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Closure last won the day on February 12 2015

Closure had the most liked content!

About Closure

  • Birthday 11/13/1971

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  • Service Connected Disability
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Closure's Achievements

  1. Thanks to all of you, my claim was granted 100% P&T.
  2. What are your thoughts? I am already SC for anxiety & depression rated at 70%. I filed for TDIU and receive SSD for the same. C&P listed below. Thanks, 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes[ ] No ICD code: 309.81 If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: PTSD ICD code: 309.81 Mental Disorder Diagnosis #2: Unspecified Bipolar Disorder and Related Disorder ICD code: 296.80 Comments, if any: Bipolar I-II have been diagnosed previously Mental Disorder Diagnosis #3: Alcohol Use Disorder ICD code: 303.90 If additional diagnoses, list using above format: #4 Cocaine Use Disorder 304.23 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Lung disease 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes[ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes[X] No[ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: Substance use and anxiety and depression are co-morbid diagnoses with the symptoms overlapping. Some of the specific symptoms, relayed to this examiner specifically re-experiencing/flashbacks/nightmares are more specific to PTSD. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[ ] No[X] Not shown in records reviewed 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Total occupational and social impairment b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[X] No[ ] No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: Substance use and anxiety and depression are co-morbid diagnoses with the symptoms overlapping. Some of the specific symptoms, relayed to this examiner specifically re-experiencing/flashbacks/nightmares are more specific to PTSD. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? No response provided. SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ a. Medical record review: Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes[ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes[X] No If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [X] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [X] Other: VBMS b. Was pertinent information from collateral sources reviewed? [X] Yes[ ] No If yes, describe: Appeal info 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): see remarks b. Relevant Occupational and Educational history (pre-military, military, and post-military): see remarks c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post- military): see remarks d. Relevant Legal and Behavioral history (pre-military, military, and post-military): see remarks e. Relevant Substance abuse history (pre-military, military, and post-military): see remarks f. Other, if any: No response provided. 3. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks more than once a week [X] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks [X] Flattened affect [X] Impaired judgment [X] Impaired abstract thinking [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Inability to establish and maintain effective relationships [X] Suicidal ideation [X] Impaired impulse control, such as unprovoked irritability with periods of violence [X] Persistent danger of hurting self or others Behavioral observations: see remarks 4. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [X] Yes[ ] No If yes, describe: PTSD symptoms 5. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No 6. Remarks (including any testing results), if any: --------------------------------------------------- Veteran reports to C&P for the Mental Health DBQ on FEb. 24, 2016 after being evaluated during his last C&P evaluation on 3-16-15. This is a C&P examination report dealing specifically with a compensation related disability assessment. Do not construe it as a thorough evaluation of other unrelated issues. It should not be used for clinical, diagnostic, or treatment planning purposes as we are specifically directed not to treat patients in the C&P setting. Behavioral Observations Veteran presented to the C&P area for the Mental Health DBQ Evaluation ambulatory and unaccompanied. Veteran was explained the limits of confidentiality and reported an understanding of the contents verbally provided and Veteran verbally consents to the evaluation. Veteran was considered a reliable historian. Veteran is a 44 year old African American male who appears the stated age. Veteran appears to be of average height and weight. Veteran's adhered to civilian social conventions. Veteran's grooming was adequate and Veteran was appropriately dressed for the interview and climate. Veteran related to the examiner with ease in an open/candid manner after rapport was developed. Social/Family History: Veteran currently resides in Jackson, MS in the homeless program. Social support: mom Highest Level of Education/Degrees /Special Services:No changes since his last C&P evaluation on 3-16-15. Military: No changes since his last C&P evaluation on 3-16-15. Latest Civilian Jobs:No changes since his last C&P evaluation on 3-16-15. Legal: Arrested for domestic violence in January 2016, in jail x4 days, called 20 times Mental Health Treatment: Veteran reports receiving all of his mental health treatment under the direction of the Jackson VA. He indicates he has been receiving mental treatment at the Jackson VA. Mental Health Hospitalizations: Veteran reports no inpatient mental health treatment. Alcohol/Drug Use History: Drug Treatment Programs:currently in drug treatment at VA. 30 day program-then to TRP Current Use: Last Use-ETOH, Cocaine-January 20, 2016 Head Injury-No changes since his last C&P evaluation on 3-16-15. Current