Jaina Bledsoe

As mentioned, here is my upcoming response...draft version: Dear Claims Department, This statement is in response to a Statement of the Case you sent dated June 21st, 2012 for a decision reached on a De Novo Review dated April 24th, 2012 at the Portland VA Regional Office. I appreciate the time and effort that have been put forth in this process by your office and the many medical specialists involved. However, I still believe my claim of service connected PTSD is still very much warranted and valid, and that evidence exists to support that belief versus Preexisting Borderline Personality Disorder. I ask that a service connection for PTSD rated at 70% or higher per your rating schedule be awarded. The basis of this rating is supported by the evidence while in service and the medical opinion of Dr. Munoz dated November 23rd, 2010. I also ask that Major Depressive Disorder be accepted as a secondary injury to PTSD and rated according to prescribed standards. It should be noted that this statement includes a request for RECONSIDERATION. The facts in your SOC dated June 21st, 2012 which I feel are in error or need to be applied to the law more closely are as follows: ● §3.102 (CURRENT) Reasonable Doubt. I believe that service records prior to my assault, particularly those in my 201 personnel file, provides a significant amount of “positive evidence” contrary to a diagnosis of Borderline Personality Disorder or any other pre-service condition. I also believe that responses, symptoms, and developed issues after my assault constitute “probable results of such known hardships”. ● §3.159 (05/08) Department of Veterans Affairs assistance in developing claims. The Department of Veterans Affairs has been extremely helpful in retrieving missing records, ensuring they are present in the claims file, and to the best of my knowledge reviewing all given evidence. However, I have significant concern that independent examiners Dr. Munoz and Dr. Andersen have either not had or missed reviewing evidence that would support §3.102 above. In the Veterans Administrations duty to assist, it should be reasonably interpreted to include ensuring ALL pertinent evidence is adequately reviewed and cited in an examination. Both examiners have listed evidence reviewed. Both examiners have failed to list evidence from my personnel file other than a DD-214. Since the establishment of my in service stressor relied almost exclusively on changes in behavior, performance, and development of issues that did not exist or did not exist to nearly such an extreme degree prior to 1996, it is reasonable to expect the same evidence should be reviewed by both examiners. This evidence is accepted under §3.304(f), paragraph 4 and should be included, reviewed, and cited when conducting a diagnostic evaluation. Any and all lay statements submitted to the Department of Veterans Affairs should also be reviewed by both examiners since it covers both periods prior to and after the assault in 1996. It is my belief that all this evidence would have been extremely helpful to the examiners at the time of diagnosis. ● 38 U.S.C. 5103A© Paragraph (4(i)) states “In a claim for disability compensation, VA will provide a medical examination or obtain a medical opinion based upon a review of the evidence of record if VA determines it is necessary to decide a claim.” Since it is reasonable to assume that the Veterans Administration reviewed lay statements, personnel records, and medical records when it determined conceding my in service stressor was warranted the same evidence should be available to the examiners the Veterans Administration chose. ● §3.2600 Review of benefit claims decisions. Paragraph (a) states that “The reviewer will consider all evidence of record and applicable law, and will give no deference to the decision being reviewed.” Paragraph © states that “The reviewer may conduct whatever development he or she considers necessary to resolve disagreements in the Notice of Disagreement, consistent with applicable law.” It is reasonable to assert that the reviewer does not have the authority or expertise to address what is arguably a misdiagnosis by the examiners based on a lack of knowledge or indifference to evidence supporting a reasonable doubt. Therefore further development, either by independent 3rd party examination as requested during the hearing or a further review by the original examiners, could and likely should have be conducted. ● §3.303 Principles relating to service connection. Paragraph (a) states that “Service connection connotes many factors but basically it means that the facts, supported by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisting such service, was aggravated therein. This may be accomplished by affirmatively showing inception or aggravation during service or through the application of statutory presumptions. Each disabling condition shown by a veteran's service records, or for which he seeks a service connection must be considered on the basis of the places, types and circumstances of his service as shown by service records, the official history of each organization in which he served, his medical records and all pertinent medical and lay evidence. Determinations as to service connection will be based on review of the entire evidence of record, with due consideration to the policy of the Department of Veterans Affairs to administer the law under a broad and liberal interpretation consistent with the facts in each individual case.” This CFR supports the relevance of the contents of my personnel file prior to the