dritz77

Thanks for the review guys. Its in preparing decision. I guess I'll see soon. Thanks for the info and message John. I was concerned a bit with the disocociative sub classification. I tend to check out a lot it something is getting to me. Out of all my symptoms the anger and the inability to feel emotionally connected are my biggest concern. If I could fix those I think I would be able to manage so much better.

I pasted a sanitized version of my c&p I got from my heathevet. I tried to marry it up with the rating percentages on the compensation chart but I seem to have symptoms from 10, 30, 50 and 70 percent thresholds. Any help guessing at the rating level would be appreciated. Thanks Does the Veteran have a diagnosis of PTSD that conforms to DSM-5Criteria based on today's evaluation?[X] Yes [ ] No ICD code: 309.812. Current Diagnoses--------------------a. Mental Disorder Diagnosis #1: PTSD with dissociative symptoms (derealization) ICD code: 309.81 4. Occupational and social impairment-------- Which of the following best summarizes the Veteran's level ofoccupational and social impairment with regards to all mental diagnoses?(Check only one) [X] Occupational and social impairment with reducedreliability and productivity 5. Symptoms-----------For VA rating purposes, check all symptoms that actively applyto theVeteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often [X] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Impairment of short- and long-term memory, for example,retention of only highly learned material, while forgetting tocomplete tasks [X] Disturbances of motivation and mood [X] Inability to establish and maintain effectiverelationships Behavioral Observations------------------- During the interview, veterans appearance and grooming wereunremarkable. He looked physically tense. When asked to describe stressor events, he became mildly agitated and upset, and he asked for a few minutes to calm down before the interview continued. He was alert and oriented to time, person, and place. He spoke in an organized, logical,coherent, and relevant manner, displaying a full range of appropriate affect.He expressed some anger and frustration at being offered another course of exposure-based therapy when CPT had not been effective, and he also expressed anger at recent events in Iraq. He asked me what the odds were that his PTSD would never get better, which is a question I was unable to answer (I did encourage him to continue seeking treatment). There were no indications of psychosis, such as delusions, hallucinations or paranoia. The veteran fully meets DSM-5 diagnostic criteria for PTSD With Dissociative Symptoms (Derealization), which is as least as likely as not the result of a fear of hostile military or terroristactivity stemming from his two deployments to Southwest Asia. Although the veteran's VA providers rated his GAF score as 60or 65 ("Moderate symptoms OR any moderate difficulty in social,occupational, or school functioning"), one provider also noted the veteran'suse of clich?s and minimizations in describing his functioning and history.These verbal behaviors are best understood as characteristic of PTSD, in that alexithymia (i.e., difficulty in finding words to identifyfeelings, and associated emotional numbing). Furthermore, in my opinion, a score of 60-65 is overly optimistic, given the veteran's current report concerning occupational and social functioning. Specifically, he had a verbal outburst at a supervisor, has had anger issues that have caused his wife to leave him twice in the past and which are still at a serious level, has distanced himself from family, has no friends or social activities, has depressed mood and anhedonia daily, and has failed to complete simple tasks at work due to distractibility associated with PTSD. If the GAF score were in use as part of DSM-5, a GAF score of 35-40 would be appropriate ("Some impairment in reality testing or communication OR major impairment in several areas, such as work or school, family relations,judgment,thinking, or mood).The following opinions reflect impairments stemming solelyfrom PTSD and not from any other conditions that may be present:The veteran is considered fully capable of managing funds inhis own best interest. His ability to understand and follow instructionsis considered not impaired. His ability to retain instructions as well as sustain concentration to perform simple tasks is considered mildly impaired. His ability to sustain concentration to task persistence and pace is considered mildly impaired. His ability to respond appropriately to coworkers, supervisors, or the general public is considered moderately impaired. His ability to respond appropriately to changes in the work setting is considered not impaired. His ability to acceptsupervision and criticism is considered not impaired. His ability to accept criticism is considered moderately impaired. His ability to be flexible in the work setting is considered not impaired. His ability to work in groups is considered not impaired in small groups, but markedly impaired in larger groups (the veteran currently works at night and does not deal with large groups at work). His ability for impulse control in the work setting is considered moderately impaired with respect to verbal outbursts but not impaired concerning physical aggression. The veteran's ability to sustain meaningful interpersonal relationships is profoundly impaired. The current level of functioning should not be considered permanent, since further treatment may alter the veteran's symptoms