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HenryS

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HenryS last won the day on September 13 2014

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About HenryS

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  1. I agree - you definitely got one of the good guys. You might even want to write a letter to the Medical Center Director praising the examiner. But ask the examiner first, because some nasty management types have a habit of turning a positive into a negative. Manager: "What?! You delivered treatment services during a C&P exam? That violates Grand Poobah Directive 2634(b)(3)! You will receive an admonishment for this serious error." C&P Psychologist: "When I have a vet in my office who needs some advice and encouragement to receive the help he deserves, and I have time to offer it to him, I'm not just going to sit on my ass and do nothing because of some bureaucratic b--l s--t. Manager: "And now I am going to write up a Report of Contact because you used foul language with your superior--that's insubordination!" C&P Psychologist: "If you feel that castigating me for helping a veteran will help you get your next promotion, go right ahead boss. You're the one that has to live in your skin." (Walks away). At least that's my fantasy of how I wish more of these conversations would go... Henry Henry
  2. The criteria for Social Security Disability and VA Individual Unemployability are quite different. With SSD they consider all your medical and psychological diseases, permanent injuries, disorders, etc. For IU, VBA can consider only the impact of your service-connected disabilities on your ability to secure and follow a substantially gainful occupation. Sure. You can just say something like, "Here are copies of documents that should be in my claims file, but just in case, I made some copies of them for your convenience." If the examiner says he or she can't take them, don't insist or anything, just let your VSO know and see what happens. It depends who you're referring to. Definitely the VBA Rater has to take them into consideration. The C&P examiner does not make a decision, in the sense of deciding on a rating, but I think you know that. If you mean should the examiner consider what the other psychologists wrote, yes they should. A formal appeal is your most powerful course of action. There is no short cut. Henry
  3. Did you get a copy of the psychologist's C&P exam report? If so, and if you are comfortable posting excerpts from it, I (and others) might be able to offer some more specific suggestions. Do you think you might have overemphasized some symptoms? I'm not suggesting that you 'lied', but it's human nature to pump it up a bit when the stakes are high. If that was the case, and sometimes it's subconscious, then the psych tests will often pick up on it and it will look like you were exaggerating. Having said that, a DUI 33 years ago and 1-2 standard drinks a night is definitely not alcohol abuse. (A standard drink = 12 oz. regular beer; or 5 oz. table wine; or 1.5 oz. 80 proof liquor). Henry
  4. < The VA is supposed to fix me up with another therapist, but in this area they're severely short-staffed > Then they should refer you to a specialist in private practice via the Non-VA Healthcare Office, i.e., VA pays for it since they can't provide it for you at the VA facility. That is part of the new law Congress just passed and the President signed. IMHO vets need to hold VA's feet to the fire on this one. If the local VA can't/won't provide the care a vet needs, then the VA has an obligation to find the vet that care in the community and VA foots the bill. Regarding the loss of your long-time therapist, my heart goes out to you. That is a major loss and you have a right to grieve--and anger is part of the grieving process! On the one hand it is true that it is hard for VA to hire bad employees. In fact, I understand it's one of the top vote getters in VA surveys--VA employees see it as a problem and say "we need to be able to get rid of the deadwood!" On the other hand, there are a lot of highly skilled, compassionate, hard-working healthcare professionals who do get fired (or forced to resign) because they won't go along with management b.s., or the won't kiss the derrierre of a power-hungry, narcissistic boss; or they are a whilstleblower, and we all know how VA management deals with whistleblowers; etc., etc. So I bet your therapist pissed off some tyranical manager and they made her life hell for a long time and found nit picky reasons to force her out (kind of like Chinese water torture is a typical M.O.). Maybe your therapist will go into private practice in your community. Look on the Psychology Today therapist finder website, Google/Bing her name, check on Facebook - maybe you can find her and she can give you the scoop. There might be legal issues that prevent her from talking about it, but maybe not. Hang in there. And, yes, do go to the C&P exam. Don't shoot yourself in the foot. VA screwed up (probably)--don't let their mistake hurt you. And if you get a good C&P doc, they might be sympathetic to what happened to you.
