MKAH

Thank you sir. I am going to give myself the weekend to unwind a bit. This process has been very draining and difficult for me, as I expect it has been for other disabled Veterans?

Thanks GBArmy Thank you again for all the great advice. I'll keep everyone up to date on any changes or updates.

The only thing that I feel might be possible is i have a sever balance (vertigo) problem. The VA treated me for Menieres Disease, however I still suffer from daily imbalance which has been well documented in my VA health record. The C&P physician that performed my migraine claim, commented to me that she was entering a notation that she thought my vertigo was a result of my Tinnitus. In a few more weeks, me and my attorney I will see the Migraine C&P and determine if this information is sufficient to move forward with a new claim for vertigo, or file for TDUI un employability for combined 10% tinnitus, 50% hearing loss and 50% migraines. As I mentioned before, I have not been able to work due to my SC disabilities since 3 Jan 2016.

Hi Hucast21, See the timeline below for the Migraine claim. Looks roughly like: 6 months for the claim to first denial 10 months for the denial SOC on the NOD 6 months for BVA approval 10 months for the RO to perform a C&P 3 weeks for RO to rate disability and send me notification via E-Benefits. I called the VA "Peggy" on the 800 number. She said from her view, I will be receiving multiple retro payments, but they are still in the approval process. My PTSD claim has been ongoing since 11/14/15. I have received a C&P via a remand from the BVA for the PTSD (see below link). However, I am still waiting for the RO to determine service connection or not. VA sent you a claim decision on July 12, 2018 VA received your Notice of Disagreement on July 30, 2018 VA sent you a Statement of the Case on May 28, 2019 VA received your Form 9 on June 14, 2019 Your appeal was sent to the Board of Veterans’ Appeals on July 20, 2019 Board of Veterans’ Appeals made a decision on January 09, 2020

Thanks for the reply 63Charlie, On Monday, I will be calling my attorney (Woods & Woods) to discuss this. I have not worked since 3 Jan 2016 due to my SC disabilities. We will likely file the 21-8940 ASAP as my remaining claim for PTSD, if determined to be SC, would be rated at 70% best case scenario. This combination would bring me to SC of 94% rounded down to 90%. Thank you for the Form number.

Thank you very much.

Thanks for the reply GBArmy, I was surprised that VA.gov shows nothing regarding this specific claim for Migraines (a BVA grant, ordering a C&P which happened about 2.5 weeks ago and the RO rating happening today)? My last claim pending is PTSD. A remand by the BVA for a C&P (which occurred about six months). The RO must still be working on (waiting to get to it) to determine service connection or not, then possible rating. Thank you for the kind words

Hello everyone, Today I was on Ebenifits and saw that my Migraine claim had updated to 50%, bringing me up to 80% total. VA.gov shows no information on this claim..? I did some quick math and backpay will be about 22,068, less 500 for doctor exam and letter, and 4,413 for my attorney = 17,154. Anyway, I have not seen a direct deposit so I presume that large amounts take a little longer to process? ******************************************************************************************************************************** Total Combined Disability You have a 80% final degree of disability. This percentage determines the amount of benefit pay you will receive. How is this calculated Add Disabilities Submit a claim to make any updates to the disabilities that you believe are related to your military service. Apply Now. Rated Disabilities Disability Rating Decision Related To Effective Date tinnitus 10% Service Connected 03/08/2011 migraines (previously addressed as headaches) 50% Service Connected 08/01/2017 bilateral hearing loss 50% Service Connected 02/11/2016

The marriage reference is funny but true

UPDATE: A few months ago I received a BVA decision; “Entitlement for headaches, to include as secondary to service-connected tinnitus, is granted. Resolving all reasonable doubt, in favor of the veteran, the evidence is at least in equipoise that the veteran’s headaches are caused or aggravated by his service-connected tinnitus.” Sine this BVA notification letter, I have been patiently waiting for the RO to rate the service connection. Today (3/28/2020) I received a phone call from a company that schedules C&P exams for the VA. She confirmed that they were conducting a C&P for the SC headaches grant and will be using a contractor. She also said the C&P will likely be performed within the next 60 days or sooner. Anyway, finally to my question: Since I have severe headaches so frequently, I have found it difficult to keep a journal or record of them as I have seen mentioned in the HADIT forums for some time now. A few years ago, I did have write a spreadsheet spanning about three weeks, which contained dates, times, diet, activity, severity and length of vertigo which included headaches. #1) Is it too late to start tracking them starting now, so I can provide the C&P doctor / examiner with the most recent information? #2) Should I also provide the C&P examiner the vertigo / headache tracking form, even though its several years old? I just want to have what is needed so that the C&P doctor / examiner does not have to guess or me trying to describe from memory. Thank You

I am curious if RO operations with the exception of walk in traffic, will remain active considering the recent Coronavirus polices? Eg; BVA appeal decision ratings, C&P reviews, etcetera.

