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Found 238 results

  1. I noticed that the VA didn't award me anything for my anxiety. I was diagnosed with PTSD, depression, anxiety and MDD all at the same time. I looked through my records and see where it's all listed. It has been less than a year since I received my award. Can anyone tell me how to go about getting my anxiety added into my disabilities. Do I file an appeal or..........
  2. May 2016 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 [ ] Military service personnel records [X] Military enlistment examination [ ] Military separation examination [X] Military post-deployment questionnaire [X] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [X] 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: VHA medical record (CPRS) and VA e-folder (VBMS records) were reviewed. There was no physical C-File available as all documents were available in e-folder per C&P exam instructions. b. Was pertinent information from collateral sources reviewed? [ ] Yes [X] No 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Pre-military: Veteran was born in Weslaco, Texas and raised in Alamo, Texas. He was raised by both parents and grew up with a brother. Veteran described his childhood as "okay, my mom was a stay at home mother, my dad worked, and was also an alcoholic, always talking down to me and hitting my older brother when he was drunk." Veteran reported that he got along with other children and teachers while growing up. He participated in baseball and football while in school. Military: Veteran reported that he got along "pretty good" with other soldiers. Post-military: Veteran lives with his spouse and two children, seven year-old son and one year-old daughter. Veteran and his wife have been married since 2005. He described his relationship with his wife as "married, have our ups and downs." Veteran described his relationship with his children as "nice." He spends most of his time with his daughter. His hobby is to "coach a travel selected team for softball." He stated he spends time with friends "on the weekends" barbecuing. b. Relevant Occupational and Educational history (pre-military, military, and post-military): Pre-military: Veteran obtained a high school degree from Pharr-San Juan-Alamo High School. He reported that his grades were average and denied having any learning or attention problems. Military: Veteran served active duty in the Army from April 17, 2002 to April 16, 2005. MOS: 92F, Petroleum Supply Specialist. Rank at Discharge: E-3. Discharge: Honorable. Veteran was awarded the Army Lapel Button, National Defense Service Medal, Global War on Terrorism Expeditionary Medal, Global War on Terrorism Service Medal, Army Service Ribbon. Veteran served in Southwest Asia from February 7, 2004 to August 24, 2004. Post-military: Veteran completed a certificate for medical assistant in 2015 from Southern Careers Institute. Veteran is current unemployed; he was last employed February 2015. Veteran stated he was a heavy equipment operator for the city of Donna from December 2014 to February 2015. He stated he was fired because his "director told [him] [his] position was no longer needed." He denied having disciplinary problems at this job. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): Pre-military: Veteran denied mental health history including hospitalizations for mental health problems. Veteran reported that his father was "always drinking alcohol." Military: Veteran stated that he was diagnosed with depression "January 2004." He reported that he was hospitalized for two weeks at John Randolph hospital in Virginia. Veteran reported, "When I came back from my tour in 2004, I woke up one morning and decided to cut my wrist with my Gerber knife. Then I realized what the hell I was doing, I drove myself to the local hospital in Virginia." Veteran denied seeing anyone wounded, killed or dead during deployment when he completed September 2, 2003 Post-Deployment Health Assessment. He did endorse feeling like he was in great danger of being killed. Veteran denied having little interest in doing things, feeling depressed, nightmares, avoidance behavior, hypervigilance, and feeling detached from others. He reported that his health in general was "very good." According to Report of Consultation from John Randolph Medical Center dated January 19, 2005, Veteran was "admitted to psychiatric services with depression." According to the Behavioral Health Initial Assessment from John Randolph Medical Center dated January 15, 2005, "He is in the process of getting divorced from his wife who lives in Texas. He said that he has been feeling stressed since this past weekend and yesterday he held a knife in his hand and wanted to hurt himself. He reported feeling depressed, having decreased energy, decreased appetite, decreased sleep. He has been having some flashbacks and nightmares about the war in Iraq." Post-military: Veteran is prescribed Buspirone and Fluoxetine; he stated he is compliant with psychotropic medication. Veteran attended primary care mental health integration initial appointment on January 19, 2016. He then attended mental health initial evaluation on February 10, 2016. Veteran attended VPTT Consult on February 23, 2016. He was no-show to follow-up appointment for VPTT on May 2, 2016 and May 9, 2016. Veteran denied current auditory and visual hallucinations. He denied current suicidal and homicidal ideation, intent, or plan. Nonetheless, he was provided with Veterans Crisis Line information. Veteran was instructed to monitor symptoms, including emergence of suicidal or homicidal ideation, and to utilize this number, call 911, or go to nearest ER at closest hospital, in case of mental health emergency. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): Pre-military: Veteran denied legal and behavioral history. Military: Veteran reported he lost rank "for being late so many times." He denied receiving Article 15s. Post-military: Veteran denied legal and behavioral history. e. Relevant Substance abuse history (pre-military, military, and post-military): Pre-military: Veteran denied substance use including alcohol and cigarettes. Military: Veteran reported that he drank alcohol "like every weekend." He stated that he smoked cigarettes "just the weekends probably like six or seven cigarettes." Veteran denied use of other substances. Post-military: Veteran reported that he drinks "2 - 3 beers a week." He stated he is no longer smoking cigarettes. Veteran denied use of other substances. f. Other, if any: No response provided. 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: Veteran reported that he served in Kuwait and Iraq. He denied engaging in direct combat. Veteran reported, "We were, I was doing guard duty one night and we heard the patriotic missiles, there were SCUD missiles coming in," "cause we were near Camp Virginia," "and we had to put on MOPP [mission oriented protective posture] gear" "because there was blood pathogen in the air." He stated, "one of my friends getting killed" "something I heard about." "We saw some dead bodies on our way back from Iraq," "we were 50 miles close to border line, coming back to Kuwait." Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- No response provided 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Anxiety [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships 6. Behavioral Observations -------------------------- Veteran was alert and oriented x3. Dress was casual but appropriate. Attitude was cooperative and polite. Speech was clear, coherent, and relevant. Mood was "pretty good." Affect was consistent with mood and topics discussed. Thought processes were logical, linear, and goal-oriented. Thought content was WNL, with no signs or reports of A/V hallucinations, delusions, paranoia, or homicidal ideation/plan/intent. Veteran denied current suicidal ideation/plan/intent. Memory appeared intact. Judgment appeared adequate. 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 -------------------------------------------------- Please note that level of impairment is only based on Unspecified Trauma-and Stressor-Related Disorder and Major Depressive Disorder, in partial remission. Veteran has physical impairments, which were not assessed today. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. /es/ MARIA T Artiaga, PsyD Supervised Psychology Staff Signed: 05/31/2016 11:28 Receipt Acknowledged By: 06/05/2016 16:22 /es/ DESI A. VASQUEZ, PHD SUPERVISORY PSYCHOLOGIST ------------------------------------------------------------------------- November 2016 2nd C&P Exam Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran: Edgar Sandoval SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [ ] Yes [X] No If no diagnosis of PTSD, check all that apply: [X] Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria [X] Veteran has another Mental Disorder diagnosis. Continue to complete this Questionnaire and/or the Eating Disorder Questionnaire: 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: unspecified trauma-and stressor-related disorder ICD code: F43.9 Mental Disorder Diagnosis #2: persistent depressive disorder ICD code: F34.1 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): deferred to medical 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [X] No [ ] 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 and discuss whether there is any clinical association between these diagnoses: symptom overlap 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 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 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 [X] No [ ] 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: symptom overlap 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 ------------------ Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): He was born in Weslaco, Texas and raised in Alamo by his biological parents. He has one brother. He stated that his father was an alcoholic and would "talk down at [him]." He was also physically abusive. He got along with peers and teachers and played sports in school. The veteran was living with his wife, daughter, age two and 8-year-old son, but they separated and he is now living with a friend. He visits with his children regularly. He stated that he was arguing and irritable with his spouse and that he was "swearing" in front of his children. "I was getting mad for no reason." His mother died in a nursing home with stroke (09/2016) and his father died of "alcoholism" (10/2016). He stated the symptoms of depression have increased since they died. "The whole world's on top of me." He continues to coach softball with teenage girls on the weekends. Relationships were good in the military. b. Relevant Occupational and Educational history (pre-military, military, and post-military): He graduated high school with average grades. There were no learning or attentional problems. He worked part-time at a department store during his teenage years. He was active duty Army (2002-2005) with highest rank SPC and rank at discharge of PFC due to disciplinary problem. Discharge was honorable. He received GWOT, NDSM, Global war on terrorism expeditionary medal. He was in Southwest Asia (2004). Post-military, he received a certificate for medical Assistant (2015). He has been unemployed since February 2015 after having productivity problems in a position as heavy equipment operator. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): He did not report pre-military mental health issues or family history of psychiatric problems, though his father drank heavily. Records indicate he was admitted to John Randolph Medical Center in January 2005 with "depression." Recent VA records show he has been receiving mental health treatment for trauma-related disorder and depression since January 2016. He has received both group and individual therapy. The veteran stated that symptoms of depression have been increased since his parents died 1-2 months ago. Currently, he reports symptoms of depression including feelings of guilt, decreased pleasure and interest in activities, decreased energy, irritability, tiredness, and problems sleeping. He stated that he feels guilty for not being with his parents anymore or with his family. He reports symptoms of trauma- and stressor- related disorder including occasional distressing dreams or intrusive memories, reactions to cues in the environment (seeing people with Middle Eastern clothing"), decreased interest in activities, irritability, hypervigilance, and problems sleeping. Medications: Buspirone, lisinopril. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): none e. Relevant Substance abuse history (pre-military, military, and post-military): 6-pack of beer per month. f. Other, if any: No response provided. 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: Feeling that his life was threatened during deployment with danger of being killed. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No b. Stressor #2: Seeing "dead bodies" when coming back from Iraq. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No c. Stressor #3: Hearing that one of his SM friends was killed. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criterion 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 Criterion 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 violence, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) [X] Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic events(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] 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: No response provided. Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1 [X] Stressor #2 [X] Stressor #3 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [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 6. Behavioral Observations -------------------------- MENTAL STATUS EXAMINATION Appearance: Casual, appropriate. Behavior: cooperative. Speech: WNL Mood/Affect: WNL, appropriate to content. Orientation: Oriented to all spheres. Cognitions: WNL, not formally tested. Safety: Danger to self/others? NO Safe to return home? YES Risk Factors assessment: [NO] Patient has current thoughts of hurting or killing themselves? [NO] Patient has current thoughts of hurting or killing someone else? [NO] Patient has is looking for a way to kill themselves or has a plan? [NO] Patient has taken actions to activate plan? [NO] Patient has history of compromised impulse control? Judgment: FAIR Insight: FAIR 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 -------------------------------------------------- Please comment on the effect of the Veteran's service connected disabilities on his or her ability to function in an occupational environment and describe any identified functional limitations. Please refrain from opining on if the veteran is unemployable or employable; instead focus and reflect on the functional impairments and how these impairments impact occupational and employment activities. Comment: The veteran is able to function independently and engage in activities of daily living. He is able to drive an automobile and research jobs or prepare for job interviews. However, symptoms of depression and trauma-and stressor-related disorder would negatively impact his motivation. Problems sleeping and tiredness may negatively impact performance and productivity. Irritability may cause interpersonal problems on the job. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. **************************************************************************** Medical Opinion Disability Benefits Questionnaire Name of patient/Veteran: Edgar Sandoval ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Does the Veteran have a diagnosis of (a) unspecified trauma and stressor related disorder with major depressive disorder that is at least as likely as not (50 percent or greater probability) incurred in or caused by (the) friend killed in action during service? b. Indicate type of exam for which opinion has been requested: DBQ PSYCH PTSD INITIAL TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] a. The condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. c. Rationale: STRs show treatment for depression during service (2005). He served in Southwest Asia, feared for his life and found out that a SM friend of his was killed in service. He currently reports symptoms of depression and trauma-and stressor-related disorder, such as irritability, low energy, problems sleeping, intrusive memories, distressing dreams, reactions to cues in the environment. ************************************************************************* /es/ Paul Loflin, PhD Clinical Psychologist Signed: 11/23/2016 12:21
  3. Hello all. I am looking for some thoughts on how much of an impact a VA psychiatrist note in my record. I am filing for aggravation of mental conditions the pre-existed prior to service. I had a special waiver signed prior to joining where the military doctor granted me permission to enter because I had been taking lithium trials. The psychiatrist note from 2016 therapy session that states "In brief, -------- has contended with depression, anxiety, and anger as far back as teenage years. There were aggravating circumstances during his time in the Army (1988-96), though he was not in combat, and for quite a period of time alcohol misuse exacerbated his symptoms, but he says today he's been sober since 2011, when he went through treatment in the VA hospital. He doesn't attend AA; he just knows he's better off not drinking. -------- has contended with hostility and paranoid perceptions and ideation for many years. When it's been bad he'll use Abilify to counteract those symptoms. I have been seeing the VA doctors for mental health problems since 2009 and have an extensive history in my VA records of meds and groups etc. Do I have a nexus? I have been appealing this for years. Happy to provide more info if needed. Thank you
  4. Am I the ONLY ONE OUTRAGED by this prejudiced, stigmatizing, doubled standard *%#! calling VETERANS drug addicts!! That is exactly what is happening here! Oh, Holy Mother of God! How are you all not speaking out about this injustice? We have bore the Injuries on the Battlefields resulting in lifetime injuries of pain and suffering to our Knees, from jumping out of planes, boats, trucks, helicopters; to our Necks and Spines from carrying the loads not meant for the human body; suffered the TBIs -with constant migraines....these are but a few that are DENIED their CHRONIC PAIN MEDS by the very Doctors in Chronic Pain Clinics by Anesthesiologists that receive their training from the Prestigious State of Art Pioneering STANFORD UNIVERSITY in CALIFORNIA who just released "National Pain Study" in clinicalpainadvisor.com, dated 5/27/16 - Where Sean Mackey, MD, PhD, Stanford Pain Management Center at Stanford University evaluated 5,300 Chronic Low Back individuals, "Do opioids make a difference to patients with Chronic Pain? The Answer was, YES!" When I presented this STUDY TO MY GMC. - She threw Secretary McDonald's Letter at me, dated 8/1/16 (yet C-SPAN didn't air until 8/12/16) and said, we are VA- not Stanford. Although, Stanford Residents and Surgeons, fill VA Hospitals to gain their experience, practicing on Veterans before they leave to get "real jobs." I have been a Successful, Functional, less Painful with my Significant Back Injury w Sciatica for over 10 years and now being told there will be no Opiates for Vets. I say to Secretary McDonald, it seems YOU want all Disabled Veterans to go to the Streets to find alternative pain medication. That seems to be CONGRESSES ANSWER TO VETERANS SINCE AGENT ORANGE and the Viet Nam War-altho it still has never been declared a WAR!! We need to Stop this AND STAND UNITED! Disabled Veterans are NOT Drug Addicts, we have fought the fight once, we should not have to endure another battlefield for the respect we have already earned. God Bless America! God Bless our Veterans still Fighting the Good Fight
  5. So, here's the thing. I got off active duty in 2012 after 6 years of AD. Since 2012, I was granted 40% for my dual knee replacement after getting injured in combat. Since I was only granted 40%, I had continuously submitted for PTSD disability as I'm treated for it and have been for 2 years now through a non VA psychiatrist. I've had numerous sessions within VA Mental Health regarding my mental state, issues, etc. Now, about 2 weeks (Nov 2016), I submitted another claim after being denied about 6 times since 2012. I gave as much detailed information as possible. My symptoms, issues, etc. This is the weird part. I've never seen such a quick turnaround. The claim is already in the "Preparation for Decision" phase, with an estimated completion of Feb 2017. Could anyone elaborate on why all of a sudden the process is much quicker? I haven't received any appointment to have an evaluation and I'm just stunned. Does this have anything to do with Trump making changes to the VA? Any input would be much appreciated. Thanks brothers!!
  6. back in 2011 I filed for a plethora of disabilities that i received during my time in the air force as a load master. I was given an 80% rating. One of the claims was for depression an ptsd. However, I missed that c&p appt (i forget everything) and i obviously was not given a rating. However, I was sent a letter that says: "You were denied service connection for depression/anxiety/stress because you did not report for the scheduled exam in order to determine if the current disability began on active duty and to obtain sufficient information for evaluation of the disability. Although there is a record of treatment in service for anxiety/depression/stress, no permanent residual or chronic subject to service connection is shown by the service medical records or demonstrated by evidence following the service." Now this was sent to me in 2011. Since then ive received a ton of treatment but ive also have had some unfortunate events happen as a result of the depression, anxiety, anger etc (jail, a stint at the mental health clinic, even a broken hand twice on two separate occasions on 2 separate faces, and few more incidents. i am working so hard on controlling my frustrations with the world and i am taking my meds and getting counseling - i hate living like this because i physically cant control it. And i was never like that prior to 06' my join date). so my question is what exactly does that quote from the va mean? does it mean that they recognize i was treated for depression during active duty but due to me missing the appointment, they need more information? And if i were to file a claim for depression and ptsd - and i were to receive the 80% I need in order to be rated 100%, how would the back pay work? Would the date go bak to my initial 2011 date? Or would they back pay me from the current date of filing? Sorry for the long post - thanks for the help. Also am i correct in saying that they would only be paying the difference between the 80% pay and the 100% pay right??
