smoothc100

Below are the documents the VA used to make their decision, but I do not see the letters from family or the updated one from the Vet Center. I did however dig in my old personnel file and found orders my NCO who was with me for over 1/2 my tour and by luck found him on facebook of all places, so I will ask him for a letter as well as he was present during most of the incidents I address in my letter. Evidence Considered In making our decision, we considered: DD 214, from September 19, 1996 through March 18, 2001 5103 Notice Response and statement from Veteran received July 18, 2014 Service treatment records, Received April 24, 2014 Statement from Veteran received August 13, 2013 Disability Benefit Questionnaire, posttraumatic stress disorder, XXXX, PhD, dated August 13, 2013 Private treatment records, XXXXXXXs Psychological Associates, Neuropsychological Evaluation, Received August 13, 2013 Medical Opinion, Dated October 27, 2014 VA examination, Dated February 8, 2013 VA examination, Dated September 16, 2014 VA examination, Dated October 14, 2014 Rating Decision, Dated March 11, 2013 VA Form 21-0820 Report of General Information, telephone contact, dated July 7, 2014 Letter from Disabled American Veterans, reconsideration of claim for posttraumatic stress disorder received August 13, 2013 Timeline of traumatic events received August 13, 2013 5103 Waiver Review Letter dated June 27, 2014 Letter from Disabled American Veterans received July 24, 2014 What You Should Do If You Disagree With Our Decision If you do not agree with our decision, please download and complete VA Form 21-0958, Notice LETTER FROM VET CENTER 10 July 2014 RE: Veteran To Whom It May Concern; The veteran named above was self-referred due to emotional detachment, avoidance, intrusive thoughts, anger, anhedonia, and hypervigilance in varying degrees since his deployment in 1999. He did not think in terms of these being related to experiences he had while deployed however, until recently with more public talk about PTSD and war zone trauma. His own experiences are related to some of the patrols he went out on but especially the frequent casualty and injury reports he was exposed to during the course of his job in personnel records. An intake assessment was conducted on May 14, 2012, and follow up sessions have occurred approximately biweekly between then and now, at the Annapolis Vet Center. The veteran completed a 12-week course of Cognitive Processing Therapy (CPT) for PTSD with the undersigned in March of 2014. Veteran enlisted in the Army in 1996 and deployed to Kosovo in 1999 as a peacekeeper. His duties included going out on patrols and he was also responsible for accountability of the soldiers, and for casualty reporting (military and civilian). A major part of his duty was to enter casualty and injury reports into the records which exposed him to frequent, graphic information about fellow soldiers as well as civilians. Veteran endorses the following symptoms under Criterion B (re-experiencing): frequent intrusive thoughts and nightmares about the traumatic experiences, and severe distress when exposed to reminders of the traumatic incidents. Criterion C (avoidance and numbing): symptoms include avoidance of anything reminding him of or connected to his experiences in deployment, significant lack of interest in any activities, feeling emotionally detached from other people, and severely limited ability to care about the problems of others. Symptoms endorsed under Criterion D (hyperarousal) include: initial insomnia and outbursts of anger/rage. He is often suspicious and mistrustful of others, and tends to perceive threats even when it is not warranted. He finds it very difficult to concentrate and focus, and frequently reacts to unexpected sounds and movements with an exaggerated startle response. These symptoms have significantly affected Veteran’s life in the following ways: the break-up of his marriage and other subsequent personal relationships due to excessive anger and diminished ability to relate to any emotions besides anger; living an isolated lifestyle in which he rarely leaves his house except for appointments or to visit his parents' house; extreme discomfort while riding public transportation to and from work due to hypervigilance and perception of threats; and having to recently drop out of school due to inability to concentrate enough to complete his assignments. XXXXXX, Psychiatric Nurse Practitioner at the XXXXX VA Outpatient Clinic, prescribed XXX, XXmg for sleep; XXXX, XX mg for nightmares; XXXX, XX mg three times a day for anxiety; and XXXX, XX mg twice a day for mood. The results seem to indicate improvement in the Criterion D (hyperarousal) symptoms, slight improvement in the Criterion B (re-experiencing) symptoms, and little to no change in the Criterion C (avoidance and numbing) symptoms.

