ptsd Help with benefits questions?

[Stick Slinger]

I served in Desert Storm/Desert Shield in 90 - 91 as a door gunner on a CH-53. I received my combat aircrew wings with one star. I recently applied for benefits for PTSD after struggling for years with alcohol and destructive behaviors. Divorced, remarried, etc.. and having all the symptoms but not knowing what to do about it.

So I got a rating of 30% thanks to my (outside the VA) Psychiatrist. I have  been diagnosed with TMJ after breaking 4 teeth at night while sleeping and I am on my 3rd mouth guard. I chewed through the first two.

I am taking meds for Migraines and was denied for headaches the first time I applied. I have them every 2-3 weeks and they put me in bed.

My Dr also sent me for a sleep study which recommended a CPAP? machine which he has ordered.

So how do I tie all of this together for an appeal in the next two months?

I have until May of this year to appeal anything and want some advice on how to best get this done. Lots of great info here but really tough to do this stuff not knowing exactly what to do.

Thanks in advance for any and all help. This is a great site and I am glad it is available! And did I post this in the right place?

 

Edited March 9, 2017 by Stick Slinger

[Berta]

I assume the 30% is for the PTSD.

The TMJ can be claimed as well and it will take a brief IMO from your psychiatrist ,with a full medical rationale as to how the stress of PTSD can cause this disability.

I posted some info on TMJ claims and the rating schedule,available here under the hadit search feature.

So how do I tie all of this together for an appeal in the next two months?

The appeal is for the PTSD (I think) the doctor you have might also be able to support the sleep apnea claim as secondary due to your PTSD.Does the SA appear in your SMRS?

The SA and TMJ would be a separate claim........as I understand this...

Do you feel you fall into a higher rating for the PTSD based on the VA Schedule of Ratings?

 

[Stick Slinger]

4 hours ago, Berta said:

I assume the 30% is for the PTSD.

The TMJ can be claimed as well and it will take a brief IMO from your psychiatrist ,with a full medical rationale as to how the stress of PTSD can cause this disability.

I posted some info on TMJ claims and the rating schedule,available here under the hadit search feature.

So how do I tie all of this together for an appeal in the next two months?

The appeal is for the PTSD (I think) the doctor you have might also be able to support the sleep apnea claim as secondary due to your PTSD.Does the SA appear in your SMRS?

The SA and TMJ would be a separate claim........as I understand this...

Do you feel you fall into a higher rating for the PTSD based on the VA Schedule of Ratings?

 

the 30% is for PTSD. My psychiatrist said it should be rated higher as he had put a lot of the 50% ratings determining factors in my initial evaluation.

What is an IMO? And I am sure he will help any way he can in relating the PTSD to the TMJ. I will look for your TMJ info and thanks!

And the sleep apnea is not in my records as I have just recently been diagnosed. I got out in 91. But it makes sense and I have read studies where they are all related. The migraines, TMJ and sleep apnea all seem to be secondary from the PTSD. And my psychiatrist do all this for me?

Also reading here that the DMQ has to be done by a DR or higher.. my family Dr is actually a PA that works under a DR so I assume having the PA do the paperwork will be a waste of time?

[Berta]

IMO  Independent Medical Opinion or IME Independent Medical evaluation.

"My psychiatrist said it should be rated higher as he had put a lot of the 50% ratings determining factors in my initial evaluation." Those things should be brought up in the appeal.

I wouldn't get a PA for any of this.The psychiatrist might be able to tie it all in together.

 

[Buck52]

Ms berta

 The VA Has hired a lot of PA's at the VAMC's  I think it would be ok if its a  Certified PA  they can give there professional  opinion ?  that is if you can get them to?

 My VA urology Doc is a PA-C (certified) & He is pretty cool dude.

Maybe not on using the PA's but its always in the Veteran best Interest to seek a Specialist!

just to be on the safe side.

[Berta]

I feel that the vet above, who has a psychiatrist ,and who is seeking to tie in his SA and TMJ as secondary to his PTSD, would not be able to get the full medical rationale he needs , from a PA .

[Stick Slinger]

UPDATE: I had a sleep study done and diagnosed with SA. I have been prescribed a CPAP and it really helps. I had my PA (also signed off from the MD he works with) to fill out the DBQ forms for SA, TMJ, and migraines. He also wrote out a statement that , "in his opinion that is was at least as likely as not" all tied back in to the diagnosed PTSD. This letter was signed by the PA and the MD he works for..

I am also asking my psychiatrist to write the same type letter, tying the migraines, TMJ and SA back to my PTSD... though he wont do the DBQ because he says they are a complete waste of time as the VA pays no attention to them. I also have a letter from my dentist about my TMJ as I have chewed through 3 mouth guards and have broken several teeth requiring root canals and crowns.

 

I have until the end of this month to get the appeal in... any other advise??

thanks to all!