allan

TBird, I was going through rage and not able to sleep for up to three days for many yrs. Than they put me on Depakote for my bi-polar and busparone. I don't have the rage anymore. Still have insomnia. Only sleep around 4 hrs at a time at the most. I can sleep more if I take benadryl. But get so tired of adding another pill to my long list, I generally don't take it as long as I can atleast get 4 hrs. Sorry to hear you experience this also. Rage is not good on your heart and blood pressure thats for sure. The only thing I've found to control it is medications. Folks can tell you that you can control it yourself and I know it doesn't work that way. Imbalance due to toxins or something. But tryng to meditate and relax doesn't cut it when it's brain injury or an illess like PTSD. My best to you, Allan

I had been going through periods of the pharmacy forgetting to send a months supply of morphine about every other month for nearly a yr when they forgot to send all my meds for a month. Morphine, Gabapentin, Paxil, Busparone, muscle relaxant, ashma meds, my whole supply. A week went by and all I got is the Dr didn't sign off on your meds. Then the Dr said he signed off, the pharmacy had it wrong and screwed up. Another week went by. I was getting to be a complete emotional and mental mess after sudden withdrawal from all my meds. Another week, than another. No meds and no reply. I was near suicidal one night & drove to the VAMC ER 150 miles away on ice covered roads. When I got to the ER the nurse said she wasn't about to break into the pharmacy and get "DRUGS" for me. Blew my off like I was a street addict and refused to give me any treatment.. I headed from Spokane to Medical lake near Seattle through the night. Slept in below freezing temps at a rest area for a while. First time in days I got any sleep due to the lack of bi-polar meds. Ended up at a private hospital in Everet after I met up with my daughter. I was so messed up I didn't know what I was doing or where I was. Not long after that the Spokane ER let a vet die outside their window after refusing to treat him. Do not waste your time at any VA ER. If it's an emergency and your life depends on seeing medical help now, I would go to a private ER. Call your team nurse or VAMC PCP and ask to see a psychiatrist right away. Explain to the Dr that your going through sudden withdrawals and ask him to prescribe something for the pain or to renew your pain med. Also get it documented how all of this has caused increased emotional stress and depression if it has. Don't wait like I did. Go there during working hours and see if you can see one as a walk in. At my VAMC clinic the Dr won't see you as a walk in if your dieing, so call ahead to see, but the psychiatrist might. I hope my experience saves you or another Vet from going through this. Allan

I would like to add that Dr Bash's 3 medical opinions on me were based on my service records, medical records since service and a radiology MRI film I perchased from the VAMC showing lesions throughout the white matter with one in the corpus callosum. With the first IMO and diagnosed MS, the BVA refused to give it any weight. They said he didn't review the "entire" C-file since I never requested a copy of it. I sent the BVA over 30 yrs of requests for my c-file that went unanswered. Than I recieved a copy just one yr prior to Dr Bash's IMO and sent them a record in my C-file of the request and the date they sent it. So they requested Dr Bash view the entire record of evidence again after that. This time in a reply to the BVA's request, he wrote his medical opinion is the same and unchanged after viewing the copy of the c-file the BVA sent. The PVA and Dr Bash went to a hearing before the BVA in Washington, DC a few months after this other IMO and gave testimony as to his opinion. They still denied it and put it on hold until my other issues were decided in 2010. I'll hang in there. i know they can play their games, but at some point in time they have to look at the truth and properly review "all" the evidence of the record. If not now than at the CAVC. If I live so long.

Alan Simpson sure has demonstrated with his own mouth, just how much of an enemy of US Veterans he is. Keep voting idiots like this in government positions and we will all see our VA and Social Security benefits disappear. Two yrs ago billions were spent in corporate welfare. Today it's make the Vets, disabeled and seniors pay for it. Maybe we should stay out of the business of fraudulant wars. They get to be expensive finacially and with the lives and bodies of our military personel.

Thanks Philip, Another 5 yrs sounds right. I don't expect anything but a remand and more C&P's from the BVA. All my issues before the CAVC stim from the same car accident as the award the BVA granted for my shoulder last yr. They awarded after getting a favorable IMO from the VA orthopeadic clinic I was treated at. The issues before the CAVC are there due to the BVA not including the remaining issues in my service records with the ortho IMO they granted the shoulder issue for. So it strings the rest out another 5 or 6 yrs, thats all. But I'm sure i'll win in the end. So is my attorney, or his law firm wouldn't have taken the case.

