ptsd Unsure About Ptsd Claim

[westcoastlv]

My husbad was in the Persian Gulf. His DD214 shows Combat Action Ribbon and Southwest Asia Service Medal w/bronze Star, Kuwait Liberation Medal Saudi Arabia and Kuwait. We have recently (July 2010) filed a claim for PTSD. We have received the VCAA notice, and a letter stating they are still working on the claim. We have a service rep at the VAC who told us that the next letter to expect is to schedule the C&P Exam.

About 5 years ago my husband was diagnosed with BiPolar Disorder by a private psychiatrist. He has been taking medicine for it ever since. Little did we know at the time that the symptoms for Bi Polar and PTSD are very similar, with the exception of the stressor. The private psych didn't ask about any stressors, and we didn't even think there was a connection to the Gulf War. After some research and long thought, we started to pinpoint when my husbands behavior actually began to change. This 'disorder' began during his shore duty, after his time on the ship. He has just started seeing at VA pysch, and we told her about the PTSD, but also had to mention the bipolar (which we said was a misdiagnosis) so that he could keep on his meds. We obtained a copy of his first and only visit with the VA pysch and she mentioned the PTSD and bipolar, had a GAF of 65, and stated that there were some other mental health issues. This has been requested and received by the VA Comp as well. It did not give a definitive diagnosis of PTSD. We have NOT sent any private pysch clinic notes. I spoke with my husbands previous private pysch, and he agrees that his issues are most likely PTSD, but has no notes to that effect because the stressors were never discussed, and he based his diagnosis on what we told him had been previously diagnosed. We have another VA appt tomorrow, and I am thinking that we should stress the PTSD (at least to get it in her notes).

The VAC service rep said that we would most likely get 70% for the PTSD because of the Combat Action Ribbon, but I am concerned that is may not be such a slam dunk. My husband is in desparate need of a rating because he is unable to work. He has an extremely hard time coping with life, even with the medications.

My questions are: should we request that the VA pysch give him a complete PTSD evaluation tomorrow? How does the civilian diagnosis of BiPolar affect the PTSD claim? Or, will this all be resolved in the C&P exam regardless of previous diagnosis? Should we also go to a private pysch and request the PTSD evaluation?

I have written a letter about how my husband's life has been affected by this, and also a letter from him. Who do I show these to?

We've requested other ratings as well: Tinnitus, Bilateral Hearing Loss, and Elbow.

Any advice or insight would be helpful.

[carlie]

The VAC service rep said that we would most likely get 70% for the PTSD because of the Combat Action Ribbon, but I am concerned that is may not be such a slam dunk. My husband is in desparate need of a rating because he is unable to work. He has an extremely hard time coping with life, even with the medications.

westcoast,

Welcome to Hadit.com.

The CAR has nothing to do with the disability percentage.

The CAR is kind of like a stand in showing that he served under combat situations.

The percentage of disability granted goes strictly by the Schedule of Rating Disabilities.

For PTSD the percentage criteria is under Schedule of Rating Mental Health.

39 CFR 4.130

Here's a link that will get you there for research.

http://www.access.gpo.gov/nara/cfr/waisidx_09/38cfr4_09.html

I hope this helps a vet.

[john999]

What you should try and get from the private shrink is a letter saying that he believes your husband is suffering from PTSD and that his is due to his combat service in the Gulf. This would help pinpoint the PTSD dx while backing off from the bipolar. You can have PTSD and bipolar. If he was not treated for the bipolar in service then it muddies the water for the PTSD claim. However, claim the PTSD. Do you have SMR's for your husband. Your private doctor should review these and then make the PTSD DX. You have to start with what you have. File for TDIU as well.

[westcoastlv]

Thanks for the info, I believe I've read almost everything I can. Do you have any insight regarding how the previous diagnosis of bipolar will affect the claim. It is only noted in the visit notes from the VA psych along with the PTSD? And should we try to explore more into the PTSD at our next visit?

[westcoastlv]

To John999

He wasn't treated for anything in the service except his elbow. These mental conditions began after the gulf war, and were displayed as anger, anxiety, hyperactivity, and extreme agitation. He got in trouble a few times and busted down due to the above, however, was not treated medically. He was honorably discharged later. I knew something was wrong in the years after the service, but it took me forever to convince him that what he was going through was not normal. Finally, he saw a doc that diagnosed him bi-polar. We now feel as if that is an incorrect diagnosis, especially seeing this all started after the gulf war. With his symptoms, the civilian doc thought this was most likely, as I my husband never talked about the stressors. And, as we researched the symptoms at the time, bipolar seemed to fit. Of course now, PTSD seems to fit, due to the stressors and him never really have the totally down depression of bipolar, although he is depressed at times. The only mental health assessments have been post service. I am now concerned that the VA will gravitate toward bipolar so they won't have to grant PTSD.

I am thinking we should go to a new private psych, telling them PTDS, and have them officially diagnose. However, shouldn't we request the same of his VA pysch?

[Pete53]

Welcome to Hadit.

There is no such thing as automatic

[john999]

What you might want to do is get what is called an independent medical examination from a psychiatrist to support a DX of PTSD. There is some problem now about who can DX PTSD. The VA says they are the ones to make the DX. If your VA shrink would say this vet has PTSD that would help a lot. As you say the symptoms of bipolar and ptsd can be similar. Even the meds can be similar. The VA often gives ptsd and bipolar patients the same meds. When you use a private doctor he needs to say he has reviewed the vet's service medical records. This is a buzz phrase that needs to be in the report. Keep posting because others will have good advice. If he is disabled due to emotional problems and has the CAB he should be able to get a DX of PTSD. I would read all about PTSD. The VA has recently started saying this or that combat vet does not have all the symptoms of PTSD. This is crap but a tactic to deny for ptsd specificaly. Since he was never treated or DX'ed for bipolar in the service then ptsd is the goal to shoot for for SC. The more evidence you have for ptsd the better. Your husband should really open up about incidents and stressors to his shrinks. He should describe the events that he relives and dreams about etc. Look carefully at symptoms for ptsd. The way it is now he needs to have most of them. Some may disagree about that. If the VA is playing games they look for lack of certain symtoms or signs to deny ptsd. The VA sees a wave of potential ptsd claims coming at them and I belive they are trying to get out of the way. You don't want to lie or invent things but you must have symptoms that relate to ptsd. Can I get an amen on that?