Hi Pete, I did a letter from the BVA judge that ruled in favor of service connection (see below) . It's my understanding that my file is now back at the Regional Office to determine a percentage..if any? This is the meat and potatoes of that specific decision: These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). After the SOC was issued in May 2019, VA treatment records and a private DBQ and medical opinion pertinent to the Veteran's headache claim were associated with the claims file. However, as the claim of entitlement to service connection for headaches, to include as secondary to service-connected tinnitus, is being granted, and that is a full grant of the benefit sought on appeal as to that issue, the Board finds no prejudice with proceeding with the adjudication of that claim. Interestingly, the Regional office is also in possession of what seems to be a favorable C&P for PTSD, that was ordered by a BVA judge via remand. I'm wondering if the RO is looking at both the Headache & PTSD claims in conjunction with my current service connected hearing loss & tinnitus to determine a combined service connection percentage? Thank you for your reply.

Thanks Richard.

Years ago I filed a BVA PTSD appeal which was update as follows: Disability compensation appeal updated on June 4, 2019 Status: The Board made a decision on your appeal Issue on appeal: Service connection, Post-traumatic stress disorder Submitted on: September 20, 20160 View details In the view details section, it was a C&P remand request. On August 98th, 2019 the C&P was conducted and the exam information (DBQ or C&P ???) was sent to the local (Oakland California RO) for review. I expect another year or two before I hear anything. My question is: VA.gov still shows the claims as GREEN and not closed but a decision being made. Since Ebennie's shows nothing other than an AB8 letter showing not service connected from years ago, will VA.gov update or will Ebennies update with whatever decision is ultimately made from this point forward? Thank You

I was reading the BVA decision and it contained this line. What specifically does " and that is a full grant of the benefit sought on appeal" mean? If the entire BVA decisaion of needed, I can provided is? THX ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). After the SOC was issued in May 2019, VA treatment records and a private DBQ and medical opinion pertinent to the Veteran's headache claim were associated with the claims file. However, as the claim of entitlement to service connection for headaches, to include as secondary to service-connected tinnitus, is being granted, and that is a full grant of the benefit sought on appeal as to that issue, the Board finds no prejudice with proceeding with the adjudication of that claim. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

I got the printed BVA decision. The law Judge approved the service connection Tension Headaches as a secondary condition of Tinitus. The decision letter from the BVA contained lots of physician notes & detail which is very similar to what GBArmy pointed out regarding severity. GBArmy's comment: "headaches 5 x week and have to lie down 5 X week. Migraines/headaches under diagnostic code 8100 states that migraines are rated on symptoms of frequency, severity and prostrating. You also say you have to lay down in a dark room due to the severity." Anyway, the letter did not specify a rating or start date, so I reached out to my VA attorney which is handling my case. Woods & Woods, They said the BVA has sent the Judges Grant to the Oakland RO and they will rate it and determine a start date. She said the current BVA approved appeals rating time, is about 120 days and I will likely see a deposit before a notification of increase (if any). Is it just me, or does this process seem somewhat convoluted and inefficient? Anyway, I am genuinely grateful to be closer to the end of this process.

Thank You for your opinion GBArmy. I'll let you know how it turns out.

GB Army, Here is a redacted version of the brief my attorney submitted to the BVA for the appeal for headaches.