What a crock of sheet - and just what c8CFR Reg did they use to support this ? ? ? Carlie, after being denied SC for MS and VA Dr jacking me around, I went to Dr bash for an IMO to find out for myself if I actually had MS, since my signs/symptoms for it were so consistant for decades. In 2005 Dr bash diagnosed me with having MS. I turned the IMO over to my Dr at the time. A month later I was assigned to a nother VAMC Dr at a local new clinic. This Dr said the VA informed him of this. He acuused me of paying a dr to say what ever I wanted him to say. He than removed all currant medical diagnoses on the VA computer and cancelled all medicines I recieved through the VA at the time and said to get my health care through private Dr's. Before changing Dr's, the previous VAMC Dr at the other facility said I should go to a private dr to get my oxys for pain since the VA no longer carried them. This is in my records. He said I just need to inform my Dr of who I get them from so they can cordinate with each other over the pain meds. Well, this new VA Dr accused me of trying to get pain meds from two different surces at the same time after I faxed my private dr'd contact information to the VAMC facility and the new VA's Dr's contact information to the private Dr. I was all on top of being honest about it. But he took it as another issue he was trying to prove I was a lying thief thrying to get benefits and drugs through the VA. It didn't work. I filed a complaint against him and I proved in my complaint what he did to me. All my diagnoses and medication treatment were restored. One of thos diagnoses in my file now say Multiple Sclerosis. The Va Neurologists also said I have a TBI. But I never see that listed as a diagnoses, nor do I recieve treatment for it. He lasted abut two yrs at this clinic after that and moved back to a southern state. Never the less the BVA didn't except Dr Bashs IMO's & the attorney I have now says their not likely to either. The PVA refiled for MS in 2005 after reading Dr Bash's IMO. This claim was put on hold until 2009 when the BVA made a final on my other claims. The MS claim went before the Seattle VARO in June 2009. This last May/2010, without being prior notified, the examiner I went before for other issues aparently did a neuro workup. I later recieved a letter from QTC saying a neuro problem was discovered during the exam and recomended I discus it with my current Dr. I just recieved a copy of my C&P and it shows the RO requested an exam for MS during the other schedualed C&P exams. Since they've now done performed a C&P for it, found neuro problems and i've had a diagnoses since 2005, they may reconsider Dr Bash's IMO's as atleast have some kind of weight. The QTC examiner didn't comment as to wether the MS was SC or not. My guess is due the the VARO rater not asking him to answer this question. Where I am now is anyones guess. I sure can't figure out what their doing. Why order a C&P for MS, but not have the examiner answer the question is this more likely than not service connected? This is just the same game i've gottin from the appeals center and the BVA for more than a decade.

John, My case went to CAVC in June/2009. According to my attorney, timetable results from 3,000-4,000 cases filed each year, seven judges to deal with them all. It can take up to next summer before my case gets before a judge. Another year sitting in remand is likely after the judge sends it back to the BVA . New C&P's will likely be ordered, if favorable another year or so at the VARO waiting to be rated. Another year after that with a NOD because of the low ball ratings is also likely. It's either delay or deny. Why is there such a back log of claims? Mine should have never taken 13 yrs to get to the CAVC.

Politico, Webb, Principi In my usual self controlled self I have responded to this Mr. Rogers of Politico regarding this dribble put out by Webb and Principi. When are these reporters going to learn in this issue if their lips are moving they are lying. I am finding out from everyone that more and more of these so called reporters are putting out bad information provided by the what seems to be now the Webb/Principi connection of BS. It is time someone told our side of the story in no uncertain terms and I did not leave much out as you will see. I did not even broach the lies on birth defects as it is too long to begin with but I felt I had to at least try and put these egg sucking dogs in their place on this issue. If you agree even though it is somewhat tempered on what I really wanted to call these bums please send out to your respective groups. It looks like this meeting in September is getting more and more attention. I can tell you this. If we lose this one then all is lost for the rest of the legacy which is what they are after anyway. I think they see the handwriting on the wall finally even with the birth defects and quite frankly I think it scares the hell out of them. http://www.2ndbattalion94thartillery.com/Chas/morecommittee.htm By the way I do not want to hear the word PAYGO out of any of these disgraceful human beings. While they were denying all impacts for almost 28 years there was no PAYGO. They were just sorry human beings. Kelley

