free_spirit_etc

So after they sent you the NON final decision and you sent in the appeal form - they sent you to the two C&P exams? And they then sent you a finaly decision of denial? Who sent you the "Ruling - we place our weight with the psychiatrist as they were psychiatrist." Wow! That is some profound reason and bases based on sound medical rationale. Geez! (and you gotta wonder if they thought they needed a psychiatrist - why they didn't send you to one in the first place) But was that sent by the Ro - or the AMC? It says that the AMC handles the remands from the BVA. The website says: "Development is completed in strict compliance with the wording of the remand order." Do you know what the remand order says? What was it the BVA asked the AMC to do with your claim. It does look like the AMC will have to send you a statement of case if they deny your claim. ANd if they do - you will probably need to be ready to move on it pretty quick -- as I think cases that have been remanded by the BVA get shot up the docket when they are returned. Free

Nothing to be sorry about. If they do the discharge physical like they do the other physicals - they just go down the form and check all the little boxes as normal - then they can say you were okay, as if the doctor actually had really throughly examined you or something. The lady that helped me look at the file at the VA tried to tell me that maybe they didn't DO a discharge physical. Of course they DID a discharge physical. That would be like saying they didn't do an entrance physical. A couple C&P's have refered to the discharge physical. One stated that my husband had stated that he reported fatigue at his discharge exam. Another - the lung cancer pesudo-C&P stated that his discharge physical didn't indicate any signs of respiratory problems. But again, if they don't HAVE the discharge physical - they certainly can't go quoting how wonderful his lungs were upon discharge. So they can't use it as a link the the chain to try to disprove our claim. It might even be in his file. I doubt they bothered to look. I imagine they figured that I had just looked at his file - and if I didn't find it - they wouldn't look for it. If they deny the claim and then start spouting off how the discharge physical said this and the discharge physical said that - then they better dang well send me a copy. Free

Don't you just want to bite somebody? Free

http://www.hadit.com/forums/index.php?showtopic=2639 http://www.hadit.com/forums/index.php?showtopic=2639 These links might also be useful. They go into what Berta has discussed how the court has ruled the VA is not allowed to go on a "fishing expedition" to gt evidence AGAINST your case. If you already had evidence - and your own doctors report and a C&P exam IN YOUR FAVOR - they don't really have the right to seek ANOTHER opinion without having good reasons and bases for why such an opinion is neccesary. By the way - was the second C&P AFTER the partial statement of case they gave you in 2004? I am not sure - but it would seem like if they had already sent you for ONE C&P - they would have to notify you that they were sending you on a SECOND one - and WHY they felt it necessary to do that. Does anyone know -- Do the reasons and bases for the additonal evidence have to be given to the vet BEFORE they send them for an extra C&P or seek another medical opinion? I think the strength of your argument here will lie in the fact that they were not presented with a couple half-hearted medical opinions. They HAD a C&P that was done by the doctor THEY CHOSE! It would seem like they would have to have a DANG good reason to send you to a DIFFERENT doctor of their choosing, rather than merely contacting the FIRST doctor THEY sent you to, if they had any questions. Free

Thanks Pete and Josephine! I am flattered. Especially since I still don't know all that much about the BVA - but I do know how to take arguments apart and how to put arguments together. By the way Josephine - did you see the picture of my husband and I that I put on with my name. That is our wedding picture! Free

Well - if they can't find the discharge physical - then they certainly can't say that his discharge physical showed he didn't have any problems when he exited the service. So, if it really didn't show that he had any problems, like they had previously stated - it looks like they have lost a piece of evidence in their own pile. Let's see - cancer diagnosed two years post service. No discharge physical showing good health on exit.... It doesn't "prove" anything. But it doesn't help DISprove our case either. Or.... it didn't say what they say it said - so it disappeared. Who knows.. Free

Josephine, I am not real clear here - this says it is a prelimanary review - and NOT a final decision of the DRO MAKE a final decision? It seems like they would have made a final decision after that and then sent you an actual statement of Case BEFORE you filed the appeal. I am concerned on this one. Because if the AMC denies it - and then you have to appeal THAT to the BVA - then can the BVA let it sit THERE a couple years and then REMAND it saying the DRO had NOT made a final decision and thus, they have no jurisdiction to hear the case? I don;t know. Maybe I am missing something. I know that my husband appealed his original claim - and it sat at the BVA for a LONG time -- and when they finally set it for review - they sent it BACK to the RO - because the RO had not sent a copy of his DD-214 along with the file. So it took THEM 6 months to send it BACK to the BVA before they looked at it. And I have read a lot of cases where the BVA will decide they can't hear the case because the person wasn't given a Statement of Case, or something or the other. So they remand it BACK to the RO before they can hear it. So does anyone know? Does this Statement of Case even COUNT as a Statement of Case? Did the DRO ever make a decision? Free

