MKAH

Thanks Broncovet.

Killemall, The Regional office used the examination for re-evaluation as the C&P. I discovered this as it was annotated in my medical notes that I was able to view via Blue Button in MyHealEVet. The rating ended up being: 50% Bi-Lateral Hearing Loss / Word Recognition 10% Tinnitus =VA math 55%, rounded up to 60%. This is a fair and accurate representation of my SC hearing loss and how it effects my life and work. However, the PTSD-MST claim was denied without the use of a C&P, as I did not officially report the crime while in the Army back in 1984. The rater simply made an incorrect decision, which was absolutely devastating to me. I don't expect the rater to fully understand how this could happen to a man and not be officially reported. No one deserves to understand that first hand. It took me a few months to write up a short statement of disagreement as instructed by my VSO. Interestingly, the VA (Medical / Physiological) division of the US Government, consisting of Clinical Psychiatrists and other experts in the field, believe I need intensive and specific treatment for my PTSD-MST. So on November 6th, I will be heading to another VA inpatient PTSD facility located in Virginia for seven weeks. This particular program is a tertiary referral center which has a division that specializes specifically on male MST cases like mine, which the Regional Office rater said does not exist due to lack of documentation. This matter will now last for many more painful years and I vow to never give up, just like when this unthinkable crime against me was committed. I apologize for going off topic. BTW, this is the place I am headed to in November: http://www1.va.gov/directory/guide/facility.asp?ID=116

Hello everyone. This year. I have been getting treatment from inpatient VA psychiatric centers fairly close to my home so I was able to get a ride for the eight week treatment. On November 6th, the VA us sending me to a more specialized facility, from California to Roanoke Virginia for a seven week MST program. I am extremely nervous and apprehensive about being on crowded airplanes from morning until night. When the travel department ordered the plane tickets, they said that I would not be able to select seats. Something like..they don't do that anymore and I will get a seat when I get my boarding pass. Has anyone ever called the airline well in advance of the flight date and asked for Aisle seating near an exit? I hope this does not sound ridiculous, but I am six weeks out and covered with perspiration as I type this. Thank You Mark US ARMY Combat Medic 1/94th FA C Battery MLRS 1983 - 1986 SC - Bilateral Hearing Loss 50% SC - Tinnitus 10% PTSD-MST: Claim submitted 11/14/15 NOD / Appeal Submitted

Hello everyone, A few days ago I was approved for SSDI and a direct deposit was posted to my account. I have been drawing California State Disability since 1/6/2016 and understand that as far as SDI is concerned, I can draw both at the same time. However, it is also my understanding that the SSDI used an "offset" formula to reduce the total combined government benefits to not more than 80% of that the SSDI website calls "average current earnings" income? The Social Securty pamphlet; "How workers compensation and other disability payments may effect your benefits" page 4, reads "we use different formulas to calculate your average current earnings". The information I was able to find is as follows: 504.3What is average current earnings? “Average current earnings” is the highest of: Your average monthly wage upon which your un-indexed disability primary insurance amount is based (see Chapter 7); Your average monthly earnings from covered employment and self-employment during the highest five years in a row after 1950; or Your average monthly earnings based on the single calendar year of highest earnings from covered employment. This single calendar year can be the year that your disability began or any of the five years immediately proceeding the year your disability began. My income for the past five years is as follows (2013 being highest amount): 2015 $72,421 2014 $72,934 2013 $98,924 <-------- 2012 $83,397 2011 $76,085 My current SDI monthly income is: $3,272 My current SSDI monthly income is $2,324 ----------------------------------------------------- Total government SDI/SSDI $5,596 $98,924 dived by 12 = $8,243 $5,596 dived by $8,243 = 67.88% of my income in 2013 The question: Based on my math and understanding of the rules, it appears to me that I will not have an offset applied to my SSDI? (I have four months of SDI remaining) Any comments would be great. Mark

