Patriot3g

Does anybody understand this? Could it lead to an increased rating for PTSD? I tried to fix the copy paste mess up LOCAL TITLE: COMP AND PEN NOTE STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: SEP 06, 2018@15:30 ENTRY DATE: SEP 06, 2018@16:45:47 AUTHOR: EXP COSIGNER: URGENCY: STATUS: COMPLETED Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire Name of patient/Veteran: I s this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No SECTION I: --------- 1. Diagnostic Summary -------------------- Does the Veteran now have or has he/she ever been diagnosed with PTSD? [X] Yes [ ] No ICD Code: F43.12 2. Current Diagnoses ------------------- a. Mental Disorder Diagnosis #1: PTSD ICD Code: F43.12 Mental Disorder Diagnosis #2: MAJOR DEPRESSIVE DISORDER ICD Code: F33 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): NONE 3. Differentiation of symptoms ----------------------------- a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [X] No [ ] Not applicable (N/A) If no, provide reason: THE SYMPTOMS OF PTSD ARE OUTLINED ELSEWHERE IN THIS REPORT AND INCLUDE REEXPERIENCING, AVOIDANCE, HYPERAROUSAL, NEGATIVE COGNITIONS, HYPERVIGILANCE. DEPRESSION IS CHARACTERIZED BY PERSISTENT DEPRESSED AND/OR IRRITABLE MOOD, ANHEDONIA, INTENSE GUILT AND JUDGEMENTS OF NEGATIVE SELF WORTH, DECREASED ENERGY, CHANGES IN APPETITE, SLEEP DISTURBANCE, PSYCHOMOTOR AGITATION OR SLOWING, AND SUICIDAL IDEATION. THERE IS SIGNIFICANT OVERLAP IN SYMPTOMS WITH BOTH DISORDERS, SO ATTRIBUTION FOR SOME SYMPTOMS IS NOT POSSIBLE. DEPRESSION IS SECONDARY TO PTSD. DEPRESSION HAS BEEN EXACERBATED BY RECENT INCIDENTS RELATED TO PTSD (ARREST FOR ASSAULT RELATED OT PTSD EPISODE AND SUBSEQUENT SUSPENSION FORM HIS JOB). c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed Comments, if any: EXPOSED TO BLASTS IN IRAQ BUT NO SCREEN OR HOSPITALIZATION. HE HAD A BRIEF LOC AND SOME CONFUSION. HE HAD HEADACHES. SYMPTOMS CLEARED UP. 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) [X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [X] Yes [ ] No [ ] Not Applicable (N/A) If yes, list which occupational and social impairment is attributable to each diagnosis: OCCUPATIONAL AND SOCIAL IMPAIRMETN IS DUE TO PTSD AS DEPRESSION IS SECONDARY TO PTSD. c. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] Not Applicable (N/A) SECTION II: ---------- Clinical Findings: ----------------- 1. Evidence Review ----------------- Evidence reviewed (check all that apply): [X] VA e-folder [X] CPRS Evidence Comments: THE VETERAN'S LAST EXAM WAS FEBRUARY 2018 AND THE CURRENT EXAM GENERALLY FOCUSES ON TIME SINCE. 2. Recent History (since prior exam) ----------------------------------- a. Relevant social/marital/family history: MR. XXX LIVES ALONE IN AN APARTMENT IN QUEENSBURY. HE HAS A DOG. HE HAS ARRESTED JULY 9TH FOR ATTACKING A FRIEND. HE DOES NOT REMEMBER THE INCIDENT. HE HAD A PANIC ATTACK. SINCE THEN HE STAYS AT HOME MOSTLY. HE VISITS HIS MOM DAILY AND COOKS HER DINNER. HE SEES HIS SIBLINGS OCCASIONALLY AS THEY DO NOT LIVE LOCALLY. HE HAS NOT HAD ROMANTIC ATTACHMENTS. HE CLEANS THE HOUSE. HE DOES HANG OUT WITH FRIENDS FROM WORK BUT MONEY IS TIGHT SO HE DOES NOT GO OUT. HE ATTENDED THE SARATOGA WAR HORSE PROGRAM FOR 3 DAYS (IN MARYLAND) WHICH HE ENJOYED. HE DOESN'T LIKE BEING AROUND CROWDS. HE ENJOYS FISHING, SWIMMING. b. Relevant occupational and educational history: MR. XXX HAD BEEN WORKING AS A CORRECTIONS OFFICER AT A NYS CORRECTIONAL FACILITY FOR THE PAST 3 1/2 YEARS. HE ADMITTED THE WORK WAS DIFFICULT AND HE ENJOYED THE COMRADERY AMONG THE STAFF. HE WAS SUSPENDED WITHOUT PAY AFTER AN ARREST - HE HAD A PANIC ATTACK AND ATTACKED ONE OF HIS FRIENDS, THE NEIGHBORS CALLED THE POLICE AND HE WAS ARRESTED. c. Relevant mental health history, to include prescribed medications and family mental health: THE VETERAN HAS HAD ONE VISIT WITH VA BH AND ONE VISIT WITH VA PSYCHIATRY SINCE LAST EXAM. HE HAD A