Motherof3

Mine was delayed for same reason although I handcarried mine to my former employer's HR department who advised they do not keep of former employee's attendance, sick days etc past 5 years. They then quickly denied my claim and here I sit with NOD 9 months later. I agree with the politician who stated, if VA can decide thousands of back logged claims in two months, what the hell have they been doing for the past decades? Backlog is growing because they are currently only working on claims up to Nov 30, 2012! So now Dec 2012 claims are now 210 days back logged. NOTE: I have not been able to work since 2008. I'm just saying.

Local DAV chapter doesn't even return calls and I can't even find out who in American Legion (my representative, which I did not select) I should speak with. Doing it on my own as usual. I find the VFW, DAV, and American Legion to be all talk. Look good on paper only.

They are just another "Peggy". They just don't read you a script.

My experience when I involved my congresswoman was that they just sent her the same "template, fill in the blank" letters they sent me and quickly denied my claim and here I am still fighting for the same disability claimed.

OH MY GOD! WOW!

Praise God!!!!!

I hope I'm wrong in assuming this will also affect those of us with claims after Nov 30, 2012. Although, I am still confused about claim dates. Example: Original claim date: Oct 25, 2010 Approval date: Dec 23, 2011 PTSD 50%, Migraines 30%, Hypertension 10%, Sinusitus 10% Immediately filed for IU Jan 2012 Denied IU Oct 25, 2012 Reapplied Dec 11, 2012 for PTSD IU with MDD C&P Exam May 23, 2013 supporting IU with PTSD now including MDD. So I am now officially in the back logged category (180 days), which I believe should be Jan 2012 (the latest). Sitting at Prep for Decision. I am starving, dodging bill collectors, neglecting my health waiting and now they are pushing back?! Then again, it may move faster with them throwing everyone under the bus! This is who/what we fought for? I used to be able to proudly say I served.

I feel you GlitterPopRock, at 70% I can't afford a thing. I am in panic mode every month, because im broke before payday even arrives. Any new financial need puts me into complete decomposition. I've over drafted so many times, I'm afraid my bank will cancel me. I am in Preparation for Decision phase and I'm afraid to request expedition due to hardship because I fear they will deem me incompetent to handle my finances although my C&P examiner agrees I can and do. Opinion anyone. Not only are my finances causing hardships, but my neighborhood (criminal element) does not help my PTSD/MDD. My doors and windows are locked 24/7 and I have secure doorstops under my door 24/7. I am a prisoner in my own home!

Good info harleyman. That's why I love hadit.com. I read the short bio on its conception this week and that made me appreciate this site even more. Many thanks to you all. You are truly a ministry from God for all.

Thanks Berta and Chuck 75. I agree with both your comments. I find it best to choose the battles I can handle and my current claim and everyday life events are quite enough right now.

Oh yeah, still have hammertoe, dr. Took out a joint and shortened one toe. Sliced bone in bottom of foot at 45 degree angle and shifted it up. Leaving a screw to hold. LOL. nothing to do with my question, just wanted to say she basically deformed my toe.

WOW, Berta you are so knowledgeable! I have a 1151 or FTCA question. It's nowhere as complicated as what I've seen posted, so I haven't posted in the past. I had a complete hysterectomy including appendix in 2006 due to "undiagnosed GWI" I don't have. Here's the scenario. Foot surgery to fix metarsalgia/hammertoe caused by imbalance and gait changes which are also not "GWI" in Oct 2012, which Dr. Didn't treat until worsened into unbearable pain. I still have nerve pain in both feet and topple over all the time. Fell downstairs and fractured tailbone two weeks later. Had XRay at ER which prompted CT Scan Discover surgical clamp from 2006 surgery during XRay. Does the surgical clamp equal malpractice? Some say its stainless steel and no worries. Others say it should not be there and it could travel in my body. Just curious. Current claim for PTSD/MDD increase has left me empty.

Thanks John and Veldrina! So I just need to wait and breath. It's been a long, hard road.

Thanks for your response. Funny example. Thanks for all you do and taking the time to assist us in this forum.

