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By SameOldSong · Posted
OK, despite treating you for Complex PTSD, you may not end up with a PTSD rating. Here's why: (Read along with me on the DBQ form, please: https://www.vba.va.gov/pubs/forms/VBA-21-0960P-3-ARE.pdf ) Skip down to Section V, Clinical Findings. The stuff above Section V is using the findings to rate you in the sections above. Section V involves your past history. Trust me, any of us with PTSD has a 90% chance of having a very unhappy childhood with a lot of attachment issues and possible abuse. Now, they'll try to blame all of your problems on your unhappy past. Or drug use. If you admit sniffing the white lady (cocaine) or doing other drugs or heavy alcohol usage, they'll try to pin the problems on that. Then it's your fault and they don't have to rate you. Sentinel events are things that are vivid in your past that stand out. A traumatic event that happened before the military service. They'll say your problems were prior to service, but if the military stressors made your problems worse, they are still liable. Section VI is the important point and they need something in Criterion A through F. All of them. Not just a couple of things, every Criterion MUST be there, or it's not PTSD. Every Criterion. There must be a specific stressor event. Lots of fear with combat zones and possible IEDs and watching your buddies get hurt daily around you WILL NOT CUT IT. There must be a specific event. A particular attack or bombing. All of the attacks that end up in the military reports are put together and sent to an archive that tracks these events. Your stressor will be checked at this center and must match within a timeframe of a couple of months. (The name of the center is the Joint Services Records Research Center.) The utter crap of PTSD is that our memory of these events is shattered into fragments. We can't remember timeframes or events or faces or sequences of events clearly. For the Vietnam guys, we suggest that they try to remember whether it was Monsoon or Dry Season. For Iraqi, try to remember if there was some event that was near your stressor like Ashura or Eid Al-Adha or Ramadan. Or if the dates were ripening. Something that could be in a season or timeframe within two months of the event. Back to the Criterion. Let's start with A: Criterion A: The Veteran experienced, witnessed or was confronted with an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. AND The Veteran's response involved intense fear, helplessness or horror So, BOTH of these conditions have to be there. You saw threats to others or saw something awful and as a result of it, felt intense fear, helplessness or horror. Once again, it had to be a particular event. And it had to fit the criteria above. Criterion B: There are several conditions under Criterion B. At least one of them must be experienced, or they check the last box that states that the traumatic event is not re-experienced. And we do re-experience that crap in PTSD. It ambushes us at odd moments due to some thing we see or do or hear and leaves us lost in the event memories. In my own PTSD experience, I can tell you that I hit every one of those conditions in Criterion B. I trigger on some random minor thing and suddenly I can see stuff in pieces from the event. It's awful. One of my jobs before I got checked into Happy Meadows to sort it out refused to let me call the fire department to report something burning in the office because I'd smell burning metal all the time. I also was seeing and hearing hallucinations of the event pieces disconnected. And I'd wake up either choking and unable to breathe or I'd have night terrors. That's always fun for your spouse/partner. I'm putting the criterion here in case the VA disappears the PTSD DBQ the way the TBI DBQ vanished: Recurrent and distressing recollections of the event, including images, thoughts or perceptions. Recurrent distressing dreams of the event. Acting or feeling as if the traumatic event were recurring; this includes a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including those that occur on awakening or when intoxicated. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. Criterion C : Criterion C is avoidance and numbing. You avoid anything to keep from remembering. You can't remember it clearly. You turn off your feelings so that you can't feel because otherwise this crap will sink you. In Criterion C, not all of them have to be met. But at least 3 of them do have to happen. The Criterion: Efforts to avoid thoughts, feelings or conversations associated with the trauma. Efforts to avoid activities, places or people that arouse recollections of the trauma. Inability to recall an important aspect of the trauma. Markedly diminished interest or participation in significant activities. Feeling of detachment or estrangement from others. Restricted range of affection (e.g., unable to have loving feelings). Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children or a normal life span). Criterion D : Persistent symptoms of arousal, at least 2, not present before the trauma. They have to have started since the stressor occurred. Difficulty falling or staying asleep. Irritability or outbursts of anger. Difficulty concentrating. Hypervigilence Exaggerated startle response Criterion E : Duration of symptoms. This has to show that this is ongoing and persistent. It has to have happened for greater than a month. Criterion F : The PTSD symptoms are ripping your life up in social, occupational, or other important areas of functioning. I can't seem to hold a job because job stress has a tendency to make my PTSD symptoms surface and romp around the office. It freezes me. I can't think or function and end up in panic attacks often. If the evaluator asked those 5 or 6 questions for the Criterion above and you didn't have the response that fits the VA definition of PTSD, then they will rate you as not having PTSD. Event -> Symptoms -> Your Reactions -> Long Duration -> Destruction of Your Life. That's what they look for. Then, once they establish PTSD, they look for how it's impacting you. That's Section VII - Symptoms. This is where they decide the level of impact on your life. Of course you won't have all of these. It's impossible to have every single one because some are diametrically opposed. Section VIII - Other Symptoms. If you have something going on that wasn't on that Section VII list, then it should be listed here. Section IX: Are you competent to handle your financial affairs? My