Here are the exam results I received in the mail below. So, I am really confused at this point as they labeled my condition as depression, also claimed as PTSD and basically denying the claim and then saying I meet the criteria for being treated for depression, because I was in the service when it was diagnosed. Maybe I'm just lost as all get out over here. I guess the way I'm reading this is I can claim depression even though they denied the depression as PTSD claim????? I know it sounds confusing but it is confusing to me. Still fight for the PTSD claim and file for depression? At the end of the day I just want to get the right help for my condition, which in my opinion and the Vet center for 2 years is PTSD and my doc at the VA has been treating me for depression and anxiety, but nothing else. They did not even consider the letters from my family. Issue/Condition depression, also claimed as PTSD A claimant may reopen a finally adjudicated claim by submitting new and material evidence. New means that the evidence has not been considered before and material means it applies to the specific issue for which you were previously denied. New and material evidence must raise a reasonable possibility, that when considered with all the evidence or record (both new and old), that the outcome (conclusion) would change. The evidence can't simply be redundant (repetitive) or cumulative of that which we had when we previously decided your claim. The evidence from Baltimore VA examination is not new and material evidence because it does not establish a fact necessary to substantiate the claim and does not raise a reasonable possibility of substantiating the claim. A claimant may reopen a finally adjudicated claim by submitting new and material evidence. New evidence means existing evidence not previously submitted to agency decisionmakers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim.The VA examiner stated that there was no evidence to suggest a change in diagnosis from your previous VA examination. Consistent with both VA treatment notes and previous VA evaluation, and in consideration of all data submitted by you or on your behalf, criterias are not met for posttraumatic stress disorder per DSM-IV or DSM-5.The VA examiner did provide a diagnosis for unspecified depressive disorder with anxious distress. We then requested a medical opinion if this diagnosis was related to military service. The VA examiner stated that your reported stressors occurred in 1999. You reported symptoms are not consistent with a posttraumatic disorder, including posttraumatic stress disorder, depression or anxiety. Rather, your symptoms are a mild non-specific depression. The examiner further states it appears that you have tied your symptoms to in-service events, but have done so mistakenly. You reported irritability with anger, poor sleep, loss of interest and anxiety in crowds, on airplanes and during fireworks. There is no evidence of mental health treatment until 2012, 13 years after your reported stressors. Your report of symptoms has been rather vague and not consistent with a posttraumatic disorder. Thus, there is insufficient evidence to link your current mild depression to reported stressors that occurred in 1999.The evidence from Baltimore VA examination and neuropsychological evaluations from Dr Ziskind reviewed in connection with the current claim does not constitute new and material evidence because it does not relate to an unestablished fact necessary to substantiate the claim and does not raise a reasonable possibility of substantiating the claim. Entitlement to medical treatment for an active psychosis or mental illness is established because the evidence of record demonstrates you developed this condition within the required time period. You may apply for medical treatment at your local VA Medical Center. Please bring a copy of this notification letter with you if you wish to pursue this entitlement. A determination of service connection under 38 U.S.C. 1702 is for the purpose of providing eligibility for hospital and medical treatment for Veterans of World War II, Korean Conflict, or Vietnam era; or for Gulf War Veterans who develop an active psychosis or any active mental illness during or within two years from the date of separation from such service or within two years of the end of the war period, whichever is earlier. The Veteran was discharged on February 14, 2014. A psychosis/mental illness was first diagnosed on September 16, 2014. Entitlement to treatment is established because a psychosis/mental illness was diagnosed within the required period of time.

No claim in for depression as I thought it would be listed as a secondary after the PTSD claim was approved.