So it looks like you already appealed in 2004. If your case is set to be reviewed at the Appeals Managment Center very soon - I am not sure what else you can do at this point except wait. Unless you get confirmation from them of when your case is set for review - and submit a well structured argument before then - and ask that they waive the time-frame for filing evidence and accept it. They don't like you submitting the same stuff over and over - because that means they have to skim over it and ignore it several times. But this statement of case seems very incomplete. Not just not detailed enough - but like something that was started but never finished. I don't see anything on it that gives a bases for denial. It looks like they just listed some of the evidence considered. I am not sure what the procedure is with the AMC - Are they used INSTEAD of the BVA - or as a step in between? If they are a step in between - then if they deny the claim - Do they give you a statement of Case? And then you go on to the BVA? I am not sure. I haven;t looked anything up about that. If they DO deny - and you can appeal to the BVA - I would certainly think that the statement of case you have so far would be deemed inadequate - as it doesn't really give you any valid information on why the case was denied that you could use to perfect your appeal. However, I am not sure whether you would want to pursue that or not. If you made a case that the Statement of Case was not a valid one - that would give the BVA the opportunity to REMAND the case BACK to the RO - for no other purpose than to issue you a NEW statement of case telling you WHY they denied the claim - so you could RE-APPEAL -- in other words - just give them a tangent to go off on to drag the whole sordid process out for a few more years while pretending they were protecting your rights. That is just my first thought. Others might have other ideas on the issue. You might have to bring it up at the BVA level to protect the issue at the court of appeals level - I am not sure. I was just thinking - Wow! What a crappy SOC they gave you. But when I thought of addressing it - I thought - Wow! They could sure seize that chance to drag the claim out longer. So I am totally unsure of how to proceed on that one. Just some random thoughts on the issue. Free

Berta - I am really interested in the incompetence issue. That is one of the requirements of being granted the Post Death application for the Serviceman's Life Insurance. The regs say that it was created to grant life insurance to vets who become incompetent from Service Connected disabilities and thus, couldn't apply for it during their lifetime. But the way they are deciding it is that they don't count the point of time immediately proceeding death that a vet is incompetent - as if they didn't apply for it while they were alive and compentent - Congress didn't allow for it to be applied post death. To qualify for the Insurance you have to be granted a SC disability (as it is supposed to be a means to get insurance for people who might have trouble getting other insurance) and you have to be in insurable health EXCEPT for you SC disability. The way that they have been applying it - even if the service connection was granted AFTER death - the person had to be incompetent FROM a SC disability prior to their death - and the incomptency has to last UNTIL their death - and they DO NOT COUNT the incompetency that results immediately preceeding death. There is even a case where the woman's cancer was granted SC AFTER death -but her husband didn't qualify because she wasn;t incompetent BEFORE her death - aside from possibly during her last illness which resulted in her death. I will tell you for SURE - that if My husband's cancer gets granted SC - I am GOING AFTER THIS! And I will argue it up through the courts if I have to - and hopefully do something to STOP THIS CRAP! If the VA drags cases out until the vet dies - and then precludes them from qualifying for the post death life insurance because they weren't incompetent at the RIGHT time or LONG enough - that is crap. I think it should be where THEY would have to PROVE that you were entitled to the insurance and able to get it before they could deny your claim based on the fact that Congress didn't intend to consider the incompetence immediately before death to count. For instance, in my husband's case - He was not elgible for the insurance UNTIL he was granted SC for a condition (applied for SC in 1998). By the time he was granted SC for ANYTHING,(and therefore eligible to apply) he had already been diagnosed with cancer (2000)- which even if he had applied at that time - he was not elgible as he was not in good health EXCEPT for his SC condition. By the time he would have been considered "insurable" (i.e. cancer free for two years or more) he had already passed the deadline to apply for the insurance (within two years of being granted SC for a condition). He applied for SC for the cancer - but was not granted SC before his death. To me - I don't care if he was incompetent for 5 minutes before his death - He was precluded from purchasing the insurance BECAUSE of his SC condition (cancer) that had not been granted SC yet at the time he was eligible to apply for insurance, nor before his death. So them quoting that stuff about Congress didn't intend for the incompetence a person had in the period right before death to be used - because the person hadn't purchased the insurance when they were competent. But I also think this law should be changed. If you have to be granted SC before you can APPLY for the insurance - then IF you are granted SC DURING YOUR LIFE - then they should allow you to be granted insurance post death IF you were incompetent before the 2 year period to apply has expired. But if they don't grant the SC until AFTER your death - you should be able to get the post death insurance (especially if that service connected disability CAUSED your death) whether you were competent or not because you weren't eligible to apply for it UNTIL you were granted the SC. How in the world can they go on and on how someone didn't buy it while they were alive and competent - when they can't even apply for it without an SC connection? TITLE 38 > PART II > CHAPTER 19 > SUBCHAPTER I > § 1922 ( (1) Any person who, on or after April 25, 1951, was otherwise qualified for insurance under the provisions of section 620 of the National