Medical Issues-Lung disease Surgeries-No changes since his last C&P evaluation on 3-16-15. Medication Currently Taking: Aripiprazole, Buproprion Mental Status: Veteran speech was clear, audible, logical, and goal directed. Eye contact was good. There were no bizarre or unusual gestures or mannerisms. Veteran related to the examiner as well as he could given his current emotional state. Veteran reported mood to be "anxious". Affect was observed to be EXTREMELY anxious with limited range of affect. Affective responses were mood content congruent. There was not any evidence of hallucinations, delusions, loose associations, or flight of ideas. Veteran denied any current thoughts of harming himself, others, or property. Veteran was provided the Veterans Crisis Hotline number. Veteran was oriented to time, place, person, and purpose. The quality of Veteran's thinking was adequate, as Veteran could answer/explain 3/3 of the proverb questions, without difficulty. Veteran's abstract- conceptual thinking was adequate as Veteran could relate to 2/2 of the abstractions. Veteran's memory functions were not rendered impaired, as Veteran was able to recall 3/3 objects presented earlier upon immediate recall and 2/3 after a one minute and 2/3 after a three minute delay. Veteran's mental control is viewed as adequate as Veteran was able to spell WORLD forward and backwards, recite the alphabet without error, count forward by three's, and conducted basic mental calculations without pencil and paper, with ease. Veteran's insight and judgment are considered adequate. Veteran's overall intellectual ability is clinically estimated to be at least average based on his vocabulary, fund of information, and language usage. Assessments: Veteran's overall MMSE score is29\30, which is suggestive of normal cognitive functioning. The MMSE is a screening instrument designed as a screening tool for cognitive impairment and it is not designed for diagnostic purposes. Veteran reports, "Not to well. I am not sleeping. I am having alot of anxiety. I hear voices. off and on since the past 5 years or longer". I-"run off the road". "I had one suicide attempt in Dec. 2015 took pills"-20-refused treatment when ambulance came. I get real depressed and that makes me irritable and I can't concentrate and focus. I have bad relationships and I get in fights with family and people in the community. I have racing thoughts. I am always thinking about dying, either me or my family. I see a dark spots and then it disappears when I look". Veteran reports to C&P for the Mental Health DBQ. Veteran was assessed for the following clinical symptoms. Veteran reported how much the following symptoms were bothersome over the last two weeks, using the rating scale 1 (little)-10 (great deal) or d (denies experiencing the symptom over the past two weeks). Please note that a self-report assessment is not sufficient to use alone for diagnostic purposes. Impulsivity-y; poor memory-y; mood changes-y; sadness/depression-y; loss of interest/pleasure-y; hopelessness-y; thoughts of death-denies current si, no plans, no intentions; self-harm behaviors-see above; harming others-ddenies; crying spells-y; Loneliness-y; low self-worth-y; fatigue-y; lack of motivation-y; appetite changes-x2 meals daily; gambling problems-not currently; sexual problems-ED; relationship problems-separated from wife; auditory hallucinations-see above, command male voice; visual hallucinations-see shadows, tactile hallucinations-d; gustatory hallucinations-d; olfactory hallucinations-d; racing thoughts-y; excessive energy-manic x2-3 monthly lasting 4 days guilt/shame-y, not being able to provide for family; withdrawal from people-y; anxiety-y/worry-death/panic attacks-y, x1 weekly; fear away from home-y, scared something is going to happen; social discomfort- y; obsessive thoughts-ruminate about death all the time; compulsive behaviors-d; aggression-y/ fights-x30 including wife; frequent arguments- wife; irritability-y/anger-y; flashbacks-x2-3 weekly, kissed me on my neck in the service, fighting; sleep problems-y; nightmares-kissed in service, denied treatment for problems, anguish about service, x2 weekly; recurring/disturbing memories-saa, x4-5 weekly; and work/school problems- last worked 2014, paranoid due to abseenteeism; hypervigilance- y; exaggerated startle reflex-loud and grinding; and avoidance-gay people- reminded me of being molested as a child and kissed me. molested by cousin who was gay, kissed by shipmate, fear that he is gay because of molestation and being targeted by other gay men. Veteran's Diagnosis is based on the DSM V. Veteran Jones is a 44 year old African American married/separated male that served in Navy as a cook(MOS) and received several service accommodations for his service. Veteran reported that due to his experiences while being deployed he feared for his life and feared he was in great danger due to being in a hostile environment. This information was confirmed by documents in the records. Remarks rationale: Based on the clinical interview, analyses of symptoms endorsed, reported events/stressors (MST/MTE), VBMS and CPRS review, and collateral information, the Veteran meets the criteria for a diagnosis of PTSD, Unspecified Bipolar, Alcohol Use, and Cocaine Use Disorder, that is debilitating for this VEteran. Veteran's triggers to his untreated PTSD is causing on-going symptoms and further exacerbating his Bipolar Disorder in which he is service connected. Veteran continues to be on high risk for suicide, in the substance use unit, and take medications as prescribed. IU Veteran's PTSD, Bipolar, and substance use disorders cause severe impairment in social and occupational functioning that reduces his ability to be around others; increased noise level, uncertainty/unpredictability, and other known and unknown triggers to PTSD, bipolar, and anxiety further exacerbate his symptoms and further results in isolation and decompensation and debilitating anxiety. Veterans symptoms will be present whether he is sitting or standing. Therefore the likelihood of him functioning in a work setting in a productive manner at this time is highly unlikely. In fact, working in and environment that is outside of isolation of one-on-one, predictable, and controlled is likely to increase his symptoms.
