes 0 No X No diagnosis of TBI If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: __ If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: __ SECTION II: Clinical Findings: 1. Evidence review In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. Medical Record Review Was the Veteran's VA claims file reviewed? 0 Yes X No Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? X Yes O No If yes, li st any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: 0 Mi litary service treatment records 0 Military service personnel records 0 Military enlistment examination 0 Military separation examination 0 Military post-deployment questionnaire O Department of Defense Form 214 Separation Documents 0 Veterans Health Administration medical records (VA treatment records) 0 Civilian medical records O Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) 0 No records were reviewed 0 Other: b. Was pertinent information from collateral sources reviewed? 0 Yes X No If yes, describe: __ 2. History Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or OoO Use Only* a. Relevant Social/Marital/Family history (pre-military, military, and post-military): The veteran was born in Nevada and raised in Washington State. Her father left the family when she was age 9 and she was raised by her mother. She is the youngest of her siblings and has 1 brother and 3 sisters. She describes her childhood as having a dysfunctional family, but she has no history of abuse. In her youth, she enjoyed showing horses. The veteran has been married for 26 years and they have one daughter, who is an independent adult. Her hobbies include gardening and outdoor activities. She has a group of friends she socializes with regularly. b. Relevant Occupational and Educational history (pre-military, military, and post-military): The veteran graduated from high school and describes herself as a "little above average" student. After finishing high school, she attended college for 2 years, but did not obtain a degree. She worked as an office manager for her brother for 4 years, then joined the military. She served in active duty for 2 years and reserved duty for 4 years. She obtained the rank of E4 and worked as radar operator in active duty and in personnel support in the reserves. She received an honorable discharge. She is currently self-employed as a website designer and has been working in this type of work for 20 years. She was working for the Small Business Administration until March 2015, and is now self-employed. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military: The veteran describes her mood as "a rocky last 3 years," but "I have been doing fairly well for the last couple months." Xxxxxxxxxx The veteran had a lot of difficulties with emotional outbursts and problems in her marriage to the point the her husband was going to leave her. The veteran participated in counseling from April to October 2014, but she has not had counseling since then because her counselor has been on medical leave. She reports that the counseling was "very helpful." xxxxxxxxx Her current medication is clonidine 0.1 mg hs prn, which is helpful. She reports that she has not had to take this medication "for awhile." She reports no history of suicidal or homicidal ideation. She reports no history of psychiatric hospitalizations or hallucinations. She reports a history of panic attacks that have improved in the past 3 months. The veteran describes her sleep as 6 hours per night which is her normal sleep pattern . She reports a history of nightmares related to military sexual trauma, but this has improved. She reports a history of flashbacks and intrusive memories of military sexual trauma, but this has improved. She reports avoidance behaviors and has difficulty tolerating being around men. She quit her job last April because she was uncomfortable around her male co workers. She has problems with self-image and tries "to make myself invisible." When she is around men, she has anxiety. She is distrustful of men. She has a history of anger and irritability that has improved. The veteran reports no history of head injury or loss of consciousness. The veteran reports no pre military service history of psychiatric disorders. She reports no family history of psychiatric disorders. Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire *Internal VA or OoO Use Only* d. Relevant Legal and Behavioral history (pre-military, military, and post-military): The veteran reports no legal history. e. Relevant Substance abuse history (pre-military, military, and post-military): The veteran describes her current alcohol consumption as very rare. She reports a history of alcohol abuse before she was pregnant with her daughter related to coping with anxiety. She stopped drinking after this time. She does not use marijuana. She reports no history of illegal drug abuse. She does not use tobacco. She drinks 2 cups of coffee per day. f. Other, if any: _ _ 3. Stressors The stressful event can be due to combat, personal trauma , other life threatening situations (non-combat related stressors). NOTE: For VA purposes, "fear of hostile military or terrorist activity" means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire ; or attack upon friendly military aircraft. Describe one or more specific stressor event (s) the Veteran considers traumatic(may be pre-military, military, or post-military): a. Stressor #1 : XXXXXXXXXXXXXXXXXXXXXXXXXX Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? X Yes 0 No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? 0 Yes X No If no, explain : The stressor is military sexual assault. Is the stressor related to personal assault, e.g. military sexual trauma? X Yes 0 No If yes, please describe the markers that may substantiate the stressor: The stressor is sexual assault. b. Stressor #2: XXXXXXXXXXXXXXXXXXXX Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? X Yes 0 No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? 0 Yes X No If no, explain: The stressor is sexual harassment. Is the stressor related to personal assault, e.g. military sexual trauma? X Yes 0 No If yes, please describe the markers that may substantiate the stressor: The stressor is sexual harassment. c. Stressor #3: XXXXXXXXXXXXXXXXXXXXXXXxxx Does this stressor meet Criterion A (i.e. , is it adequate to support the diagnosis of PTSD)? X Yes O No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? 0 Yes *No If no, explain: The stressor is sexual harassment. Is the stressor related to personal assault, e.g. military sexual trauma? X Yes 0 No If yes, please describe the markers that may substantiate the stressor: The stressor is sexual harassment. d. Additional stressors: If additional stressors, describe (list using the above sequential format): __ 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 #6 - 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) 0 Witnessing, in person, the traumatic event(s) as they occurred to others 0 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 event(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: 0 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) . 0 Dissociative reactions (e . ~ .. 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). 