Service Life Insurance Act of 1940, or under subsection (a) of this section, but who did not apply for such insurance and who is shown by evidence satisfactory to the Secretary (A) to have been mentally incompetent from a service-connected disability, (i) at the time of release from active service, or (ii) during any part of the two-year period from the date the service connection of a disability is first determined by the Secretary, or (iii) after release from active service but is not rated service-connected disabled by the Secretary until after death; and (:) to have remained continuously so mentally incompetent until date of death; and © to have died before the appointment of a guardian, or within two years after the appointment of a guardian; shall be deemed to have applied for and to have been granted such insurance, as of the date of death, in an amount which, together with any other United States Government or National Service life insurance in force, shall aggregate $10,000. The date to be used for determining whether such person was insurable according to the standards of good health established by the Secretary, except for the service-connected disability, shall be the date of release from active service or the date the person became mentally incompetent, whichever is the later. http://www.va.gov/vetapp95/files5/9523297.txt The Board notes, however, that Congress has provided that RH insurance can be issued after a veteran's death under certain limited circumstances under the provisions of 38 U.S.C.A. § 1922(B) (West 1991). (RH Insurance pertains to life insurance acquired by veterans with service-connected disabilities and ARH Insurance pertains to gratuitous life insurance benefits to veterans with service-connected disabilities who are not competent to apply for such insurance.) Basically, this part of the law was enacted to provide insurance for a person who did not have other Government insurance and who could not apply because he or she was terminally ill. Section 1922(B) of Title 38, United States Code provides that any person who could have qualified for RH insurance under 38 U.S.C.A. § 1922(a), but who: (A) did not apply for such insurance because that person was mentally incompetent due to a service-connected disability, either at the time of release from active service or during any part of the one-year period from the date the service-connected disability was determined by VA, or after release from active service, but was not rated service-connected disabled by VA until after death; and (B) remained continuously so mentally incompetent until date of death; and ©died before the appointment of a guardian, or within one year after the appointment of a guardian; shall be deemed to have applied for RH insurance and be granted such insurance. 38 U.S.C.A. § 1922(B) (West 1991); 38 C.F.R. § 8.116 (1993). (As noted, Public Law 102-86 amended 38 U.S.C. § 1922 to increase the eligibility period from one year to two years for veterans found eligible for RH Insurance on or after September 1, 1991.) Essentially, if the evidence demonstrates that the veteran was mentally incompetent the time period for filing an application for RH insurance could be extended. See 38 C.F.R. § 8.0(B) (1994). Under the regulations applicable to ratings and evaluations for service-connected disability compensation, a mentally incompetent person is one who, because of injury or disease, lacks the mental capacity to contract or to manage his or her own affairs. 38 C.F.R. § 3.353 (1994). In this regard, the Board notes that guidance for some of the questions in this case may be found in a decision by a former VA Administrator concerning the interpretation to be given the term incompetence for purposes of 38 U.S.C.A. § 1922(B) (West 1991). In this regard, the term incompetence has been determined to exclude conditions present for a brief period immediately preceding death. The brief periods of coma or unconsciousness incident to a person's terminal illness, immediately preceding death, are not considered a period of incompetence for purposes of insurance under 38 U.S.C.A. § 1922(B) (West 1991). The Administrator's decision stated that a sensible construction must be given to the law, and that it would be an absurdity to hold that incompetency for several hours or days prior to death was such as that contemplated by the law if the veteran had not availed himself of the right to apply for insurance while he had ample opportunity to do so during his lifetime. The Administrator's decision indicated that incompetency should not be held to have existed because of conditions noted for a brief period immediately preceding death or because of a brief period of unconsciousness or a sedate condition which only had a brief effect upon the veteran's mental processes. Administrator's Decision No. 973 (Feb. 1, 1961). Thus, a transitory loss of capacity to contract or manage one's affairs would not be considered mental incompetency if there had been no practical effect on the veteran's right to obtain insurance benefits or upon the veteran's ability to act on her own behalf with regard to applying for insurance benefits. http://www.va.gov/vetapp98/files1/9804101.txt Analysis. In order to have been entitled to Service Disabled Veterans' Insurance under the provisions of 38 U.S.C.A. § 1922(a), the veteran would have had to have filed an application for such insurance during her lifetime. This is the clear requirement of 38 U.S.C.A. § 1922(a). The Board notes, however, that Congress has provided that Service Disabled Veterans' Insurance can be issued after a veteran's death under certain limited circumstances under the provisions of 38 U.S.C.A. § 1922(B). (RH insurance pertains to life insurance acquired by veterans with service-connected disabilities and ARH insurance pertains to gratuitous life insurance benefits to veterans with service-connected disabilities who are not competent to apply for such insurance.) This provision was enacted to provide insurance for a person who could not apply because he or she was mentally incompetent. The record does not indicate, and it is not contended, that the veteran in this case was incompetent. Inasmuch as the veteran did not apply for Service Disabled Veterans' Insurance during her lifetime, and she was not mentally incompetent, the applicable provisions of 38 U.S.C.A. § 1922 provide no authority for entitlement to such insurance.

