Joe Johansen

It's probably obvious but make sure to make a copy of your signed letter! Save that and the Certified Mail receipt -- do it with the little green post card that someone has to sign acknowledging receipt of your letter.

I would write the examiner a letter. Type it if possible. Be polite but direct, like, "I'm writing to correct an error in your report of my C&P exam..." Send it Certified Mail. Ask him to file an amended report with the error corrected or an addendum making the correction. If he says "no" then you have it on record that you told him he made an error. He might claim "he told me 17 during the exam" but then it's your word against his and "the benefit of the doubt goes to the veteran" (part of the law). [i'm not an attorney--just my understanding]. Good luck! Joe

In my area the examiners write their reports within a week but then guys (and gals) end up waiting 6-9 months for a decision from the RO. Sounds like you have a strong case. Joe

Sounds like he got a good exam. The fact that she explained that the symptoms he had in service were symptoms of the prodromal (early) phase of schizophrenia is very good. Schizophrenia is often compensated at 100% because it's such a debilitating illness. Sorry you're having to go through all this. I admire your pluck and determination! Best Regards, Joe

Right. An Adjustment Disorder is definitely less severe than a personality disorder. Wikipedia has good articles on both: Adjustment Disorder - Personality Disorder. Unfortunately the military (especially Army & Marine Corps) were notorious for giving everybody an Adjustment Disorder (or personality disorder) diagnosis so that they wouldn't qualify for disability benefits (and for other reasons). I use the past tense in that last sentence because my (limited) understanding is that this tendency to under-diagnose has lessened in recent years. Of course, even if that is true, it doesn't help all the veterans who were in the service during the old days of "everyone has an adjustment disorder." The good news is that experienced C&P examiners know about this history too and they take the military-based adjustment disorder diagnoses with a grain of salt. Joe

I and others often write something like, "Find an attorney experienced with representing veterans with compensation claims." But how do you find such a lawyer? Asking other vets and asking a VSO are good ways. I also found a website that lists lawyers who specialize in this area. Here is the URL: http://www.vetadvocates.com/directory.html Btw, I'm not affiliated with that website in any way. I just happened to stumble across it while searching for something else and I thought it might be a good resource for vets looking for an attorney. Joe

Under the new (as of July 2010) regulations issued by the Obama administration you no longer have to prove your stressor. If you were stationed in a war zone then that's enough. That said, if the Regional Office sends you a questionnaire or invites you to make a "stressor statement" (or words to that effect), definitely do it. And take your time to write a detailed account of your stressors, including what you experienced emotionally and physically at the time and since then. Here's an example: WRONG: "I was under enemy fire several times while in country. I knew guys that got killed." RIGHT: "One incident that still haunts me is when we were on patrol and we walked right into a VC trap. Before we knew it we were taking fire from all around us. I was so scared I was shaking. My Sergeant yelled at me to take cover near his position and start firing at anything that moved. We were pinned down for what seemed like forever. One of the guys I had gotten to know pretty well, John, was just about 10 feet away from me. He panicked and started running. The VC fired on him from like three different directions. He didn't have a chance. I watched as he was riddled with bullets and fell down. I could hear him crying for his mother. It was so horrible. I'm crying now writing this and I feel like stabbing this paper with a knife over and over. I dream about John dying--I hear his moaning and crying and I try to help him but my feet are all tangled in underbrush or something and I can't move. I wake up soaked in sweat and forget where I am the first few seconds I'm awake until my wife says, 'It's okay honey, you're safe.'" Obviously writing such a statement is painful. So have some support in place before you start. Make a copy of what you write and give it to your examiner at the beginning of the exam. It will be in your C-File too (or should be) but don't take the chance that he or she will see it and read it. Joe

True although it's important to only file for an increase if your symptoms and functioning deteriorate significantly. Otherwise, if you're really still about the same and you request an increase the next examiner might not believe you're as disabled as the original examiner did and you could receive a lower rating. Joe

That's not accurate although it's easy to see why you thought that was case. The regulatory language is: "Whether or not the claimed stressor is related to the Veteran's fear of hostile military or terrorist activity." The logic is rather convoluted but what that phrase translates to is: "Does the veteran meet Criterion A of the DSM-IV diagnostic criteria for PTSD?" I can't find the regulation that explains why but that's the way it is. Therefore, the veteran who made the original post might be diagnosed with PTSD by a C&P examiner. Joe