HIGH RISK FLAG FOR SUICIDE RISK THAT WAS ENDED RECENTLY. HE SEES A THERAPIST PRIVATELY, KRISTIN X IN X. HE TAKES WELLBUTRIN AND LEXAPRO AND BUSPAR. HE HAS BEEN PRESCRIBED XANAX BUT HASN'T TAKEN ANY YET. d. Relevant legal and behavioral history: ON JULY 9, 2018 HE HAD A PANIC ATTACK AND ATTACKED ONE OF HIS FRIENDS, THE NEIGHBORS CALLED THE POLICE AND HE WAS ARRESTED. HE DOES NOT RECALL THE INCIDENT. HE IS OPTIMISTIC FOR A GOOD OUTCOME LEGALLY AS HIS FRIEND IS WANTING HIM TO GET HELP VS. BEING PUNISHED. e. Relevant substance abuse history: HE RARELY DRINKS ALCOHOL. HE HAS HAD >5 2X IN PAST YEAR. NO ILLICIT DRUG USE. HE CHEWS TOBACCO. f. Other, if any: No response provided. 3. PTSD Diagnostic Criteria -------------------------- Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors). Do NOT mark symptoms below that are clearly not attributable to the Criterion A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 - "Other symptoms". Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violence, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) Criterion B: Pre sence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Reckless or self-destructive behavior. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] The duration of the symptoms described above in Criteria B, C, and D are more than 1 month. Criterion G: [X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 4. Symptoms ---------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often [X] Chronic sleep impairment [X] Flattened affect [X] Impaired judgment [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Impaired impulse control, such as unprovoked irritability with periods of violence [X] Grossly inappropriate behavior 5. Behavioral observations ------------------------- THE VETERAN WAS ORIENTED TO THE NATURE OF EVALUATION, THE SEPARATION OF VHA AND VBA AND THAT THE AUTHOR WAS NOT PROVIDING TREATMENT AND THAT NO PATIENT PROVIDER RELATIONSHIP EXISTS. THE VETERAN WAS ORIENTED TO THE LIMITS OF CONFIDENTIALITY AND ASSENTED TO EVALUATION. HE WAS ALSO INFORMED OF THE NATURE OF THE REVIEW EXAM WHICH WOULD GENERALLY FOCUS ON TIME SINCE LAST EXAM. MR. X PRESENTED ON TIME. HE WAS DRESSED CASUALLY AND APPROPRIATELY WITH ADEQUATE HYGIENE. HE WAS PLEASANT AND COOPERATIVE THROUGHOUT THE SESSION. HE WAS ALERT AND FULLY ORIENTED. MOOD WAS DEPRESSED/ANXIOUS; AFFECT WAS FLAT, CONSTRICTED WITH RESTRICTED RANGE. SPEECH WAS NORMAL IN TONE, RATE AND VOLUME. CONVERSATION WAS COHERENT. THERE WERE SOME DEPRESSIVE SYMPTOMS INCLUDING: SAD/IRRITABLE MOODS, ANHEDONIA/LOSS OF INTEREST OR PLEASURE, SENSE OF GUILT, NEGATIVE SELF-WORTH, DECREASED ENERGY, DISTURBED SLEEP, PSYCHOMOTOR AGITATION. HE DENIED CURRENT SUICIDAL IDEATION ALTHOUGH HAD EXPERIENCED THIS IN JULY AFTER BEING ARRESTED. HE DENIED HX OF PSYCHOSIS, MANIC OR HYPOMANIC EPISODES. HE HAS EXPERIENCED PANIC ATTACKS, OBSESSIONS, COMPULSIONS, FLASHBACKS, INTRUSIVE MEMORIES, EXAGGERATED STARTLE RESPONSE, HYPERVIGILANCE. 6. Other symptoms ---------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 7. Competency ------------ Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 8. Remarks, (including any testing results) if any: -------------------------------------------------- MR. X MEETS THE CRITERIA FOR CHRONIC PTSD. HE HAS HAD MULTIPLE INSTANCES OF PANIC AND DISASSOCIATION WHERE HE HAS ATTACKED OTHERS. THESE EPISODES ARE MORE LIKELY THAN NOT RELATED TO THE PTSD FORM MILITARY SERVICE. THESE EPISODES CAN BE DANGEROUS. HIS ABILITY TO EFFECTIVELY RETURN TO HIS CURRENT WORK ENVIRONMENT IS CERTAINLY QUESTIONABLE. HE LIKELY WILL HAVE SOME LIMITATIONS AND RESTRICTIONS WHERE HE CAN WORK. HE IS INT TREATMENT AND THERE IS SONE REASON THAT HE SYMPTOMS AND QUALITY OF LIFE CAN IMPROVE. THE INSOMNIA AND ANXIETY ARE PART OF THE PTSD AND THESE SYMPTOMS DO NOT REQUIRE AN ADDITIONAL DIAGNOSIS. /es/ Michael McCann, Ph. D. Licensed Psychologist/Neuropsychologist Signed: 09/06/2018 16:45