Buck52, Yes, the VA has DX'ed me with severe PTSD, however they have not been able to connect my MST claim to my PTSD as it was 30 years ago. I provided the VA with all the evidence that I had, which was strangely not even mentioned in the decision letter. So now I will be going thru the lengthy appeals process with an attorney. I have spent seven weeks in a VA PTSD facility already and am getting ready to head to Virginia for an six week MST specific treatment program next month. I did apply for SSDI for both PTSD (DXed) and Profound Hearing Loss (DXed). Currently I am not allowed to drive due to SI, and I am taking a fair amount of psychiatric medication. eg: Mirtazapine, Tizanidine, Gabapentine, and Quetiapine. SS are estimating a decision date of around December 2016 since I did not apply until July 8th. I really did not think I would be off work this long, it has just been tougher to get over the MST issues than I thought. In fact, I don't think I have made any headway in that department. Anyway, I have certainly considered and am interested in VOC rehab, and will be doing some research this week. My biggest concern is that I may not qualify since I can not drive yet? What is the abbreviation you mentioned " IIP"? I Thank you so much!

I have not worked since 1/4/2016 Berta. But it has been due to PTSD which I am not rated as SC for....

OK, thanks Broncovet, that it helpfull.

A few months ago my service connected hearing loss was increased from; 10% tinnitus 20% Bi-Lat hearing loss 30% total to 10% tinnitus 50% Bi-Lat hearing loss 60% total While I do not meet the single disability percent to apply normally needed to apply for IU, I do see a "Special Consideration" which I believe applies in my case" http://benefits.va.gov/benefits/factsheets/serviceconnected/iu.pdf Below is my letter asking for my increase. I was wondering if anyone could give me some feedback on the content in order to determine of I should even bother to apply for UI ? BTW, I will be 57 years old on December 1st, of that matters? Thanks in advance, Mark *********** 3/17/2016 Department of Veterans Affairs I am respectfully requesting consideration for an increase in my current Service Connected Bilateral Hearing Loss rating based on VA Autonomic re-evaluation dated 2/16/16, performed by XXX Snyder, MS, Audiology which included Maryland CNC word recognition testing, conducted at the VA Audiology Clinic, 760 XXXX Avenue, XXX Ca. 96001 (530) XXX-8830. History: I am currently rated at 20% Service Connected Bilateral Hearing Loss and 10% Service Connected Bilateral Tinnitus, dated 3/8/2011. The details and evaluation of that service connection are documented in my VA file number XXX XX XXXX. Continued and ongoing issues: Based on my ongoing occupational, Retail Store Manager and non-occupational hearing problems, which include but not limited to; Understanding and or comprehending spoken words Understanding and or comprehending telephone, conference call conversation and intercom announcements Understanding and or comprehending MIS helpdesk, police and other government or municipal telephone conversations. Understanding and or comprehending streaming television, computer, radio or other electronically produced broadcasts. Communicating in moderate to noisy environments, including retail store operations. Communicating with a group of individuals, including retail store operations, staff meetings and training. Communicating using retail store, company provided two way radio handsets. My service connected hearing problems, severely limits my ability to applicably react to audible occupational signals from: Building alarm, emergency warning and other electronic security systems Fire and Loss prevention alarm / notification systems Point of Sale alarm / notifications and alert systems Point of Sale scanners; Symbol DS9808, Motorola LS2208, Inventory management scanner; Symbol MC3100 EAS Loss prevention entry/exit scanners Refrigeration / Freezer malfunction notification systems Environmental systems (heating/cooling) notification systems Energy management systems NOVAR notification systems Freight delivery truck, backup warning notification systems My service connected hearing problems have resulted in: My inability to efficiently communicate with friends, acquaintances, family, customers, vendors, subordinate employees, peers and supervisors. Frequent outsourcing or shifting of my normal and personally assigned managerial functions that require high amounts of communication, to my subordinate managers. Personal, occupational and social withdrawal due to reduced access to services and difficulties communicating with others. Experiencing significant emotional problems caused by a drop in my self-esteem and professional confidence. Exacerbation of my VA diagnosed PTSD, that I am currently being treated for at the VA XXX VA Behavioral Health Department. Recent VA recommendations and action by XXX Snyder, MS, Audiology: Since my recent VA Autonomic re-evaluation which included Maryland CNC word recognition testing, dated 2/16/16, I have been issued and subsequently fitted with updated VA issued hearing instruments: PHONAK AUDEO V90-13 RIC to replace my previous hearing instruments: AUDEO SPICE SMART IX UZ RIC. I have also been issued and fitted with a Remote Control, ComPilot II and Remote Microphone in order to specifically assist with my occupational communication problems. Mr. XXX Snyder explained to me that the new hearing instruments will provide a longer usable service life for my substantial and difficult to manage hearing loss. ***************** Below is the actual examine results: 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 30 | 50 | 75 | 85 | 95 | 105+ | 100+ | 76 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 35 | 50 | 70 | 80 | 85 | 105+ | 100+ | 71 | +=======================================================================+ * The puretone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. ** The average of B, C, D, and E. *** CNT - Could Not Test b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 56% | Thank you, Mark Nicholson