0 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 event(s) occurred, as evidenced by one or both of the following: 0 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: O Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). O Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g ., "I am bad, : "No one can be trusted,: ''The world is completely dangerous,: "My whole nervous system is permanently ruined"). X Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or others. X Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). 0 Markedly diminished interest or participation in significant activities. 0 Feelings of detachment or estrangement from others. O Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) 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 Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 0 Reckless or self-destructive behavior. 0 Hypervigilance 0 Exaggerated startle response. 0 Problems with concentration. 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 Criterion H: * The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 5. Symptoms For VA rating purposes, check all symptoms that apply to the Veterans diagnoses: X Depressed mood X Anxiety X Suspiciousness 0 Panic attacks that occur weekly or less often 0 Panic attacks more than once a week 0 Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively 0 Chronic sleep impairment 0 Mild memory loss, such as forgetting names, directions or recent events 0 Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks 0 Memory loss for names of close relatives, own occupation, or own name 0 Flattened affect 0 Circumstantial, circumlocutory or stereotyped speech 0 Speech intermittently illogical, obscure, or irrelevant 0 Difficulty in understanding complex commands 0 Impaired judgment 0 Impaired abstract thinking 0 Gross impairment in thought processes or communication 0 Disturbances of motivation and mood O Difficulty in establishing and maintaining effective work and social relationships X Difficulty in adapting to stressful circumstances, including work or a worklike setting 0 Inability to establish and maintain effective relationships 0 Suicidal ideation 0 Obsessional rituals which interfere with routine activities 0 Impaired impulse control, such as unprovoked irritability with periods of violence 0 Spatial disorientation 0 Persistent delusions or hallucinations 0 Grossly inappropriate behavior 0 Persistent danger of hurting self or others 0 Neglect of personal appearance and hygiene 0 Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene 0 Disorientation to time or place Behavioral Observations: The veteran presents with mostly normal mood and affect. She was tearful while discussing the issues of MST. 6. Other symptoms Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? O Yes X No If yes, describe: __ 7. Competency Is the Veteran capable of managing his or her financial affairs? X Yes 0 No If no, explain: __ MEDICAL OPINION (to be completed by the examiner) Medical Opinion Disability Benefits Questionnaire If checked, please provide a discussion including name of doctor/facility, type of record, date, diagnosis and any pertinent findings: VA records 2014- mental health records depressive disorder, anxiety and military sexual assault. Civilian med records 2014- Ox PTSD 4. Medical opinion for direct service connection Choose the statement that most closely approximates the etiology of the claimed condition. a. X The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. b. 0 The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. c. Rationale: The military sexual trauma occurred while serving in the military as described in detail above. The VA records document the MST issues as the veteran describes them. 5. Medical opinion for secondary service connection a. 0 The claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the Veteran's service connected condition. Provide rationale in section c. b. 0 The claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran's service connected condition. Provide rationale in section c. c. Rationale: 6. Medical opinion for aggravation of a condition that existed prior to service a. 0 The claimed condition, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression by an in-service injury, event, or illness. Provide rationale in section c. b. 0 The claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. Provide rationale in section c. MEDICAL OPINION (to be completed by the examiner) IS THE VETERAN'S POST TRAUMATIC STRESS DISORDER AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) INCURRED IN OR CAUSED BY MULTIPLE OCCURRENCES OF MILITARY SEXUAL TRAUMA THROUGHOUT SERVICE AND RESERVE SERVICE TO INCLUDE SEXUAL HARRASSMENT, ATTEMPTED SEXUAL ASSAULT AND SEXUAL ASSAULT THAT OCCURRED DURING SERVICE. Are these markers of a below average performance evaluation, marital/relationship problems, and voluntary discharge due to miscellaneous reasons be considered substantial markers to your previous evaluation of the PTSD stressors related to MST? PLEASE PROVIDE COMPLETE RATIONALE. b. Indicate type of exam for which opinion has been requested (e.g. Skin Diseases): PTSD 3. Evidence review Was medical evidence available for review as part of this examination? X Yes 0 No If yes, indicate evidence reviewed as part of this examination (check all that apply): *VA claims file (C-file) If checked, documents listed separately below tAat are included in a C-file. do not need to be additionally indicated. X Veterans Health Administration medical records (VA treatment records) X Civilian medical records X Military service treatment records X Military service personnel records O Military enlistment examination 0 Military separation examination 0 Military post-deployment questionnaire 0 Department of Defense Form 214 separation document 0 Previous disability decision letters If checked, please provide a discussion including name of doctor/facility, type of record, date, diagnosis and any pertinent findings: QTC eval- August 2015- dx PTSD 2014- mental health records - depressive disorder anxiety, military sexual assault Civilian med recs 2014 dx PTSD Military tx 4. Medical opinion for direct service connection Choose the statement that most closely approximates the etiology of the claimed condition. a. X The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. b. 0 The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. c. Rationale: This claim is based upon self report. The veteran reports that she experienced sexual harassment and sexual assault while serving in the military. This has been difficult for her to discuss, but the symptoms she reports are consistent with PTSD related to MST. The VA records reveal a history of being diagnosed with mental health issues including depression and PTSD. The only marker that is documented in the military records is the voluntary discharae. 5. Medical opinion for secondary service connection a. 0 The claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the Veteran's service connected condition. Provide rationale in section c. b. 0 The claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran's service connected condition. Provide rationale in section c. c. Rationale: 6. Medical opinion for aggravation of a condition that existed prior to service