Yep. I think one of the boxes they put themselves in (by trying to box YOU in) was giving you the label Histrionic. It just doesn't match your other evidence whatsoever. So it will be easier to disprove. If they wanted to attribute your problems to a personality disorder - they should have used the "avoidant" or "anxious" personality disorder. Then it would be much harder for you to argue that the anxiety you feel is "generalized anxiety disorder" which began in the service after some traumatic events, rather than a "anxious personality disorder" - that was always present ready to come out as it was built in to your personality to be so. Had they given you THAT label - you would have a heck of a time trying to prove that your anxiety is an aquired consition (was caused by something) rather than a "constitutional defect." But they did NOT give you that label. They gave you the HISTRIONIC label -which doesn't fit the picture created by all your other evidence. And it is too late for them to change that. They had their chance to give you a personality disorder label that matched your symptoms - to make it really hard for you to fight the aquired vs inborn battle. And they can't go back and decide - "Oh no. She is NOT Histrionic. She is Avoidant / Anxiety Personality Disorder." It will be MUCH easier for you to prove that you are NOT Histronic, than that your anxiety is not caused by an anxiety related personality disorder. Histrionic personality disorder would have been back at that church, declaring they were a war hero, insisting on being the ONLY one who could play the organ, throwing a fit that someone else played the organ while they were gone serving their country, set out to turn everyone against the other organ player, dressed to the hilt, trying to seduce half the deacons, etc. etc. It sounds like what they might have done during the exam was to set you up and take advantage of your anxiety to create an emotional reaction - and then used that emotional reaction (when you felt very unsafe and fearful) as a basis to say you "over-react emotionally." Based on what you said the nurse shared, they may do that all the time. They might not even know they are doing specifically that. They might think they are saving the world. Doctors can easily do that in psychiatric cases - intentionally or unintentionally set the patient up to display exactly what the doctor is looking for. Thye can push your buttons until you explode in anger, or react emotionally, or wither up inside -- and then see what they expected to see - and THINK they are helping you. So it is hard to say whether the doctors were working with the VA to deny you - or if the VA just knew which doctor to send you to to get the information they needed to deny the claim. But again, I think the doctors gave them the wrong label to work with. Here is some more info - with some diagnostic criteria from the World Health Organization http://oaks.nvg.org/disorders.html GENERAL diagnostic criteria for personality disorders that are not attributable to gross brain damage or disease or to another psychiatric disorder, must meet the following criteria in addition to the specific criteria for any personality disorders: a. Markedly dysharmonious attitudes and behaviour, involving usually several areas of functioning, e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others; b. The abnormal behaviour pattern is enduring, of long standing, and not limited to episodes of mental illness; c. The abnormal behaviour pattern is pervasive and clearly maladaptive to a broad range of personal and social situations; d. The above manifestations always appear during childhood or adolescence and continue into adulthood; e. The disorder leads to considerable personal distress but this may only become apparent late in its course; f. The disorder is usually, but not invariably, associated with significant problems in occupational and social performance. A deep problem pattern can be manifested in two or more of these areas: · Cognition: perception and interpretation of self, others and events. · Affect: the range, intensity, labilit, and appropriateness of emotional response. · Interpersonal functioning. · Impulse control. For different cultures and subcultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations. For diagnosing most of the subtypes listed below, clear evidence is usually required for at least three of the specific items in a clinical description list. To recap: to qualify as a sign of a personality disorder a long-lasting pattern must be rigid and detected across a broad range of personal and social situations. It must lead to obvious and marked distress or impairment in social, occupational, or other important areas of functioning. Its start can be traced back at least to adolescence or early adulthood. It is not better accounted for as a manifestation or consequence of another mind-disorder, and is not due to the direct physiological effects of a substance e.g. drug or a general medical condition such as head injury. A blend of legal issues and psychiatric ones also result in this: People under 18 years old who fit the criteria of a personality disorder are usually not diagnosed with such a disorder, although they may be diagnosed with a related disorder. Antisocial personality disorder cannot be diagnosed in persons under eighteen. Mainly Personality Disorders THERE are differences between personality disorders and other mental disorders. For example, the obsessive-compulsive personality disorder (OCPD) is defined differently than the obsessive-compulsive disorder (OCD). In the following you can find personality disorders defined by the concepts that professionals use, with nothing omitted from the central definitions. Anxious (Avoidant) Personality Disorder Anxious (Avoidant) Personality Disorder ? WHO F60.6 PERSONALITY disorder chalked out by at least three of the following: a. Persistent and pervasive feelings of tension and apprehension; b. Belief that one is socially inept, personally unappealing, or inferior to others; c. Excessive preoccupation with being criticized or rejected in social situations; d. Unwillingness to become involved with people unless certain of being liked; e. Restrictions in lifestyle because of need to have physical security; f. Avoidance of social or occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection. Associated features may include hypersensitivity to rejection and criticism. Diagnostic criteria for 301.82 Avoidant (Anxious) Personality Disorder - DSM-IV Individuals with this Cluster C Personality Disorder are socially inhibited, usually feel inadequate and are overly sensitive to criticism. A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following: 1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection. 2. Is unwilling to get involved with people unless certain of being liked. 3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. 4. Is preoccupied with being criticized or rejected in social situations. 5. Is inhibited in new interpersonal situations because of feelings of inadequacy 6. Views self as socially inept, personally unappealing, or inferior to others. 7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. Borderline Personality Disorder Emotionally Unstable (Borderline) Personality Disorder - WHO F60.3 There is a marked tendency to act impulsively without considering the consequences, together with affective instability. The ability to plan ahead may be minimal, and outbursts of intense anger may often lead to violence or "behavioural explosions"; these are easily precipitated when impulsive acts are criticized or thwarted by others. Two variants of this personality disorder are specified, and both share this general theme of impulsiveness and lack of self-control. Impulsive type: The predominant traits are emotional instability and lack of impulse control. Outbursts of violence or threatening behaviour are common, particularly in response to criticism by others. INCLUDING: explosive and aggressive personality (disorder). EXCLUDING: dissocial personality disorder. Borderline type: Several of the marks of emotional instability are present; in addition, the patient's own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. A liability to become involved in intense and unstable relationships may cause repeated emotional crises and may be associated with excessive efforts to avoid abandonment and a series of suicidal threats or acts of self-harm (although these may occur without obvious precipitants). INCLUDING: - borderline personality (disorder) Diagnostic criteria for 301.83 Borderline Personality Disorder - DSM-IV Individuals with this Cluster B Personality Disorder behave impulsively and their relationships, self-image, and emotions are unstable. A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating conduct covered in Criterion 5. 2. A pattern of unstable and intense interpersonal relationships chalked out by alternating between extremes of idealization and devaluation. 3. Identity disturbance: markedly and persistently unstable self-image or sense of self. 4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating conduct covered in Criterion 5. 5. Recurrent suicidal conduct, gestures, or threats, or self-mutilating conduct. 6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). 7. Chronic feelings of emptiness. 8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 9. Transient, stress-related paranoid ideation or severe dissociative symptoms. Histrionic Personality Disorder Histrionic Personality Disorder - WHO F60.4 Personality disorder chalked out by at least three of the following: a. Self-dramatization, theatricality, exaggerated expression of emotions; b. Suggestibility, easily influenced by others or by circumstances; c. Shallow and labile affectivity; d. Continual seeking for excitement, appreciation by others, and activities in which the patient is the centre of attention; e. Inappropriate seductiveness in appearance or behaviour; f. Over-concern with physical attractiveness. Associated features may include egocentricity, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behaviour to achieve own needs. INCLUDING: - hysterical and psychoinfantile personality (disorder) Diagnostic criteria for 301.50 Histrionic Personality Disorder - DSM-IV Individuals with this Cluster B Personality Disorder exaggerate their emotions and go to excessive lengths to seek attention. A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Is uncomfortable in situations in which he or she is not the center of attention. 2. Interaction with others is often chalked out by inappropriate sexually seductive or provocative conduct. 3. Displays rapidly shifting and shallow expression of emotions. 4. Consistently uses physical appearance to draw attention to self. 5. Has a style of speech that is excessively impressionistic and lacking in detail. 6. Shows self-dramatization, theatricality, and exaggerated expression of emotion. 7. Is suggestible, i.e., easily influenced by others or circumstances. 8. Considers relationships to be more intimate than they actually are. Posttraumatic Stress Disorder (PTSD) When an individual who has been exposed to a traumatic event develops anxiety symptoms, reexperiencing of the event, and avoidance of stimuli related to the event lasting more than four weeks, they may be suffering from this Anxiety Disorder. Diagnostic criteria for 309.81 Posttraumatic Stress Disorder - DSM-IV & DSM-IV-TR A. The person has been exposed to a traumatic event in which both of the following were present: 1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. 2. The person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated conduct. B. The traumatic event is persistently reexperienced in one (or more) of the following ways: 1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed. 2. Recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content. 3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur. 4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. 5. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: 1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma. 2. Efforts to avoid activities, places, or people that arouse recollections of the trauma. 3. Inability to recall an important aspect of the trauma. 4. Markedly diminished interest or participation in significant activities. 5. Feeling of detachment or estrangement from others. 6. Restricted range of affect (e.g., unable to have loving feelings). 7. Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span). D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: 1. Difficulty falling or staying asleep. 2. Irritability or outbursts of anger. 3. Difficulty concentrating. 4. Hypervigilance. 5. Exaggerated startle response. E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month. F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if: Acute: if duration of symptoms is less than three months Chronic: if duration of symptoms is three months or more. Specify if: With Delayed Onset: if onset of symptoms is at least six months after the stressor. Also: Acute Stress Disorder, battle fatigue, gross stress reaction, shell shock.