I know I have seen this either in MHV or Ebenefits, however I can't seem to find the letter that details my disabilities? In my case, it would look sort of like this: MyName US Army Bla Bla Bla Tinnitus : 10% Bilateral Hearing Loss: 50% Combined Service connected disability: 60% Signed Uncle Sam Thank you for your service... Yada Dada.......

I have looked thru the mileage topics but do not see my exact scenario. Back in early July I spent a week at the BH_ICU lock down unit for PTSD located in Sacramento California. During my short term care, the doctors submitted applications for me, all over the country for long term inpatient residential care. Unfortunately every VA treatment center located in California and most other states all over the country, were full or could not treat my specific disability. After becoming more stable, I was sent home for a few weeks under strict care from my family, our local VA clinic, and was classified as high risk while I waited for a VA residential treatment program to become available. After about two weeks I was contacted via phone by the Roseburg Oregon VA mental health hospital staff, which was a two month program. After speaking with the Roseburg staff, my primary provider and the BC-ICU staff, we concurred that this would be a good medically necessary choice for treatment for my PTSD-MST and subsequently accepted the offer for treatment. So I had my wife drive me from Redding Ca. to Roseburg Oregon on my scheduled addition date. After arriving, I punched my VA ID card into the travel Kiosk in Oregon for travel reimbersiment. After two months, I successfully completed the PTSD-MST care. On ethe day of my discharge, my wife came back to Roseburg and picked me up. We traveled back to our hometown in Redding Ca. and submitted my request for travel benefits at my local VA. I provided them a copy of my VA admission report, my KIOSK print out showing that I had arrived in Oregon as scheduled, and of course my discharge . My request for reimbursement was for a single one way trip to Oregon, and a single one way trip back home to Redding (about 500 mile total). Pretty straight forward, medically necessary and well documented (I thought). However, the employee at my local travel office at the VA said she did not know how to submit my claim since it spanned more than a month, but she said would give it to the regular travel clerk in order to ensure it was done correctly. A few days later, I stopped in to the VA clinic and confirmed that the travel clerk did indeed get the travel information. She said she had everything I provided and they were trying to figure out of the Roseburg Oregon VA was going to pay foe the travel to the facility, so she had given my travel documents to her supervisor for review. So I stopped by again today, the clerk again confirmed that her supervisor had the travel documents, however they were having difficulty approving the mileage since it evolved an out of state trip. The clerk said was very nice, but explained that her supervisor was not available, so she gave me her direct phone number so I could call her directly tomorrow. All I know for sure is; I have traveled many times all over the state of California with now reimbursement problems. I have not worked since 1/4/2016, have a family of four and simply can not afford to have a delay like this with my travel pay. I am at a complete loss and very frustrated why this simple travel request has become such a complected matter. The question: Am I missing or not fully understanding a VA travel reimbursement policy, that excludes me from being compensated for round trip travel pay to this VA care facility that is located out of my home state? Thanks in advance Mark

