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USMC_HVEQ

Ptsd C&p Revaluation

Question

Hi,

I've read many of the FAQ's and other posts about the topic. I guess the questions I have are specific to my case in nature. I think this is a great site and wished I had found this years ago, when i filed my initial claim.

Background of my case

  • I am a OIF vet, served 04-05 in Al Anbar Province.
  • filed for claim while awaiting diagnosis, back in 2006 but was backdated, since under 1 yr from AD separation date to June 05, paid in July.
  • was medically retired for PTSD (10%) and ortho problems (40%), so 40% combined rating
  • Med Board in 06, diagnosed as severe combat related PTSD w/agorophobia, it had no GAF score
  • been in treatment since at VA outpaitent therapy off/on 2 days a week since 2006.
  • while gathering evidence for my claim in 2006 VA rated me, based on a letter from the USMC.
  • It awarded me from july 2005 to present. I was also getting 10% for tinnitus, so 50% combined is what I am currently receiving.



    • I was laid off in 2007, mainly due to my behavior at work, although they used different excuses during a merger. I was first told nobody in my group would be laid off, then I was promptly moved and the new group in which I was moved to was laid off. I was given a hard time for having to attend PTSD appts 2-3 times a week while awaiting military medical retirement. I have been unemployed since July 2007-Dec 2008/present).
    • I have had more thoughts of suicide to the point that my outpaitent therapist did a risk assesment, which I don't have the notes on (dec 3rd, 2008)
    • I had been seen by a different pyschologist but once I lost my job i had to get someone closer to my house. At the time I had positive PTSD test results, major depression screening (pos), alcohol audit (pos).
    • I had massive wgt gain of over 100+lbs
    • I drank to self medicate until I got meds, but didnt take meds consistently ( I know, hurting my cause, now I'm out of meds-Seratraline 100MG
    • I have had constant panic attacks -at least 1 time a day., 1 which required emergency room treatment
    • I have been majorly depressed
    • I have lost many many Marine corps friends over PTSD stigma from my old unit.
    • I stay in my room pretty much most of the time. Only go out to drive thru or get food at market.
    • I have had to move 3 times since return, for behavior problems, drinking, loud, messy
    • I have turned into a gambler, use to play cards inorder to try and get mind off flashbacks and nightmares.
    • I have massive sleeping problems, cant get to sleep and stay a sleep. My body just passes out on its own. Inturn, I am very cranky. I am very irritable and grouchy.
    • I am very distant from a very close Irsh catholic family.
    • I used to be extremely outgoing, now I am a different person somewhat
    • no romantic relationships since 2006, feel disgusting and unable to love someone when I dont love myself
    • had close friend die during my tour, still been guilty thoughts
    • picked up bodies of gate bombing
    • lost interest in mostly every area of fun or leisure

    My current pysch eval said

    axis I: ptsd, major depression

    axis 2: (blank)

    axis 3 (previosu ortho and tinnitus probs)

    axis 4: economic stress

    axis 5: GAF score of 50

    said I had suicidal idealtion, panic attacks, nightmares/flashbacks, irritability, social isolation and bunch more stuff. I will elaborate later.

    I was told by my pysch therapist that I had a gaf of 45, but i didnt see it in the notes. I had a 70 on PCL-m test.

    I got with a VSO to help with a NOD. I inquired if NOD was rec'd in dec 08 yet, since I met with rep in nov. They stated they ahd not, so I filed one myself jsut in case. I finally heard back from VSO and said they had sent it in a while ago and sent another one to be walked in by hand by a rep. I sent copies of my VA notes, my stressor letter and a letter from my dad ( only mentioned stuff about me being back form Iraq when i immediately came back, might have misunderstood the extent of letter). I was called the very next day, after 1 year time frame on last award, to come in for a C&P exam

    I scheduled C&P for later that day since I am not working and want this claim to be processed asap.