assault in 1996. The “circumstances of his service” should reasonably include the character of my service for the 6 years, 8 months prior to my assault as well as the character of my service in the Korean Peninsula. Paragraph © states “In the field of mental disorders, personality disorders which are characterized by developmental defects or pathological trends in the personality structure manifested by a lifelong pattern of action or behavior, chronic psychoneurosis of long duration or other psychiatric symptomology shown to have existed prior to service with the same manifestations during service, which were the basis of the service diagnosis will be accepted as showing pre-service origin.” This CFR alludes to a “lifelong pattern of action or behavior”. This in itself is significant in that in order for one to believe this was preexisting, or existing at all for that matter, a pattern should have been existent prior to the assault to the same degree as after. The evidence in my personnel file does not support this belief or this diagnosis. Paragraph (d) states “Post service initial diagnosis of disease. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. Presumptive periods are not intended to limit service connection to diseases so diagnosed when the evidence warrants direct service connection. The presumptive provisions of the statute and Department of Veterans Affairs regulations implementing them are intended as liberalizations applicable when the evidence would not warrant service connection without their aid.” “All the evidence, including that pertinent to service” again supports my belief that for a true, accurate, and justifiable diagnosis to be done my personnel file information should be reviewed and cited by both examiners. The only evidence cited by both examiners was that which could be used to support a diagnosis that would prevent establishing a service connection. Furthermore, diagnoses by competent and accredited professionals while actually in service diagnose an “adjustment disorder”. An adjustment disorder is an excessive reaction to stress, and is more closely related to PTSD than a Borderline Personality Disorder. It is my belief that the only reason PTSD was not diagnosed post assault was the disassociation of the event. I also believe that if I had been able to convey this information at the time, the DSM-IV would have supported a diagnosis of PTSD secondary to sexual assault. Neither VA examiner addressed the issue of disassociative amnesia (Psychogenic Amnesia) and the possibility other stressors coinciding with the time of the assault became a “fall back” explanation for the behaviors, symptoms, and issues that developed. There was also no mention of what effect a sudden reintegration of that memory could have, under a very closely mirrored situation at the time. As they stand currently, both VA diagnoses attempt to “change” the diagnoses of the professionals who spent significantly more time with me, and viewed my behaviors and symptoms directly immediately after the assault. The first diagnosis of Borderline Personality Disorder appears just prior to discharge, and only then to facilitate the removal from service I had been seeking a month prior due to severity of issues that developed in 1996. At the time it was an extremely expedient method to salvage an honorable career and escape the reprisals I had endured by supervisors for months. The detail of this diagnosis itself is minimal at best and was supported wholly by events, behaviors, and issues that developed after the assault in 1996. ● §3.304(a), (b), and © Direct service connection; wartime and peacetime. Paragraph (b) states “The veteran will be considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakeable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in examination reports are to be considered as noted.” An entrance exam conducted July 19th, 1988 and a subsequent Class ONE Flight Physical dated August 10, 1992 support a presumption of sound condition prior to the assault in 1996. It should be noted that a detailed psychological examination is standard for any Class ONE Flight Physical (Required with Warrant Flight School applications) and is not arbitrarily passed. Borderline Personality Disorder, in any degree, would be cause for exclusion. I received a “SAT” or satisfactory rating. Furthermore, symptoms of “”Frequent trouble sleeping” and “Depression or excessive worry” and “Attempted suicide” were never previously checked on Standard Form 93 (Report of Medical History) until I sought an early out opportunity January 12th, 1998. This was more than one month prior to receiving a diagnosis of Borderline Personality Disorder, resulting in a Chapter 5-13 Discharge. [Federal Register: May 4, 2005 (Volume 70, Number 85)] [Rules and Regulations] [Page 23027-23029] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr04my05-3] The effect OF this new interpretation is to establish different standards to govern for disabilities that were noted at entry into service and those that were not. If a disability was not noted at entry into service, VA will apply the presumption OF Sound condition under 38 U.S.C. 1111. If VA fails to establish either that the disability existed prior to service or that it was not aggravated by service, the presumption OF Sound condition will govern and the disability will be considered to have been incurred in service if all other requirements for service connection are established. In such cases, the presumption OF aggravation in 38 U.S.C. 1153 will not apply because VA will presume that the