Broncovet, The 3 day Neuropsychological Evaluation I had was conducted by a civilian and they even disputed the VA doctor’s report. You’re correct it was very, very costly as my VA doctor would not even refer me to take the exam after I requested it. Like you said according to the VA if it’s not one of their doctors then it doesn’t matter. I even thought under the new DSM IV criteria I would have a different outcome with letters from family members, updated Vet Center letters etc. I might go and see a lawyer on this matter no disrespect to the VSO Reps, but I submitted everything and done all I can do without going in there and acting a fool, which is what it seems like they want (VA).

Try a NOVA lawyer. There is a directory under Veteran Help. https://vetadvocates.org/

Yes, it will slow your award down not the process as VA keeps changing things and now they are combining all the open claims. For example if you go on the ebenefits and look at your claims it now states that the VA will work to resolve all open claims to send out 1 overall rating. So if one claim is done and you put one in the Hooper before the previous claim is closed then you will not receive an award prior to both being complete is my understanding. My claim for my PTSD was completed, but my status didn't change until my claim for my feet was completed as well.

Here is the original C&P below the doctor did determine that I have depression and this was also stated on my Exit Physical from the Active Duty Army as well as sleep issues. What the VA stated they needed for was New and Material Evidence to connection between PTSD and service and they did accept the reopen. I initially provided a Trauma Timeline of the events I was exposed to during my deployment, 214 (Kosovo Campaign Medal, NATO Medal, and Armed Forces Commendation Medal) with medals relevant to deployments in a hostile environment according to the VA guidance have some form of presumptuous evidence, Letter from my therapist at the Vet Center, and Neuropsy. Eval. My current C&P was done via video conference due to the distance. LOCAL TITLE: C&P EXAM STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: FEB 08, 2013@09:00 ENTRY DATE: FEB 09, 2013@10:55:57 URGENCY: STATUS: COMPLETED COMPENSATION AND PENSION EXAMINATION INITIAL EVALUATION FOR POST-TRAUMATIC STRESS DISORDER (PTSD) ============================================================ REVIEW OF RECORDS ================= C-FILE WAS: Reviewed MEDICAL RECORDS WERE: Reviewed OTHER MATERIAL REVIEWED: DD-214 MEDICAL HISTORY =============== AGE: 35 PERIOD OF SERVICE: Army 1996-2001; Air force reserves 2005-present PAST MEDICAL HISTORY -------------------- SIGNIFICANT NON-PSYCHIATRIC ILLNESSES, INJURIES, OR HOSPITALIZATIONS: Herniated disc DATES, CURRENT TREATMENT, AND OTHER SIGNIFICANT DETAILS OF NON-PSYCHIATRIC ISSUES: Navy Medical Center- Nerve ablition Oct 2012. He reports he gets that Every 6 mos and also gets cortisone shots. TREATMENT WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes DATE(S) OF OUTPATIENT TREATMENT: 2012-present CONDITION(S) AND LOCATION OF TREATMENT: Depression/Insomnia Currently sees,CRNP-CNS for medications management at the Baltimore VA. Also attends Annapolis Vet Center for individual sessions once every 2 weeks since May 2012. He reported he started sessions there . HOSPITALIZATION(S) ------------------ WERE THERE ONE OR MORE HOSPITALIZATIONS FOR A MENTAL DISORDER? No PRESENT MEDICAL HISTORY ----------------------- SYMPTOMS PRESENT DURING PAST YEAR: Yes IS THERE CURRENT TREATMENT FOR A MENTAL DISORDER? Yes SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER: CURRENT TREATMENT(S): Anti-depressant, Anti-anxiety SPECIFY MEDICATION AND OTHER COMMENTS: 1) SERTRALINE 100MG TAB (ZOLOFT) 2) TRAZODONE 100MG 3) BUPROPION ORAL SR 150MG MEDICATION SIDE EFFECT(S): None GROUP THERAPY: No INDIVIDUAL PSYCHOTHERAPY: Yes OTHER THERAPY: None EFFECTIVENESS OF THERAPY: Good COMMENT ON