Good morning, Just last week I completed an eight week out of state PTSD residential program. Long story short, I have a combination claim filed since November 10th, 2016 for PTSD-MST (new) & Hearing Loss (increase). A recent VA Audiology re-evaluation by my local VA clinic appeared in MHV notes as a DBQ for my current claim and was counter signed by an audiologist (AU). : ************************* Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No **** ACE and Evidence Review ----------------------- 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. Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 30 | 50 | 75 | 85 | 95 | 105+ | 100+ | 76 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 35 | 50 | 70 | 80 | 85 | 105+ | 100+ | 71 | +=======================================================================+ b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 56% | |=============+=========| | LEFT EAR | 56% | +=======================+ ***************** The audiological reports looks fine to me. Since November 2014, I have had extensive treatment by four different VA Clinical Psychiatrists, as well as many NP's and of course many LSW's in treament of my PTSD-MST. Treatment has ranged from medications, two separate (week long inpatient admissions to BH-ICU's) in both California and Oregon. EMDR treatment, Progressive Exposure Therapy treatment at a residential facility for eight weeks, as well as MANY MANY other VA PTSD treatment classes. I am now scheduled to fly back east in September for PTSD-MST specific treatment as my treating psychiatrist is believes that I need additional specific MST treatment as she an the other VA doctors describe as Chronic and Severe. In a nut shell, everyone, including the doctors and staff at the VA have been working there butts off to make progress in my treatment, but I continue to require more treatments in a PTSD-MST specific facility this coming September. I currently have about 600 pages of VA PTSD related notes in my blue button download report. QUESTION: Anyway, my questions is; My claim has recently been moved from collecting evidence to prep for decision and I have not had or been scheduled for a C&P exam for PTSD-MST. Do C&P exams always need to happen for claims to be decided or rated? Thanks in advance

Thanks brovnet. I did see some odd a asterisks * & ** in the cp exam stating I may not be eligible for compensation based on threshold and frequencies phycobable? Interestingly, I also noticed the C&P stated that no etiology (cause of loss) was not needed as already service connected, and retesting would not provide any additional information. I have not worked all year and I was a retail store manager. The combination of my hearing loss and pending ptsd claim made it a nightmare to interact with employees and customers? Using any of the phones in the store was effectively impossible. Fortunately I have taught myself how to read lips at a basic level. My claim for ptsd & hearing loss increase were submitted separately by two months. However the VA linked them together on one claim. My cover sheet statement provided numerous things I could absolutely not hear. Eg theft alarms, emergency exit alarms, vehicle backup alarms, refrigerator system alarms, the beeping sound of scanners used on the cash registers, ect ect ect. I also pointed out how my hearing loss continued to my ptsd, especially while at work. Anyway, thanks for your reply?..but I'm still worried about the comments that read "may not be rate able". With astrikes next to my hearing results. Sorry for the typos, I did this on my iPhone? ? Mark Nicholson