veteran entered service in Sound condition. On the other hand, if a condition was noted at entry into service, VA will consider the claim with respect to the presumption OF aggravation in section 1153. I would also like to note that a Medical Board Report dated April 11th, 1996 was conducted after a second suicide attempt. The AXIS 1 Diagnosis was “Adjustment Disorder” and the AXIS 2 Diagnosis was “Dependent Personality Traits”. This diagnosis was done after 12 (Twelve) days of in hospital observation, by medical personnel who witnessed my behaviors firsthand, and still is absent a Borderline Personality Disorder diagnosis. I reasonably must question a diagnosis 14 years later based on a 40 minute interview or simple review of medical records, especially when the same personnel records that allowed me to remain in service at that time are not cited in the more recent diagnoses. I assert that the Veterans Administration, through hurried and incomplete diagnoses, has failed in providing “clear and unmistakeable (obvious or manifest) evidence demonstrating that an injury or disease existed prior thereto and was not aggravated by such service.” Paragraph (b(1)) states “...Determinations should not be based on medical judgment alone as distinguished from accepted medical principles, or on history alone without regard to clinical factors pertinent to the basic character, origin, and development of such injury disease. They should be based on thorough analysis of the evidentiary showing and careful correlation of all material facts, with due regard to accepted medical principles pertaining to the history, manifestations, clinical course, and character of the particular injury or disease or residuals thereof.” Both evaluations done after filing for Compensation for PTSD address medical opinions of Borderline Personality Disorder, and cite only evidence that supports that diagnosis. Neither evaluation weighs the evidence with the “thorough analysis of the evidentiary showing and careful correlation of all material facts, with due regard to accepted medical principles pertaining to the history, manifestations, clinical course, and character of the particular injury or disease or residuals thereof.” This claim was filed for PTSD secondary to a Military Sexual Assault. It was not filed for Borderline Personality Disorder, PTSD, and Major Depressive Disorder secondary to childhood trauma. The focus of these evaluations should have been to weigh the information against a DSM-IV criterion for PTSD first and foremost. If that was not possible, or could not be supported, it should have been cited exactly why, and only then an alternate diagnosis provided. Paragraph (b(2) states “History conforming to accepted medical principles should be given due consideration, in conjunction with basic clinical data, and be accorded probative value consistent with accepted medical and evidentiary principles in relation to value consistent with accepted medical evidence relating to incurrence, symptoms and course of the injury or disease, including official and other records made prior to, during or subsequent to service, together with all other lay and medical evidence concerning the inception, development and manifestations of the particular condition will be taken into full account.” This paragraph supports my claim that evidence should have been weighed against the criteria of PTSD first and foremost, and that all pertinent records should have been cited. Particularly records that would establish a sufficient baseline prior to the assault in 1996. Again, if the evidence did not support a diagnosis of PTSD secondary to personal assault only then should an alternate diagnosis have been provided. I submit that it would be a fair and just means in resolving this disagreement as follows: Allow and provide a disinterested 3rd party not affiliated (or under contract) with the Veterans Administration (hereby referred to as “the evaluator”) to conduct an evaluation per the “Department of Veterans Affairs Best Practice Manual for Post Traumatic Stress Disorder (PTSD) Compensation and Pension Examinations” Guidelines. This should also include testing, to rule out or support congenital factors. Ensure the evaluator reviews and cites the veteran history as evidenced in the personnel file before, during, and after the assault as well as medical records. Provide an opinion as to whether the service record prior to the assault would be attainable if PTSD was preexisting. Ensure the evaluator addresses the issue of psychogenic amnesia, memory loss, and the effect of reintegration of memory. Ask the evaluator to address multiple diagnoses of “Adjustment Disorder” in relation to a disassociative memory event, PTSD, and the presence of unrelated stressors. Compare to Borderline Personality Disorder under same guidelines, noting similarities and differences. Omit previous evaluations after discharge from military service from the claims file, or instruct the evaluator to disregard them, on the basis they are incomplete for reasons I stated earlier. This will also prevent bias or influence of the 3rd party. Allow me to present my own case (argument) in support of a diagnosis of service connected PTSD secondary to Sexual Assault to the evaluator citing the specific evidence in my claim I feel is relevant. Return the claim and the evaluators findings for RECONSIDERATION by the Portland VARO. If unable to provide a independent 3rd party evaluation, consider allowing an addendum with #'s 1-4, and 6-7 to Dr. Munoz, complete with a substantial in-person interview.