Pete made some good points on the point by point argument. Build an argument that doesn't leave them wiggle room. Also and idea for generating more evidence - is to just get someone to diagnose you. I don't even think they would have to be willing to write any opinion, or provide any nexxus statements. It seems like you have the nexxus evidence firmly in place. You have evidence of your pre-service state of functioning. You have evidence of treatment for anxiety in service. You have evidence of the drastic change people saw in you after the service. You have recieved ongoing treatment showing the condition has been chronic. You have a C&P exam where the doctor clearly states there is no question that you suffer from anxiety - the question was whether it started in service. (The fact that he made the statement that you diagnosis had not been under question - and the only question to be addressed is whether it was incurred in service - and points out that your treatment records show MUCH earlier treatment than the VA had indicated - . His statement would lead me to believe that they informed him of your diagnosis - did not question it - but asked him to provide an opinion as to it's onset, while also indicating that your treatment didn't start until much later than it did.) And you have the C&P that says your problems stems from a personality disorder - but also links it to problems back in the service. So - the battle is not as to whether the problems started in service. The battle is fighting the personality disorder diagnosis. So you might want to get diagnosed. If your local college has a graduate program in psychology - they are ALWAYS looking for people who are willing to let graduate students do psychological testing on them. You might want to volunteer - and take all the tests - and see what the tests show. I don't know for sure if you could use any of those as evidence - but they could give you some indication of what a psychological profile might look like with some intensive testing. Then you might want to schedule yourself for some psychological testing. Maybe your treating doctor can help with that. Maybe she can refer you to someone who will do some of the tests on you and send her the reports. Again, I don't think they would have to be willing to write any VA opinions for you (which is what scares so many docs off). You already have the opinions and evidence. But they can send your doctor REPORTS of TESTS which SHOW what your diagnosis is - using the standard diagnostic tools. I think this could add strength to your case if you have to appeal. You have supportive statements and diagnosis. You have one C&P that lables it as something else. You have actual psychological testing that shows that the lable is not appropriate ADDED to all your supporting evidence. If the ONLY thing the VA has to deny you is the diagnosis in the C&P they sent you to AFTER the first C&P was in support of the claim, (and some crap discharge code) and ALL of the other evidence is in support of the claim INCLUDING diagnosis based on psychological testing, (especially if the second C&P did NO testing before giving you a diagnosis that was completely different than the treating doctor or the first C&P) it will be awfully hard for them to wiggle out of that one. Free