1) [did you have any evidence in your Service Medical Records that would help point toward a diagnosis of MS?] In the IMO's I recieved from Dr Craig Bash, he found flucuating vision, ocular inflamation and hearing loss he said was specific to MS. Eye exams in service show changing between 20/40 to 20/50 and back to 20/40. It was 20/50 when I left. In separation exam it was noted defective vision, defective hearing. This I found out when I recieved a partial service medical record in 1997. 2) [if there was some evidence in your SMR and/or VA examinations or other medical records shortly after discharge,] I was discharged in 1973. I traveled alot after service and can not get any medical records any sooner than 1977. From 1977 until now, according to the IMO's there is medical evidence showing neuromuscular signs and symptoms. Complete absent of reflexes, Muscle spasms, Short leg syndrome, Urinary incontinance, Chronic neuro pain, Double vission, Ocular inflamation, Nystagmus, Vertigo and the list goes on. This is how I was able to get a diagnoses during the 1997 C&P exam for Pension. I became T&P disabled in 1993 from this according to my SSDI records. VA was the first to reconize the symptoms of MS and send me for a diagnostic workup for 13 yrs. But I had to go outside of VA to get it resolved of wether I actually had MS or not. I suspect the RO will deny this once again since the BVA refused to reconize Dr Bashs IMO's. They said if they order it thats one thing, but for a vet to pay for it, thats another thing. I have a very good attorney working my claim thats at CAVC that i'll try to use once they deny. I won't make my self sick over their refusal to reconize primary evidence from a reputable an experienced neuroradiologist like Dr Bash. I'l lat an attorney explan it to them next time. Allan

This was taken from the proposed rule changes TBird posted. I have a current claim with the VA for Multiple Sclerosis. The VARO rater has recently asked that I show medical evidence that I've had MS, "continuous" since separation in 1971.I've sent in service medical records showing signs and symptoms of MS, a current diagnoses and three IMOs by a neuroradiologist stating a link or nexus in medical terms. Do I meet the requirement of subjective and objective evidence? VA was the first to provide a diagnoses of "neuromuscular disorder of unknown cause, probable multiple sclerosis"T&P, during a C&P for Pension in 1997.I didn't receive a firm diagnoses for MS until 2005 from an IMO. Allan [Federal Register: September 1, 2010 (Volume 75, Number 169)][Proposed Rules] [Page 53743-53771] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr01se10-19] if the chronicity provisions do not apply, VA will grant service connection if there is competent evidence of signs or symptoms of an injury or disease during service or the presumptive period, of continuing signs or symptoms, and of a relationship between the signs or symptoms demonstrated over the years and the veteran's current disability. See Savage v. Gober, 10 Vet. App. 488, 498 (1997).Current part 3 refers only to ``symptoms''. We would add ``signs'' because the contemporary view of the medical profession distinguishes between signs and symptoms. A sign is ``any objective evidence of a disease, i.e., such evidence as is perceptible to the examining physician, as opposed to the subjective sensations (symptoms) of the patient.'' Dorland's Illustrated Med. Dictionary 1733 (31st ed. 2007). A symptom is ``any subjective evidence of disease or of a patient's condition, i.e., such evidence as perceived by the patient.'' Id. at 1843. Subjective and objective evidence are equally relevant to establishing continuity of [[Page 53750]] symptomatology, and the inclusion of more specific terminology does not represent a departure from current VA practice.

Don't go feeling bad. Most don't reconize Navy Vets as serving in the military. we're used to it. Expecially Army officers for some reason. Maybe it's their hat size.

Im not sure why this article has no reference to why MS is common among Gulf War Vets at all or just how many have it. It's common and thats it? Has there been any studies on Vietnam vets to show if it's also common with them and if military vaccines used during Vietnam and Gulf war may have caused it? So since it's common, is it a presumptive ilness among Gulf War Vets? We don't know. We only know the symptoms and that its common. Not very informitive is it?

Philip is right. Shake it off. It's nothing to stress over. I've been here since 1998 and the date didn't carry over to the new boards. They've changed many times. TBird can't be expected to be on top of it all. It's enough to keep the board up and running for us all.