Why do you suppose their contract keeps being renewed? Could it possibly be their evaluations that result in VA C+P awards at a nice, easily digestible number for the VA? I am sorry, but I have issue with someone who spent 40 minutes with me basically rewriting a diagnosis from 14 years earlier by 3 doctors who spent weeks evaluating me in a 24/7 environment. These assholes make me sick.

I have complete copies and will be drafting a response in the coming weeks. I will post a copy of what I write to the BVA here. My dx is there, my stressor is there. All I need to do is link the two. The C&P examiner did NOT list my personell records in his evaluation, therefore a substantial basis of my arguement will be that his diagnosis would be incomplete since the "performance and behavioral changes" were the crux of my establishment of the stressor... which has been conceded. The fact that this DR is attempting to rewrite dx from doctors who saw me at the time is also a point I will argue. hopefully effectively. SSDI is basing their denial on VA records, but they have not disclosed what records, whole or in part, they have reviewed. Despite the C&P difficulties, my S&I impairment has been listed as high and highly unlikely i would be able to work. GAF at the C&P was 23 - barely above blithering idiot. NO, the SS has NOT sent me to any exams, only constantly innundated me with questionaires over and over. I have a SS rep, but he does not appear very active. I have already signed a compensation agreement with him so I will not change at this time. The 2 denials so far are for same claim. an appeal hearing is in the works... ~1 year from now I won't be online very much after tonight, as I am leaving the housing at which I access the internet. I will occassionally be able to access the internet via friends homes, but that will be hit or miss.