Okay I'm not sure if I would qualify for an increase, but my latest incident had me get in a fight with my best friend and ended up with me being arrested...I do not recall what started the fight but he claimed I just attacked him. Neighbors called the police and I ended up being arrested, lawyer is confident Ill see the charges dropped (never been in trouble, and I am a peace officer). However this ended up with me being suspended from work, for the second time (first time was when I was suicidial). Is this something that may help with getting an increase? I am scared of being forced to not work, 3 grand is not enough to live on in my area (new car, rent, utilities in NY).

Hey guys, I am currently 70% SC for PTSD "posttraumatic stress disorder with major depressive disorder, recurrent, severe", I was wondering if its possible to claim anxiety and depression (both are well documented) as secondary to my PTSD, and get rated for them? I'm confused about how the whole system works...seems to be a lot of conflicting information out there. Thanks!! Adam

I haven't recieved my notification packet yet...but I was pleasantly surprised by my backpay. And I have a hard time trying to figure out how they figured it out: Net Payment Amount: $17,916.35 Payment Date: 09/12/2014 Payment Type: Compensation & Pension - Retroactive Payment Method: Direct Deposit And this is from the benefits letter you can generate on eBenefits: You have one or more service-connected disabilities: Yes Your combined service-connected evaluation is: 50% Your current monthly award amount is: $822.15 The effective date of the last change to your current award was: December 01, 2013 Or maybe they went back to when I began treatment for PTSD? I filed the claim in October...so I was figuring on 10 months of backpay @ the 50% rate. Did they overpay me?

Thanks. Only took 14 months! I guess thats faster than most veterans claims. Atleast I can stop checking ebenefits everyday and freaking out. Is backpay calculated in some weird VA fashion? or is just the 50% rate from dec to now?

Today Ebenefits update, claim complete. I haven't recieved my packet yet (probably takes a while?) I got 50%. Pretty surprised, I figured I'd get low balled like most people do. Even though I filed the claim in october, the benefit is awarded 1 Decemeber 2013. So that means 10 months of back pay, right? Does anyone have any idea how long it takes to recieve that chunk of change? Also, my claim is up for review in 2019...is that normal? Atleast I have 5 years to worry. Thanks for your help!!

Hopefully higher than 10%. This thing has dragged on for almost a year and it's sucked. It just moved to the "prep for decision" phase. I'm freaking out waiting :( You guys have any idea how long it takes to upgrade your Healthevet account to "premium"? I sent the form in the mail and faxed it. It's been a month and nada.