[We need more people to write fast letters and we will reassign a few hundred seasoned claims raters to study the problem.] Thats the reality we all experience Sledge. Year after Year the same thing. Congress votes the funding in and the VA spends it on frivalous studys and waste. If this government really wanted to give us good health care and cut costs they would give us a medical card to use at any local, private facility, Dr or hospital of our choosing. Do away with these VAMC's, and sell the property. I see nothing they provide that the private sector doesn't already have.

Make sure to send it certified, return, reciept. Seattle is great at loosing or misplacing forms and evidence or claiming they never recieved it when it's under their noses. A quick way to get it settled it request a local hearing. Get a copy of the TDIU form from your SO and stick it right in front of the rater at the hearing and show them by actually pointing to the date with your finger of when they recieved it. You can spend months playing cat and mouse until it goes missing out of your folder. It's all about retro back to when you filed. Requesting a local hearing is your best way of getting it resolved. You won't get travel pay and with winter looking like it might be early in Washington State I would send in a written request soon. Sometimes they will just blow you off until you nail them down.

I would't put any faith in the accuracy of an EMG test. They often come out normal and seldom show what is really going on with nerve damage.

It seems to be expensive for Oxycontin Controled Release no matter who you go through. I see a highly respectable MD for the prescription after he examines me and checks my records out. This Dr and my VAMC PCP keep close taps on what I take. Than I pay hundreds through Walmart or a local pharmacy for the prescription. So if you go to one that hands it out like candy without an examination or checking your records, I guess it just makes it a little easier, but the proceedure of paying for the Dr's appointment and the prescription out of pocket is the same. I get a break on the Dr's`appointment by useing my medicare, but I also pay a hundred a month for it. I make to much to get any break on medications I pay for is what Medicare informed us. It comes to a fourth of my disability income just for this one pain med. Expensive? Yes. But I don't have much of a life without it. All this just to take a drug that doesn't make me sick and only dulls the pain. I have many hot, searing ice pick stabs that it doesn't seem to have much of an effect on. It wakes me out of a dead sleep. Usually wakes me and startles the crap out of the wife when I jump up out of bed. Some days are better than others. The more active I am the more pain I have. Than theres always the weather. Another alternitive is to try medical marijuana if your state allows it. Although this isn't a cheep form of pain relief either. It does work were some drugs don't, without having an effect on other medications. Allan

John, Maybe much of what is decided at these facilities concerning pain meds is location. I'm not finding as much difficulty in my area. Just that they no longer carry the long acting on formulary. Maybe where there are a high number of drug and alchohol abusers at that facility, they may be more paranoid about prescribing even if others are not abusers. Also I may not be getting as much trouble with having severe pain due to a neuromuscular disorder. I know that the psychiatrists i've seen have had alot to do with my pain meds. I've never been to a pain clinic. They asked me to attend one once one winter. They wanted me to travel 600 miles round trip every monday to watch films. All I said was are you crazy? Would you do that on ice covered roads? That was the end of that. They never asked again. I go to a small local VA clinic now. But I don't think they have a pain clinic or my Dr doesn't think I need to attend it maybe. I'm so sorry to hear you have to go through this. I know others are as well. Allan

They don't want any more claims than they already have sledge. Deny until they die is how they will likely rate most any claim outside of Vietnam. Even most of those claims where a vet can prove in country, they have denied. You are right. Almost any military base has AO or other chems and heavy metals, radiation, bioweapons. If a vet has an ilness that has been connected medically to what has been used in their enviroment, no matter where it is they should be service connected in my opinion. But I can tell you also just how much my opinion counts in the realm of things. Resently my NSO asked, with all the illnesses i've been diagnosed with, have I ever been exposed to agent orange? I said it was used on the Naval base Treasure Island I was stationed on. So I asked if he thought VA would be granting benefits for AO for US bases soon? We agreed probably not in my life time. Allan

"We--DoD and VA--simply cannot afford to be less than aggressive in our effort to identify, treat and rehabilitate TBI victims," Shinseki told the approximately 1,000 military" I was diagnosed with having TBI in 2004 and have not seen any sign of treatment for it yet. I'm not an Iraq or Afghanistan vet so maybe this is why. I think my TBI was either caused by a head injury I had during a car accident, artillary trauma during live fire practice or exposure to high levels of vanadium and fuel oils from marine boiler repair and operation. All occured during the Vietnam era. Since I served in the regular Navy, 7th fleet, the TBI maybe doesn't count as far as treatment or compensation. I've had no other injuries or exposures that could have caused it. I'm not sure if Vietnam combat TBI vets even qualify for any of this, since I never hear if anyone but Iraq and Afghanistan vets qualify for treatment and compensation. Why is TBI treatment & benefits limited just to these vets?