  7. I was recently diagnosed with Narcolepsy after experiencing sleep issues over the last 12 years. 12 years ago I was injured by a hand grenade (close Proximity) and am currently service connected %70 for mostly shrapnel wounds allover my body, nerve damage, and an additional %10 for PTSD. I do not have a service connection for a TBI and did not know what TBI was at the time of checking out and filing a claim with the VA. Over the last 12 years I have had issues with sleep and sought treatment during that timespan. I was referred to a new sleep doctor who tested me for Narcolepsy as well as Apnea, which came back positive for Narcolepsy. His opinion was this diagnosis' onset was from the blast along with other symptoms of PTSD, depression, etc. I was however tested for TBI in 2005 and it came back negative, however there was no claim made for this when I got out. My question is, should the Narcolepsy be service connected through a new TBI test (if it comes back positive), or another route such as PTSD?
  8. I filed a claim sometime in early October for an increase of my PTSD, a foot injury, as well as put in for 2 new conditions and one secondary condition. While I am largely very happy with how the claims for my physical disabilities has gone (my examiner told me within the first 5 minutes he was going to connect me for all the new stuff and that I rated an increase for the foot issue - after that I just had to actually do the C&P! My PTSD exam and resulting DBQ however were not nearly as smooth as my other C&P's had gone. Honestly I was actually kind of shocked when I finally got around to pulling it off myhealthevet and reading it. A big reason I was so surprised is that as far as "evidence" goes I've been piling it up over the last year. To get to how this all went down I have to run it back a little bit and explain my situation. I ran into a rough time around February of last year...... So I had my big sob story all typed up and then chickened out. Sufficed to say that I lost everything. Not only did I lose my wife and kids, I lost the dream property we had worked so hard to get to. I just walked away from it, I couldn't bring myself to walk back into the cabin. I literally just left everything I'd worked for the last 6 years of my life at 9,000 feet on the side of a mountain and just walked away. Sufficed to say I crashed and burned really hard. For about 3 weeks I spent every waking moment doing everything I could to make the pain go away, up to and including multiple attempts at OD'ing. I finally was able to get my wits together, did some searching online and ended up in a VA domiciliary program in Texas. While I've never identified myself as a drug addict, I definitely needed some help getting the wheels back on so the first thing I did was enroll myself in a 45 day substance abuse program. After that I was able to put in 3 1/2 months of inpatient trauma treatment, followed by 2 months of inpatient PTSD treatment. It's been about 9 months but I'm glad I did it, I honestly don't think I would have made it through to the New Year if I hadn't come here. Anyhow, after 9 months of inpatient therapy which included almost 6 months of trauma/PTSD treatment, daily group meetings, twice weekly counselor/psychologist one on ones, and intensive medication programs to help me through everything, I kinda thought I had a decent chance of getting an increase from 30%. I've tried for increases in the past but I haven't been the most consistent person over the years. I have a hard time following through on treatment and in addition to that due to having a non-combat trauma I haven't had a very easy time getting the VA to accept my diagnosis, at least on the disability side. The treatment side has no issue with it. Anyhow, like I said I had hope because in the past I had been told that I wasn't getting increases in my rating because I wasn't following through on treatment and because of that it made it difficult for me to build much of a case. Everything was simply my word as to how things were, or how I was getting by, but I didn't have anyone respectable to back me up about the things that I was going through and the troubles I have. So this leads me to my most recent C&P/DBQ. I've cut out a decent amount of personal information and trauma narrative stuff, but the meat and potatoes should be in there for anyone that's familiar with these things. I've been service connected since 2004 and my trauma is most definitely legitimate. I really hope there's a possible sunny side to all of this. I've done a massive amount of googling over the last few days and I've seen posts where people say that just because the examiner says one thing doesn't mean that's the direction the rater is going to go with things. I'm really discouraged right now. I've had a very contentious relationship with the VA for a long time. I have a very hard time trusting the VA anymore. I've had some very bad caregivers who were telling me one thing to my face while shredding me in their notes after I'd left (We have access to those you know....) One LCSW in particular went out of here way to push a personality disorder diagnosis on me, essentially getting the diagnosis put in my chart by filling up my psychiatrist with a lot of crap; all the while telling me how much she was trying to help me. Now here I am again. I feel like I'm really getting the short end of the stick by the VA and in particular this examiner, after I did have a pretty awesome doctor for my physical C&Ps and lord knows I'm not the first one to get the un-greased by the wonderful VA. That being said I'm just frustrated because I've really put in so much effort into my recovery and treatment. I'm working the DBT, mindfulness and challenging beliefs far more than I'm comfortable with, but I'm doing it. Anyhow I went from erasing my sob story to writing a whole new one. Thanks for taking the time to read through this and pass on any info/experience/ideas you might have. Thanks in advance, OGG The following is an excerpt from another thread I started about a DBQ for my back that ended up digressing a little. I figured there's no reason to type it all out again new so I just copy and pasted the "important" parts. Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire SECTION I: --------------------- 1. Diagnostic Summary -------------------- Does the Veteran now have or has he/she ever been diagnosed with PTSD? [X] Yes[ ] No 2. Current Diagnoses: ------------------- Mental Disorder Diagnosis #1: PTSD Mental Disorder Diagnosis #2: Cannabis Use Disorder, In Early Remission, In a Controlled Environment Mental Disorder Diagnosis #3: Alcohol Use Disorder, In Early Remission, In a Controlled Environment Mental Disorder Diagnosis #4: Inhalant Use Disorder, In Early Remission, In a Controlled Environment Alright I'm definitely not proud of the huffing. All I can say is that my life had fallen to pieces. My wife took my kids and left me while I was getting the car fixed overnight. She filed false abuse charges against me to keep me from the kids. I'm no saint but I never abused my wife or my kids. Up until this moment I hadn't had a drink in 5 years... I just smoked pot - which I was prescribed. Also I think this would be a good time to put what my actual working diagnosis list for a little bit of contrast. This list was pulled straight off my myhealthevet file and reflects 9 months of inpatient treatment. I can't help but feel like this lady was snowballing me. Yes there's some overlap. What's the difference between PTSD and Chronic PTSD? I don't know. Why do I have 2 types of insomnia DX'd? I don't know that either. #1)Chronic post-traumatic stress disorder (SCT 313182004) #2)Posttraumatic stress disorder (SCT47505003) #3) Anxiety (SCT 48694002) - symptom of PTSD #3) Depressive disorder (SCT 35489007) - symptom of PTSD #4) Insomnia (SCT 193462001) - symptom of PTSD #5) Psychophysiologic insomnia (SCT 425832009) - symptom of PTSD #6) Cannabis dependence (SCT 85005007) #7) Alcohol dependence (SCT 66590003) 3. Differentiation of symptoms ----------------------------- a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes[ ] NO b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [X] Yes[ ] No[ ] Not applicable (N/A) I have a problem with this part. Just how is she going differentiate between my various diagnosis which all are attributed to the PTSD? (besides the substance abuse issues) 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 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. I have a problem with this as well. I haven't been able to work in 6 years. I've tried but it always ends up being a failed attempt. I usually end up getting myself too worked up about social situations, get too depressed to get out of bed, get fired for being late because I have serious sleep problems which sometimes lead me to not being able to wake up for my alarm, etc etc. In addition I barely go out. Hell I went out of my way to move 10 miles from the closest power poll 9,000' above sea level just to find myself some peace. I can't handle large groups, I psych myself out when I'm out at night, I see danger and trouble everywhere. Anyhow back to getting smeared. 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? [X] Yes[ ] No[ ] No other mental disorder has been diagnosed If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: Symptoms of PTSD and substance use contribute to social and occupational impairment. However, symptoms of PTSD have not increased in severity since the veteran's last C&P exam in 2013. A quick side note A: I've been in a treatment facility for almost a year now, I'm pretty sure my "substance abuse" isn't contributing to my issues. I smoked cannabis medicinally and I don't even drink. Why do I smoke pot because it helps with my PTSD as well as a laundry list of other issues. That being said I've been "clean" for a year now. So... now that she's basically said I barely have PTSD, and my troubles are simply because I'm a drug addict, let's get on to the next section. 3. PTSD Diagnostic Criteria -------------------------- Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors.) 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". 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).d [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent 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). [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] Reckless or self-destructive behavior. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] The duration of the symptoms described above in Criteria B, C, and D are more than 1 month. Criterion G: [X] The PTSD symptoms described above cause 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. That last one is my favorite! Not only does she say that my disturbances are NOT attributable to substances be it medication or drugs nor are they attributed to another medical condition. She also manages to manages to assess me with 20 out of 24 possible sub-criteria or disturbances in the diagnosis of PTSD. I'm sure I'm reading into this wrong and I can't look at things like this but that certainly feels like more than 30% disabling. I dunno. 