  3. I do not know why I was denied my TDIU. Please read my C&P results and provide me with direction. Thank you!!! Mental Health C&P.pdf
  4. Thank all of you for your comments. I too believe TDIU is favorable!!!
  5. Just passing on this info... ALLISON HICKEY EMAIL TO VA EMPLOYEES VBA Colleagues and Partners, There is no particular reason for this email today no anniversary event, no service birthday, no major milestone just a few thoughts to share. I have missed sending you more frequent notes. Some of you might have wondered where I went the last 2 months or so except for Marines in our midst who clearly saw their Birthday message and responded in force to me! Frankly, I have been talking to our Veterans many who have sent me emails. I cant tell you how many emails I now get and personally write everyday but you are helping me answer their questions by your actions across the nation. Many of you are completing claims for them that have been waiting some time now. Thematically, their questions are about the status of their appeals, their dependency claims and even their health care concerns. I probably do well over 3-4 hours of emails with Veterans every day (many at night and on the weekends as well.) In fact, there are so many email communications going back and forth that some have asked how we sustain this level of engagement with our Veterans. Then I remember That is why we are here to take care of them to answer their questions and concerns. It is our whole reason for being. Its the reason we have a job, a passion to serve, a sense of purpose, a roof over our heads and food on the table we have a job to do and they are the ones we do it for every day. Each of us has the blessing to do this humble mission. Without the needs and questions from our Veterans, their families and Survivors we have no reason for our existence. They define our very reason for being. The extra patience, kindness and transparency we can show no matter how many times they land in our email box or phone or claims receipts make all the difference in their experience and thoughts about us and the honorable mission we serve. Every interaction you have with a Veteran, their family or Survivor is an opportunity for us to show our kindness, appreciation, and understanding that they are the reason we do this mission. I ask you humbly, please do it well. If you are meeting with a Veteran, talking on the phone, or emailing be at your kindest and most compassionate self. Understand that sometimes they are frustrated (and often rightly so) and they need to be heard. I was reminded this week that we have one mouth and two ears for a reason we are designed to hear more than we say. Lets hear them and respond in healing ways. Thank you for all the times you are so very kind, compassionate and professional with our Veterans, their families and Survivors. Proud to be your USB Allison
  6. I appreciate the advice, and thanks to all of you.
  7. I received this message from THE DIRECTOR of the VARO Jackson, MS Good morning Daryl, Your file was returned to our office from the Office of General Counsel (OGC) on Friday, January 30, 2015. We have begun processing your case as directed by the Board of Veterans Appeals (BVA) Remand. We will provide you with a more detailed update concerning our actions taken as directed by the Board of Veterans Appeals (BVA) Remand in the next 3-5 days. I want to assure you that our goal is to process your appeal as quickly as possible.
  8. Same Post BIGGER Font. @ Berta & et al, First of all thanks for the quick responses and support. Is the VA aware that you have received SSDI solely for the Bi Polar?yes And are they aware of the hospitalizations,in private or VA hosps? Yes. Also this is what I sent to the Associate Director @ the VARO Jackson, MS via email. Hello Mr. Sanders, I would like for you to assist me in getting my claim processed. I have a TDIU claim that is dated 1/27/2014, that has been in the gathering of evidence phase for a while. I have submitted the VA Form 21-8940, VA Form 21-4192, C&P results, statement in support of claim, numerous Dr. notes, SSDI notes Dr. statement. Also, please read and compare DR. Linda Lindman C&P note dated 10/29/2014 to Dr. Beth Curry's C&P note dated 5/9/2011 both being from the VAMC Biloxi. I regret that Dr. Lindman did not give me a fair C&P. Sir, I cannot afford another setback. This has become soooo stressful I am no longer employed due to my service connected disiabilty please see 21-4192 and Dr. John Beddingfield notes dated 12/31/2014. and my condition has progressively gotten worse. Please note that Alcohol was stated to be related to my military service according to Dr. Beth Curry statement as well as my Bipolar disorder of which was retroactive to 6/2005, I have been service connected for my Bipolar Disorder for 9 plus years. Furthermore Dr. Lindman did not follow the priority of the exam which was for an increase not to determine whether my Biploar was Service Connected which has already been proven and established I have been at this since 2005 remanded back from the BVA three times since then. Sir, can you please be the one to review my case so that I will not endure anymore Hardships than necessary? Your help would be GREATLY appreciated as I have no further evidence, also I believe that the Evidence weighs in my favor resolving all reasonable doubt. I really need your assistance. Thank you in advance for your assistance in this matter.
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