pdoc basically said to me that it was best if my spouse took over all financial matters. I have immense problems with this, but he was right. Section X : Remarks. If there's anything else missed, your pdoc should put it here. Mine mentioned that my symptoms through a particular set of circumstances caused me to gain weight. So, that's how you can be treated for Complex PTSD by the organization that won't verify your PTSD. It's the Criterion A-F. If you don't hit every one, you don't have PTSD by their standard. Because the VA's standard of PTSD hinges on one event causing the PTSD. Not a weardown over months that makes you manifest the PTSD symptoms. "Complex PTSD" means that it was gained through numerous events that created an environment of fear, not simply one. Appeals on PTSD take years. And he didn't nail down the criterion. If he works with his treatment team and manages to remember a particular event **and timeframe of that event** that left him in horror, file a new case because you have new evidence. Always, always tell them the truth. They'll figure it out, if you aren't telling them the truth. But I suspect the first question the evaluator asked was, "what event occurred to create your PTSD?" or some variation of that. And then I suspect he answered, "well, it was not a particular event but there was all this stuff always happening." And that would be that. Not PTSD. No criterion met. No need to go further. -
By SameOldSong · Posted
I'm going to add a bit to Buck's excellent advice. Your PTSD and TBI will be combined if the VA feels that the symptoms are identical and cannot be teased out to "this set of symptoms for PTSD" and "this other different set of symptoms for TBI". They are similar ailments, but they can be teased out. Buck's absolutely right about the nexus letter --that's the letter from the private doc who examines you and states that: He's seen your military service medical records and says so in the nexus letter. He describes that the conditions that have resulted are "at least as likely as not" or "is likely as not" that the conditions were caused by the military service injury/disease. It is also helpful if the doctor discusses the condition and why the doc feels that the military service injury/disease caused it. The "likely as not" wordings of the two choices above is specific because these phrases do not have the legal weight of "caused by" or "most likely as not" so the doc won't put himself in some sort of legal stranglehold. He evaluates your condition on the DBQ and also USES THE PROPER ICD CODE. The ICD code is the military code for an injury or illness and is completely different from the Medicare codes that are used by every doctor. You've got to have the right ICD codes on that form, or the VA questions that the private doc is familiar with VA rating. So, look up the ICD code for PTSD and TBI. And anything else you are being evaluated for. If you don't know them, this site may help you: http://www.militarydisabilitymadeeasy.com Other things to know about the Byzantine way that PTSD and TBI are diagnosed: PTSD must first be diagnosed and rated by the military docs. You can't have a private doc diagnose it first. But you have that diagnosis now. Now a second private doc can sort out the details. ( TBI also may have to be diagnosed first by the military. I'm not sure because the DBQ is no longer on the VA site.) PTSD has only specific types of docs that can diagnose and write these letters. For PTSD, look at the top of the DBQ for the listing of health provider types that can Review your military diagnosis. https://www.vba.va.gov/pubs/forms/VBA-21-0960P-3-ARE.pdf TBI also has only a set group of physician types that can diagnose or Review your military diagnosis. However, the DBQ for TBI has been missing on the VA site for at least a year. I can't find it. I did find the Coast Guard's version, which is very similar to what used to be printed up on the VA site. https://www.dcms.uscg.mil/Portals/10/CG-1/PSC/PSD/docs/VBA - Initial evaluation of TBI residuals.pdf?ver=2017-03-28-105323-973 I think a private doc can diagnose a TBI, but pick a specialist. I'd try to find a Neurologist or Psychiatrist to do it. Now the fun. You must separate the symptoms to get them rated separately. Well, not you, but someone trained that can evaluate you. If you have a TBI, it can cause a lot of the issues that PTSD have. Look at the DBQ for PTSD. TBI can also have physical symptoms like headaches, vertigo, tinnitus. If you can get it done, talk to companies that do SPECT MRIs (Warning: they are expensive). SPECT MRI can actually pinpoint the difference between TBI and PTSD in the brain. The VA was all over backing that analysis method until they realized that it would cost a fortune to analyze every soldier and would provide solid evidence about the physical injury. Places that offer SPECT scans also usually have neurological testing and usually will write nexus letters from the appropriate healthcare providers. They rated you at 70% for both. But it's going to hard to get to 100% from that point. The VA always low-balls your rating. Fight to raise the rating. There are now a lot of residuals that will eventually pop up and you will need to file on those. Use part of the lump sum payment they give you to arrange for private evaluation. The good news is that they should rate it as Permanent & Total because TBI has no expectation of getting better. If they did not do that on your rating, ask on this site and see if someone can instruct you on the letter to write about it and where to send it. PTSD is now viewed as treatable, so the VA likes to mix those because then they can harass you every 2-3 years until they take your rating away. It's never settled until you reach P&T. -
By Oceanbound · Posted
So currently I have one in legacy because it was days before the switch over to the new system. The one that is a GWI presumptive is being sent to see DRO review and this dro review estimated to be in December. And after the dro review gotta NOD it for EED since the clowns at the RO are cowards. -
@Buck52, @Vync, can you please take a look at what I have provided previously and comment. hayes vs Brown states: that there is not requirement to accept a VA examining physician's opinion a private physician's opinion, a social worker's opinion, or the opinion or contention offered by any other source, but there is a responsibility ot assess the credibility and weight to be given the evidence and to give sufficient reasons and bases for a decision.