Thanks for the suggestion. I, too, have looked back at many posts to see what has happened, and eventually lose track of them. I guess I am going to have to do the track feature. I think my case was a little unique though. I don't think it usually takes the VA four months to put a hold on the funds or six months to take them. I think they usually move much more quickly. Free

I haven't ever had that experience - but I would think the rating schedule criteria would be a very good idea. In fact - you wonder why the VA doesn't use the checklist. If the doctor used a checklist of the criteria - then it would seem less likely that the VA would misinterpret their reports. It would be very clear what level of impairment the doctor was talking about. Of course, you would also want the doctor to write a narrative to discuss the results - along with the checklist. It would seem like the VA would also like the checklists - as it could speed up the processing of claims...and actually make claims processing more accurate. The only reason they wouldn't like them - is it gives them less ability to take what the doctor said and put their own interpretation on what it meant. But as they are lay people, and therefore not competent to issue medical opinions - checklists would be to their advantage. I think in the claim in question - the VA was just out to deny the increase and other issues. The court also reversed some other decisions of the BVA in the case. Personally, I think the checklist - which shows the level of impairment - along with a narrative to justify the rating would be very good. But again, I have no personal experience with it. Free

Well my bank account is $225 slimmer now. The VA FINALLY reclaimed the March 1, 2007 payment from my husband's Feb 5, 2007 death that they had put a hold on the bank account on May 20, 2007. According to the IRIS reponse - I won't get the Month of Death payment now until they decide the DIC claim. Oddly enough - I am relieved that they finally took the money back. I was getting aggravated seeing it sitting held hostage in my bank account - showing on my balance but unavailable to use. I asked them to either take the money or release the hold. You would think if someone died in February they could make up their mind by August. So at least they did SOMETHING - even if it was just taking the money back. Technically, what they SHOULD do in these cases IS to actually reclaim the money from the bank account. And then issue a check to the widow. Because the check is payable to the widow.. and there is no guarantee that the widow is the person with rights to the Vet's bank account. So to make sure the widow actually IS the one who gets the money - it DOES make sense that the VA would take it back from the bank and send it to its rightful owner. That way there is no question as to if the widow got the money - or if someone else also had access to the account, or if the account became part of the Estate, etc. The argument for leaving the money IN the bank account is most often the widow is the joint owner of the account (though I am not sure how this plays out in community propery states). Also - the more steps invloved - the more chances the VA has to make a mistake. So maybe - some day - down the road - I might get the $225 back. In the mean time - I am guarding the statement from the bank proving that the VA took the money - so I can prove I didn't already get it. Free

http://www.magellanassist.com/mem/library/...mp;CategoryId=2 Borderline Personality Disorder Treatment Medication In addition to psychotherapy, mental health professionals may use medication to help provide stability during treatment. Frequently used medications include mood stabilizers, such as lithium and carbamazepine; anti-depressants; and low-dose neuroleptics when manic or psychotic features (very distorted thoughts or beliefs) are present. Anti-anxiety medications, such as Valium (diazepam), Xanax (alprazolam) or Librium (benzodiazepine), generally aren't good for BPD patients. These medications reduce inhibitions, which is fine for an otherwise anxious patient who's uptight yet in control, but potentially hazardous for people who are impulsive, extremely sensitive and reactive and prone to abuse alcohol or drugs.

Here is something else to add to your stash. Librium, which I think you said you were prescribed for anxiety, is not only not used to treat BPD, but is actually not recommended for use with people with BPD. http://psyweb.com/Drughtm/jsp/librium.jsp Librium has been known to interact undesirably with certain medical conditions. Tell your doctor if you have, or have a history of, any of the following conditions: · Borderline personality disorder or a history of violent behavior. Just another tidbit of info Free

Here is the Court case I was talking about. The RO is not allowed to prejudice your claim by tainting the evidence - i.e. they can't guide the person issuing the medical opinion as to what to say. So - it would be interesting if you could get the request the RO wrote to obtain the second C&P. You can bet that at they sent you for a second one after the first one was favorable - they were looking for something specific. If they had any questions about the first one - they could have contacted the doctor who wrote it and asked him to clarify or expand on what he had said. They did not WANT his further opinion. They wanted a different one. So there MIGHT be something in their request to the second examiner that you can show prejudices your claim. But they also could have just tainted it orally, rather than in writing. Or as the nurse seemed to confirm that strange things always happened in that room - they might just have known exactly where to send you. http://www.hadit.com/library/law/971178colayongvtogo.htm AOAS COLAYONG, APPELLANT, v. TOGO D. WEST, JR., SECRETARY OF VETERANS AFFAIRS, APPELLEE. 12 Vet App 52412 Vet. App. 524; 1999 US App Vet Claims LEXIS 8851999 U.S. App. Vet. Claims LEXIS 885 In an October 1, 1996, memorandum to the Chief Medical Officer (presumably at a VA medical facility in the Philippines), the RO stated: 1. This is a BVA remand. The veteran is service connected for Pott's disease with kyphotic deformity and complete limitation of motion evaluated at 60%. A private physician, not an orthopedic surgeon, has reported that the veteran's spine has complete bony fixation (ankylosis) with unfavorable angle and with marked deformity and involvement of major joints (Marie-Strumpell type) or without other joint involvement (Bechterew type). his description of the veteran's spine is lifted verbatim from the Rating Schedule which would warrant the veteran a 100% evaluation. 2. The veteran was examined on August 21, 1996. Kindly review the claims folder and provide us with an expert opinion as to whether the above description by the private physician matches the veteran's spine condition. You might want to review the January 1973 examination and x-rays to determine if there is a significant increase in the severity compared to the 1993 and current examinations. 3. We will appreciate your resolving the above problem for us. Please feel free to refute the private physician's report as fully as possible for a better argument. Moreover, in light of the objective medical evidence as to pain (R. at 28, 38-39, 80, 89-90, 107, 179, 135), which could cause functional impairment under DC 5286-5295, the Court will remand this claim for a new examination that adequately evaluates the functional impairment due to pain, followed by a decision that specifically addresses the pain issue, supported by an adequate statement of reasons or bases. See _CFR_4.40 38 C.F.R. § 4.40 , 4.45 (1998); DeLuca v. Brown, 8 Vet. App. 202, 207-08 (1995); see also Smallwood v. Brown, 10 Vet. App. 93, 99 (1997); Green, 1 Vet. App. at 124 ("fulfillment of the statutory duty to assist . . . includes the conduct of a thorough and contemporaneous medical examination, one which takes into account the records of the prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one"). Also, "in regard to cases affected by change of medical findings or diagnosis", VA agencies are charged with handling such cases "so as to produce the greatest degree of stability of disability evaluations consistent with the law and [VA] regulations", and the Secretary's regulation provides: "It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history." _CFR_3.344 38 C.F.R. § 3.344(a) (1998). On remand, the Board must ensure that this regulation is heeded. b. BVA Reliance on Medical Opinion Obtained by Tainted Process: The Court notes that, in reaching the above conclusion, the Board relied on the October 1996 orthopedic medical opinion by the VA specialist that was solicited by the RO. R. at 6-7. Although the Board also said that "even without the doctor's opinion" it had concluded that DC 5286 applied only to conditions that affect "the entire spine", the Board was obviously influenced by the conclusion in the October 1996 medical opinion by the specialist that DC 5286 was not applicable to Pott's disease, even if the entire spine had been involved (R. at 191). The RO, in its October 1996 engagement memorandum that led to the October 1996 opinion, alleged that Dr. Lloren's October 1994 diagnosis as to the veteran's back disability was "lifted verbatim from the Rating Schedule", sought a resolution to that "problem", and then proposed that the specialist "feel free to refute the private physician's report as fully as possible for a better argument." R. at 255. That language suggested and, in effect, requested that the orthopedic specialist refute Dr. Lloren's opinion that the veteran's condition was ratable under DC 5286. In addition, the RO limited the inquiry to two narrow issues -- whether the previous report was accurate and whether the veteran's disability had recently worsened -- and left to the specialist's discretion whether he would {12 Vet. App. 535} review certain prior examination and x-ray reports ("you might want to review the 1973 examination and x-rays", R. at 255). The Court holds that the questions that the RO presented to that orthopedic specialist in the engagement memorandum were fatally flawed in that a "question may not suggest an answer or limit the field of inquiry by the expert." Bielby v. Brown, 7 Vet. App. 260, 268-69 (1994); see also Austin v. Brown, 6 Vet. App. 547, 552 (1994). The Secretary has conceded the impropriety of that memorandum. Under _CFR_4.23 38 C.F.R. § 4.23 (1998), "rating officers must not allow their personal feelings to intrude . . . and fairness and courtesy must at all times be shown to applicants". That regulation was violated by the engagement memorandum prepared here. Moreover, the memorandum also violated a requirement in _CFR_4.1 38 C.F.R. § 4.1 ("it is thus essential, both in the examination and in the evaluation of disability, that each disability be reviewed in relation to its history" (emphasis added)), because it gave the examiner discretion as to whether to review certain prior medical records. See Green (Victor), supra ("thorough and contemporaneous medical examination" is one that "takes into account the records of the prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one").