CARLIE - The SOC reads as follows: On July 29th, 2011 the VARO recieved your request for a reconsideration the recent decision dated April 12, 2011. In that decision the VARO granted eligibility for treatment only with medicalcare for mental health issues, and confirmed the denial of service connection for PTSD. You provided your own statements for reconsideration, a statement from your ex-spouse, and "lay" statements from individuals who have witnessed the severity of your mental health symptoms. The additional service treatment records document the suicide attempt Feb 22, 1996 in which you exhibited an overdose using the medical of dyphenhydramine. The treatmentnotes state that at the time you were in the midst of Article 15 proceedures (field grade). A diagnosis of adjustment disorder secondary to impending divorce was provided. Based on this additional material evidence, we sent your entire claims file to the Portland VAMC to be reviewed by a VA examiner, and provide an addendum opinion. This examiner was required to review the entire body of evidence, including a previous opinion by VA physician K. Anderson, MD on Jan 17, 2011. Dr. Anderson opined that you have Borderline Personality Disorder with significant symptoms of depression, as well as PTSD secondary to childhood trauma, which is the same stressor that happened while on active duty. On January 26, 2012 the same VA examiner, Dr. Munoz conducted the examination provided an opinion that concurred with the opinion in 2011 by Dr. anderson. Dr. Munoz changed his diagnosis to Borderline Personality Disorder with significant symptoms of depression, as well as PTSD secondary to childhood trauma. He opined that "it is less likely than not" the current mental health problems were occured in or was caused by a military service event. As stated in the rating decision: "Rationale to support this opinion included several factors. The examiner opined that, while the sexual assault that you you suffered in 1996 was during your military service, it was not the cause of mental health disorder since the record contains evidence of other psychological stressors. Furthermore, your reaction to personal stressors was expressed in behavior associated with borderline personality Disorder and not PTSD. In a statement you submitted (which the examiner also reviewed), you contend that a significant part of your trauma is the lack of support you recieved from people in your unit, as well as unprofessional treatment. the examiner agreed that this is unfortunate event, but noted that it does not meet criteria for a PTSD stressor. Both examiners who have reviewed your record have confirmed their belief that you have a diagnosis of PTSD, both also opined that it is due to trauma, horror, and feelings of helplessness you suffered for an extended period of childhood. Dr. Munoz opined that PTSD, major depressive disorder, and Borderline Personality disorder are commonly co-morbid." Both of the VA examiners did review all aspects of your records (as well as your statement), "lay" statements, all of the military treatment and opined that the symptoms from which you suffer are a result of Borderline Personality disorder. VA is unable to provide compensation for benefits for Borderline personality disorder because it is a congenital disorder. (38 CFR 4.9) During the hearing at the VARO, testimony was taken that repeated the documented facts related to this appeal. The evidence is material, but it does not show that any further development or VA examination are required. As of the date of this decision, the VARO has not recieved any additional evidence, which is material to this appeal. according to this regulation, service connection for PTSD requires medical evidence diagnosing the condition in accordance with $ sec. 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occured. If a PTSD claim is based on in-service personal assault, evidence from sources other than the veteran's service records may corroberate the veteran's account of the stressor incident. Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, MH counselling centers, hospitals, or physicians; pregnancy tests or tests for STD's; and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifyable cause; or unexplained economic or social behavior changes. VA will not deny a PTSD claim that is based on in-service personal assault without first advising the claimant that evidence from sources other than the veterans service records or evidence of behaviour changes may constitute credible supporting evidence or advise VA of potential sources of such evidence. VA may submit any evidence that it recieves to an appropriate medical or mental health professional for an opinion as to whether it indicates that a personal assault occured. (38 CFR 3.304(f)) The VARO has conceded your in-service stressor, but the medical specialists have not linked the diagnosis to that specific event. they believe that your PTSD is related to your childhood abuse. In the lay statements, your own statements and testimony, document that the current PTSD did not surface until roughly 2000. During active duty, the specialists have stated your mental health problems were your diagnosed Personality disorder. The VARO has followed the duty to assist requirements of the law. The VA letters informed you what was needed to develop the claim, requested any sources of evidence that we would have obtained, and requested a VA examination and addendum opinions based on additional material evidence. (38 CFR 3.159) During the hearing, you stated that you have been recieving counselling at the Vets Center, but believe that this evidence is personal, and should be kept private from the VARO. If you change your mind, the VARO will obtain copies of theses records in support of your appeal, or you can furnish a copy of the records to DAV and they can submit them as evidence. This current decision has been completed using the DRO de novo review process. this means that the same evidence that was used in the rating decisions that denied service connection were readjudicated as if those rating decisions had not been completed. (38 CFR 3.2600) Yes I have applied for SSDI, but they have already denied 2x stating my symptoms are not severe enough to prevent working. I was in a Grant Per diem program the last 8 months but am being removed now. I was dealing with harassment and intimidation from another tenant (not in a VA program) that went on for 4 months. I attempted to resolve the issue with management, letters from therapists describing PTSD aggravation, etc to no avail. 2 weeks ago there was yet another confrontation and I drew a knife to defend myself / keep this individual at bay (he would get in my face). that ended my involvement with the program. I have filed a complaint with the VA OIG as I am not the only veteran who has had these issues, which are not intervened upon by management. The VA program had delegated these issue to be resolved by a non-profit organization that manages properties, but fails to reengage when this management company fails. In essence, they delegate authority and behave as if the responsibility is delegated as well. I have complained to the OIG for a "systemic veteran safety issue", argueing that the safety of veterans in its program is not a responsibility that can be safely delegated to an outside agency which repeatedly fails in addressing or resolving safety issues.