Thanks in advance. I truly wish I knew about this site years ago. It really helps a lot of veterans and is such a blessing no matter what our claim results are. I tried to delete all my personal information. C&P EXAM IU/PTSD Date/Time: 23 May 2013 @ 0930 Note Title: C&P EXAMINATION Location: VA TENNESSEE VALLEY HEALTHCARE SYSTEM - NASHVILLE DIVISION Signed By: GOODNOW,ANNE C Co-signed By: GOODNOW,ANNE C Date/Time Signed: 23 May 2013 @ 0930 ------------------------------------------------------------------------- LOCAL TITLE: C&P EXAMINATION STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: MAY 23, 2013@09:30 ENTRY DATE: MAY 23, 2013@10:52:38 AUTHOR: GOODNOW,ANNE C EXP COSIGNER: URGENCY: STATUS: COMPLETED Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire Name of patient/Veteran: Your patient is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will consider the information you provide on this questionnaire as part of their evaluation in processing the Veteran's claim. Please note that this questionnaire is for disability evaluation, not for treatment purposes. NOTE: If the Veteran experiences a mental health emergency during the interview, please terminate the interview and obtain help, using local resources as appropriate. You may also contact the Veterans Crisis Line at 1-800-273-TALK(8255). Stay on the Crisis Line until help can link the Veteran to emergency care. The following health care providers can perform REVIEW examinations for PTSD: a board-certified or board-eligible psychiatrist; a licensed doctorate-level psychologist; a doctorate-level mental health provider under the close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; a psychiatry resident under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; a clinical or counseling psychologist completing a one-year internship or residency (for purposes of a doctorate-level degree) under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; or a licensed clinical social worker (LCSW), a nurse practitioner, a clinical nurse specialist, or a physician assistant, under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist. SECTION I: ---------- 1. Diagnostic Summary --------------------- This section should be completed based on the current examination and clinical findings. Does the Veteran now have or has he/she ever been diagnosed with PTSD? [X] Yes[ ] No If yes, continue to complete this Questionnaire. If no diagnosis of PTSD, and the Veteran has another Axis I and/or II diagnosis, then continue to complete this Questionnaire and/or the Eating Disorders Questionnaire. 2. Current Diagnoses -------------------- a. Diagnosis #1: PTSD, chronic ICD code: 309.81 Indicate the Axis category: [X] Axis I [ ] Axis II Comments, if any: THE VETERAN'S PTSD HAS ALREADY BEEN ACCEPTED AS SERVICE CONNECTED. THE VETERAN REPORTS AND EXHIBITS MORE IMPAIRMENT THAN HER 50% RATING INDICATES. INDIVIDUAL UNEMPLOYABILITY: THE IMPACT OF PTSD WITH MDD ON BOTH ACTIVE AND SEDENTARY EMPLOYMENT IS: -concentration difficulties with short term memory impairment render her unable to effectively study and/or learn new skills -low energy and amotivation render her unable to effectively study and/or learn new skills -low frustration tolerance render her unable to handle the stress of being challenged in academic and occupational settings -anxiety, fear, and anger when put in an inferior position render her unable to effectively work with supervisors, bosses, and/or teachers due to mood swings and emotional outbursts -irritability renders her unable to effectively interact with co-workers, clients, and/or fellow students Diagnosis #2: MDD, recurrent, severe without psychotic features ICD code: 296.33 Indicate the Axis category: [X] Axis I [ ] Axis II Comments, if any: THE VETERAN'S MDD IS MORE LIKELY THAN NOT SECONDARY TO THE STRESS OF LIVING WITH PTSD AND THE MANNER IN WHICH IT HAS NEGATIVELY IMPACTED HER LIFE. Diagnosis #3: ICD code: Indicate the Axis category: [ ] Axis I [ ] Axis II Comments, if any: Diagnosis #4: ICD code: Indicate the Axis category: [ ] Axis I [ ] Axis II Comments, if any: If additional diagnoses, describe (using above format): b. Axis III - medical diagnoses (to include TBI): See TVHS record and medical C&P examination ICD code: Comments, if any: c. Axis IV - Psychosocial and Environmental Problems (describe, if any): low social support, health, unemployment, limited financial resources d. Axis V - Current global assessment of functioning (GAF) score: 45-50 Comments, if any: 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes[ ] No If yes, complete the following question: b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes[X] No[ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis: There is overlap between the symptoms of PTSD and MDD. If yes, list which symptoms are attributable to each diagnosis: c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[ ] No[X] Not shown in records reviewed Comments, if any: If yes, complete the following question: d. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes[ ] No[ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis: If yes, list which symptoms are attributable to each diagnosis: 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [ ] No mental disorder diagnosis [ ] A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication [ ] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication [ ] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation [ ] Occupational and social impairment with reduced reliability and productivity [ ] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood [X] Total occupational and social impairment b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[X] No[ ] No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: There is overlap between the symptoms of PTSD and MDD. As such, it is not possible to ascertain the extent to which each condition individually contributes to her current impairment without resorting to speculation. If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes[ ] No[X] No diagnosis of TBI If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ If any records (evidence) were reviewed, please list here: is a 52-year-old, female veteran who is currently 50% service connected for PTSD. The following is a review/increase C&P examination to address the veteran's contention that an increased rating is warranted. All available records were reviewed, including the veteran's TVHS record, Vista Web records, and Virtual VA records. He last C&P examination for PTSD was conducted in 8/2011. The emphasis of the present examination will be on how the veteran has fared since that time. 2. Recent History (since prior exam) ------------------------------------ a. Relevant Social/Marital/Family history: The veteran's TVHS record documents that she was homeless as of 11/2011. She had been living in Arkansas with her family until approximately 9/2011 but decided to move to Clarksville because living near her family of origin had become unhealthy. Moreover, she had lost her job in Arkansas. She is documented to have been staying at a friend's apartment as of 11/7/2011. She was experiencing difficulty finding employment at that time. The veteran's psychosocial difficulties are documented to have worsened in a 11/8/2012 SWS note as follows: "Veteran reports she has been having a really hard time coping with her limited resources, lack of support, lack of transportation, environment she lives around, and difficulty coping with feeling alone. Veteran reports she is doing a little better but having a hard time getting her needs met because of lack of support and decline of her benefits. Veteran has had to cancel appointments because of having not transportation. She reports she has trouble making ends meet with her money and then trouble having food because there is only so much a person can take on a bus. She was very tearful, reports feeling very sad, stays afraid of people around her, and now has her son living with her with no job or means of supporting himself and this just make things worse." Her psychiatrist was concerned enough about her psychosocial impairment and associated mental health symptoms that psychiatric hospitalization was recommended on 12/14/2012. The veteran declined hospitalization at that time and did not exhibit enough risk of harm to self or others to warrant involuntary hospitalization. currently resides in an apartment in Clarksville, TN. Her son had been living with her until May 13, at which time she "had to put him out". She elaborated that her son was not respectful toward her and got aggressive with her at times. These experiences triggered her PTSD symptoms because of her past abuse history with his father. She is relieved to have her son out of her home. However, the whole experience was very painful. The veteran reported that she has some casual friends. However, she pulls away from people whenever she feels that they are getting too close. She stated that she is unable to trust anyone. The veteran denied incidents of physical aggression over the past year. However, she acknowledged having verbal outbursts. She stated that she often snaps at people and then feels guilty about having done so. b. Relevant Occupational and Educational history: The veteran has not been gainfully employed since her last C&P examination in 8/2011. The following is documented in a 5/16/2013 SWS note with regard to her occupational functioning: "Vocational rehab tells her she is unable to work or go to school and this frustrates her yet SS won't approve her for disability it makes no sense." applied for vocational rehabilitation in late 2012. Her mental health treatment team at the Clarksville VA Clinic filled out paperwork associated with her application. The following barriers to employment and/or successful participation in an academic program were documented: -inability to pace herself -minimal ability to maintain persistence/low frustration tolerance -trouble coming to work daily due to physical, personal, and emotional issues -mood swings and hypersensitivity affect her ability to effectively interact with others -difficulty making decisions; "markedly" limited social interaction ability -"markedly" limited concentration ability -"markedly" limited memory ability -side effect of mirtazapine is sedation, which can reduce productivity -incapable of even working in a "low stress" occupation stated that her vocational rehabilitation counselor informed her that she was too psychologically impaired to go to school or work at the present time. As such, her application was denied. The veteran expressed a great deal of discouragement, helplessness, and sadness about her occupational difficulties. c. Relevant Mental Health history, to include prescribed medications and family mental health: The veteran transferred her outpatient mental healthcare to the TVHS on 12/13/2011 after running out of her psychiatric medications that had been prescribed by her provider at the Memphis VAMC. She has been prescribed the following medications since transferring her care to the TVHS: -bupropion: d/c'ed 5/21/2012 -zolpidem: d/c'ed but not well documented when -mirtazapine: increased 6/7/2012; increased 11/30/2012; increased 12/14/2012; the veteran reported that she self d/c'ed mirtazapine many weeks ago The veteran has also received individual psychotherapy through the SWS since 7/9/2012. Appointments have been once monthly or less frequent. Her last session was on 5/16/2013. d. Relevant Legal and Behavioral history: Denied. e. Relevant Substance abuse history: The veteran denied regular use of alcohol. The veteran reported that she occasionally uses marijuana. Her last use of marijuana was in 12/2012-1/2013. She stated that smoking marijuana helps to improve her appetite and helps her to relax enough to be able to fall asleep. f. Sentinel Event(s) (other than stressors): g. Other, if any: 3. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, referred to as Criteria A-F, are from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Criterion A: The Veteran has been exposed to a traumatic event where both of the following were present: [X] The Veteran experienced, witnessed or was confronted with an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. [X] The Veteran's response involved intense fear, helplessness or horror. [ ] No exposure to a traumatic event. Criterion B: The traumatic event is persistently reexperienced in 1 or more of the following ways: [X] Recurrent and distressing recollections of the event, including images, thoughts or perceptions [X] Recurrent distressing dreams of the event [X] Acting or feeling as if the traumatic event were recurring; this includes a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including those that occur on awakening or when intoxicated [X] Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event [X] Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event [ ] The traumatic event is not persistently reexperienced Criterion C: Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by 3 or more of the following: [X] Efforts to avoid thoughts, feelings or conversations associated with the trauma [X] Efforts to avoid activities, places or people that arouse recollections of the trauma [ ] Inability to recall an important aspect of the trauma [X] Markedly diminished interest or participation in significant activities [X] Feeling of detachment or estrangement from others [X] Restricted range of affect (e.g., unable to have loving feelings) [X] Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children or a normal life span) [ ] No persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness Criterion D: Persistent symptoms of increased arousal, not present before the trauma, as indicated by 2 or more of the following: [X] Difficulty falling or staying asleep [X] Irritability or outbursts of anger [X] Difficulty concentrating [X] Hypervigilance [X] Exaggerated startle response [ ] No persistent symptoms of increased arousal Criterion E: [X] The duration of the symptoms described above in Criteria B, C and D is more than 1 month. [ ] The duration of the symptoms described above in Criteria B, C and D is less than 1 month. [ ] Veteran does not meet full criteria for PTSD Criterion F: [X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. [ ] The PTSD symptoms described above do NOT cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. [ ] Veteran does not meet full criteria for PTSD 4. Symptoms ----------- For VA rating purposes, check all symptoms that apply to the Veterans diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [ ] Panic attacks that occur weekly or less often [ ] Panic attacks more than once a week [X] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks [ ] Memory loss for names of close relatives, own occupation, or own name [ ] Flattened affect [ ] Circumstantial, circumlocutory or stereotyped speech [ ] Speech intermittently illogical, obscure, or irrelevant [ ] Difficulty in understanding complex commands [ ] Impaired judgment [ ] Impaired abstract thinking [ ] Gross impairment in thought processes or communication [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [ ] Inability to establish and maintain effective relationships [ ] Suicidal ideation [ ] Obsessional rituals which interfere with routine activities [ ] Impaired impulse control, such as unprovoked irritability with periods of violence [ ] Spatial disorientation [ ] Persistent delusions or hallucinations [ ] Grossly inappropriate behavior [ ] Persistent danger of hurting self or others [X] Neglect of personal appearance and hygiene [ ] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene [ ] Disorientation to time or place 5. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [X] Yes[ ] No If yes, describe: -irritability/anger outbursts -concentration difficulties -amotivation; lethargy; stays in bed all day unless she is forced to leave her home -unable to enjoy anything in life -significantly reduced appetite with a 30 pound weight loss -increased urges to resume drinking alcohol to self-medicate -feelings of worthlessness -discouragement and hopelessness about the future 6. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No If no, explain: 7. Remarks, if any: ------------------- INDIVIDUAL UNEMPLOYABILITY: THE IMPACT OF PTSD WITH MDD ON BOTH ACTIVE AND SEDENTARY EMPLOYMENT IS: -concentration difficulties with short term memory impairment render her unable to effectively study and/or learn new skills -low energy and motivation render her unable to effectively study and/or learn new skills -low frustration tolerance render her unable to handle the stress of being challenged in academic and occupational settings -anxiety, fear, and anger when put in an inferior position render her unable to effectively work with supervisors, bosses, and/or teachers due to mood swings and emotional outbursts -irritability renders her unable to effectively interact with co-workers, clients, and/or fellow students NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review