UPDATE: My appeal for PTSD also included an appeal for Migraines / Sleep Apnea This morning on Vets.gov I see the following (I highlighted the most interesting parts): "See past events July 12, 2018 – January 09, 2020 Current status The Board made a decision on your appeal The Board of Veterans’ Appeals sent you a decision on your appeal. Here’s an overview: Granted The judge granted the following issue: Service connection, Migraines If this decision changes your disability rating or your eligibility for VA benefits, you should see this change made in 1 to 2 months. Denied The judge denied the following issue: Service connection, Sleep apnea Please see your decision for more details. This appeal is now closed -------------------------------------------------------------------------------------------------------------------------------------------------- However, I looked at my rating in Eebenefits and it does not appear to have been updated yet (see below). Disability Rating Decision Related To Effective Date tinnitus 10% Service Connected 03/08/2011 bilateral hearing loss 50% Service Connected 02/11/2016 headaches Not Service Connected post traumatic stress disorder (PTSD) Not Service Connected PTSD - Personal Trauma sleep condition Not Service Connected ----------------------------------------------------------------------------------------------------------------------------------------------------- I guess I'll have to wait for a while to get the letter in the mail?

GBArmy, broncovet Thank you both for the detailed explanations. It's great to have a place like the Hadit Community, where veterans can get quality information about this complicated process. Of course, that hard part now is waiting for the decision letter.

Hi GBArmy, After reading your post again, I just noticed that in my profile information I had not specified my 60% total Service Connection as: 10% Tinnitus & 50% Bilateral Hearing loss. I have now corrected that in my Profile/Interest section. I have read the VA requirements for TDIU and am still a bit unclear on the single vs multiple percentages required to meet the policy. Based on the above line item description of my combined SC's, is TDIU still possible? Thank You

Hello everyone, Thank you for all the replies. I thought I would answer a question which is not included in the original information I provided. a. About two months after filing my claim, back in late 2015 I was weened off of narcotics & alcohol with Naltrexon and put on traditional mental health medications. Since then I have not been able to, and have not worked at all. My social security earnings statement since 2015, confirms zero earnings. (It's shameful for me to admit, but narcotics and booze allowed me to get out and at least hold down a job. However, at the direction and insistence of VA mental health staff, I completely stopped all narcotic drugs and was RX'd every conceivable psychiatric medication. Unfortunately, I now have great difficulty in any public place. The Rx meds just don't work that well for me). Thank you again for all your replies