    C&P results as follows

    clean, cooperative, normal affect, anxious mood, unremarkable speechand pyschomotor activity

    history of violence: yes

    suicide attempts : no but has repeated episodes of S/I as recent as 12/3/08, which poutpatient did formal assesment for suicide risk., conitues to have probelms with road rage as well

    orientation: all fine except off by day and day of week by one.

    spelling backwards: slow, but correct

    sleep impairment: yes, combat related nightmares most nights ( i told him everyday), additionally trouble getting to sleep and staying a sleep

    inappropraite behavior: yes, examples fighting

    serial7's and proverbs: yes, no probelm

    panic attacks: yes, stated panic attacks at least weekly ( i told him daily, sometimes more then 1 a day)

    pressesnece of homicidal thoughts?: no

    pressence of suicide thoughts/: yes, see risk assesment

    Comments

    used to ahve OCD behavior of checking car for bombs until a year ago.

    ADLs-doesnt need assistance but some days just doesnt get up at all, depression.

    Memory: normal

    recalls 3 of 3 though he does struggle a bit to get correct answers.

    Symptoms onset: Chronic

    length of remissions and capacity for adjustment: NONE

    Persistent Re-experienceing traumatic event by: recurrent and intrusive distressing recollections of event, including images, thoughts or perceptions, recurrent distressing dreams. Intense pyschological distress at exposure.

    Persistenet avoindence: refforts to avoid thoguths, feeling, conversations assoc w/ trauma. Marekedly diminished interest or participation in siginif activites, feeling of detachment or estrangement from others.

    Peristent sympt of increased arousal: difficulty sleeping (falling or staying alseep), hypervigilance, exaggerated startle response

    Freq, Severity and duration PTSD symptoms found: nightmares many nights, maniced feelings generally daily. Freq problem startle response. Hypervigilences less of a prob than it used to be.

    Employemtn history:

    occupation: accountant

    currently employed : no

    vet retired: no

    vet unemployed but not retired: yes

    duration current unemployment : 1 to 2 years

    reason given: havent found anything since

    Unemployed due to ptsd? NO ( told examiner I thought it was awful strange and thought it was possible).

    Diagnosis

    Axis I: PTSD, Depressive disorder NOS

    Axis II: none

    Axis III: see list

    Axis 4: unemployment of > 1 yr.

    Axis 5: GAF: 53 current functioning (timeframe)

    changes in functional status : performance in employment and family role functioning.

    QUESTIONS

    [*]based on background info, does my claim fall under 50% criteria or 70% criteria?

    [*]if currently already receiving 50% comp (40% shoulders, 10% ptsd, 10% tinnitus), how is backpay calulated. I mean do they say ok now ptsd is increased to say 50%, so that would increase my combined total to 70% and I would be backpayed for the difference of 70% to 50%? (current rate is 1228 for 70% no dependents and 50% is 770, do you take the difference?)

    [*]I tried to give cliff notes verisions, sorry about that. Should I apply for TDIU?

    :lol:

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Hi,

I've read many of the FAQ's and other posts about the topic. I guess the questions I have are specific to my case in nature. I think this is a great site and wished I had found this years ago, when i filed my initial claim.

Background of my case

  • I am a OIF vet, served 04-05 in Al Anbar Province.
  • filed for claim while awaiting diagnosis, back in 2006 but was backdated, since under 1 yr from AD separation date to June 05, paid in July.
  • was medically retired for PTSD (10%) and ortho problems (40%), so 40% combined rating
  • Med Board in 06, diagnosed as severe combat related PTSD w/agorophobia, it had no GAF score
  • been in treatment since at VA outpaitent therapy off/on 2 days a week since 2006.
  • while gathering evidence for my claim in 2006 VA rated me, based on a letter from the USMC.
  • It awarded me from july 2005 to present. I was also getting 10% for tinnitus, so 50% combined is what I am currently receiving.