Hey guys, I got a copy of my C&P Results in the mail today....I had to type it out, so I skipped some stuff. Let me know if you need more. I appreciate it. The doctor had horrible spelling during my stressor description, etc. Hopefully that doesn't mean I have to go thru this all again :( 1. Diagnostic Summary Does the Veteran have a diagnosis of PTSD that conforms to the DMS-5 criteria based on today's evaluation? [X] Yes ICD Code: PTSD 2. Current Diagnosis a. Mental Disorder Diagnosis #1: PTSD 4. Occupational and social impairment [X] 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. 2. History a. Relevant Social/Maritial/Family history (pre-military, military, and post-military): Pre military: Raised by both his parents and well adjusted socially Military: served in US Army, had honorable discharge. Post military: veteran is single, never married and lives with his parents, he does not feel close to any body and prefers to be alone al the time, he avoids people and isolates himself and he doesnt not have any social relationships. b. Relevant Occupational and Education history Pre Military: Completed 12th grade. no work history noted. Military: served in US Army, was deployed in Iraq from July 2006-Nov 2007 and Aug 2009-Aug 2010. Post Military: veteran went to school from 2011-2014 but did not get degree. Has been working in local paper mill for the past one year. c. Relevant mental health history: Veteran recieved PTSD treatment at VAMC Albany NY from oct 2012 to april 2013, currently not in mental health treatment, no h/o hospitalisations and no h/o suicidal attempts noted. 3. Stressors. <Too long to type> Does this stressor meet criterion A (to support diagnosis of PTSD) [X] yes Is the stressor related to the veterans fear of hostile military or terrorist activity? [X] Yes Is the stressor related to personal assault [X] No 4. PTSD Diagnostic Criteria Criterion A [X] Directly experiencing the traumatic events [X]Witnessing, in person, the traumatic events [X] Learning that the traumatic events occured to a close family member, close friend... Criterion B [X]Recurrent, involuntary, and intrusive distressing memories of the events [X]Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X]Dissociative reactions (flashbacks) [X]Intense of prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic events. Criterion C [X] Avoidance of or efforts to avoid distressing memories, thoughts or feelings... [X] Avoidance of or efforts to avoid external reminders (people, places, conversations...) Criterion D [X]Inability to remember an important aspect of the traumatic event(s). [X]Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world. [X]Persistent, distorted congnitions about the cause or consequences of the traumatic events that lead to the individual to blame himself/herself or others. [X]Persistent negative emotional state [X]Markedly diminished interest or participation in significant activities. [X]Feelings of detachment or estrangement from others [X]Persistent inability to experience positivie emotions Criterion E [X]Irritable behavior and angry outbursts [X]Reckless or self-destructive behavior [X]Hypervigilance [X]Exaggerated startle response [X]Problems with concentration [X]Sleep disturbance Criterion F [X]Duration of the disturbance is more than one month Criterion G [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning Criterion H [X] The disturbance is not attributable to the physiological effects of a substance 5. Symptoms [X] Depressed mood [X]Anxiety [X]Suspiciousness [X]Panic Attacks that occur weekly or less often [X]Chronic sleep impairment [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 work like setting [X]Inability to establish and maintain effective relationships 8 Competency Is the veteran capable of managing his or her financial affairs? [X] Yes Medical Opinion: Restatement of requested opinion: a. Opinion from general remarks: Provide opinion as to if it is as least likely as likely as not that PTSD is due to fear of hostile military activity: b. Indicate type of exam for which opinion has been requested: Initial PTSD A. The Condition claimed was at least as likely as not (50% or greater probability) incurred in or caused by the claimed in-service injury, event or illness. Rationale: Veteran urrently meets criteria of PTSD, did not have PTSD before he joined service, while in service he was deployed in combat where he was exposed to hostile military activity to which he responded with intense fear. This fear of hostile military activity meets criteria of a PTSD stressor which is an adequate stressor to support a DX of PTSD.

Hey guys, I've been lurking here for awhile, figured I'd join in on the discussion. Last year I did an FDC claim for PTSD, after going to see a VA Pysch for almost a year (at the insistance of my family). She diagnosed me with PTSD, and encouraged me to go thru with a claim. On the 7th I had my C&P exam. The doctor didn't ask very much....just if I was single, and why, if I drank a lot, etc. When I got up to leave after he was done (like 10 minutes), he said that the VA asked him to answer two questions: Do I have PTSD, and did my service in OIF cause it. He said he felt I had it, and that service in Iraq was the cause. I forgot to do my in person authentication for Healthevet, so I just mailed in the form. I was just wondering if anybody here has any idea on what I might recieve as a rating, before I get the C&P exam results (hopefully soon). When I submitted my claim, they asked me to fill out a form "STATEMENT IN SUPPORT OF CLAIM FOR SERVICE CONNECTION FOR POST-TRAUMATIC STRESS DISORDER (PTSD)" so I filled out two of them, one for the Battle of Zarqa. And one for the killing of my squad leader. I figured these would be the best two to put in my file, since they can be easily verified as true (squad leader was kinda famous, Zarqa was a huge fight). I have my notes from the doctor that used to talk to me, and what she put in my file seems pretty convincing about PTSD and my service, but I guess I'm just stressed/worried/scared shitless that the VA will lowball me and give me 0% or something. I honestly have the worst luck with anything! Thanks.