Recent VA News Releases To view and download VA news releases, please visit the following Internet address: http://www.va.gov/opa/pressrel <http://www.va.gov/opa/pressrel> VA Secretary Addresses Traumatic Brain Injury Conference WASHINGTON (August 30, 2010) - Recognizing the longstanding, integrated collaboration shared by the Department of Veterans Affairs and Department of Defense, VA Secretary Eric K. Shinseki gave the keynote address Monday at the fourth annual Traumatic Brain Injury (TBI) Military Training Conference here. "We--DoD and VA--simply cannot afford to be less than aggressive in our effort to identify, treat and rehabilitate TBI victims," Shinseki told the approximately 1,000 military, VA and civilian health care workers at the conference sponsored by the Defense and Veterans Brain Injury Center (DVBIC). The Defense and Veterans Brain Injury Center was established by Congress in 1992. DoD and VA together offer clinical care, research and education on traumatic brain injury. DVBIC is the operational component of the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury. In praise of the collaborative DVBIC model, Secretary Shinseki said it should be replicated for all military personnel transitioning to VA care, and not just for TBI or burn care. "When it comes to DoD's patients, there is a network of information and hands-on human care," the Secretary said, "that helps a wounded warrior transition from one system to the other-- from the battlefield to our polytrauma centers." There are DVBIC researchers assigned at each of the four VA Polytrauma Rehabilitation Centers (Tampa, Richmond, Minneapolis and Palo Alto) where they gather information regarding care of patients with TBI, analyze and translate this information into recommendations to improve care, and educate providers in implementing those improvements clinically. DVBIC and VA have shared, and continue to collaborate, on many significant initiatives. Recent examples include developing and implementing: * Joint DoD/VA clinical practice guidelines for TBI; * Materials and information for families and caregivers of Veterans with TBI; * Integrated education and training curriculum, and joint training on TBI of VA and DoD heath care providers; * A Congressionally-mandated 5-year pilot program to assess the effectiveness of providing assisted living services to Veterans with TBI; * The TBI Screening tool used for all Veterans who served in Iraq or Afghanistan and are receiving care within VA; and * A specialized Emerging Consciousness Care program at the four polytrauma centers to serve those Veterans with severe TBI who are also slow to recover consciousness.