Congratulations!

Congratulations! Whoosah, take a deep breath. So happy for you!

Veldrina, Is it okay to ask you to take a look at my C&P exam and your opinion? I'm sitting at Preparation For Decision and I plan to fax hardship letter with support documents to see if I can get my claim expedited; next week.

Why doesn't the C&P Examiner, Individual making Rating Recommendation have the ability to "Flag" a claims file when their recommendation is for 100% and/or IU? This would be another way to move claims along and prevent/help backlog. Current claims are slowly moving into backlog status (I.e. 180 days). Depending on whose claim date you go by.

I am a Desert Storm Vet with these issues: abnormal weight loss, fatigue, palpitations, diagnosed with hypertension after ETS'g muscle and joint pain, headaches separate from migraines, menstrual disorders culminating into total hysterectomy and appendectomy in 2006, (i wont discuss details; use imagination) neurological and psychological problems, chronic insomnia, memory loss (getting worse), fainting spells upon standing, balance off (always tumbling over).................. I keep getting denied for Presumptive illnesses. Part of current claim now. Filed when GWS was first accepted. Everyone wants to put all my issues on PTSD/MDD. Took all those shots, of course. Therapist/social worker has hinted at Chronic Fatigue Syndrome. I know I have not been exactly right since returning from Desert Storm. My problem is Primary Care Doctors and my labs indicate pretty healthy. Duh, that's where we get Presumptive illnesses. C&P for PTSD/MDD should pretty much take me to 100% or IU. But I've learned from you guys about SMC if 60 % or more above the one SC for 100% right? We shall see. Sorry so long. Just haven't had anyone to discuss with who understands in 16 years since I got out.

Congratulations OLDDUDE63! Whatever is happening, it's all good just to see the success stories posting lately. Gives the rest of us hope.

Oh, my primary care brings it up every time I see her. I tell her look at my records from 1982 to present date. No narcotics. Didn't even use prescribed Vicodin or Valium after foot surgery where I had bone cut and toe shortened. No pain meds after childbirth or major surgery. Told her I would snap on her if she didn't stop treating me like a common druggie. LOL. That felt good. She then explained about the VA's new policy and I went and looked it up. She then prescribed Gabapentin for my nerve pains, body aches, etc. it's not a narcotic. VA is just VA. Gotta love em

That's absolutely crazy and scary. I would call the Regional Office handling your claim for clarification, not the 800 number.

Thanks WhyMista

This is due to the epidemic of addiction to pain medication and VA announced this month their plans to reduce opiate prescriptions/addiction. There are so many abusers, that they treat us all the same. I agree it is invasive and should not be done without discussion with the patient and certainly not without cause for suspicion.