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Denied for PTSD and Depression after C&P examiner made diagnosis of Borderline Personality Disorder

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jcox129

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Today both my PTSD due to MST and my Major Depression claims were denied. I had my C&P on 12/17/2015. I picked up my exam notes from the records department of my local CBOC where the exam had been held, and just a few minutes later my MST coordinator called to tell me of my denial. I checked e-Benefits and it has already been finalized with notification letter sent. 

The C&P examiner did several things I find fishy and that I was uncomfortable with during the exam, and then apparently diagnosed me as Borderline Personality Disorder and reported that I don't have PTSD. I had been diagnosed with PTSD by different (civilian)doctors in both 2006 and in 2014. I am very upset by this because in her report, she states that I meet all the criteria, but that she won't count the D and E criteria because she thinks it fits better with a BPD diagnosis. I have no idea how or why she made this determination. She said my symptoms were "long-standing." Well, yes, they were, because the stressor that caused my PTSD occured 17 years ago. This is what her notes said when she denied that I have PTSD.

“The Veteran is reporting an alleged sexual assault during her time in the Army that would meet Criterion A and reporting symptoms consistent with criteria B, C, F, G, and H. However, her reported mood symptoms, anxiety, impulsivity, substance use, irritability and angry outbursts, risky behaviors, risky sexual behaviors, and social and occupational are better accounted for by her BPD diagnosis.”

“The symptoms she is reporting that would meet PTSD criteria D & E are better accounted for by her BPD diagnosis, appear to be long-standing and more of a characterological nature.”

I don't feel comfortable at this time sharing more of her C&P notes. It is still too fresh for me.

I am trying to figure out what my next step will be...filing for an appeal or a reconsideration. Any advice or insight would be greatly appreciated. 

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Check the credentials of your C&P doc. You don't have to tell us, but I'll give you some questions to consider. Were they a psychiatrist or psychologist with a PhD and/or MD? You can look this information up online. You can also find out how long they have been practicing. The VA is known to have had persons perform C&P exams who are not qualified or do not have enough experience. I hope they were not a resident doctor either. Many of them are good, but some cannot find their way out of a wet paper bag.

I'm not a psych expert, but have taken several college level psychology courses. I don't think I have ever heard of someone getting BDP from MST, but it could be possible. The usual way it tends to work, military or not, is MST --> PTSD --> other conditions. It sounds like this doctor was trying way to hard to categorize you into a particular diagnosis instead of honestly admitting that you fit the criteria of multiple disorders. Each disorder can have varying levels of severity, such as mild, moderate, latent onset, major, severe, etc... and it can change hour by hour or day by day. One day, the patient is experiencing more of this and less of that, etc...

I hope this helps!

 

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Pack a lunch and get on the NOD Train. Just me, but I recommend and prefer the DRO Personal Hearing. Appeals can take 11/2 to 4 yrs or so, no fast track, unless your dying or a Hardship case.

Make an appointment to visit your RO and review your C-File, then request a complete copy. You have, already obtained all your SPR & SMRs evidencing your in service MST, right? If not get them.

You haven't received your Official VA Award/Denial letter yet, right? You may still pick up a MH SC for the discussed non PTSD issues that are related to your MST. You may have filed for PTSD but any other Ratable conditions that are DX'd by the C&P Psychiatrist will be considered by the Rater.

You may want to check the 38 CFR 4 for ratings associated with your other MH issues.

Semper Fi

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  • Content Curator/HadIt.com Elder

Pack a lunch and get on the NOD Train. Just me, but I recommend and prefer the DRO Personal Hearing. Appeals can take 11/2 to 4 yrs or so, no fast track, unless your dying or a Hardship case.

Make an appointment to visit your RO and review your C-File, then request a complete copy. You have, already obtained all your SPR & SMRs evidencing your in service MST, right? If not get them.

You haven't received your Official VA Award/Denial letter yet, right? You may still pick up a MH SC for the discussed non PTSD issues that are related to your MST. You may have filed for PTSD but any other Ratable conditions that are DX'd by the C&P Psychiatrist will be considered by the Rater.

You may want to check the 38 CFR 4 for ratings associated with your other MH issues.

Semper Fi

I second the DRO personal hearing. How often does a veteran actually get to interact with a rater? Plus, they look at everything with a fresh set of eyes. Some veterans have had good while others have had bad experiences with DRO personal hearings, but I found them very beneficial.

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Vynce, I think the outcome of a DRO Hearing, negative or positive,  is greatly dependent upon the effort and knowledge of the Vet. I personally don't believe that the VA has some unwritten Denial policy or that Raters just want to screw with Vets.

Self-performance appraisals are difficult for everyone. Just about any negative outcome on any of my past claims, all have 1 thing in common, me.  My Procrastination and lack of continuity of follow-up, are all on me. When I buckle down and prosecute the claim or NOD appropriately, I usually prevail. Just have to lay out all issues and evidence by the numbers, then walk the Rater or DRO t0 the correct decisions based on the Evidence of Record.

Semper Fi

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Thanks everyone for the solid advice. I was told that an initial PTSD diagnosis for these purposes needed to be from a VA doctor, whereas mine are from civilians. I made a couple of missteps. For instance, my DBQ and Nexus were from a civilian LIMHP, which apparently are not qualified to do initial DBQ but I think can only do review DBQs - I researched it last night because the C&P doctor discredited my  private provider's DBQ on the basis of the lack of credentials. But she also ignored two other diagnoses of PTSD by qualified providers. I think filing an NOD is probably the best route. I will read up more on DROs, as I am not very familiar with the process.

My letter is not in hand yet, though it has supposedly been mailed and I'm hoping to get it soon because I live in the same city as my VARO. Borderline Personality Disorder, the C&P diagnosis, is considered an unratable condition.

Thanks for all the helpful advice. 

 

 

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As already stated above, I am sorry for what you went thru. As you have already stated, there were a few steps that need to be redone. I always tell Vets, that #1 you have to make sure you Get Diagnosed and Treated thru the VA, then you dont have to fight the "Who is a Better Psych Doc, the VA or Civilian Lolly Pops".  Even though the Bipolar sounds bad to you, in the End really it is Helpful as the VA C&P Doc is admitting that you are Messed up and it is from your Time in Service. Good luck and keep us posted. God Bless

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