CARLIE - currently i recieve 10% for tinnitus, but it is being recouped for a severance pay i recieved in 1998. RETIRED - I am happy with my VSO, and I feel that the harder I fight the harder he is willing to fight for me. I may hire an attorney at some point, but for now I feel the evidence is all there. I just need to cram it down their throat until the actually acknowledge it. BRONCO- I have been in treatment for 2 years now. individual therapy at VA, DBT (CBT) classes, and the VetCenter. I still take meds but not nearly as much as i once did. I am pretty much on meds as needed to deal with sleep and anxiety/panic attacks. Mailing addresses I can get. My family lives here. Unfortunately recieving mail is all I can count on them for. Our family dynamic has always been that I was the one to turn to. They seem unwilling to change or alter that dynamic. I have complete copies of everything, including documents they keep "mysteriously losing". I will continue to shove them down their throats. An I-9 has been filed since they finally did concede the stressor. It asked that they approve on the basis of aggravation. I will be adding a follow up tomorrow asking that the C+P examiner justify his dx vs the multiple dx in service/psych evals which say otherwise. I will also be asking that he justify his belief that childhood trauma caused BPD w/o any records stating what kind of abuse, how long, or how I recovered once removed from the home. I would also like a definative reason why he feels aggravation can be ruled out considering the 6.5 yrs of service records prior to the assault. I just applied for NSC pension, as I was erroneously told by a previous VSO that I would not be approved if i had a debt to the government (the severance). I am also requesting that they take payments of no more than 25% if approved so that I may secure housing. ETHANS GMA- The VetCenter does treatment and will not do diagnosis. I have not released those records because at this point I feel they would only be gleaned for what the VA would find useful towards their denial. Screw me once, screw me twice.... not allowing a 3rd. Also, the VetCenter therapist earlier this week tried to insinuate I would recover better if I abandoned the fight I feel is futile. She also said that since i showed great progress in DBT, it lends credibility to the BPD diagnosis. I was afraid of the latter coming back to haunt me, but DBT is being used to treat PTSD patients as well so I will not fret at this point. I have considered dropping the Vetcenter therapy based on this recent discussion however. Same with individual therapist. VA employees are reluctant to become involved in the administration / benefits side of things. I may, however, find something useful in his notes. The VA would have that, but they undoubtedly only see what they like to see.

Are you working with an advocate or VSO? I Have a DAV representative who has been working with me on this. His feeling is I am getting a thorough railroading on this. Did you have treatments, diagnosis, evaluations, etc., prior to service, or was that from what was gathered in the questions from the C&P, or any treatments through VA, or what was noted from your entry exam? There were no diagnoses prior to service of any issues what so ever and I signed a complete medical release. There were the 3 events prior to the assault which I already listed below. The recent dx was based on those and the discharge I recieved 2 years after the assault, a re-interpretation of the MEB diagnosis (adjustment disorder), and some cherry picking of VA treatment notes when I experienced a relapse 2 years ago. There has also been a long standing issue of association since the assault. At the time I was having financial, marital, and workplace difficulties all coinciding. I was handling these pretty well for months until the assault occured and once it did I totally flipped out. The assault was supressed and everything else going on was associated with the resulting paranioa, sleep issues, hypervigilance, withdrawal, etc. Hence the Adjustment Disorder dx vs BPD or PTSD. I do NOT have to substantiate the attack occured any longer, as I provided sufficient evidence and it has been conceded by the VA. For years since i have dealt with varying degrees of symptoms depending on how closely my situation mimics that from the time of my assault (hence discharge 2 years later). When I recalled the assault in 2010 I had the perfect trifecta, on steriods, and a trigger directly related to the assault. It required 3-4 hospitalizations and one possible suicide attempt (they say i did, I can't recall having intent). It took me months to accept what I was remembering was reality, as I was still associating the feelings with the outside stressors. In time I came to accept it as my stress subsided but the memory became more detailed and recurrent.