4. Symptoms ---------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events 6. Other symptoms ---------------- In this section she just goes about telling whatever version of my life story she could piece together from old treatment records. Spends a lot of time on the fact that I smoke pot, that I didn't have a relationship with my father and various other fun facts that do a lot to distract you from the lack of a cohesive narrative or making any of what she wrote mean anything as far as the DBQ goes. She doesn't list a single "other symptom" like the line below talks about. She just kinda makes me out to be a flaky loser. Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No....... 7. Competency ------------ Is the Veteran capable of managing his or her financial affairs? [ ] Yes[X] No At this point she pulls out some more fun facts from my medical record. She says that "I frequently go on spending sprees", and brings up how when I was 25 and got my first backpay check and I blew it on fun stuff like a car, and a computer and whatnot (I was single going to university at the time). What this cluck of a woman doesn't see in her precious computer is that other than my time here at the VA facility I'd been able to support my wife and two kids on my 50% SC. Trust me there's no spending sprees going on there. 8. Remarks, (including any testing results) if any: -------------------------------------------------- Psychological Testing: A test of response bias specifically related to PTSD symptoms was administered to the veteran during this examination to assess the credibility of his self report. The name of this measure is withheld in this report in order to protect the integrity of the test. This test was specifically standardized on a sample of veterans applying for financial remuneration for a claim of disability resulting from PTSD. The veteran's score on this test was below the established cutoff, indicating that his performance was consistent with individuals responding in a valid manner. As such, he did not appear to be intentionally exaggerating signs and symptoms of PTSD or attempting to appear worse off that he actually is. Ahh what a finish eh? I think she should spend less time worrying about my credibility and a little more about hers. Well, last but not least let's hear her final word on the subject: Signed: 10/30/2015 13:35 11/03/2015 ADDENDUM STATUS: COMPLETED PTSD is less likely than not a result of military duties. /es/ Her Name Goes Here, PSYCHOLOGIST Signed: 11/03/2015 15:22 So yeah that's essentially where I'm at. I'm just hoping that whoever rates my PTSD takes what she says with a grain of salt and also takes time to look at the 1200 pages of treatment records I've added to my medical record in the last year as well as the weakly psychologist appointments, 20 page typed trauma narrative, the countless notes that were put in on my behalf. I hope they also see the weekly PCL-5s averaging between 65 and 72, the by weekly CAPs averaging around 66, the PHQ9 score of 23, the gad-7 score of 20 - All of which were administered by a Doctor or LCSW. Yah I've got this one too; World Health Organization Disability Assessment Schedule 2.0 Cognition: 75 Mobility: 12 Self-care: 70 Getting along: 83 Life activities (household): 100 Life activities (work/school): 85 Participation: 79 Summary: 70 *Range is 0 to 100 where 0 indicates no disability and 100 means full disability I realize I'm probably putting too much hope into all of this. I know that the disability tests and rating exams probably don't amount to anything as far as determining anything with the VA. If the particular examiner is up on their stuff they might know the significance of the WHODAS 2.0 or put stock in the CAPs screening but really they don't have to look at them at all. Hopefully at the very least I can use all I've put together to apply for SSDI. If you've gotten this far thank you so much for reading my rant and hopefully pulling out the important bits from what I did post of my DBQ. Hopefully I haven't over edited it but I just didn't think what she wrote was particularly applicable to the questions that the DBQ was asking and I generally feel she was just trying to prove out whatever she had come to believe based on small glimpses of my medical record. I really wish I had been afforded the opportunity to address some of the conclusions she was making about me and the picture she was painting.
  9. In recently received my C&P exam and here is a summary of the results. What do you believe my raiting would be? This was done using the DSM 5 standards.The examiner found that you do have a diagnosis of PTSD that meets the DSM V criteria. He also opined that your PTSD was at least as likely as not incurred in or caused by the claimed in service stressor event. It was also noted that your primary diagnosis is bi-polar Veterans Diagnosis: Depressed mood Anxiety Suspiciousness Chronic Sleep Impairment mild memory loss, such as forgetting names, directions or recent events disturbsncea in motivation and mood difficulty in adapting to stressful circumstances including work or work-settings suicidal ideation impaired impulse control, such as unprovoked irritability with periods of violence i do well when I work and worry if I get 100% if I cannot continue my contracting for the military which would really hurt my kids support and make things more stressful. Though I have difficulty working when things get bad, Is it possible to be 100% without unemployability? just would like some feedback and opinions Sincerelrey Just Some POG
  10. Hello HadIt Community, TL:DR Skip down to bold section “So that brings us to today….” I've been a bit of lurker on the forums, searching and researching information already presented, hence the lack of postings. I was not quite sure where to post this, in the “Appeals” section or the “Disability and Claims” section.” I decided on the “Appeals” section due to the fact that the claim was already submitted and decided on, and so the next step logically would be an appeal. Moderators, if it needs to be moved, please move it to the correct section. I know that there is a lot of postings, questions, and information in regards to sleep apnea and trying to get it service connected, namely to PTSD and/or TBI. I hope that by sharing my path/progress it will help others who are in a similar situation. I am SC for TBI (70%), PTSD (50%), Mechanical neck pain syndrome (10%), tinnitus (10%). Total combined rating with fuzzy math puts me at 90%. This path of medical issues and nuances began in 2007 when I was in the Marine Corps, and it has taken my up until this year to really get most of my issues addressed and sorted. What delayed the entire process would be attributed to not knowing the secondary effects to injuries. Certain things were obvious (a head injury has secondary consequences like memory issues), but other things (namely the PTSD) were not. The VA, for me, has done an excellent job in diagnosing things, as well as the therapy afterwards. I know that this is not the case for everyone, but I was persistent and proactive towards trying to learn about myself and the changes I was going through and had been through. Not having considered PTSD as a problem for me (denial maybe?), I had attributed everything (headaches, poor sleep, attention problems, behavioral changes) to the head injury. Turns out that a lot of the symptoms of TBI are shared with PTSD, making treatment harder. Is the poor sleep because of the head injury or the PTSD? If the memory and lack of focus because of the head injury or the PTSD, etc. It took me a year and a half, after 6 months of initial therapy, to go through the medicine trial run. Try different medications, see if I feel any different. If I do, do I feel better? Once the right medicine is found, then it’s about finding the best dosage for me. Because everyone is different, and we are all wired differently, no 1 chemical will react the same way for everyone. At times, it felt that nothing was really working, and it didn’t help that the trial period takes time for your body to adjust to the new drugs. But with an open line of communication with my psychiatrist made it easier to track changes and make the changes so that I felt better. For me, it’s been a night and day difference. Looking back and remembering how I felt, it was almost as if my brain was in a constant fog. I was awake and aware of things, but almost as if things were in a dream-like state. I don’t know how else to describe it, but it felt like the drag I had on my mind and shoulders was eased. There are still bad spells and moments, but that is where the discipline and focus really comes into play. It hasn’t been easy, and I can’t even begin to imagine how it is for those who have a bigger challenge than I. But what I do know, is that you need to be wanting to make things better for yourself. It’s a bit of a process. Therapy isn’t the easiest, as you need to revisit certain areas in your life that you don’t want to. It takes time, and you feel quite low during certain times. In some ways, it allowed me to learn more about myself, and what I needed to do and go through to make myself better (know yourself and seek self-improvement…). But it gets better, I promise. Biggest takeaway from disability claims with the VA, is to make sure you have your paperwork in order BEFORE you submit things. At the beginning I did not know what I had, how the VA system worked, or anything at all. So my first claim consisted of: neck pain, lower back pain, headaches, memory problems. Very broad and generic symptoms. They were denied, but through the intake process, I did learn that I should talk to the VA clinic, namely the poly-trauma area to have my TBI assessed. From there, it was evaluation after evaluation to try and get an answer as to why I was having problems. TBI led to tinnitus and neck problems. TBI therapy then lead to depression screening which led to PTSD screening. PTSD screening then led to therapy. Once those two main areas (TBI and PTSD) were stable enough for me, I started to address other issues, namely sleeping problems. Headaches every day when I wake up, cold sweats every other night (changing sheets couple time a week….), nightmares. I had attributed all those symptoms to the head injury, but that was when I had learned that it could be partially the head injury, and partially the PTSD. More research lead to asking for a sleep study done. I figured that if there is something going on while I sleep, maybe it’ll show up on the results and give me a better idea to what’s going on. Having a better idea, it would allow me to attack the problem from a different angle. I found that throughout the entire VA process (starting in 2007), the best way to tackle things is to focus on it like a puzzle. Define the problem, get a better idea of what it is, and this then leads to knowing how you can attack it head on. I don’t know what exactly I was expecting out of the sleep study, but I certainly did not think that I would have an issue with breathing while I sleep. I had assumed that my combination of injuries was manifesting itself while I was sleeping (my most relaxed state). Long story short with my sleeping habits from the past, the sleep study showed that I had mild sleep apnea, namely obstructive sleep apnea. CPAP machine was then issued. Now to me, that didn’t make any sense at all. I don’t fit the OSA poster-boy, at all. Overweight? Thick neck? Older? I’m 28, 6’, 