EFFECTIVENESS OF THERAPY: Veteran reports he is calmer on the medications and his overall mood is improved. ***************************************** FREQUENCY, SEVERITY, AND DURATION OF NON-PTSD PSYCHIATRIC/MEDICAL SYMPTOMS: Veteran reports daily back pain of 5 (on a scale from 1-10 with 10 being the most pain)and prevents the veteran from physical activity such as running, basketball, and PT. PTSD INITIAL: PRE-MILITARY HISTORY ----------------------------------- EDUCATION: Masters FAMILY STRUCTURE AND ENVIRONMENT WHERE RAISED: Veteran was raised by mom and dad and moved around often. Both parents were in the military. His mom was in AF and father in Army. They stayed together. He reports a good childhood; denies exposure to abuse/violence. Veteran is oldest of 4 children. FAMILY PSYCHIATRIC HISTORY: Sister-diagnosed bi-polar Mother-mother bi-polar suffers from depression QUALITY OF PEER RELATIONSHIPS AND SOCIAL ADJUSTMENT: Was an honor student. Went into the service after graduating from HS. PERFORMANCE IN SCHOOL: Completed a BA and 2 Masters degrees in Human Resources and business degree. Veteran received all degree online. TYPE OF JOB(S): DLA DATE(S) OF EMPLOYMENT: 1994-1996 ISSUES ASSOCIATED WITH ALCOHOL USE: No use ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE: No problematic effects BEHAVIORAL DISTURBANCES OR LEGAL PROBLEMS PRIOR TO SERVICE? No OTHER SIGNIFICANT PRE-MILITARY HISTORY: None reported. MILITARY HISTORY ---------------- DATE(S) OF SERVICE: Army 1996-2001; Air force reserves 2005-present BRANCH OF SERVICE: Army HIGHEST RANK OBTAINED: Army E4; Air force E-6 TYPE OF DISCHARGE: Honorable RANK AT DISCHARGE: Army E-4; Air force E-6 DECORATIONS AND MEDALS AWARDED: Kosovo Campaign Medal DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes WERE COMBAT WOUNDS SUSTAINED: No LOCATION AND DATE OF COMBAT EXPERIENCE: Veteran served with peacekeeping forces in Yugoslavia, Kosovo in 1999 for 6mos. This was a peace keeping mission. ALCOHOL USE OR ABUSE: No Problematic Effects OTHER SUBSTANCE USE OR ABUSE: No Use OTHER SIGNIFICANT MILITARY HISTORY: Herniated disc from lifting doing a two man carry during an exercise in 2007 Gulfport Mississippi. ******************************* PTSD INITIAL: POST MILITARY PSYCHOSOCIAL HISTORY ------------------------------------------------ LEGAL HISTORY? No EDUCATIONAL ACCOMPLISHMENTS? Yes COMMENTS AND DESCRIPTION OF EDUCATIONAL ACCOMPLISHMENTS: Veteran has completed 4 year degree and 2 master degrees online. DESCRIPTION OF MARITAL AND FAMILY RELATIONSHIPS: 1st married 1999-2006. Step daughter 21 and 1 daughter 12 years old. Veteran has a 9 year old son with another German woman that he never married. Veteran provides child support for both of his kids. His kids live in Germany. Veteran reports he ended a 2 year old relationship and is not currently dating. DESCRIPTION OF DEGREE AND QUALITY OF SOCIAL RELATIONSHIPS: Veteran reports he is not in any relationships right now. He reports has had 3-5 different relationships that last about 2-3 years. DESCRIPTION OF ACTIVITIES AND LEISURE PURSUITS: Reports school was his hobby. He reports he likes to play puzzled computer games like Bewjewled also first person shooters such as Call of Duty. Likes to watch marital arts Movies. Made a point of saying he does not watch military oriented movies anymore. HISTORY OF SUICIDE ATTEMPTS? No HISTORY OF VIOLENCE/ASSAULTIVENESS? No SUMMARY STATEMENT OF CURRENT PSYCHOSOCIAL FUNCTIONAL STATUS: Veteran reports he has mostly military friends he does not normally associate with people outside of the military. ISSUES ASSOCIATED WITH ALCOHOL USE: No problematic effect ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE: No use PSYCH EXAM ========== GENERAL APPEARANCE: Clean PSYCHOMOTOR ACTIVITY: Unremarkable SPEECH: Slow ATTITUDE TOWARD EXAMINER: Cooperative AFFECT: Normal MOOD: Good, Elated ATTENTION: Attention Intact ABLE TO DO SERIAL 7'S? No ABLE TO SPELL A WORD