had my DRO hearing 2 months ago and recieved an SOC letter a few days ago. Feel it is some sort of progress because after 2 years the VA finally "concedes your in-service stressor". However, the obstacle remains on tying it to the diagnosis. VA outsourced examiner spent 40 minutes and linked PTSD/MDD/BPD as co-morbid disorders originating in childhood, based on questioning that focused on prior service factors (3 years physical abuse, article 15 in basic training, 3 day hospitalization for situational depression 2 years prior to a sexual assault (the conceded in-service stressor). Also, the suicide attempts (2) and subsequent issues of sleep, irritability, paranioa, etc after the assault were used to reinforce this diagnosis. I am not to pleased with symptoms AFTER the assault being used to reinforce that dx, but you can't question a PhD with the VA without looking like a malcontent or somehow feeling like you are supporting a misdiagnosis/inflated diagnosis of BPD. My question is.... What should I do from here? The VA has already denied my request for a re-evaluation, and nobody at the VA appear to be willing to look at flight physicals (with psych evals), performance records, service school performance, awards, etc. prior to the assault in an effort to disprove the BPD discharge I was given after 9 years of service. the real kicker is that 1 month prior to discharge everything checked out OK while attempting an early out. Not to mention the 2 suicide attempts prompted an MEB for "adjustment disorder" related to other stressors which occured simultaneously with the assault. No mention of BPD during that process, but now it feels like the VA wants to change everything to suit their denial. I actually won the fight with the MEB based solely on those very same records of service 2 years prior to the BPD dx that got me out. ANY ideas would help. I am homeless and have absolutely no income since the VA is recouping my severance pay with the 10% I was awarded for tinnitus in both ears. Therefore, no money for civilian independent opinion. Do I at least have recourse for aggravation even though the thought of letting the BPD dx stand makes me sick to my stomach?

First... I am sorry for your loss. Second... I am sorry the VA screwed you during this extremely traumatic time. Third... Hang in there. You already have an established DX of PTSD. The VA can readjust your percentage back (or even higher) based on the current aggravation of symptoms. You are doing the right thing on this by involving a congressman. It should speed things up. Best wishes and hope it resolves soon.

Look for the ever-elusive "at least as likely as not related to military service" on your examination. If it states that (or something stronger) you should expect little problems.

thank you Pete. All my friends have theirs crossed as well. So far i have: 1) copies of my records showing 2 GCM, 3 AAM, 5 CoA, and two officer letters stating they saw no "personality or psychological issues" while serving under them for 3+ years. I also have 4 years of NCO evaluations showing superior performance. 2) Proof from Social Security that my attacker lived with me, as I was their payee for SSDI 3) 3 separate physicals all "normal" in the psych range. One was Class 1 flight physical and a test was given. 4) statements from 2 friends about my mental state prior to and after recalling the trauma. One explains a sexual encounter triggered the memory. 5) a PEB summary a month after the assault showing no diagnosis of BPD. Only Adjustment Disorder and Dependent Personality traits post 2x suicide attempts 6) A DAV representative attempting to contact the commander I served under at the time of the assault to attest to the drastic and quick change in mental state. 7) Lots and lots of motivation Also, can anyone tell me if IU is automatic based on S&O impairment? do I need to file for that separately? did I screw up by not filing for it when I filed for PTSD?

My friend who is a caregiver by trade has agreed to accompany me there. She has helped me through the last 2 years of this and was at the original IMO C+P exam with me (in the room). She will attest to the brevity and focus of the interview. It never seemed to proceed beyond my childhood history and very little was asked (or annotated - 2 sentences on a 5 page report) about the assault in '96. These guys have me scared. Seems that every time I have sent supporting evidence it is only picked apart or misrepresented to support their position. I fear even speaking about it any more. I try not to even discuss it in therapy either, unless it is at the Vet Center. There I have made it clear that the records are not to be released to the VA. that is where I get my true therapy

Retiredat, What I am "defending" is my service record up to the date of an assault. 3 physicals (one a class 1 flight) stated everything was fine, but once I filed at the VA it became "Personality disorder pre-existing service".