165 lbs. But I had some answers. My shallow breathing would cause decreased oxygen intake which causes an increase in CO2 in my blood. Heart pumps faster, fight/flight response starts, body is working harder to supply blood to muscles, cold sweats start to try and dump CO2. Then I wake up and I have to go use the bathroom, 1-2 times per night. I just figured I was well hydrated…haha… With the answer of sleep apnea of the obstructive kind, I started to research causes for it, and correlations to different injuries. One thing leads to another and there are correlations between head injuries and PTSD. So at that point (more answers…yay), I go back to VA research and learn that there can be claims filed for OSA. Since I was diagnosed with OSA outside of service, then I would need to either prove it happened while I was in (no evidence, so scratch that), or have a secondary connection to a service connected disability. Seeing that I was SC for TBI and PTSD, that would be the route I would take. What this meant was that I would need to present information to the VA showing a correlation between the injuries, and have the weight of a doctor behind it. I made sure to file an Intent to File notice so that my date was locked in for retroactive pay. With this date locked in, I needed to go about finding information on IMOs. Researching and learning, I decided to go with Dr. Anaise and get an Independent Medical Expert Opinion. $1500 later I had a nice sizeable book with him stating (and with evidence too) that he opined that it is more likely than not that my sleep apnea is secondary to my service-connected PTSD, TBI and tinnitus. With my new information and medical opinion in hand, I submitted a Fully Developed Claim, since I had no more information to submit (IMO from private doctor, and the VA had all my medical records including the sleep study). 6 months of waiting and checking eBennies (torture….) and it finally finished and showed that a decision had been made. Paperwork comes in the mail and the claim is denied… Frustrated? Not really, since I had expected that it would be denied. Most claims, unfortunately seem to be denied the first time around. Bit let down sure. But it is what it is, I can’t change that, so now time to look at how to keep pushing forward. So that brings us to today…. I do plan to submit a Notice of Disagreement to have it reviewed again. I have been told that the reviewal process is in the time length of 2-5 years (frustrating but backpay will be nice…). My posting on HadIt is based on wanting to get other people’s input and a fresh set of eyes on the information I have and what the next steps are, different viewpoints, and maybe anything I missed/am missing, as well as posting my information and path on here for others to read and learn from. Medication: Venlafaxine 300mg for PTSD Zolpidem Tartrate 5mg for sleep (Ambien) -------------------------------------------------------------- VA Decision letter verbatim: Issue/Contention sleep apnea Explanation The evidence does not show that sleep apnea is related to the service-connected condition of traumatic brain injury, nor is there any evidence of this disability during military service. Service connection for sleep apnea is denied since this condition neither occurred in nor was caused by your service. Your service treatment records do not contain complaints, treatment, or diagnosis for this condition. The evidence does not show an event, disease or injury in service. The evidence does not show that your condition resulted from, or was aggravated by, a service-connected disability. The VA examiner stated that your current sleep apnea is due to the airways in your throat relaxing too much to allow normal breathing and closure of your muscles than your service connected TBI, tinnitus, and/or PTSD. ------------------------------------------------------------------------------ VA Examination I was not there for the exam because verbatim: [X] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. Verbatim: MEDICAL OPINION SUMMARY ----------------------- opinion ---OSA 2/2 to PTSD LESS LIKLEY THEN NOT THE OSA IS 2/2 TO PTSD -- RATIONALE --OSA IS A OBSTRUCTIVE DEFECT Obstructive sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These muscles support structures including the soft palate, the uvula ? a triangular piece of tissue hanging from the soft palate, the tonsils and the tongue. When the muscles relax, your airway narrows or closes as you breathe in and breathing may be inadequate for 10 to 20 seconds. This may lower the level of oxygen in your blood and cause a buildup of carbon dioxide. Your brain senses this impaired breathing and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it. You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths. You may make a snorting, choking or gasping sound. This pattern can repeat itself five to 30 times or more each hour, all night long. These disruptions impair your ability to reach the desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours. People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they slept well all night /es/ *Name removed* FNPC PRIMARY CARE PROVIDER -------------------------------------------------------------------------- IMO excerpts verbatim “After reviewing the veteran’s c-file and the pertinent recent medical literature, I opine that is more likely than not that the veteran’s sleep apnea is secondary to his service connected PTSD, TBI and tinnitus” “After reviewing all of the veteran’s medical and military records, it is my expert medical opinion that it is more likely than not (50% or more) that the veteran’s sleep apnea is secondary to his service-connected PTSD and TBI. The scientific observation that the derangement of REM sleep prominent in the PTSD patient is the cause for sleep apnea is of particular importance in this case. It is more likely than not that the veteran’s sleep apnea is secondary to his service-connected tinnitus.” --------------------------------------------------------------------- The report is 7 pages long with 5 5 exhibits of evidence (scientific journal reports). If needed for better clarity, I can scan the 7 pages in (edited for privacy). I can also post the findings from the sleep study if needed as well. I don’t want to provide my thoughts and input on this just yet, as I would like to see what the community’s thoughts are on where things are so far, based on what there is. What I ultimately am looking for, besides getting my claim granted, is to gain a better idea of what route I should take based on what I have. The VSO who I was working with suggested a simple medical statement that says my medication for PTSD affects my OSA (throat muscles relaxing), was also recommended to have a DRO review the case (instead of a RO?) since it might speed up the process because it was more ‘in-house’. De Novo review? CUE? Thank you in advance for your thoughts, view points, and suggestions The CPAP machine, took a bit of time getting used to, but it is a night and day different (no pun intended ha). The nightmares are less, the cold sweats are essentially gone, morning headaches aren’t there, and I feel rested now when I wake up and throughout the day. Getting sleepy while driving isn’t there anymore. I wanted to see its effectiveness, so I decided to try sleeping 2 nights without the mask, and the first night, instantly the prior symptoms came back. Headaches, cold sweats, over tired all day. My conclusion, from my personal experience, is that if you have PTSD, TBI or both, get a sleep study done. There is strong enough correlation between the three to have symptoms overlap and exacerbate one another. I may not know the exact scientific workings behind it, but logically it makes sense. PTSD or TBI, get testing and therapy done to better understand the challenge that YOU have, and how to better work through/around/over it. If they recommend medication, ask why. Not to push back against it, but so that you understand what the purpose of it will be, how it will help you. Self-knowledge and self-learning are very important in order to have a better grasp of things pertaining to you. Be patient with medication, and be honest with your prescribing doc. Everyone reacts differently to medication, and only YOU can determine how you feel. I might even recommend keeping a small journal of how you FEEL throughout either therapy or medication trials. Be patient with your meds. Medicine doesn’t work overnight, especially finding the right one and dosage. Be patient with therapy. Not during therapy necessarily, but in the length of things. It takes time depending on severity. You will feel worse some days more than others. Therapy, like medicine, is unique to YOU. What worked for me, may not work exactly (or at all) for you. But you need to be honest with yourself and with your guides (therapists and docs). I had a small ‘good luck charm’, a grounding tool, that I would touch and hold when my mind would start to wander. Helped to keep/bring me back to reality. Grounding techniques worked wonders, but you need to be disciplined about it. My good luck charm was a 550 cord bracelet I made when I was in. Feeling the knots and mentally talking to myself kept me ‘here’. Doesn’t have to be something big. Just a small item that has meaning and significance to YOU. You don’t even have to tell people what it is or does or anything. But it gets better, I promise.
  11. I hope you can help me; not sure what I should do. I was rated Service Connected Disable for PTSD on August 21, 2012 @ 70%. I didn't expect this at all. If anything, I thought I would get a low rating for my physical aliments............(neck, back head shoulder). When I applied in 11/2011, I had been out of work for 3 yrs and was totally distraught,confused and disoriented. Needless to say, I finally got a job in 02/12 and it is no where near what I use to do or the money I use to make. I'd like to know what your advice would be for this: I see where I do have serious social and economic problems and believe I am totally diasable & want to ask for 100% PTSD, Permanent and Total. I'm still on this job that wrecks my nerves, can't stop the obsessive thoughts and wants to hurt people because I don't work well with people at all. I took this week off because I couldn't pull up the gumption to go back in there after the week, mentally. What should I do; appeal my rating 1st and then apply for TDIU while working or do I go ahead and let the job go in order to apply for TDUI and then appeal the VA's decision? Thanks in advance.
  12. 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!
  13. 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?
  14. 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.
  15. "What did the combat vet say to the Psychiatrist?"... Answer - I don't know, I'm having a heck of a time finding one... So here is my request for help from you all who live in Texas - Houston to be exact. Can anyone recommend a Psychiatrist who has experience with Vets (combat vets a plus)? I'm having a hard time picking up the phone to make an appt with a Psychiatrist who may not understand a Vet. I know I can make an appt with a Psychiatrist at the VA but at this point I'd feel more comfortable not going that route if I can.... Thank you for reading my post and recommendations.
