ptsd Working with PCP/VSO's

[Corpsman8404]

Good morning everyone! First post.

I have switched my PCP to a VA doctor, and have my first meeting with him on Oct 5th. My assumption (you know how that goes) is that using the VA PCP would benefit me in my claims.  My question is, how do I go about telling them that, "look, here is my goal".  
I'm not asking to "lead" him, but I'd like to tell him my issues and have some comfort in knowing that he will help with IMO/Nexus letters, et cetera?

I will be mentioning Headaches, my TMJ issues, and my upcoming sleep study on the 27th of Oct.

As well, I meet with my VSO's on the 28th to discuss these issues and to even try to bump up my PTSD to 70%.  It will be the first time I "meet" them, since they have done everything in the background.  (Virgina Dept of Veterans Services).  With them, I'd like to discuss "here is my plan, here are the numbers I'd like to try and reach on each issue, and how can I get there?".

Is this reasonable? This may be common sense to most of you, but I want to do this right, and thus far I have went from 20%-70% within this year with the signature items below.  With the right numbers on Sleep, TMJ, and Headaches I am shooting of course, for 100!
Thoughts?

[Corpsman8404]

Thanks for the reply, Vync.  I use a bite guard now from Walgreen's.  (Drug store like Rite Aid). I do not have an injury for my TMJ, but I have severe popping like when I yawn it cracks and hurts, and is very audible. When I do that, it hurts, then there is "relief" if that makes sense? Constant ache at ear level/TMJ joint. I have seen where TMJ has been shown secondary from PTSD in cases, which I assume I can apply? Also the stress headaches, as well.

I have started a headache log, and a PTSD/"crap that pissed me off" log today, on myhealthevet site, as per USMC_VET's advice.

I do have chronic heartburn, and I appreciate that advice on that! Makes sense to look into a GERD claim. Thank you.

Edited September 22, 2015 by Corpsman8404

[Corpsman8404]

Are you working full time?   Remember, VA compensation is designed to compensate the Veteran for the average loss in earning capacity.  If you make 300,000 per year and are working full time, its hard to justify above the rating you are now.  

If you are not working, then consider seeking IU.  

Remember, too, the VA requires you have a diagnosis for SC, but compensates you only on SYMPTOMS, not diagnosis.  

That is important because some VEts make the mistake of applying for every little hangnail that is asymptomatic.  Asymptomic conditions are not compensated, so my view its no point to apply for them.  

If you are seeking compensation for Migraines, you need to show how they effect your work.  Do you take time off for migraines?  How often?  Ditto for PTSD..do your doc appointments cause you to miss work?  How often?  Do you get mad at work?  If you look at the criteria for mental disorders, they will clearly show up in working and social life in the higher levels.  

Thanks for that, bronco. I believe I can make a case for headaches, secondary to anxiety/PTSD condition.  I am working now, but I have extreme concentration issues, and it is affecting my work. I don't like crowds, and "people" bother me, if that makes sense. Over the years I have become recluse and distant. Withdrawn, so to speak.  Nice to others, but not involved...

As for mad at work, yes.  I tend to keep my thoughts to myself about issues at work, and not outwardly show them, but work is difficult and I sleep during lunch from tiredness et cetera.  I will include any issues in my Headache log pertaining to work missed, and/or appointments.

 

 

[Corpsman8404]

Thanks USMC_VET,

 

I too stopped drinking in 2013, after yeaaaaaars of pushing everything aside with the use of a bottle.  Once I did, things became clearer, but it also had the effect of reality creeping back in even harder.

Appreciate the info on the logs, and I am going to continue that. I did start my Sleep Apnea, Headaches, TMJ submission on the 14th, and after I meet my PCP and have my Sleep Study done at the end of Oct, I will "submit". (One more thing, if I may. When I meet my PCP on Oct 5th, should I ask for a consult/referrals for HEADACHES, and TMJ?)