On Fed Register Tuesday, Aug 31st http://www.access.gpo.gov/su_docs/aces/fr-cont.html -----Original Message----- From: VA Media Relations [mailto:va.media.relations@VA.GOV] Sent: Monday, August 30, 2010 10:28 AM To: colonel-dan@sbcglobal.net Subject: VA Publishes Final Regulation to Aid Veterans Exposed to Agent Orange VA Publishes Final Regulation to Aid Veterans Exposed to Agent Orange VA Health Care and Benefits Provided for Many Vietnam Veterans WASHINGTON (August 30, 2010)- Veterans exposed to herbicides while serving in Vietnam and other areas will have an easier path to access quality health care and qualify for disability compensation under a final regulation that will be published on August 31, 2010 in the Federal Register by the Department of Veterans Affairs (VA). The new rule expands the list of health problems VA will presume to be related to Agent Orange and other herbicide exposures to add two new conditions and expand one existing category of conditions. "Last October, based on the requirements of the Agent Orange Act of 1991 and the Institute of Medicine's 2008 Update on Agent Orange, I determined that the evidence provided was sufficient to award presumptions of service connection for these three additional diseases," said Secretary of Veterans Affairs Eric K. Shinseki. "It was the right decision, and the President and I are proud to finally provide this group of Veterans the care and benefits they have long deserved." The final regulation follows Shinseki's determination to expand the list of conditions for which service connection for Vietnam Veterans is presumed. VA is adding Parkinson's disease and ischemic heart disease and expanding chronic lymphocytic leukemia to include all chronic B cell leukemias, such as hairy cell leukemia. In practical terms, Veterans who served in Vietnam during the war and who have a "presumed" illness don't have to prove an association between their medical problems and their military service. By helping Veterans overcome evidentiary requirements that might otherwise present significant challenges, this "presumption" simplifies and speeds up the application process and ensure that Veterans receive the benefits they deserve. The Secretary's decision to add these presumptives is based on the latest evidence provided in a 2008 independent study by the Institute of Medicine concerning health problems caused by herbicides like Agent Orange. Veterans who served in Vietnam anytime during the period beginning January 9, 1962, and ending on May 7, 1975, are presumed to have been exposed to herbicides. More than 150,000 Veterans are expected to submit Agent Orange claims in the next 12 to 18 months, many of whom are potentially eligible for retroactive disability payments based on past claims. Additionally, VA will review approximately 90,000 previously denied claims by Vietnam Veterans for service connection for these conditions. All those awarded service-connection who are not currently eligible for enrollment into the VA healthcare system will become eligible. This historic regulation is subject to provisions of the Congressional Review Act that require a 60-day Congressional review period before implementation. After the review period, VA can begin paying benefits for new claims and may award benefits retroactively for earlier periods. For new claims, VA may pay benefits retroactive to the effective date of the regulation or to one year before the date VA receives the application, whichever is later. For pending claims and claims that were previously denied, VA may pay benefits retroactive to the date it received the claim. VA encourages Vietnam Veterans with these three diseases to submit their applications for access to VA health care and compensation now so the agency can begin development of their claims. Individuals can go to a website at http://www.vba.va.gov/bln/21/AO/claimherbicide.htm <http://www.vba.va.gov/bln/21/AO/claimherbicide.htm> to get an understanding of how to file a claim for presumptive conditions related to herbicide exposure, as well as what evidence is needed by VA to make a decision about disability compensation or survivors benefits. Additional information about Agent Orange and VA's services for Veterans exposed to the chemical is available at www.publichealth.va.gov/exposures/agentorange <http://www.publichealth.va.gov/exposures/agentorange/> . The regulation is available on the Office of the Federal Register website at http://www.ofr.gov/ <http://www.ofr.gov/> . "Keep on, Keepin' on" Dan Cedusky, Champaign IL "Colonel Dan" See my web site at: http://www.angelfire.com/il2/VeteranIssues/