FORWARD AND BACKWARD? Yes COMMENTS: Veteran had some trouble doing serial 7's. His concentration was mildly impaired. ORIENTATION: INTACT TO PERSON: Yes INTACT TO TIME: Yes INTACT TO PLACE: Yes THOUGHT PROCESS: Unremarkable THOUGHT CONTENT: Unremarkable DELUSIONS: None JUDGMENT: Understands outcome of behavior INTELLIGENCE: Average INSIGHT: Patient understands that he/she has a problem. DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILYACTIVITY: Veteran falls sleep between 12 midnight-5am. Difficulty falling and staying asleep. Wakes up feeling tired. Veteran reports he has night sweets. TYPE OF HALLUCINATIONS: None DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? No INTERPRETS PROVERBS APPROPRIATELY? Yes DOES THE PATIENT HAVE OBSESSI VE/RITUALISTIC BEHAVIOR? No DOES THE PATIENT HAVE PANIC ATTACKS? No IS THERE PRESENCE OF HOMICIDAL THOUGHTS? No IS THERE PRESENCE OF SUICIDAL THOUGHTS? No EXTENT OF IMPULSE CONTROL: Good EPISODES OF VIOLENCE: No EXAMPLES OF EFFECTS ON MOTIVATION/MOOD OR OTHER COMMENTS: None ABILITY TO MAINTAIN MINIMUM PERSONAL HYGIENE? Yes IS THERE PROBLEM WITH ACTIVITIES OF DAILY LIVING: No COMMENTS OR ELABORATION OF ANY ITEMS IN THE MSE OR FOR ITEMS NOT COVERED OR OTHER COMMENTS: None MEMORY ------ REMOTE MEMORY: Normal RECENT MEMORY: Mildly Impaired IMMEDIATE MEMORY: Normal EXAMPLE(S) OF MEMORY DISORDER: Veteran was able to immediately recall 4 words pen, clothespin, car, dog. However after a 1 minutes delay veteran started to recall the 4 words again and then stopped and then said he could not recall the Last three words. Veteran appeared to be underperfoming on purpose. PTSD STRESSORS ------------- STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC: Combat experience DESCRIPTION OF STRESSOR: Combat experience DATE AND LOCATION: 1999, Kosovo TRAUMA OCCURRED: During Military Service INTENSE FEAR: No FEELING OF HELPLESSNESS: No FEELING OF HORROR: No OTHER REACTION: No ADDITIONAL COMMENTS: He reported that while on patrols he was often fired out by snipers. ******************************* TRAUMA EXPOSURE TESTING ----------------------- TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE: No testing has been done PTSD SYMPTOMS ------------- PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY: No symptoms present PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA AND NUMBING OFGENERAL RESPONSIVENESS: Restricted range of affect (e.g., unable to have loving feelings) PERSISTENT SYMPTOMS OF INCREASED AROUSAL: Difficulty falling or staying asleep, Hypervigilance THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN SOCIAL, OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: No DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND: Veteran reports he has weekly issues with hyper vigilance and sleep but is able to report normally for work every day. He did not report missing work because of feeling sleepy. LENGTH OF REMISSIONS AND CAPACITY FOR ADJUSTMENT DURING REMISSION: None BEHAVIORAL, COGNITIVE, SOCIAL, AFFECTIVE, OR SOMATIC CHANGE THE VETERAN ATTRIBUTES TO STRESS EXPOSURE: Veteran reports he has some depression and he said specifically he feels "emotional numbing" and detached from other people. The veteran reports he has violent dreams but did not report reoccurrence of the specific traumas he reported that he saw. In fact his dreams were vaguely described. Veteran had a typed list of a number things any deployed solider would witness while on a deployment however, he did not specifically report fear or feeling traumatized by these events. The veteran seemed very familiar With the PTSD symptoms and even mentioned very psychological specific terms such as emotional numbness and hyper vigilance which most veterans are not familiar with. Despite the veterans depression and social withdrawal he still works full time as XXX for the air force. Veteran appears very motivated by his work and even handed the examiner a letter of appreciation