I have been looking at some of your info, and will definitely download your material for good use! Thank you for doing that work on the side. 

Semper Fi!

 

Edited September 23, 2015 by Corpsman8404

[Vync]

Corpsman,
I know exactly what you are going through with the TMJ.

PTSD does some odd things to people like bruxism, neck pain, hypertension, migraines, etc...

I like your "crap that pissed me off" log. That's a good way to put it!

Consider talking with your MH doc and also ask them about migraines, bruxism, and GERD. If your doctors would actually work together, it could be beneficial.

Unrelated to VA claims, look into contacting the Job Accommodation Network. They know a lot about the ADA and can advise you on potential reasonable accommodations at work. Don't expect a lot, but it might be helpful.

Something else to consider is talking with your VA audiologist and asking if you can get a white noise machine, maybe one for home or work. They help mask the ringing noise of tinnitus. It can help drown out distant sounds/voices, but not necessarily much up close. It's better than nothing.

[Corpsman8404]

Vync,

Will definitely look at a white noise machine for work.  I sleep with a loud fan at home, so that helps. Going to bring up the GERD and Bruxism as well. (Can't get sc'd for Bruxism, but from what I've read it's a symptom of PTSD stress et cetera. I def have it, and my dentist has mentioned it in appointments).

Edited September 23, 2015 by Corpsman8404

[USMC_VET]

Thanks USMC_VET,

 

I too stopped drinking in 2013, after yeaaaaaars of pushing everything aside with the use of a bottle.  Once I did, things became clearer, but it also had the effect of reality creeping back in even harder.

Appreciate the info on the logs, and I am going to continue that. I did start my Sleep Apnea, Headaches, TMJ submission on the 14th, and after I meet my PCP and have my Sleep Study done at the end of Oct, I will "submit". (One more thing, if I may. When I meet my PCP on Oct 5th, should I ask for a consult/referrals for HEADACHES, and TMJ?)

I have been looking at some of your info, and will definitely download your material for good use! Thank you for doing that work on the side. 

Semper Fi!

 

I would ask for a neurology consult on your headaches for sure.  make sure to send a secure message to your PCP stating your symptoms and how it affects you for both headaches and TMJ.  let them know if OTC work for you or not, and if so you cna ask that the VA issue a prescription for them, if not, state that and ask for other options.  I got a MRI done and all that and the neurologist then suggested physical therapy.  Great except they wanted me to drive 4 hours round trip to go to their hospital, whcih i cant do..

As far a sleep study goes you have to remember that even though most medical research out there consideres apnea among the many secondary issues to PTSD, the VA doesnt give it the acceptance it deserves.  If you have documented sleep issues while you were in you are in a good spot, if its a case of "i have PTSD and now i have sleep apnea" it will be a harder fight.

To Get Sleep Apnea as a secondary to PTSD you need the following.

 

1) SC for PTSD (check)

2) Diagnosis of Sleep Apnea (will be confirmed or not via sleep study)

3) Nexus between the two.

By that i mean you need to have the Sleep Doc or your PCP basically saying, this guys got sleep apnea because of his PTSD.

More than likely that WILL NOT HAPPEN.  If you have it, of course they will say you do.  You can be treated for it, which will help you immensely.  However to get rated for it you need someone (sleep specialist is best) to say its caused solely by PTSD, that without the PTSD you would not have this.

This is where a good IME/IMO would play in.  Having a sleep specialist AND a Psychologist both say it would be phenomenal.  I would start looking for a sleep specialist for a IME/IMO outside of the VA.  It may cost you 500 bucks but in the end if you have sleep apnea that needs a CPAP, thats an additional 50%.

I know you are a total of 70% and im guessin gyour PTSD is 50% so that would mean you probably have a 30% as well.  with the additional 50% you would be bumped up to 80% total would mean a bump in your compensation and easily pay for itself.  Think of it as an investment.  even if you need to save for it now and it takes longer to get and file, its well worth it then having to jump in the appeals train.