Review Examination for Post-Traumatic Stress Disorder Name: SSN:Date of Exam: C-number:Place of Exam: The following health care providers can perform review examinations for PTSD. a board-certified psychiatrist or board "eligible" psychiatrist; a licensed doctorate-level psychologist; a doctorate-level mental health provider under close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist; a psychiatry resident under close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist; a clinical or counseling psychologist completing a one year internship or residency (for purposes of a doctorate-level degree) under close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist; a licensed clinical social worker (LCSW), a nurse practitioner, a clinical nurse specialist, or a physician assistant, if they are clinically privileged to perform activities required for C&P mental disorder examinations, under close supervision of a board-certified or board eligible psychiatrist or doctorate-level psychologist. . A. Review of Medical Records. B. Medical History since last exam: Comment on:Hospitalizations and outpatient care from the time between last rating examination to the present, UNLESS the purpose of this examination is to ESTABLISH service connection, then the complete medical history since discharge from military service is required.significant medical disorders (resulting pain or disability; current medications) frequency, severity and duration of psychiatric symptoms.length of remissions from psychiatric symptoms, to include capacity for adjustment during periods of remissions.treatments including statement on effectiveness and side effects experienced.subjective Complaints: describe fully. C. Psychosocial Adjustment since the last exam legal history (DWIs, arrests, time spent in jail)educational accomplishmentsextent of time lost from work over the past 12 month period and social impairment. If employed, identify current occupation and length of time at this job. If unemployed, note in complaints whether veteran contends it is due to the effects of a mental disorder. Further indicate following DIAGNOSIS what factors, and objective findings support or rebut that contention.marital and family relationships (including quality of relationships with spouse and children)degree and quality of social relationshipsactivities and leisure pursuitssubstance use and consequences of substance use history of violence / assaultivenesshistory of suicide attemptssummary statement of current psychosocial functional status (performance in employment or schooling, routine responsibilities of self care, family role functioning, physical health, social/interpersonal relationships, recreation/leisure pursuits)D. Mental Status Examination Conduct a brief mental status examination aimed at screening for DSM-IV mental disorders. Describe and fully explain the existence, frequency and extent of the following signs and symptoms, or any others present, and relate how they interfere with employment and social functioning:Impairment of thought process or communication.Delusions, hallucinations and their persistence.Eye contact, interaction in session, and inappropriate behavior cited with examples.Suicidal or homicidal thoughts, ideations or plans or intent.Ability to maintain minimal personal hygiene and other basic activities of daily living.Orientation to person, place and time.Memory loss, or impairment (both short and long-term).Obsessive or ritualistic behavior which interferes with routine activities and describe any found.Rate and flow of speech (note any irrelevant, illogical, or obscure speech patterns and whether constant or intermittent.)Panic attacks noting the severity, duration, frequency and effect on independent functioning and whether clinically observed or good evidence of prior clinical or equivalent observation is shown.Depression, depressed mood or anxiety.Impaired impulse control and its effect on motivation or mood.Sleep impairment and describe extent it interferes with daytime activities.Other disorders or symptoms and the extent they interfere with activitiesE. Assessment of PTSD identify behavioral, cognitive, social, affective, or somatic symptoms veteran attributes to PTSD describe specific PTSD symptoms present (symptoms of trauma re-experiencing, avoidance/numbing, heightened physiological arousal, and associated features ) specify typical frequency and severity of symptoms F. Psychometric Testing Results provide psychological testing if deemed necessaryprovide specific evaluation information required by the rating board or on a BVA Remand. comment on validity of psychological test resultsprovide scores for PTSD psychometric assessments administeredstate whether PTSD psychometric measures are consistent or inconsistent with a diagnosis of PTSD, based on normative data and established "cutting scores" (cutting scores that are consistent with or supportive of a PTSD diagnosis are as follows: PCL - not less than 50; Mississippi Scale not less than 107; MMPI PTSD subscale a score > 28; MMPI code type: 2-8 or 2-7-8)state degree of severity of PTSD symptoms based on psychometric data (mild, moderate, or severe)describe findings from psychological tests measuring problems other than PTSD (MMPI, etc.) G. Diagnosis: The Diagnosis must conform to DSM-IV and be supported by the findings on the examination report.If there are multiple mental disorders discuss the relationship with PTSD. The evaluation is based on the effects of the signs and symptoms on occupational and social functioning. NOTE: VA is prohibited by statute, 38 U.S.C. 1110, from paying compensation for a disability that is a result of the veteran's own ALCOHOL OR DRUG ABUSE. However, when a veteran's alcohol or drug abuse disability is secondary to or is caused or aggravated by a primary service-connected disorder, the veteran may be entitled to compensation. See Allen v. Principi, 237 F.3d 1368, 1381 (Fed. Cir. 2001). (If you do not have Microsoft Word software installed, you may download free viewer and reader software to view the case.) Therefore, it is important to determine the relationship, if any, between a service-connected disorder and a disability resulting from the veteran's alcohol or drug abuse. Unless alcohol or drug abuse is secondary to or is caused or aggravated by another mental disorder, you should separate, to the extent possible, the effects of the alcohol or drug abuse from the effects of the other mental disorder(s). If it is not possible to separate the effects in such cases, please explain why. H. Diagnostic Status Axis I disordersAxis II disordersAxis III disordersAxis IV (psychosocial and environmental problems)Axis V (GAF score: current) I. Global Assessment of Functioning (GAF): NOTE: The complete multi-axial format as specified by DSM-IV may be required by BVA REMAND or specifically requested by the rating specialist. If so, include the GAF score and note whether