I was wondering. When I filed for DIC - I did not file for SSA at the same time through the joint application. I stated I would be filing for it independently. When my son applied - actually re-applied_ for survivor benefits with SSA - the application stated that it was a joint application for benefits through Social Security and the VA. Social Security has his records so twisted around that I had him put in a correction to the application and direct that he did NOT want to pursue a joint claim with the VA - as his Social Security record had too many inaccuracies that could prejudice a VA claim - and that we would file for VA benefits once Social Security corrects their errors. Free

Another good point. In fact I don't think many people with any kind of psychiatric diagnosis only have ONE diagnosis. So another ding on the second C&P - She's been treated for anxiety and depression for YEARS. She has a VA exam that says she suffers from them. And then suddenly - they don't exist - it is ALL personality disorder based (something that magically only appeared at discharge and a SECOND C&P - after the first C&P was favorable). Free

Yep. I am with you on that. I am pretty familiar with BPD - and it doesn't seem to fit what I know about Josephine at all. The black and white thinking - where someone is either all good or all bad, and the one who was all good says ONE thing - and gets "split" to all bad. You are their best frined one minute and their worst enemy the next.I don't see that in Josephine. She sees the shades of gray, and she doesn't flip back and forth all the time. Most people with BP think THEY are completely normal - there is nothing in the world wrong with THEM - it is everyone else who has a problem. I don't see her doing the infamous distortion campaigns -- always causing dramas and trying to turn people against each other. I have had enough dealings with BP that my radar usually detects BPD -- and I don't see any of the patterns that most BPs have. It looks like: 1. Instead of saying - "Yes. We caused you so much stress we have damaged you. We will let you go home and take care of you." They said - We are letting you out because their is something wrong with YOU that you can't handle stress. 2. She got treatment for years with no indication of personality disorders. 3. She got a C&P that could have granted her SC. 4. The RO sent her for a second C&P with someone who would take the emotional instability discharge code and connect it with it's present day "sister' diagnosis - BPD. I still think her case has a strong chance of success. But it might take a strong medical opinion that links the whole picture together - and shows how the second C&P was not adequate - and that her manifestations are more characteritic of anxiety, PTSD, etc. - and they have been consistent since AFTER the service - and that therefore, since she hasn't had any evidence of a personality disorder since the service (aside from the inadequate C&P) it is likely that she actual was suffering from anxiety when she was discharged - rather than emotional instability. Free