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Rating "Protections"
Vync posted a blog entry in Asthma ratings,
The VA has several regulations governing various levels of "protection". The terms "permanent", "protection", and "total" are misnomers due to the various ways the VA has defined them.
Here is some information on VA ratings protection (but the word "protection" has a different meaning to the VA). The exception to these rules is if they can prove fraud.
5 years
The key part to remember about the 5 year rule is found 3.327(a) indicating that these are guidelines which are not necessarily set in stone. The key takeaway for most veterans is reduction should not occur if there has not been material improvement over 5+ years or if the veteran is over the age of 55.
10 years
In brief, ratings in effect for 10 years cannot have service connection severed.
20 years
In brief, a disability rated for 20 years cannot be reduced below the lowest rating percentage it has held for the previous 20 years.
P&T
TDIU
Disclaimer: I am not a legal expert, so use at own risk and/or consult a professional representative. The VA updates their regulations from time to time, so this information may become outdated.-
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VA Law
Tbird posted a blog entry in Tbirds Blog,
Everything Veterans Affairs does with your service connected disability compensation claim, is governed by law. You may want to bookmark this page as a reference as you proceed with your claim.
It can be a bit daunting. Just remember the U.S.C. is the law, the C.F.R. is how they interpret the law and last but certainly not least is the V.A. adjudication manuals that is how they apply the law. The section of the law that covers the veterans benefits is Title 38 in the U.S.C. in the C.F.R. is usually written 38 C.F.R. or something similar.
It's helpful to understand how statutes, regulations, and VA directives such as the VA’s Adjudication Procedures Manual, the M21-1MR (Manual M21-1MR.) are related. Of these three sources of law, the statute, written by Congress, is the highest form. The statute that governs veterans’ benefits is found in Title 38 of the United States Code (U.S.C.). The VA writes regulations to carry out the laws written by Congress; these are found in Title 38 of the Code of Federal Regulations (C.F.R.). The VA’s internal instructions for adjudicating claims are contained in the Manual M21-1MR. VA regulations may not conflict with any statute; the manual’s provisions may not conflict with either statute or regulations. If they do, the Court has the power to invalidate them.
U.S.C. United States Code United States Code is the law and the U.S.C. is the governments official copy of the code.
U.S.C.A. United States Code Annotated U.S.C.A. contain everything that is printed in the official U.S. Code but also include annotations to case law relevant to the particular statute.
C.F.R. Code of Federal Regulations The C.F.R. is the interpretation of the law
VA M-21 Compensation and Pension Manual
VA M-21-4 C & P Procedures
VA M28-3 Vocational Rehabilitation
VA M29-1 VBA Insurance Manual-
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HadIt.com Branded 11oz Coffee Mug for sale
Tbird posted a question in VA Disability Compensation Benefits Claims Research Forum,
11oz Coffee Mug with HadIt.com Logo and Motto $12-
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HadIt.com Coffee Mugs and More ...
Tbird posted a question in VA Disability Compensation Benefits Claims Research Forum,
Show your support with HadIt.com logo items. Only a few to start, t-shirts and ball caps coming https://hadit.com/shop/ Can holder, Coffee Mugs and Notebook currently come take a look and check back https://hadit.com/shop/
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Army Major -response
Berta posted a topic in VA Regional Offices,
I was unable to find a reply box to your post.
We have a full Agent Orange forum here.
Many veterans (and even their survivors) have succeeded in getting a disability, not on the presumptive list, service connected due to their proven exposure to AO.
Also Secretary Wilkie is considering a few new presumptives, but we have no idea if he will even add any to the list.
I wrote to him making a strong argument, as to the potential for HBP to be added, as well as ischemic stroke and have prepared a personal claim based on the same report a veteran used at the BVA, who also had a strong IMO/IME, and the BVA recently granted his HBP as due to his exposure to AO in Vietnam.
Most veterans with HBP were deemed as having "essential" - a medical term for no know cause- now we have a cause in Vietnam veterans---AO caused it.
The report is here:
https://www.nap.edu/read/25137/chapter/2
On page 8 they found there is "Sufficient" evidence that AO caused HBP in Vietnam veterans.
The BVA case and this report is also searchable in our AO forum.
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