he received in 2008 for his work in a specific military exercise. The veteran appeared very proud of his accomplishments in the military. TESTS ===== INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD: None QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY: None DIAGNOSIS ========= PTSD INITIAL: MENTAL COMPETENCY -------------------------------- DOES THE VETERAN KNOW THE AMOUNT OF THEIR BENEFIT PAYMENT? Yes DOES THE VETERAN KNOW THE AMOUNTS OF MONTHLY BILLS? Yes DOES THE VETERAN PRUDENTLY HANDLE PAYMENTS? Yes DOES THE VETERAN PERSONALLY HANDLE MONEY AND PAYS BILLS? Yes IS THE VETERAN CAPABLE OF MANAGING FINANCIAL AFFAIRS? Yes EXAMPLE(S) TO SUPPORT THIS CONCLUSION: Has checking account but no credits cards. Veteran reports that his credit is bad cant get credit cards. IS A SOCIAL WORK ASSESSMENT NECESSARY TO RENDER AN OPINION? No EXPLANATION: See above. PTSD INITIAL: EMPLOYMENT HISTORY -------------------------------- USUAL OCCUPATION: Contract specialist for the Navy. IS THE VETERAN CURRENTLY EMPLOYED? Yes CURRENT OCCUPATION: TYPE OF EMPLOYMENT: Fulltime DURATION OF CURRENT EMPLOYMENT: 1 to 2 years TIME LOST FROM WORK DURING LAST 12-MONTH PERIOD: 2 weeks CAUSE(S) OF TIME LOST FROM WORK IN LAST 12-MONTH PERIOD: Veteran reports he has missed work due to medical procedures or for doctors appointments. OTHER OCCUPATIONAL HISTORY SINCE DISCHARGE OR SINCE LAST EXAM: Veteran was air force reserve tech. Worked in that job 2 years. PROBLEMS RELATED TO OCCUPATIONAL FUNCTIONING: Decreased concentration DOES THE VETERAN MEET THE DSM-IV STRESSOR CRITERION? No DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? No AXIS I: Depression, NOS IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: None AXIS II: None AXIS III: Herniated Disc in back AXIS IV: Physical Limitations AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING ---------------------------------------- SCORE: 65TIME FRAME: Current functioning COMMENTS: The overall pictures is one of an individual who had made a satisfactory adjustment prior to entering military service to the extent that there were no gross indications of behavior control problems. The veteran did report that both his mother and sister have bipolar disorder and that his father did two tours in Vietnam and probably had PTSD. Veteran does NOT meet diagnostic criteria for PTSD during this examine. However, he does meet crieteria for Depression, NOS. Although the veteran seemed very convinced he has PTSD and almost seemed to use this as crutch for his current failed relationships with exwife and girlfriends he did not meet full DSM-IV-TR criteria. Veteran does report stunted emotions, but does not meet Criterion 1-A of the stressor criteria despite handing the examiner a typed list of a number of events that any solider would experience in a combat evironment. Veteran was animated almost excited when discussing his stressors. Veteran did not report experiencing fear for his life while deployed, or, the life of those around him. Veteran was able to openly discuss his deployment in detail almost in too much detail in some cases, giving a running commentary as a reporter would. Veteran does have some mild depressive symptoms that currently seem well controlled on his psychotropic medications. PSYCH SUMMARY ============= OTHER COMMENTS: He does not have PTSD. WAS A MEDICAL OPINION REQUESTED? No COMPENSATION AND PENSION EXAMINATION MENTAL DISORDERS (EXCEPT PTSD AND EATING DISORDERS) =================================================== REVIEW OF MEDICAL RECORDS ========================= C-FILE WAS: Reviewed MEDICAL RECORDS WERE: Reviewed MEDICAL HISTORY =============== IS THIS EXAMINATION FOR REVIEW OF AN ALREADY SERVICE-CONNECTED MENTAL DISORDER? No MENTAL DISORDER: PRE-MILITARY HISTORY --------------------------------------