  16. Some advice on SMC- S
  17. Thanks folks. I was diagnosed with PTSD by a VA physiologist in 2011. I put in a claim for that and my knee the same year. I no showed to the C&Ps and was denied. Skip to the beginning of 2012 I ended up having to do some inpatient treatment for substance abuse and ptsd. I was reevaluated there and then again confirmed the diagnoses. The first diagnosis was under DSM-IV criteria and just 2 months ago i went back to the doc and we confirmed the diagnosis using the new DSM-V criteria. I resubmitted a claim for ptsd and my knee this June. I had a c&p where the doc did not diagnose me with ptsd but said i showed with depression anxiety and something about borderline personality disorder. My question is what are my chances of getting service connection for ptsd anyway? i mean ive seen my doc for pretty much the last 5 years and have been treated for ptsd ever since. i dont understand how a doc that has seen me 1 time for not even an hour can say that he cant confirm nor deny a diagnosis because of "substance abuse and i need 6-12 months of not drinking before a solid diagnosis can be given". will the rater take into consideration all of the documentation? how much weight does the c&p have compared to 5 years of documentation? im losing my mind here. i keep watching ebennies like its gonna change and show me something positive. Id like to add that i have found out that this C&P doc works for or used to work for a company that tries to disprove SSD claims. Not sure why the VA would use him... I will add this. I claimed sleep apnea secondary to ptsd and despite his not diagnosing me with ptsd he did write up a solid nexus for me (i believe it to be solid). Not sure why he would go to the trouble of doing this if he doesnt feel i have ptsd.
  18. Please, welcome new VET2VET podcast episode: https://youtu.be/waV5t0HPtbM Today we are joined by Thomas Wendel, DAV National area supervisor for West Cost Region. Thomas E. Wendel served in the U. S. Marine Corps from 1983 until 1997. Since 1999, Tom has worked assisting veterans in processing various entitlement claims on the local, state and federal levels; first in Clare County as a county service officer and then when he came to work for the Disabled American Veterans in 2000. In 2008 he was promoted to the position of supervisor of the DAV Service Office in Detroit and later he was promoted to the position of supervisor of the DAV National area for West Cost Region. DAV is America’s largest, most effective veterans service organizations dedicated to the needs of those injured, ill or wounded in service. We have more than 1,300 Chapters in communities nationwide to help make sure veterans from all generations and their families get the benefits and support they deserve. Today, nearly 1.3 million veterans belong to DAV, and we encourage you to add your voice to the cause. Our programs and free services help all veterans get the health, disability and financial benefits they earned. Take advantage of our benefits claims assistance, medical transportation and employment resources. Your local DAV Chapter is a great way to connect with fellow veterans in your area. ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  19. Good Morning community- Earlier this month I recieved 100% service connection, a surprizing 2 1/2 months after submitting my claim on e-benefits. After living off of a few hundred bucks a month for the past 3 years I woke up to $6k in my bank account, so life feels great right now. A friend of mine is telling me to file my NOD anyways, for the other disabilities they didn't connect, and also to get my SC backdated to the onset of condition - which would be considered starting in the last 2 months of service before recieving my honorable discharge, 9 years ago. Who has experience with this? Is there a legitimate route I can take to get my 100% backdated to the diagnosis of my PTSD, and without a lawyer? Thanks and happy Sunday.
  20. My VSO and I put in a request for TDIU. I also wonder why E-Benfits shows IU and increase for 100% PTSD when we did not file for 100% PTSD increase? Is this automatic? I am currenty at 80% total, 70% is for PTSD-Combat. My last C&P for PTSD was less than a year ago. 08/12/2015. The doctor that did the new onebelow called it a "REVIEW"??? I was working during the 1st one and I am not now, I resigned in December 2015. Please let me know what you think and please answer my above questions. THANK YOU!! Service Connected Disabilities: ASTHMA,BRONCHIAL (30%-SC) INGUINAL HERNIA (0%-SC) KNEE CONDITION (10%-SC) POST-TRAUMATIC STRESS DISORDER-COMBAT (70%-SC) IMPAIRED HEARING (0%-SC) TINNITUS (10%-SC) Review Post Traumatic Stress Disorder (PTSD)Disability Benefits QuestionnaireName of patient/Veteran:SECTION I:----------1. Diagnostic Summary---------------------Does the Veteran now have or has he/she ever been diagnosed with PTSD?[X] Yes[ ] NoICD Code: F43.102. Current Diagnoses--------------------a. Mental Disorder Diagnosis #1: Post traumatic Stress DisorderICD Code: F43.10Comments, if any: Previously diagnosed by Dr. David Coron on 8/12/2015.Currently Service Connected 70% for PTSD. Total service connection isreported to be 80%Mental Disorder Diagnosis #2: Opiod Dependence in RemissionICD Code: 304.01Comments, if any: Reports that he has been clean for last 6 years.b. Medical diagnoses relevant to the understanding or management of theMental Health Disorder (to include TBI): Please refer to Medical Recordsand CPRS for all medical problems and concerns. Veteran is currently 30%service connected for asthma; 10% for knee, 10 % for tinnitus , 0% ofinguinal hernia and 0% for hearing impairment.3. Differentiation of symptoms------------------------------a. Does the Veteran have more than one mental disorder diagnosed?[X] Yes[ ] Nob. Is it possible to differentiate what symptom(s) is/are attributable toeach diagnosis?[ ] Yes[X] No[ ] Not applicable (N/A)If no, provide reason that it is not possible to differentiate whatportion of each symptom is attributable to each diagnosis and discusswhether there is any clinical association between these diagnoses:Comorbid relationship between diagnosis such that separation ofsymptoms can not be reliably performed without engaging inspeculation. It is likely that all symptoms are related to PTSD.c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?[ ] Yes[X] No[ ] Not shown in records reviewed4. 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 onlyone)[X] Occupational and social impairment with deficiencies in most areas,such as work, school, family relations, judgment, thinking and/ormoodb. For the indicated level of occupational and social impairment, is itpossible to differentiate what portion of the occupational and socialimpairment indicated above is caused by each mental disorder?[ ] Yes[X] No[ ] No other mental disorder has been diagnosedIf no, provide reason that it is not possible to differentiate whatportion of the indicated level of occupational and social impairmentis attributable to each diagnosis: Comorbid relationship betweendiagnosis such that separation of symptoms can not be reliablyperformed without engaging in speculation. It is likely that allsymptoms are related to PTSD.c. If a diagnosis of TBI exists, is it possible to differentiate what portionof the occupational and social impairment indicated above is caused bytheTBI?[ ] Yes[ ] No[X] No diagnosis of TBISECTION 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?[X] Yes[ ] NoIf yes, list any records that were reviewed but were not included in theVeteran's VA claims file:Elecronic Medical Record was also reviewed today.If no, check all records reviewed:[ ] Military service treatment records[ ] Military service personnel records[ ] Military enlistment examination[ ] Military separation examination[ ] Military post-deployment questionnaire[ ] Department of Defense Form 214 Separation Documents[ ] Veterans Health Administration medical records (VA treatmentrecords)[ ] Civilian medical records[ ] Interviews with collateral witnesses (family and others who haveknown the Veteran before and after military service)[ ] No records were reviewed[ ] Other:b. Was pertinent information from collateral sources reviewed?[X] Yes[ ] NoIf yes, describe:Electronic Medical Record was also reviewed today.2. Recent History (since prior exam)------------------------------------a. Relevant Social/Marital/Family history:This is a 52 year old male Veteran who has been married 2 times. Hisfirst marriage was from 1988 to 1993 and he has 2 adult daughters,ages31 and 28 from this marriage. He was married a second time in 2011 and his wife, , is a medical secretary. He has no children from this marriage. He does report today that he has another daughter from aprevious high school relationship in 1986. He has some contact withher, but does not see her regularly. Veteran was born and raised in. Veteran reports that his parents were divorced when he was approximately 10 years of age. His parents have both passed away from heart attacks and he reports having one younger brother and one younger sister. He does not have contact with them on a regular basis. He attended xxxxxxxx school and graduated in1985.b. Relevant Occupational and Educational history:Upon graduation from high school this Veteran worked for approximately1 year in construction. He then entered the military (Army) on August19, 1986 and was discharged on August 19, 1995. He completed basictraining at Fort Knox, Kentucky and was then stationed at FortBelvoir,Virginia for the next 3 years. His MOS was 52-Charlie, utilitiesequipment repair. After Fort Belvoir, he spent approximately 3 yearsat Fort Bragg. He was then deployed to Desert Storm for approximately9 months, followed by 1 year in Korea. He returned to Fort Riley,Kansas for 2/3 years before discharge. While at Fort Riley he alsoattended xxxxxxxxxxx xxxxx in Kansas and obtained an associateddegree in liberal arts. Regarding his deployment to Desert Storm hestates that he was responsible for driving parts back and forth,maintenance on vehicles and generators and filling sandbags. Upondischarge in 1995 and began workinginheating and air-conditioning. He worked for xxxx forapproximately 9 years until 2004, xxxxxxx for 8/9 years until2013,xxxxx for less than a year and finally xxxxxxy for lessthana year. He resigned from xxxxxx in December of 2015. Asked forthereason he resigned, he stated that "I couldn't take thestress andanxiety of the job. They were willing to let me work from home, butthat didn't work either". He continued to say that he began"havingdifficulty rememberingthe names of clients and what needed to bedone". Since that time he has not worked. He reports that he wasreceiving NYS Insurance, but that ended 3 months ago. His TotalService Connection is currently 80%, 70% of which is for PTSD. Hestates he receives approximately 1800.00 monthly from this serviceconnection.c. Relevant Mental Health history, to include prescribed medications andfamily mental health:Veteran states that he had no medical or psychological issues as achild/teenager. While in the military he had knee surgery, a herniarepair and dental surgery. He reports that while he was at FortRiley,he received drug and alcohol counseling and was then sent to Miramarfor a 30 day inpatient stay. He reports that he began drinkingheavilyafter his deployment to Desert Storm. Continued drinking heavily inKorea and his first wife eventually