    • I was laid off in 2007, mainly due to my behavior at work, although they used different excuses during a merger. I was first told nobody in my group would be laid off, then I was promptly moved and the new group in which I was moved to was laid off. I was given a hard time for having to attend PTSD appts 2-3 times a week while awaiting military medical retirement. I have been unemployed since July 2007-Dec 2008/present).
    • I have had more thoughts of suicide to the point that my outpaitent therapist did a risk assesment, which I don't have the notes on (dec 3rd, 2008)
    • I had been seen by a different pyschologist but once I lost my job i had to get someone closer to my house. At the time I had positive PTSD test results, major depression screening (pos), alcohol audit (pos).
    • I had massive wgt gain of over 100+lbs
    • I drank to self medicate until I got meds, but didnt take meds consistently ( I know, hurting my cause, now I'm out of meds-Seratraline 100MG
    • I have had constant panic attacks -at least 1 time a day., 1 which required emergency room treatment
    • I have been majorly depressed
    • I have lost many many Marine corps friends over PTSD stigma from my old unit.
    • I stay in my room pretty much most of the time. Only go out to drive thru or get food at market.
    • I have had to move 3 times since return, for behavior problems, drinking, loud, messy
    • I have turned into a gambler, use to play cards inorder to try and get mind off flashbacks and nightmares.
    • I have massive sleeping problems, cant get to sleep and stay a sleep. My body just passes out on its own. Inturn, I am very cranky. I am very irritable and grouchy.
    • I am very distant from a very close Irsh catholic family.
    • I used to be extremely outgoing, now I am a different person somewhat
    • no romantic relationships since 2006, feel disgusting and unable to love someone when I dont love myself
    • had close friend die during my tour, still been guilty thoughts
    • picked up bodies of gate bombing
    • lost interest in mostly every area of fun or leisure

      My current pysch eval said
      axis I: ptsd, major depression
      axis 2: (blank)
      axis 3 (previosu ortho and tinnitus probs)
      axis 4: economic stress
      axis 5: GAF score of 50

      said I had suicidal idealtion, panic attacks, nightmares/flashbacks, irritability, social isolation and bunch more stuff. I will elaborate later.


      I was told by my pysch therapist that I had a gaf of 45, but i didnt see it in the notes. I had a 70 on PCL-m test.


      I got with a VSO to help with a NOD. I inquired if NOD was rec'd in dec 08 yet, since I met with rep in nov. They stated they ahd not, so I filed one myself jsut in case. I finally heard back from VSO and said they had sent it in a while ago and sent another one to be walked in by hand by a rep. I sent copies of my VA notes, my stressor letter and a letter from my dad ( only mentioned stuff about me being back form Iraq when i immediately came back, might have misunderstood the extent of letter). I was called the very next day, after 1 year time frame on last award, to come in for a C&P exam


      I scheduled C&P for later that day since I am not working and want this claim to be processed asap.

      C&P results as follows
      clean, cooperative, normal affect, anxious mood, unremarkable speechand pyschomotor activity

      history of violence: yes
      suicide attempts : no but has repeated episodes of S/I as recent as 12/3/08, which poutpatient did formal assesment for suicide risk., conitues to have probelms with road rage as well

      orientation: all fine except off by day and day of week by one.
      spelling backwards: slow, but correct
      sleep impairment: yes, combat related nightmares most nights ( i told him everyday), additionally trouble getting to sleep and staying a sleep
      inappropraite behavior: yes, examples fighting
      serial7's and proverbs: yes, no probelm
      panic attacks: yes, stated panic attacks at least weekly ( i told him daily, sometimes more then 1 a day)
      pressesnece of homicidal thoughts?: no
      pressence of suicide thoughts/: yes, see risk assesment

      Comments
      used to ahve OCD behavior of checking car for bombs until a year ago.
      ADLs-doesnt need assistance but some days just doesnt get up at all, depression.


      Memory: normal
      recalls 3 of 3 though he does struggle a bit to get correct answers.

      Symptoms onset: Chronic
      length of remissions and capacity for adjustment: NONE

      Persistent Re-experienceing traumatic event by: recurrent and intrusive distressing recollections of event, including images, thoughts or perceptions, recurrent distressing dreams. Intense pyschological distress at exposure.