If you don't receive the rating you think you deserve, I highly recommend hiring an attorney experienced with VA comp & pen claims. Then have the attorney hire a forensic psychologist as a consultant. Have the psychologist read the report and ask for copies of all the psychological testing, including the SIMS. Some important facts: The SIMS is a screening test. It should never be used by itself to say someone was malingering Recent research with the SIMS indicates that the cut-off score in the manual is too low. See:Study #1Study #2 The above facts will be known to a good forensic psychologist. If your examiner said you malingered based on a SIMS score, he made at least one error (using a screening instrument to identify someone as malingering) and maybe two (if your SIMS score was above the cut-off in the manual but below the new cut-off scores suggested by recent research). I wish you all the best, Joe

The examiner used the language for a 50% rating but his/her report is so darn skimpy that could be a problem. He/she writes "depressed mood, anxiety and social isolation" over and over. Unfortunately, that's pretty vague. He or she could have been much more detailed and specific. I'm betting your C&P was at one of the VA facilities that allow examiners only an hour or two to do everything: Evaluate the veteran, psych testing, review the claims file, review the medical records, think about it all (analyze and synthesize), and write a report. It's a disgrace! They should give examiners enough time to do a thorough, detailed exam. Joe

That's language out of the regs for 50%: Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining Effective work and social relationships ………………..50% Of course the rater doesn't have to go with what the doctor wrote. If the doctor provided a lot details earlier in the report that include some of the above symptoms then a 50% rating will be more likely IMHO. A 30% rating is probably a sure thing, if it's not 50%. Joe

Excellent advice you've received here. I can't add much except one idea (below) and to say definitely consult with an attorney who specializes in VA compensation cases, especially if they deny the claim. One thing to check is if the examining psychologist provided a detailed rationale for her opinion. For example, did she point out symptoms that your husband exhibited in service that were actually "prodromal" (early) symptoms of schizophrenia? If she (the psychologist) didn't provide much of a rationale in the report and if you get turned down, then your attorney could maybe ask the psychologist to write an addendum explaining in more detail how she reached the schizophrenia diagnosis. (I'm not sure if they can do that--really just thinking out loud here to try to cover all the possibilities for you). Good luck! Joe

I forgot to add that you can still get a 10% rating even if you're pretty much completely better as a result of psychiatric treatment. The regulations is: Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by continuous medication .................. 10% (emphasis added)

Yes. I recommend, when answering questions during the exam, that you give two answers: 1) How you were before treatment and 2) How you are now. A sympathetic examiner and/or rater might lean toward evaluating/rating you based on your functioning over the last year or something along those lines. Of course, compensation is supposed to "make up for" what you are losing on a day-to-day basis because of your disability. If you're not losing as much then it makes sense that you don't need as much compensation. I mean, if you had to choose between feeling noticeably better or getting a bigger check, which would you choose? Some veterans seem to think that VA compensation is restitution for past suffering but it's not. It's a disability program, similar to private disability insurance where you only get paid based on your current disability and if you get completely better, the disability payments end. Joe

The Regional Office should be able to tell you a) They are still researching the stressors issue; or b) Your stressor has been conceded; or c) Your stressor is not conceded. I would call them and ask specifically about that issue. Thank you for your service to our country. All the Best, Joe P.S. The VARO might not want to tell you where things stand ... although I think they should!

Sounds like you saw a good doctor. Yes, all C&P docs should do as this doctor did and see through your bad day to the truths about your condition but unfortunately they don't all do that. I agree with others, i.e., probably a 30-50% rating. It's a well-written report that covers all the essential issues. Thank you for your service to our country and the sacrifices you and your family have made. What you did in the service matters, IMHO. All the Best, Joe

Yeah, it would help to have more details. Based only on what you said it sounds like the doc did a sloppy job. Thank you for your service to our country. All the Best, Joe

You should receive a 10-30% rating, as another member said, although the part about "fear of hostile military or terrorist activity" could be a stumbling block. The examiner misunderstood the question. That's not unusual because if you look up the VA Directive that explains what that whole phrase means, it's rather convoluted. The question essentially boils down to this: Did the veteran meet Criterion A of the DSM-IV criteria for PTSD? Since the doctor diagnosed you with PTSD, the answer should have been "Yes". If you are denied based on the "fear of hostile military or terrorist activity" section you should definitely appeal. Hopefully, a sympathetic RSR will realize that the doctor messed up and either as him/her to clarify or just go ahead and give you your rating. Thank you for your service to our country. All the Best, Joe P.S. The report you posted is a good example of what I call the "Rush Job". The doctor probably didn't spend too much time with you (many examiners spend two hours interviewing a veteran and I bet this doctor didn't spend that much time talking with you); didn't administer any questionnaires; didn't use a detailed, structured interview; and didn't ask you detailed questions about impairments in functioning. If he/she had done all that there would be a lot more "meat" to the report, which usually works in the veteran's favor.