it refers to current functioning. A BVA REMAND may also request, in addition to an overall GAF score, that a separate GAF score be provided for each mental disorder present when there are multiple Axis I or Axis II diagnoses and not all are service- connected. If separate GAF scores can be given, an explanation and discussion of the rationale is needed. If it is not possible, an explanation as to why not is needed. (See the above note pertaining to alcohol or drug abuse.) J. Capacity to Manage Financial Affairs: Mental competency, for VA benefits purposes, refers only to the ability of the veteran to manage VA benefit payments in his or her own best interest, and not to any other subject. Mental incompetency, for VA benefits purposes, means that the veteran, because of injury or disease, is not capable of managing benefit payments in his or her best interest. In order to assist raters in making a legal determination as to competency, please address the following: What is the impact of injury or disease on the veteran's ability to manage his or her financial affairs, including consideration of such things as knowing the amount of his or her VA benefit payment, knowing the amounts and types of bills owed monthly, and handling the payment prudently? Does the veteran handle the money and pay the bills himself or herself? Based on your examination, do you believe that the veteran is capable of managing his or her financial affairs? Please provide examples to support your conclusion. If you believe a Social Work Service assessment is needed before you can give your opinion on the veteran's ability to manage his or her financial affairs, please explain why. K. Other Opinion: Furnish any other specific opinion requested by the rating board or BVA remand (i.e., furnish the complete rationale and citation of medical texts or treatise supporting opinion, if medical literature review was undertaken). If the requested opinion is medically not ascertainable on exam or testing please state why. If the requested opinion can not be expressed without resorting to speculation or making improbable assumptions say so, and explain why. If the opinion asks " ... is it at least as likely as not ... ", fully explain the clinical findings and rationale for the opinion. L. Integrated Summary and Conclusions Describe changes in psychosocial functional status and quality of life since the last exam (performance in employment or schooling, routine responsibilities of self care, family role functioning, physical health, social/interpersonal relationships, recreation/leisure pursuits). Describe linkage between PTSD symptoms and aforementioned changes in impairment in functional status and quality of life. Particularly in cases where a veteran is unemployed, specific details about the effects of PTSD and its symptoms on employment are especially important.If possible, describe extent to which disorders other than PTSD (e.g., substance use disorders) are independently responsible for impairment in psychosocial adjustment and quality of life. If this is not possible, explain why (e.g., substance use had onset after PTSD and clearly is a means of coping with PTSD symptoms).If possible, state prognosis for improvement of psychiatric condition and impairments in functional status.Comment on whether veteran is capable of managing his or her financial affairs. M. Effects of PTSD on Occupational and Social Functioning Evaluation of PTSD is based on its effects on occupational and social functioning. Select the appropriate assessment of the veteran from the choices below: Total occupational and social impairment due to PTSD signs and symptoms. Provide examples and pertinent symptoms, including those already reported. ORPTSD signs and symptoms result in deficiencies in most of the following areas: work, school, family relations, judgment, thinking, and mood. Provide examples and pertinent symptoms, including those already reported for each affected area. ORThere is reduced reliability and productivity due to PTSD signs and symptoms. Provide examples and pertinent symptoms, including those already reported. ORThere is occasional decrease in work efficiency or there are intermittent periods of inability to perform occupational tasks due to signs and symptoms, but generally satisfactory functioning (routine behavior, self-care, and conversation normal). Provide examples and pertinent symptoms, including those already reported. ORThere are PTSD signs and symptoms that are transient or mild and decrease work efficiency and ability to perform occupational tasks only during periods of significant stress. Provide examples and pertinent symptoms, including those already reported. ORPTSD symptoms require continuous medication ORSelect all that apply:PTSD symptoms are not severe enough to require continuous medication.PTSD symptoms are not severe enough to interfere with occupational and social functioning. Include your name; your credentials, i.e., a board certified psychiatrist, a licensed psychologist, a psychiatry resident or a psychology intern, LCSW, or NP and circumstances under which you performed the examination, if applicable, i.e., under the close supervision of an attending psychiatrist or psychologist; include name of supervising psychiatrist or psychologist. Signiture..................................................................Date......................................... Link to VA Examination Worksheet for PTSD: http://www.vba.va.go...ms/disexm56.htm Link to VA Examination Worksheet for Mental Disorders (Except initial PTSD and Eating Disorders) http://www.vba.va.go...ms/disexm37.htm

I was able to get the generic brand for a while John. But over the last few months i've only been able to get the brand name costing around $250 for a months supply of long acting. Have you tried to get the short acting Oxycodone 5 MG through the VA? I am able to recieve this since it's on their formulary. They supply it for breakthrough pain, but supplied more when they cut off the prescription for the long acting. I was lucky enough to find a general practice MD that does prescribe pain medications, so I didn't have to go to a pain clinic. Mine is a very good and careful Dr of who he prescribes pain meds to. I don't believe he would prescribe them to anyone with any sign or history of drug abuse. I was so very greatful to find a Dr like this man. He's a very sharp, therough and caring Dr.

First I would get the statement from your mental health Dr stating that your meds are the cause of it and you take your meds for the service connected PTSD. Make sure he includes the med you take and the dosage. If you have an NSO, have them write it up for you. If you don't have one, use form: 21-4138 to ask service connection for the ED following the guidelines on how to file a claim on hadit.com's home page. James stated the other day that ED is awarded as special monthly comp(SMC) at around $80 pr month.