Yes. The case shows that it doesn't always mean personality disorder. I also notice the BVA judge was a female. I would think that the change in the diagnostic nomenclature might work to your advantage in this one. It would be interesting to find why they stopped using that as a diagnosis - and what diagnosis branched off of that. I imagine the DSM changed it. I was also interested in your letters from your minister. They talked about how active you were in the church, etc. BEFORE you went into the service. Were you also active in school organizations? Service groups? I know usually the big deal is proving something occured in the service - and the nexus. However, I think the broader picture you could create of how "normal" you were BEFORE the service - the odder the "personality disorder" diagnosis would look. So - if you have to appeal - even a couple of statements from someone in the past may help. They wouldn't even have to be someone who knew you after and noticed the marked change in you. In fact someone who says things about you before the service but says they did not see you much after - and can't remark on it much - still add credibility to your other statements from those who DID see the change. and the statements should be pretty credible, as they are not testifying to things they don't have knowledge of. For example - a statement I wrote for my husband's claim - there were places where I stated - I cannot discuss that period, as I did not know him at that time, but I can discuss what I DO know. Sometimes such statements can be more supportive tha ones that have something to say about everything. They can back the other statements. I wouldn't overwhelm them with 100 statements. But you could ask 100 people - so you will get 7 - 2 of which will be good to use. Anyway - just MY idea. If I were looking at the case...And one doctor said it was personality disorder and the other doctor said it was anxiety - and both connected it to my service. And then I saw a few statements about how you were involved in this, that, and the other right before you went into the service - the personality disorder theory would start looking more questionable to me. Then I would start looking more closely at the personality disorder C&P. What tests did they do to determine that? Where did they get their information about the incidents they describe? If they state the patient reported them, why didn't she ever report the same things to someone else? Or why did no one else mention them in their reports. How do they know she is a "cutter" Did they take pictures of, or describe any scars? So a couple of statements might be helpful. At least the probably wouldn't hurt. Again, if they can describe how you changed - that is nice. But even a statement along the lines of I was surprised to hear that Josephine had so many problems after the service - because I knew her right before that and she was ______. If they don't know for sure how you were after - and state that they don't know - that can be okay - and even add credibility to their statements. They won't replace a strong medical opinion - But they can help support a positive opinion and help debunk a negative one. At least where the anxiety vs. personality disroder comes into play. I would think a rational person would start thinking - hmmm - she was normal going in - and was emotionally unstable going out - I wonder what happened in between. Free

OMG! That sounds completely horrid! I do think counseling can sometimes be extremely helpful. But it has to be the "right" help - or it really seems to make things worse - where you almost have to get counseling to get over the counseling. And often - when dealing with past trauma - even if things are helping (toward the end result) they will get much worse before they get better. The old coping skills don't work anymore. And no new ones have been firmly established. Sometimes - when everything starts spinning out of control for me...I try to retreat to the point where I have influence. Okay...I have NO control over SO MANY things - what CAN I control? Sometimes - if I focus on controlling the things I CAN control - no matter how small those things are - it helps me regain my footing and get my balance back slightly before something whacks me again. And I know it is so hard on a relationship. You have needs as a person. Your wife has needs as a person. You have needs as a couple. And there isn't enough to go around and meet all the needs at the time. And you wish she could understand you. And she wants to understand you too. But it is hard to understand you at the moment - because she doesn't even understand herself. And she wants you to understand her. And you want to understand her too - but again - it is hard because you don't even understand what is going on for you. (And us women are extremely difficult to understand.) So as much as you love each other - it is so dang hard for both of you and each of you - because there just isn't enough to go around and meet everyone's needs. Virginia Satir said that unmet needs are like starving dogs in the basement. They get hungrier and hungrier. So what started out as a SMALL need - if it goes unmet - takes on mountainous proportions. And it gets so hard to "fix" anything that has occured in the past - when the present has become so unmanageable. The best advice I could give right now - with what I know - would be take it one day at a time - one hour at a time - or even one minute at a time. When the past and future are overwhelming - stay as firmly in the present as you can - focusing on just right now - and just what you have influence over. If your thoughts are out of control - then focus on your actions -- even if you have to start with "I can control my own hand moving." Retreat whatever point you have influence - and then work up. "I can decide where I am going to sit right now." Try to stay in a place where you feel in control of what is going on until you feel like you have regained your balance some. After you have been there awhile... then you can start trying to deal with some of the things that are not as controllable. But if things start spinning - retreat again, to the point where you have influence - until you regain your balance. Free

I think they say 0 is no pain and 10 is slamming your finger in a car door. So I guess 6 would be shutting your finger in the car door, but not slamming it. When my husband was in the hospital - I questioned the nurses if he was getting too much pain medicine. They said they asked him if he was in pain and he said yes. Well - yes - but he rated it as a 2 - 8. How can they tell your level of pain when you tell them it is a 2 to 8? Apparently I SHOULD have been questioning them. As when he went to sleep after THAT dose, his breathing got real shallow, he started gurgling, I had to get the nurses - and they ended up having to give him Narcan to reverse the overdose. Narcan is NOT a pleasant trip - it is drug withdrawal condensed into a matter of minutes. Free

It almost sounds like a scary movie - especially with the nurse telling you that people have those strange experiences all the time. I would start to wonder what kind of drugs they slip to people. I am sure you posted a couple letters from your minister in here - and read them - but then didn't have time to respond. Now I can't find them. Maybe you deleted them. Anyway - I thought they were very supportive of your claim as they gave a picture of the change before and after the service. - which helps pinpoint the onset in time much better. I don't think they would stand alone - but I think they can be very important pieces of the picture - The bar association calls probative evidence - evidence that though standing alone do not neccessarily prove a case is true, it is evidence that can be an important link in a chain of evidence which indicates that it is more likely that the fact is true than that it is untrue. Free

Strange that in a medical exam - when the doctor reports "pt. denies any pain in shoulder" no one ever interprets that to mean "the pt is probably in pain - but won't admit that he is." Most often people take it to mean - I the docotr specifically asked if he was in pain and he flat out told me NO and seemed very belivable" Most often it actually means "I never bothered to ask - but I don't recall he mentioned it - and if he did - I didn't listen, but I am supposed to write something about it in this report - so I will say "denies" However, in psych exams - "Pt denies...." is sometimes taken to mean -- It is a fact, but the patient is denying it. Odd how that happens. Free