      Persistenet avoindence: refforts to avoid thoguths, feeling, conversations assoc w/ trauma. Marekedly diminished interest or participation in siginif activites, feeling of detachment or estrangement from others.

      Peristent sympt of increased arousal: difficulty sleeping (falling or staying alseep), hypervigilance, exaggerated startle response

      Freq, Severity and duration PTSD symptoms found: nightmares many nights, maniced feelings generally daily. Freq problem startle response. Hypervigilences less of a prob than it used to be.

      Employemtn history:
      occupation: accountant
      currently employed : no
      vet retired: no
      vet unemployed but not retired: yes
      duration current unemployment : 1 to 2 years
      reason given: havent found anything since
      Unemployed due to ptsd? NO ( told examiner I thought it was awful strange and thought it was possible).

      Diagnosis
      Axis I: PTSD, Depressive disorder NOS
      Axis II: none
      Axis III: see list
      Axis 4: unemployment of > 1 yr.
      Axis 5: GAF: 53 current functioning (timeframe)

      changes in functional status : performance in employment and family role functioning.




      QUESTIONS



    1. based on background info, does my claim fall under 50% criteria or 70% criteria?
    2. if currently already receiving 50% comp (40% shoulders, 10% ptsd, 10% tinnitus), how is backpay calulated. I mean do they say ok now ptsd is increased to say 50%, so that would increase my combined total to 70% and I would be backpayed for the difference of 70% to 50%? (current rate is 1228 for 70% no dependents and 50% is 770, do you take the difference?)
    3. I tried to give cliff notes verisions, sorry about that. Should I apply for TDIU?

    :lol:

    I forgot to put in the last part of the C&P, I knwo I already probably put oo much info on here as it is.

    PTSD review

    [*]is total occ and socail impairment due to ptsd signs/symptoms/: NO

    [*]if not total occ/soc impairment, do ptsd signs and symptoms result in deficincies in following areas (judegement, thinking, relations, work, mood, or school) ? NO

    [*]is there reduced reliability/productivity due to ptsd symptoms/: YES

    examples-multi episodes when employed of having difficulty getting along w/co-workers. Supervisor disciplined him several times. Reamins distant from family origins. Hasnt had romantic relationship in about 2 yrs. Judgement thinnking ok, mood markedly depressed.

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My opinion is that as of the date you were laid off you should ask for TDIU. Unfortunately you will not get it until you ask for it.

Also apply for Social Security Disability.

Good Luck

It would help your claim if you could get a Doc to write that you are unable to work due to PTSD. It looks to me like you are not going to be able to go back to work soon. The good thing is that Social Security and VA have programs to get you working.

Now the last you need to do something to stop your gambling and any other bad habits. Many of the addictions are symptoms of the problem.

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I think your disability rating will be based on, in this order:

1) Your location..VARO's in Ohio, Illinois, or Indiana will rate you lower than New Mexico or Maine, for example. Its kind of like shopping for a home..if you want a good home, go to a nice area of town. If you want an honest disability rating, move to a "Veteran Friendly" state.

2) The rating specialist. Some of them are much more generous than others, and that will largely be determined by the "luck of the draw". Some have "good days" and bad days.

3) Lastly, by the facts. The facts are not nearly as important as #1 above, according to the Attorney Generals report of the disparity between states.

So, if you are in one of the "bad states", get ready to appeal. If you are in a "good" state, then you may not have to appeal.

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Thank you for your replies, this is all very helpful. I'm in MA, so Boston is the RO. I think it is a Vet state but I don't know. As far as the TDIU, I filed a NOD myself for 70% ptsd and for TDIU on the last day of my claim, inorder to be backdated. It was postmarked, with that date. I will contiue getting treatment. I just like to hear people's opinions of my case. I can honestly see them giving me 50% and me having to appeal that, but I will wait and see.

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Never try and guess what the VA will do its like reading tea leaves.

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