divorced him. After his dischargefrom the military he reports that he attended SA treatment at thexxxxxx VA in 2000 for 28 days. At that point he states that hestopped drinking alcohol. However, he then became addicted toVicadin,which he reports that he stopped in 2011. He began taking Suboxonewhich was originally given to him by an outside provider, but which henow receives from Dr. xxxxx here at the xxxxx Suboxone clinic. His psychiatrist here at the xxxx is Dr. xxxxx, who is prescribing Quetapine, Duloxetine and Prazosin. He also reports that he sees xxxxxxx currently at the Veteran's Outreach Center on a weekly basis for individual counseling since 2015. Symptoms reported today include increased anxiety and depression. He reports feeling that his self-worth and esteem have decreased since losing his job and he keeps obsessing about the fact that he was earning 85,000 a year and now"can't hack it". He continues to report nightmares,fighting and screaming in his sleep, often wakes up wet and soaking as a result of this dreams, hyper vigilance and high startle. He also reports that hestill cannot wear a seat belt, which he attributes to a fire he wasinvolved in in Saudi Arabia and is triggered by the smells of gasoline and burning fires. He also reports panic attacks and isolating behaviors.d. Relevant Legal and Behavioral history:DWI in 2000. No other significant legal history.e. Relevant Substance abuse history:States that he has been clean from alcohol use since 2000. Clean fromOpioid Use (vicadin) since 2011. Does admit that he currently smokes tobacco.f. Other, if any:No response provided.3. PTSD Diagnostic Criteria---------------------------Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manualof Mental Disorders, 5th edition (DSM-5). The stressful event can be due tocombat, personal trauma, other life threatening situations (non-combatrelated stressors.) Do NOT mark symptoms below that are clearly notattributable to the Criteria A stressor/PTSD. Instead, overlapping symptomsclearly attributable to other things should be noted under #6 - "Othersymptoms".Criterion A: Exposure to actual or threatened a) death, b) seriousinjury,c) sexual violation, in one or more of the following ways:[X] Directly experiencing the traumatic event(s)[X] Witnessing, in person, the traumatic event(s) as theyoccurred to othersCriterion B: Presence of (one or more) of the following intrusionsymptomsassociated with the traumatic event(s), beginning after thetraumatic event(s) occurred:[X] Recurrent, involuntary, and intrusive distressingmemoriesof the traumatic event(s).[X] Recurrent distressing dreams in which the content and/oraffect of the dream are related to the traumaticevent(s).[X] Intense or prolonged psychological distress at exposuretointernal or external cues that symbolize or resemble anaspect of the traumatic event(s).[X] Marked physiological reactions to internal or externalcues that symbolize or resemble an aspect of thetraumaticevent(s).Criterion C: Persistent avoidance of stimuli associated with thetraumaticevent(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 withthetraumatic event(s).[X] Avoidance of or efforts to avoid external reminders(people, places, conversations, activities, objects,situations) that arouse distressing memories, thoughts,orfeelings about or closely associated with the traumaticevent(s).Criterion D: Negative alterations in cognitions and mood associated withthe traumatic event(s), beginning or worsening after thetraumatic event(s) occurred, as evidenced by two (or more)ofthe following:[X] Persistent negative emotional state (e.g., fear, horror,anger, guilt, or shame).[X] Markedly diminished interest or participation insignificant activities.[X] Persistent inability to experience positive emotions(e.g., inability to experience happiness, satisfaction,orloving feelings.)Criterion E: Marked alterations in arousal and reactivity associated withthe traumatic event(s), beginning or worsening after thetraumatic event(s) occurred, as evidenced by two (or more)ofthe following:[X] Irritable behavior and angry outbursts (with little or noprovocation) typically expressed as verbal or physicalaggression toward people or objects .[X] Reckless or self-destructive behavior.[X] Hypervigilance.[X] Exaggerated startle response.[X] Problems with concentration.[X] Sleep disturbance (e.g., difficulty falling or stayingasleep or restless sleep).Criterion F:[X] The duration of the symptoms described above in CriteriaB, C, and D are more than 1 month.Criterion G:[X] The PTSD symptoms described above cause clinicallysignificant distress or impairment in social,occupational, or other important areas of functioning.Criterion H:[X] The disturbance is not attributable to the physiologicaleffects of a substance (e.g., medication, alcohol) oranother medical condition.4. Symptoms-----------For VA rating purposes, check all symptoms that actively apply to theVeteran's diagnoses:[X] Depressed mood[X] Anxiety[X] Suspiciousness[X] Panic attacks that occur weekly or less often[X] Chronic sleep impairment[X] Mild memory loss, such as forgetting names, directions or recentevents[X] Difficulty in establishing and maintaining effective work and socialrelationships[X] Difficulty in adapting to stressful circumstances, including work oraworklike setting[X] Inability to establish and maintain effective relationships5. Behavioral Observations:---------------------------Cooperative and genuine throughout interview. No evidence ofhallucinations or delusions. No evidence of suicidal or homicidalideation or intent.6. Other symptoms-----------------Does the Veteran have any other symptoms attributable to PTSD (and othermental disorders) that are not listed above?[ ] Yes[X] No7. Competency-------------Is the Veteran capable of managing his or her financial affairs?[X] Yes[ ] No8. Remarks, (including any testing results) if any:---------------------------------------------------Based on today's evaluation this Veteran continues to meet thecriteriafor a diagnosis of PTSD. He is currently service connected 70% for PTSDbased on his last Compensation and Pension Evaluation performed by Dr.xxxxxx on 8/12/2015. Veteran reports that he resigned from his job in December of 2015 because " I couldn;take the stress and anxietyof thejob. They were willing to let me work at home, but that didn't workeither". He was receiving NYS Insurance up until 3 weeks ago andthat hasnow ended. Based on the veteran's report today, it does not appear that his PTSD symptoms have necessarily worsened (he is currently service connected 70% or PTSD. It appears that he was experiencing stress related specifically to his job. Since he has resigned, he has increased stress and anxiety and is emotional today, stating that he is feeling like a failure to his family because he lost a job where he was earning 85,000 because "I couldnt hack it anymore". This examiner encourage this Veteran to conitnue his weekly counseling At the Veteran's Oureach Centerwith Les xxx and to also consider vocational rehabilitation, It is hoped that one his self image and self worth begins to increase and he is able to secure another vocational opportunity, that his overall stress and anxietywill lessen. It may be that he will have to begin slowly with part time opportunities until his overall self image and self worth is restored. So what do you think???
  21. Hi Everyone, I am posting on this particular thread because I am trying to determine if CUE is the best course of action for my husbands claim. A Bit of history. My husband is a 3 tour Vietnam vet who is SC'ed 100% for PTSD, 60% IHD, and 20% DMII. His 100% PTSD is since 1988. The CUE "involves" the 100% PTSD rating. His first approved claim was in 1975 at 30% for Anxiety Neurosis with Depressive features (I have previously posted this was in 1979 by mistake). We went to the VA to get a copy of this ratings letter, but they claim it has been lost. My husband recently applied for a discharge upgrade from General to Honorable with Medical Retirement. That is currently in process and we are awaiting a decision. The Department of the Army issued an opinion in the discharge upgrade process stating "more likely than not suffered from PTSD at the time of his discharge". My husband had a suicide attempt in 1974 which lead to him being hospitalized in the county hospital. My husband's non VA doctor had written a letter to a VA psychiatrist stating this. The letter was used in the original claim (we have a copy of the letter) My husband then was admitted (not committed) to the VA psych ward in Waco, TX in 1975 (after concurrent admission in the county hospital again for psych reasons) where he filed his first claim for service connected psychiatric problems. The VA rated him as 30% at that time (Anxiety neurosis). He was also granted several short term 100% ratings while he was in the WACO VA psych facility. The VA psychiatrist during my husbands 1975 WACO admission stated my husband had had at least 12 jobs in the 3 years since he left the military, and could not hold a job and had attempted college but failed. He wrote quotes from my husband that he felt he had a personality change after seeing combat, and had lost the will to live a productive life. That he was depressed and anxious and trembled at times. (We have a copy of the inpatient summary documenting these statements by VA doc) My husband had several more psych ward admissions leading up to 1980. Receiving VA outpatient care and psychiatric medications continuously from 1975 to date. My husbands non VA doctor wrote a letter to the VA in 1977 stating he was totally and completely disabled due to his psychiatric condition and was a "fit candidate for retirement from the service". (we also have a copy of this letter). In a 1994 claim for increase and change of diagnosis, my husband was granted PTSD backdated to 1988 which is the same date Social Security had decided he was no longer able to work. The VA adjudicator stated in a hearing, they wish they could take it back further but they could not. No real explaination about why not. __________________________________ Basically what I am trying to do is get him 100% from 1975, the date of his original psych claim. I understand that he cannot get an earlier effective date for PTSD prior to 1980 due to the diagnosis not existing then. He could try for a new and material evidence claim based on the Army letter his got in the discharge upgrade process, but again PTSD did not exist so I'm not sure this would help. Therefore, my wondering is, Is it worth trying for a CUE based on the low 30% rating for Anxiety because he had proof submitted during the original 1975 claim that he had a suicide attempt, was unable to maintain gainful employment, and had a continuous psychiatric problem from service until date, he was unemployment and was not re-trainable (college failure). He has also had a continuous illness without break in treatment from 1975 to 2016. Does anyone have the CFR regs about the old regs and news regs and using the ones more favorable to the veteran? If we reopen the claim based on CUE these regs apply but I can't find them. The old psych regs indicate 100% service connection is warranted if the veteran is unable to gain or maintain gainful employment, as well as if the veteran is suicidal. Even the Army is supporting this claim that it occurred because of service. So, next question is how to I do all of this. Any ideas?