Hey gang, So I received notification that my DRO hearing is 24 April. I have been compiling records in chronoligical order and am nearly finished. Was planning on doing a timeline format for the hearing officer, showing supporting evidence, statements, topic research along the way. Do you all have any tried and true advice to give about this? I REALLY don't know what I will do if I have to wait 2 years for a BVA hearing if this fails. Also, I won't have my outside provider IMO even started until 1 May. Is this going to create a problem? My DAV rep says I should be able to defer the decision up to 180 days if I request it and show that supporting evidence is on it's way

From personal experience DON'T bring up childhood anything. Not abuse, school problems, minor run-ins with the law, nothing. If you had anything but a "Beaver Cleaver" childhood a C+P examiner (bought by the VA - remember that) is going to latch onto it tenaciously and begin building a denial case from that. Once that ball gets rolling you may find that you need to shell out hundreds or more for an IMO to set the record straight. A C+P examiner won't care if you readjusted, were resilient, got over it, grew out of it, etc. The VA can simply ignore any supporting evidence you provide to contradict their "pre-existing condition" diagnosis. Borderline Personality disorder is their own personal darling, and they are quite adept at building a case from minor things pre-service and, in my own case, using your PTSD symptoms to support a diagnosis of childhood PTSD (still scratching my head on being diagnosed 30 years later and after 9 years of service). REMIND them they are there to evaluate PTSD, NOT to weigh your previous experiences in life into the equation. If they try to say it is for a "baseline", that's bullshit. The baseline is your entrance exam into the service and your performance while serving. If you have had subsequent exams (ie flight physicals) make sure the examiner looks at it... tell him there's his baseline. If they note you are evasive...live with it. It is easier to explain why you are evasive about unrelated matters to your trauma rather than to fight an uphill battle because some pencil pusher is looking to keep the VARO within budget. If your AXIS 1 was PTSD that's not a claim killer. AXIS 1 (correct me if I am wrong) is used to diagnose more transient issues. It is possible to learn to cope with PTSD especially as a child. Children can bounce back better than adults. However, the fact you once had PTSD would have undoubtedly made you more prone to a recurrence if put under enough stress or a similar stress.

Definately have this addressed before a decision is made.

Cooter, No i am not related to Drew. I used to be asked that question A LOT when I lived in Pullman, WA and attended WSU way back in 2000. Bane of my existence. Perhaps if I had said yes I would have got better grades??? I was trying to support the others in a roundabout way I suppose. My point, which I guess wasn't too clear, is that symptoms can come back depending on life events. Stressful situations of any type can be like scratching at a scabbed over wound. I don't think anyone ever really gets "cured" of the PTSD... they just get therapy, learn to identify it, and do their damnedest to cope. Unfortunately "life" is a cruel mistress, and won't always hold her punches.

** TRIGGER ** You will NEVER know all of your triggers. Even though my assault was suppressed for over 14 years there have still been times when triggers made my life hell. The most notable when I discovered my daughter's stepfather had been abusing her from 10-14 years of age. I had to go into therapy for a year, started sleeping on the couch instead of my bed, bought a handgun, etc.... PTSD has it's ups and downs, that's what separates it from Borderline Personality Disorder (The darling of the DoD and VA). Borderlines are basically always difficult, unbudging, confrontational, highly opinionated individuals without an off switch. The fact that your symptoms have ups and downs is a sign that PTSD is a more logical diagnosis than a developmental disorder.

I encourage everyone to make a "sound off" comment about this story / your own experiences

http://newsroom.blogs.cnn.com/2012/02/24/army-downplays-ptsd-claims/?iref=allsearch