I am completely at a loss as to what it all means and just want it all to end. The more interesting parts I highlighted with BOLD text, to make reading easier. I am currently 60% SC with hearing loss/tinutus. Any insight would be great. Thank You ***************** see below ***************** Medical Opinion Disability Benefits Questionnaire LAST NAME, FIRST NAME, MIDDLE NAME (SUFFIX): SOCIAL SECURITY NUMBER/FILE NUMBER: TODAY’S DATE: MARK XXXXX XXX-XX-XXXX 08/09/2019 HOME ADDRESS: EXAMINING LOCATION AND ADDRESS: XXXXXXXXXXX Redding, CA 96001 VES HOME TELEPHONE: XXXXXXXXXX CONTRACTOR: VES NUMBER: VA CLAIM NUMBER: VES 22619376754 IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES OR COST INCURRED IN THE PROCESS OF COMPLETING AND/OR SUBMITTING THIS FORM. PLEASE READ THE PRIVACY ACT AND RESPONDENT BURDEN INFORMATION ON REVERSE BEFORE COMPLETING FORM. NOTE TO PHYSICIAN - The Veteran is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will consider the information you provide on this questionnaire as part of their evaluation in processing the Veteran’s claim. For the Claimed Compensation Condition of - ACQUIRED PSYCHIATRIC DISORDER TO INCLUDE MAJOR DEPRESSIVE DISORDER AND OBSESSIVE COMPULSIVE DISORDER ACCEPTABLE CLINICAL EVIDENCE (ACE) INDICATE METHOD USED TO OBTAIN MEDICAL INFORMATION TO COMPLETE THIS DOCUMENT: [] 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 [X] In-person examination EVIDENCE REVIEW [] Not requested [] No records were reviewed [] VA claims file (hard copy paper C-file) [X] VA e-folder (VBMS or Virtual VA) [] CPRS [] Other (please identify other evidence reviewed): Evidence comments: The veteran's file was reviewed. STATEMENT OF VETERAN RECEIPT DATE 1/26/16 BVA DECISION RECEIPT DATE 6/4/19- (REMAND ORDER) VAMC TX RECS RECEIPT DATE 5/28/19 Medical Opinion Name: MARK XXXXXXX Disability Benefits Questionnaire VA Claim Number: Page 2 of 5 Contractor: VES SERVICE TREATMENT RECORDS RECEIPT DATE 2/22/16 SERVICE TREATMENT RECORDS RECEIPT DATE 3/25/11 STRESSOR STATEMENT RECEIPT DATE 3/10/16 PERSONNEL RECS RECEIPT DATE 2/22/16 PERSONNEL RECS RECEIPT DATE 2/22/16 BUDDY STATEMENTS WITH RECEIPT DATES, 2/28/19, 12/27/16, 12/19/16, 6/20/16, 6/6/16, 5/9/16, 1/26/16, 3/24/11, 3/10/11, 3/3/11 SECTION I - DEFINITIONS Aggravation of preexisting nonservice-connected disabilities. A preexisting injury or disease will be considered to have been aggravated by active military, naval, or air service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. Aggravation of nonservice-connected disabilities. Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice- connected disease, will be service connected. SECTION II – RESTATEMENT OF REQUESTED OPINION 2A. Insert requested opinion from general remarks: THE EXAMINER IS ADVISED THAT THE VETERAN IS COMPETENT TO ATTEST TO OBSERVABLE SYMPTOMS. IF THERE IS A MEDICAL BASIS TO SUPPORT OR DOUBT THE VETERANS REPORTS OF SYMPTOMATOLOGY, THE EXAMINER SHOULD PROVIDE A FULLY REASONED EXPLANATION. PLEASE NOTE THIS IMO IS TO ACKNOWLEDGE THAT RECORDS HAVE BEEN REVIEWED AS WELL AS ADDRESSING ANY ADDITIONAL QUESTIONS NOTED AT THE BOTTOM OF THE DBQ. POTENTIALLY RELEVANT EVIDENCE: STATEMENT OF VETERAN RECEIPT DATE 1/26/16 BVA DECISION RECEIPT DATE 6/4/19- (REMAND ORDER) VAMC TX RECS RECEIPT DATE 5/28/19 SERVICE TREATMENT RECORDS RECEIPT DATE 2/22/16 SERVICE TREATMENT RECORDS RECEIPT DATE 3/25/11 STRESSOR STATEMENT RECEIPT DATE 3/10/16 PERSONNEL RECS RECEIPT DATE 2/22/16 PERSONNEL RECS RECEIPT DATE 2/22/16 BUDDY STATEMENTS WITH RECEIPT DATES, 2/28/19, 12/27/16, 12/19/16, 6/20/16, 6/6/16, 5/9/16, 1/26/16, 3/24/11, 3/10/11, 3/3/11 2B. Indicate type of exam for which opinion has been requested (e.g. skin diseases): Mental Disorder DBQ SECTION III – MEDICAL OPINION FOR DIRECT SERVICE CONNECTION Choose the statement that most closely approximates the etiology of the claimed condition. 3A. [] The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in- service injury, event, or illness. Provide rationale in section c. 3B. [] The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. Provide rationale in section c. 3C. Rationale: Medical Opinion Name: MARK ****** Disability Benefits Questionnaire VA Claim Number: Page 3 of 5 Contractor: VES SECTION IV - MEDICAL OPINION FOR SECONDARY SERVICE CONNECTION 4A. [] The claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the Veteran’s service connected condition. Provide rationale in section c. 4B. [] The claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service connected condition. Provide rationale in section c. 4C. Rationale: SECTION V - MEDICAL OPINION FOR AGGRAVATION OF A CONDITION THAT EXISTED PRIOR TO SERVICE 5A. [] The claimed condition, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression by an in-service injury, event, or illness. Provide rationale in section c. 5B. [] The claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. Provide rationale in section c. 5C. Rationale: SECTION VI - MEDICAL OPINION FOR AGGRAVATION OF A NONSERVICE CONNECTED CONDITION BY A SERVICE CONNECTED CONDITION 6A. Can you determine a baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition)? [] Yes [] No If “Yes” to question 6A, answer the following: I. Describe the baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to aggravation or the earliest medical evidence following aggravation by (service connected condition): II. Provide the date and nature of the medical evidence used to provide the baseline: III. Is the current severity of the (claimed condition/diagnosis) greater than the baseline? [] Yes [] No If yes, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by (insert “service connected condition”)? [] Yes (provide rationale in section 6B.) [] No (provide rationale in section 6B.) If “No” to question 6A, answer the following: Medical Opinion Name: MARK ****** Disability Benefits Questionnaire VA Claim Number: Page 4 of 5 Contractor: VES I. Provide rationale as to why a baseline cannot be established (e.g. medical evidence is not sufficient to support a determination of baseline level of severity): II. Regardless of an established baseline, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by (insert “service connected condition”)? [] Yes (provide rationale in section 6B.) [] No (provide rationale in section 6B.) 6B. Provide rationale: SECTION VII - OPINION REGARDING CONFLICTING MEDICAL EVIDENCE 7. I have reviewed the conflicting medical evidence and am providing the following opinion: Is there a need for the Veteran to follow up with his/her primary care provider regarding any life threatening findings in this examination (not limited to claimed condition(s))? [] Yes [X] No Additional Question 1: PLEASE PROVIDE AN OPINION AS TO WHETHER IT IS AT LEAST AS LIKELY AS NOT (50 PERCENT OR GREATER PROBABILITY) THAT THE VETERANS MAJOR DEPRESSIVE DISORDER AND OBSESSIVE COMPULSIVE DISORDER WERE INCURRED DURING, CAUSED BY OR ARE OTHERWISE RELATED TO HIS ACTIVE SERVICE. Answer Question 1: It is at least as likely as not (50 percent or greater probability) that the veterans major depressive disorder and obsessive compulsive disorder were incurred during, caused by or are otherwise related to his active service. Additional Question 2: PLEASE PROVIDE YOUR MEDICAL RATIONALE. Answer Question 2: The veteran had no prior history of mental health issues before serving in the military. He reported learning the value of routine and ritual while serving and reported this seemed to become maladaptive in response to stress. He reported becoming very depressed after leaving the service and being unable to pursue a career in medicine. He appears to have developed Obsessive Compulsive Disorder and Major Depressive Disorder in response to an in-service stressor (MST.) Though there are not apparently sufficient markers to support a claim for PTSD due to MST, the evidence in the record and presented by the veteran appear sufficient to this examiner to conclude that a serious stressor occurred during his service in Germany. This stressor appears to be the proximate cause of his subsequent Major Depressive Disorder and Obsessive Compulsive Disorder. The Obsessive Compulsive Disorder appears to have developed as a way to maintain control and ensure that he could not be victimized again and the Major Depressive Disorder developed when his experience prevented him pursuing further education. SECTION VIII - PHYSICIAN'S CERTIFICATION AND SIGNATURE CERTIFICATION - To the best of my knowledge, the information contained herein is accurate, complete and current. 8A. PHYSICIAN’S SIGNATURE: 8B. PHYSICIAN’S PRINTED NAME: JAMIE L. XXXXXXX, PsyD Medical Opinion Name: MARK ******* Disability Benefits Questionnaire VA Claim Number: Page 5 of 5 Contractor: VES Mental Disorders (other than PTSD and Eating Disorders) – DSM V Disability Benefits Questionnaire LAST NAME, FIRST NAME, MIDDLE NAME (SUFFIX): SOCIAL SECURITY NUMBER: TODAY’S DATE: MARK XXXXXX XXX-XX-XXXX 08/09/2019 HOME ADDRESS: EXAMINING LOCATION AND ADDRESS: XXXXXXXXXXXXXXX, Redding, CA 96001 VES HOME TELEPHONE: XXX-XXX-XXXX CONTRACTOR: VES NUMBER: VA CLAIM NUMBER: VES 22619376754 Your patient is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will consider the information you provide on this questionnaire as part of their evaluation in processing the Veteran’s claim. Please note that this questionnaire is for disability evaluation, not for treatment purposes. This evaluation should be based on DSM-5 diagnostic criteria. NOTE: If the Veteran experiences a mental health emergency during the interview, please terminate the interview and obtain help, using local resources as appropriate. You may also contact the Veterans Crisis Line at 1-800-273-TALK (8255). Stay on the Crisis Line until help can link the Veteran to emergency care. NOTE: In order to conduct an initial examination for mental disorders, the examiner must meet one of the following criteria: a board- certified or board-eligible psychiatrist; a licensed doctorate-level psychologist; a doctorate-level mental health provider under the 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; or 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. In order to conduct a review examination for mental disorders, the examiner must meet one of the criteria from above, OR be a licensed clinical social worker (LCSW), a nurse practitioner, a clinical nurse specialist, or a physician assistant, under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist. This Questionnaire is to be completed for both initial and review mental disorder(s) claims. For the Claimed Compensation Condition of - ACQUIRED PSYCHIATRIC DISORDER TO INCLUDE MAJOR DEPRESSIVE DISORDER AND OBSESSIVE COMPULSIVE DISORDER Is this DBQ being completed in conjunction with a VA21-2507, C&P Examination request? [X] Yes [] No If no, how was the examination completed (check all that apply)? [] In-person examination [] Records reviewed [] Other, please specify: Comments: SECTION I: DIAGNOSIS 1. DIAGNOSIS 1A. Does the Veteran now have or has he or she ever been diagnosed with a mental disorder(s)? Mental Disorders Disability Benefits Questionnaire Name: MARK ****** Page 2 of 7 VA Claim Number: Contractor: VES [X] Yes [] No ICD code: F33 NOTE: If the Veteran has a diagnosis of an eating disorder, complete the Eating Disorders Questionnaire, in lieu of this questionnaire. NOTE: If the Veteran has a diagnosis of PTSD, the Initial PTSD Questionnaire must be completed by a VHA staff or VA contract examiner in lieu of this questionnaire. If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Major Depressive Disorder, Severe, Recurrent ICD code: F33 Comments, if any: Mental Disorder Diagnosis #2: Obsessive Compulsive Disorder ICD code: F42 Comments, if any: Mental Disorder Diagnosis #3: ICD code: Comments, if any: If additional diagnoses, list using above format: 1B. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): None relevant ICD code: Comments, if any: 2. DIFFERENTIATION OF SYMPTOMS 2A. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [] No (If “Yes,” complete the following question 2B) 2B. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [X] Yes [] No [] Not applicable (N/A) (If “No,” provide reason): (If “Yes,” list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses): His obsessional rituals and compulsions are due to his Obsessive Compulsive Disorder. His suicidal ideation and prominent depressed mood are due to his Major Depressive Disorder. Mental Disorders Disability Benefits Questionnaire Name: MARK ******* Page 3 of 7 VA Claim Number: Contractor: VES There is a clinical association as the disorders tend to exacerbate each other. 2C. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [] Yes [X] No [] Not shown in records reviewed Comments, if any: (If “Yes,” complete the following question 2D) 2D. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis TBI and any non-TBI mental health diagnosis? [] Yes [] No [X] Not applicable (If “No,” provide reason): (If “Yes,” list which symptoms are attributable to each diagnosis TBI and which symptoms are attributable to a non-TBI mental health diagnosis): 3. OCCUPATIONAL AND SOCIAL IMPAIRMENT 3A. Which of the following best summarizes the Veteran’s level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [] No mental disorder diagnosis [] A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication [] 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 [] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation [] Occupational and social impairment with reduced reliability and productivity [X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood [] Total occupational and social impairment 3B. For the indicated level of occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [] Yes [X] No [] Not applicable (If “No,” provide reason): The symptoms and relative impairment overlap and exacerbate each other to such an extent that differentiation is not possible. (If “Yes,” list which occupational and social impairment is attributable to each diagnosis): 3C. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [] Yes [] No [X] Not applicable (If “No,” provide reason): (If “Yes”, list which impairment is attributable to TBI and which is attributable to any non-TBI mental health diagnosis): Mental Disorders Disability Benefits Questionnaire Name: MARK ******* Page 4 of 7 VA Claim Number: Contractor: VES SECTION II: CLINICAL FINDINGS: 1. EVIDENCE REVIEW Evidence reviewed (check all that apply): [] Not requested [] VA claims file (hard copy paper C-file) [X] VA e-folder [] CPRS [] Other (please identify other evidence reviewed): [] No records were reviewed Evidence Comments: The veteran's file was reviewed. STATEMENT OF VETERAN RECEIPT DATE 1/26/16 BVA DECISION RECEIPT DATE 6/4/19- (REMAND ORDER) VAMC TX RECS RECEIPT DATE 5/28/19 SERVICE TREATMENT RECORDS RECEIPT DATE 2/22/16 SERVICE TREATMENT RECORDS RECEIPT DATE 3/25/11 STRESSOR STATEMENT RECEIPT DATE 3/10/16 PERSONNEL RECS RECEIPT DATE 2/22/16 PERSONNEL RECS RECEIPT DATE 2/22/16 BUDDY STATEMENTS WITH RECEIPT DATES, 2/28/19, 12/27/16, 12/19/16, 6/20/16, 6/6/16, 5/9/16, 1/26/16, 3/24/11, 3/10/11, 3/3/11 2. HISTORY NOTE: Initial examinations require pre-military, military, and post-military history. If this is a review examination only indicate any relevant history since prior exam. 2A. Relevant Social/Marital/Family history (pre-military, military, and post-military) : Pre-military He reported being raised in an intact family until age 8 when his parents divorced. He initially lived with his mother, but was then raised by his father. He reported having strict, but fair parents. He has an older sister. He reported having good relationships with his family growing up. He endorsed an abuse attempt by a stepbrother, but denied anything actually occurred. Military He denied any changes to his marital or family status while in the service. Post-military He met his wife after he was discharged and they married in 1989. He had daughters born in 1994 and 1997. 2B. Relevant Occupational and Educational history (pre-military, military, and post-military): Pre-military He graduated high school before joining. Military He was an Army medic. Post-military He did not continue his education following the military. He got his EMT license and worked at a waterpark for 13 years. 2C. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post- military): Mental Disorders Disability Benefits Questionnaire Name: MARK XXXX Page 5 of 7 VA Claim Number: Contractor: VES Pre-military He denied any personal or family mental health history. Military He reported feelings of guilt and self-blame following the reported MST. Post-military He reported feeling distrustful of others. He has a hard time being around strangers. He reported beginning to have rituals and processes in the military. This appears to have come about due to his blaming himself for having poor judgment and being victimized. He is currently in therapy for PTSD and takes prazosin, duloxetine, and trazadone. He reported being irritable with his family. He reported feeling sad and disappointed with himself since leaving the service. He endorsed frequent suicidal ideation and has been placed on two psychiatric holds due to danger to self. 2D. Relevant Legal and Behavioral history (pre-military, military, and post-military) Pre-military He denied any disciplinary issues Military He denied any disciplinary issues. Post-military He denied any legal issues 2E. Relevant Substance Abuse history (pre-military, military, and post-military) Pre-military He denied any substance abuse issues. Military He denied any excessive substance use. Post-military He reported a history of taking micro doses of narcotic medication to function on a day to day basis. He reported a history of alcohol abuse up until a few years ago. He currently only drinks a few times per year. He no longer uses narcotic medication. 2F. Other, if any: SECTION III: SYMPTOMS For VA rating purposes, check all symptoms that actively apply to the Veteran’s diagnoses [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often [] Panic attacks more than once a week [] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [] Mild memory loss, such as forgetting names, directions or recent events [] Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks [] Memory loss for names of close relatives, own occupation, or own name [] Flattened affect [] Circumstantial, circumlocutory or stereotyped speech Mental Disorders Disability Benefits Questionnaire Name: MARK ******* Page 6 of 7 VA Claim Number: Contractor: VES [] Speech intermittently illogical, obscure, or irrelevant [] Difficulty in understanding complex commands [] Impaired judgment [] Impaired abstract thinking [] Gross impairment in thought processes or communication [X] Disturbances of motivation and mood [] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a work like setting [] Inability to establish and maintain effective relationships [X] Suicidal ideation [X] Obsessional rituals which interfere with routine activities [] Impaired impulse control, such as unprovoked irritability with periods of violence [] Spatial disorientation [] Persistent delusions or hallucinations [] Grossly inappropriate behavior [] Persistent danger of hurting self or others [] Neglect of personal appearance and hygiene [] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene [] Disorientation to time or place SECTION IV: BEHAVIORAL OBSERVATIONS He was alert and oriented. His affect was dysthymic and congruent with the conversation. He communicated his ideas clearly. He denied any current suicidal or homicidal ideation. He denied any perceptual disturbance. There were no cognitive or memory deficits apparent during the interview. SECTION V: OTHER SYMPTOMS 5. Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [] Yes [X] No (If “Yes,” describe): SECTION VI: COMPETENCY Is the Veteran capable of managing his or her financial affairs? [X] Yes [] No (If “No”, explain): SECTION VII: REMARKS Remarks (Including any testing results), if any: Additional comments regarding suicidal ideation, if any: In the text box below please provide specific details on whether you feel the veteran is considered to be a current imminent risk (active ideation with current plan and/or intent) or increased but not current imminent risk (no current plan or intent to take action) of harm to him/herself. NOTE: If you believe the veteran is a current imminent risk please contact your local authorities (police, 911, etc) and document in the Remarks section that you have done so. He reported feeling frequent suicidal ideation without intent. He denied any current plan or intent. He discussed protective factors including his concern about negatively impacting his family. [] I believe this Veteran/Service Member should be considered a CURRENT IMMINENT RISK. [X] I believe this Veteran/Service Member should be considered an INCREASED but not current imminent risk. [] I do not believe this Veteran/Service Member should be considered a current imminent or increased risk. Mental Disorders Disability Benefits Questionnaire Name: MARK ******* Page 7 of 7 VA Claim Number: Contractor: VES Please advise whether the Veteran was equipped with the VA crisis line (800-273-TALK): He was provided the crisis line. Is there a need for the Veteran to follow up with his/her primary care provider regarding any life threatening findings in this examination (not limited to claimed condition(s))? [] Yes [X] No SECTION VIII: PSYCHIATRIST/PSYCHOLOGIST/EXAMINER CERTIFICATION AND SIGNATURE CERTIFICATION - To the best of my knowledge, the information contained herein is accurate, complete and current. 8A. PSYCHIATRIST/PSYCHOLOGIST/EXAMINER SIGNATURE: 8B. PSYCHIATRIST/PSYCHOLOGIST/EXAMINER PRINTED NAME:

Hi everyone. My BVA appeal for PTSD-MST on Vets.gov was just updated with a curious message as follows: "Current Status The Board made a decision on your appeal The Board of Veterans’ Appeals sent you a decision on your appeal. Here’s an overview: Please see your decision for more details. What happens next? The Veterans Benefits Administration completes the remand instructions They may contact you to request more evidence or medical exams as needed. When they’ve completed the remand instructions, they’ll determine whether or not they can grant your appeal. If not, your appeal will return to the Board of Veterans’ Appeals for a new decision. 16–29 monthsThe Veterans Benefits Administration usually takes between 16 and 29 months to complete remand instructions." One footnote: I have never received a C&P for PTSD-MST. I am surprised the BVA has updated "The Board made a decision on your appeal", and then state the need to "complete(s) the remand instructions" #1) Is this pretty common? #2) When they mail me this decision, I assume I'll be able to read the remand instructions? Thank You

Hey Vync, " Have you checked this out yet?" I did follow the links on the VA.gov URL that you suggested. The closest location from where I live is San Francisco, roughly 5.5 hours away (each direction). I called them anyway, and they said the program is not available in every city, but they were very polite and professional. I could tell that they would much rather have been able to given me better news. Your suggestion of checking at my local VSO is a good one and I will do that today. " It sounds like you are unable to work. It might be worth also exploring TDIU and/or SSDI. " I am not service connected for Menier's disease, so TDIU is out for me. I did not start having symptoms until pretty recently (well after my ETS from the military) , so I think connecting Menier's to military is out of the question? Currently, I am receiving SSDI for PTSD-MST with a case review of (MIE) 3 years with a start date of July 2016. Interesting that my SSDI was approved after only 45 days from the date of submission which included my VA medical file. Since being diagnosed and treated for Menier's disease, I have contemplated updating my SSDI claim information to include that, but I am not sure if I should do that now or see if I get better closer to the expiration of my PTSD-MST SSDI review period? Any suggestions on that point? "Your profile mentions being SC for bilateral hearing loss, so if you suffer from vertigo and cerebellar gait issues more than once a week, you may qualify. " Yes, I am SC 50% bilater hearing loss and 10% tinnitus and it is getting worse every year. Yes, even after TTG ablation treatment for my Menier's, I still have more than one huge episode per week and stagger around like a drunk with a cane the rest of the time. The worse part right now, is uncontrolled head shaking due to the ablation treatment. I'm hoping that this settles down at some point, but its been going on since my first TTG treatment. The TTG treatment has reduced the severity of my Menier's episode which I am grateful for but has unfortunately further damaged my hearing. Sine I have not seen any medical or scientific studies linking NIHL to Menier's, I am not planning on perusing that a SC course of action. The fact is, this disease is such a mystery that no one seems to have a real grasp on what actually causes it. Vync, were you having vertigo attacks while in service, or did this occur later on? Thanks again Vync, Off to the VSO now to see of I can get information regarding a ride(s) to the VA Dr. office :)