  22. Hi Everyone, I am posting on this particular thread because I am trying to determine if CUE is the best course of action for my husbands claim. A Bit of history. My husband is a 3 tour Vietnam vet who is SC'ed 100% for PTSD, 60% IHD, and 20% DMII. His 100% PTSD is since 1988. The CUE "involves" the 100% PTSD rating. His first approved claim was in 1975 at 30% for Anxiety Neurosis with Depressive features (I have previously posted this was in 1979 by mistake). We went to the VA to get a copy of this ratings letter, but they claim it has been lost. My husband recently applied for a discharge upgrade from General to Honorable with Medical Retirement. That is currently in process and we are awaiting a decision. The Department of the Army issued an opinion in the discharge upgrade process stating "more likely than not suffered from PTSD at the time of his discharge". My husband had a suicide attempt in 1974 which lead to him being hospitalized in the county hospital. My husband's non VA doctor had written a letter to a VA psychiatrist stating this. The letter was used in the original claim (we have a copy of the letter) My husband then was admitted (not committed) to the VA psych ward in Waco, TX in 1975 (after concurrent admission in the county hospital again for psych reasons) where he filed his first claim for service connected psychiatric problems. The VA rated him as 30% at that time (Anxiety neurosis). He was also granted several short term 100% ratings while he was in the WACO VA psych facility. The VA psychiatrist during my husbands 1975 WACO admission stated my husband had had at least 12 jobs in the 3 years since he left the military, and could not hold a job and had attempted college but failed. He wrote quotes from my husband that he felt he had a personality change after seeing combat, and had lost the will to live a productive life. That he was depressed and anxious and trembled at times. (We have a copy of the inpatient summary documenting these statements by VA doc) My husband had several more psych ward admissions leading up to 1980. Receiving VA outpatient care and psychiatric medications continuously from 1975 to date. My husbands non VA doctor wrote a letter to the VA in 1977 stating he was totally and completely disabled due to his psychiatric condition and was a "fit candidate for retirement from the service". (we also have a copy of this letter). In a 1994 claim for increase and change of diagnosis, my husband was granted PTSD backdated to 1988 which is the same date Social Security had decided he was no longer able to work. The VA adjudicator stated in a hearing, they wish they could take it back further but they could not. No real explaination about why not. __________________________________ Basically what I am trying to do is get him 100% from 1975, the date of his original psych claim. I understand that he cannot get an earlier effective date for PTSD prior to 1980 due to the diagnosis not existing then. He could try for a new and material evidence claim based on the Army letter his got in the discharge upgrade process, but again PTSD did not exist so I'm not sure this would help. Therefore, my wondering is, Is it worth trying for a CUE based on the low 30% rating for Anxiety because he had proof submitted during the original 1975 claim that he had a suicide attempt, was unable to maintain gainful employment, and had a continuous psychiatric problem from service until date, he was unemployment and was not re-trainable (college failure). He has also had a continuous illness without break in treatment from 1975 to 2016. Does anyone have the CFR regs about the old regs and news regs and using the ones more favorable to the veteran? If we reopen the claim based on CUE these regs would be what we would base the CUE on. The old psych regs indicate 100% service connection is warranted if the veteran is unable to gain or maintain gainful employment, or if the veteran has suicidal tendecies etc. So we would be arguing that the original claim did not establish the correct ratings based on the ratings criteria at the time and the evidence that was supplied was obviously not considered. Even the Army is supporting this claim that it occurred because of service. Also, how does the fact the 1975 VA ratings letter has been lost. (We did not have a copy). I am hoping that this means the VA has no evidence to reject our claim and should give the preponderance of evidence to or favor. They do however have copies of the evidence and letters as this is where we got them. \The VA therefore should not have a copy or the argument justifying the original rating of 30%. Would they to re-rate the claim????? So, next question is how to I do all of this. Any ideas?
  23. This is a must listen. Dr Cantrell is a very good advocate for all things PTSD . http://www.blogtalkradio.com/haditcom/2016/08/26/bridget-c-cantrell-phd-is-an-award-winning-post-traumatic-stress-expert
  24. I have seen my new psych 4 times total and each time he has added new meds, or increased the dosage of existing ones. appt 1: sertraline 50mg. (Now @100) appt 2: Seroquil (quetiapine fumarade) 50mg (Now @100). appt 4: bupropion 100mg. Long story short I don't want to take All of these. At my old VA I was prescribed 1 pill, Adderall, for 8 years. It did not fix my issues, but it made me happen when I took it. New VA, new Psych stopped the adderall and gives me these pills that make me feel zombified during the day and also haven't fixed my issues. I'm still angry at random and distrust people, still have days where Im so sad with my life I want to jump in a lake, still hear bad voices, still sleep 4 hours a night. I feel even worse than before. Has anyone else had a similar reaction to this combo? I mentioned this at my last appointment; brain fog for hours after waking, pysically drained, sad and sexually useless (I dont know how to make new relationships, and all my old ones are gone). Saying that got me the Bupropion rx, my issues written off with lines like "worry it will get better eventually." Instead of seeing me as an individual I think my doc has blind faith in his own personal process. My next appointment is in 2 weeks and Im worried that when I bring this stuff up I'll get another pill added to the regimen. My personal beliefs are that all these meds aren't working on me. Maybe I'm missing something about myself, something I can't see that is the root cause of my problems. That plus my scholiosis (I seen the x-ray from PMRS and it horrified me). Seroquil does keep me asleep - first few nights it knocked me out but no longer does that. I still stay up late, and wake feeling slow and weak. More than once my arms were shaking to the point where it was effecting my morning pages (writing 2 freehand pages each morning as therapy - these are actually fun and helpful). It felt like extreme fatigue. As far as the other 2 meds they have had literally no effect on my mood, the sertraline Ive been taking 3 months already. Welbutrin doesnt lift the brain fog. Coffee is more helpful. Thank you, if you read this lengthy post. I now realize how much this topic has been bothering me and I think that Had-it is the best place to get it out. Can't wait to read responses.
  25. I am a 65 yr old Navy Veteran 20% service connected for (non combat) injuries I received while stationed with the 115th Coastal Task Force in Vietnam 1971. I know what happened to me but have no memory of the event. I was unconscious after the accident and woke up choking on my own blood in a helicopter from the 24th evac unit out of Long Bihn. Concussion, broken jaw and fractured ribs. I was sent CONUS a few days later. I was in Bethesda for several months after returning from overseas and spent the balance of my enlistment working transportation and security for CNO Washington DC. I began having anxiety and depressive mood in late 1971 and that continued throughout my entire life. I've been treated with anti-depressants and tranquilizers for over 40 years. I have also been suicidal for that many years attempting twice. Panic attacks have put me in the emergency room many times over those years. After talking to a VSO, he suggested I file for PTSD as he said I had all the symptoms. I had an initial examination and the first Dr. (VES examiner) Found I had an unspecified Neurocognitive Disorder and Memory Loss but not PTSD. I'd claimed Memory Loss prior to the claim for PTSD and it is under appeal for two years. I re-opened my claim for PTSD and recently had my second PTSD exam. The VA Dr. stated I met all criteria for PTSD except C. She diagnosed me with Other Specified Trauma Related Disorder. For rating purposes, She checked boxes for Depressed Mood, Anxiety, Panic Attacks more than once a week, Chronic sleep impairment, Mild Memory loss, Flattened effect, Disturbances in motivation and mood, difficulty establishing and maintaining effective work and social relationships and suicidal ideation. Can anyone tell me what that all means? Thanks everyone