The VA Mental Health Intake Clinic initially diagnosed me and then I saw a VA doc who said I didn't have it because I had a job, in school, and didn't even listen to what I had to say, so the VA not only referred me and called the Vet Center 2 weeks later, because they said they couldn't get me in due to my work schedule. Been going to the Vet center ever since 2 years now. I had a 3 day Neuropsychological Evaluation conducted by an outside provider which stated the following: Axis I: 309.81 Post Traumatic Stress Disorder, Chronic 296.33 Major Depressive Order, recurrent, severe 300.02 Generalized Anxiety Disorder Axis II: None Axis III: Herniated Disc with nerve damage, gall balder removed Axis IV: Problems functioning at work and school Problems with primary support group Problems related to the social event Axis V GAF: 52 (current) After my initial C&P (this was my second as a Reopen for my claim) the doctor also filled out a PTSD DBQ and refuted the C&P examiner's statements basically stating that she disagreed with his findings. Plus I have issues with my working memory as well, which was documented in the evaluation. As far as proof I type a 2 page letter showing the events and how it is currently impacting my life and relationships. I received an ARCOM and it stated "working in austere conditions". Not only that my primary job was casualty reporting among all the foot patrols etc. I guess my next question would be if they deny me for PTSD shouldn't the VA rate me for Depression? I've been working with the DAV and have followed everything to the letter of what to do.

STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: OCT 27, 2014@08:00 ENTRY DATE: OCT 27, 2014@13:11:21 URGENCY: STATUS: COMPLETED Medical Opinion Disability Benefits Questionnaire Indicate method used to obtain medical information to complete this document: [X] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. [ ] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. [ ] Examination via approved video telehealth [ ] In-person examination Evidence review --------------- Was the Veteran's VA claims file reviewed? Yes If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: VBMS/CPRS reviewed MEDICAL OPINION SUMMARY ----------------------- RESTATEMENT OF REQUESTED OPINION: a. Opinion from general remarks: Please review and opine if this diagnosis is related to his claimed stressors from military service. (please see list of stressors in your exam. If his diagnosis is related to any of these stressors, please if possible indicate which ones. MEDICAL OPINION: is veterans diagnosis of unspecified depressive disorder with anxious distress as least as likely as not related to any of his claimed stressors from military service. Please provide rationale. b. Indicate type of exam for which opinion has been requested: PTSD TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE CONNECTION ] b. The condition claimed was less likely than not (less than 50% probability) incurred in or caused by the claimed in-service injury, event or illness. c. Rationale: The veteran's reported stressors occurred in 1999. His reported symptoms are not consistent with a post-traumatic disorder, including PTSD, depression or anxiety. Rather, his symptoms are a mild non-specific depression. As noted in my evaluation, it appears that the veteran has tied his symptoms to in-service events, but has done so mistakenly. He reported irritability with anger, poor sleep, loss of interest and anxiety in crowds, on airplanes and during fireworks. There is no evidence of mental health treatment until 2012, 13 years after his reported stressors. His report of symptoms has been rather vague and not consistent with a post-traumatic disorder. Thus, there is insufficient evidence to link his current mild depression to reported stressors that occurred in 1999. I understand it's been years with no treatment but if you don't know anything is wrong how can you get help. I was diagnosed by a civilian doctor and have been going to treatment at the vet center and the VA is giving med meds.