Beer Fan

PTSD/dissociative type will not create a higher rating because of a subtype or specifier. All PTSD diagnoses are coded 309.81 with specifiers like dissociative, depersonalization, delayed expression, etc. What matters is the overall severity of PTSD that will determine its rating. A veteran may be diagnosed with PTSD, dissociative, but only have moderate deficits plus some problems with social and occupational impairment, may receive a rating of 50%. The VA follows percentage levels for rating all mental disorders starting at 0%, 10%, 30%, 50%, 70%, and 100%. So if a veteran was diagnosed with PTSD/dissociative and meets the criteria for 100% including Total Social and Occupational Impairment, along with supporting evidence, the veteran should be rated 100%. If it is severe, then 70%, and so on. The coding for PTSD is 309.81 regardless of the specifier. Acute Stress Disorder does have several codes, but the duration is only 6 months with no delayed onset. However, I always hope any veteran receives the highest rating possible.

Patrick

I do IMHOs for a number of veterans. Clearly understand, this is only my opinion, and it is up to each individual veteran to decide for themselves what is in their best interest. However, I would not suggest using Dr. Bash for an IME. One, he is not well regarded by the VA across the board, and two he charges an exorbinate fee for his services. If your willing to part with $1500 to $7000 for an IME from him, be my guest. Second, he's a radiologist and any opinions concerning PTSD or other mental disorders are moot. The VA has a hard and fast rule that only a Private or VA Psychiatrist or Clinical Psychologist can render an opinion for the VA about Mental Health issues. I can assure you, I have performed IMNOs for veterans who used Dr. Bash, and can with some degree of reliability say, most of his opinions on mental health are denied by the VA. I am not sure of his ability with medical issues, however, when any person, or organization touts they aid or can do wonders for your claim, probably can't. I am currently reviewing a IME from a Dr. Bush of Williamson, GA, who wrote a 20-page report trying to undo what Dr. Bash provided as an IME. My part is writing a mental health opinion, again attempting to undo a Mental Health Evaluation from Dr. Bash. I do not know Dr. Bash, and for all practicle purpsoes may be a very fine physician. I worked for the VA as a Clinical Psychologist and a C and P examiner for several years. I am not tooting my own horn, but I have seen his work. Need I say more?

Here's BVA decision denying a veteran SC for Sleep Apnea secondary to SC Depression, who used Dr. Bash for IME. It's interesting reading and there are many more BVA decisions with similar outcomes referencing Dr. Bash.

http://www.va.gov/vetapp10/files2/1016260.txt


If a veteran is seeking an IME, I suggest going to a Specialist at a University Medical Center and having it done. First, University doctors do not have an agenda, nor are they in it for the bucks. Additionally you will get a credible IME based on current and up-to-date medical information and procedures.

JMHO,

Patrick428