  5. No, fortunately no "VA math" for your back pay. You receive the 50% rate from the date you filed the claim to the date they cut the check. Henry
  6. Like a lot of C&P examiners, he doesn't realize what he's doing when he checks off various boxes on the DBQ. But in this case, his ignorance is probably to your advantage. This is the exact description from the General Rating Formula for Mental Disorders (the link Carlie posted) for a 10% rating: [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. However, he endorsed the following symptoms/problems, which correspond with the various rating levels as indicated: [X] Depressed mood [30%] [X]Anxiety [30%] [X]Suspiciousness [30%] [X]Panic Attacks that occur weekly or less often [30%] [X]Chronic sleep impairment [30%] [X]Disturbances of motivation and mood [50%] [X]Difficulty in establishing and maintaining effective work and social relationships [50%] [X]Difficulty in adapting to stressful circumstances, including work or a work like setting [70%] [X]Inability to establish and maintain effective relationships [70%] There are three general scenarios: 1) Mean-spirited or lazy Rater - "The doc checked off the 10% description, so vet gets 10% rating." 2) Perhaps overly generous, less thorough, or "vets have been screwed, so I'm going to give 'em as much as I can" Rater - "Doc checked off two of the 70% items on the Symptom List, therefore vet gets 70% rating." 3) Conscientious, hard-working, caring Rater - Reviews all the relevant evidence, especially progress notes from your treating psychiatrist and/or psychologist (or clinical social worker), statements you and any family members or friends submitted, and your military personnel records. He or she will start with 70% and look for evidence to support that rating, since the C&P examiner did endorse two of the 70% items from the Rating Formula. If the Rater finds information that supports those two items, e.g., frequent, fairly serious problems at work due to PTSD symptoms, strained marriage (or no spouse or partner), no friends, alienates others, etc., then he/she assigns a 70% rating. If the Rater doesn't find evidence (or not enough evidence) for those two items, but he or she does find evidence for other 70% items (see the Rating Formula that Carlie posted for the list), then they rate at 70%. If the only 'evidence' for 70% is the two check boxes the (uninformed) C&P psychologist checked off, then they move down to 50% and look for evidence supporting that rating level. And so on. In your specific case, from the examiner's report, and especially if your treatment notes are consistent with what the C&P doc wrote, it looks like there is evidence for "Inability to establish and maintain effective relationships", but there is not evidence for "Difficulty in adapting to stressful circumstances, including work or a work like setting" (since you are working and he didn't say anything about major problems on the job). Obviously that would change if your treatment notes or other documentation shows you have been having major problems on the job. The fact that you haven't been in treatment for the last year is a concern for two reasons: a) You are suffering from a very painful and disabling mental disorder. Free help is available. Why aren't you getting it? You served honorably, risked your life to protect the rest of us, and you are hurting--get the help and support you deserve! b) Some Raters will reasonably ask, "If it's so bad, why isn't he getting help?" Now, they can't officially use that against you, but you have to admit it's a reasonable question for them to ask, and it can influence their decision. But, having said all that, I'd put good money on 50%. And I'm going to say it again: Get back in treatment. If you didn't like the VAMC, go to a Vet Center. If you didn't like the psychiatrist, ask for another one. If they put you in group therapy when you're uncomfortable with groups of people (duh, it's a major problem with PTSD, I don't know why the VA pushes group therapy so much), insist (politely) on seeing an individual therapist. If they say there's a 6 month waiting list for individual therapy, ask for a referral via the Non-VA Care office to a PTSD specialist in private practice that the VA will pay for (that was part of the new law Congress passed and the President signed into law in the wake of the phony wait list scandal). If they give you the run around, call your Senators and Congressman, your VSO, and your local news stations. If there's one thing VA administrators don't like, it's bad publicity. So if they f--k with you, give 'em hell. Hopefully you won't need to do that since it sounds like you received decent treatment back when you were going, and, despite all the bad press recently, most VA docs and therapists genuinely care and try to do a good job. Good luck man. I honor and respect you for your service to our country. Henry
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