My problem is I do not know how to inturpret the C&P evluation? I'm going to format the two reports so they can hopefully, be read better; A C&P dated 6/2/16 based off of my local VA audiologist actual test and report of findings from 2/2/16. I am currently service connected at 10% Tinitus ans 20% Hearing loss bilaterally. I asked for a re-evaluation early this year due to my continued trouble with getting my hearing aids adjusted so could hear better and understand conversations. My original hearing loss service connection was over five years ago. After getting my most recent HL report I filed for an increase in hearing loss and word recognition LOCAL TITLE: C&P Audiology 13294 STANDARD TITLE: AUDIOLOGY C & P MULTIPLE EXAM NOTE DATE OF NOTE: JUN 02, 2016@08:24:04 ENTRY DATE: JUN 02, 2016@08:24:04 AUTHOR: BASS,ROBERTA EXP COSIGNER: URGENCY: STATUS: COMPLETED Hearing Loss and Tinnitus Disability Benefits Questionnaire Name of patient/Veteran: MARK NICHOLSON 9191 Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- 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. Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS This exam is for: Hearing loss and/or tinnitus (audiologist or non-audiologist clinician, using audiology report of record that represents Veteran's current condition) If using audiology report of record, date audiology exam was performed: 2.16.16 SECTION 1: HEARING LOSS (HL) ----------------------------- NICHOLSON, MARK CONFIDENTIAL Page 20 of 70 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 30 | 50 | 75 | 85 | 95 | 105+ | 100+ | 76 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 35 | 50 | 70 | 80 | 85 | 105+ | 100+ | 71 | +=======================================================================+ * The puretone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. ** The average of B, C, D, and E. *** CNT - Could Not Test b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 56% | |=============+=========| | LEFT EAR | 56% | +=======================+ e. Appropriateness of Use of Word Recognition Score (Maryland CNC word list): Right Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. Left Ear: Is Word Discrimination Score available? Yes NICHOLSON, MARK CONFIDENTIAL Page 21 of 70 Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. f. Audiologic Findings Summary of Immittance (Tympanometry) Findings: +=============================================================================+ | | RIGHT EAR | LEFT EAR | |=====================+===========================+===========================| | Acoustic immittance | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal | |=====================+===========================+===========================| | Ipsilateral | | | | Acoustic Reflexes | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal | |=====================+===========================+===========================| | Contralateral | | | | Acoustic Reflexes | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal | |=====================+===========================+===========================| | Unable to interpret | | | | reflexes due to | [ ] | [ ] | | artifact | | | |=====================+===========================+===========================| | Unable to obtain/ | | | | maintain seal | [X] | [X] | +=============================================================================+ 2. Diagnosis ------------ RIGHT EAR --------- [ ] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: NICHOLSON, MARK CONFIDENTIAL Page 22 of 70 [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3 [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: H90.3 [ ] Significant changes in hearing thresholds in service*** LEFT EAR -------- [ ] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3 [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: H90.3 [ ] Significant changes in hearing thresholds in service*** NOTES: * The Veteran may have hearing loss at a level that is not considered to be a disability for VA purposes. This can occur when the auditory thresholds are greater than 25 dB at one or more frequencies in the 500-4000 Hz range. ** The Veteran may have impaired hearing, but it does not meet the criteria to be considered a disability for VA purposes. For VA purposes, the diagnosis of hearing impairment is based upon testing at frequency ranges of 500, 1000, 2000, 3000, and 4000 Hz. If there is no HL in the 500-4000 Hz range, but there is HL above 4000 Hz, check this box. *** The Veteran may have a significant change in hearing threshold in service, but it does not meet the criteria to be considered a disability for VA purposes. (A signi ficant change in hearing threshold may indicate noise exposure or acoustic trauma.) 3. Etiology ----------- [X] Etiology opinion not indicated as: [X] Service connected condition [X] VBA did not request etiology 4. Functional impact of hearing loss ------------------------------------ NICHOLSON, MARK CONFIDENTIAL Page 23 of 70 Does the Veteran's hearing loss impact ordinary conditions of daily life, including ability to work: Yes If yes, describe impact in the Veteran's own words: DIFFICULTY HEARING 5. Remarks, if any, pertaining to hearing loss: ----------------------------------------------- PLEASE SEE PREVIOUS EVALUATIONS FOR FULL HISTORY. SECTION 2: TINNITUS -------------------- 1. Medical history ------------------ Does the Veteran report recurrent tinnitus: Yes Date and circumstances of onset of tinnitus: FROM 2.16.16 EVALUATION: "Vet describes a subjective, bilateral, constant tinnitus with an unsure onset." 2. Etiology of tinnitus ----------------------- [X] Etiology opinion not indicated as: [X] VBA did not request etiology 3. Functional impact of tinnitus -------------------------------- Does the Veteran's tinnitus impact ordinary conditions of daily life, including ability to work: No 4. Remarks, if any, pertaining to tinnitus:: -------------------------------------------- No response provided NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. /es/ Roberta Bass, Au.D. Audiologist Signed: 06/02/2016 08:24 Date/Time: 01 Jun 2016 @ 1400 Note Title: SNYDER,LEE Co-signed By: SNYDER,LEE Date/Time Signed: 16 Feb 2016 @ 1740 Note LOCAL TITLE: Audiology 10100 STANDARD TITLE: AUDIOLOGY NOTE DATE OF NOTE: FEB 16, 2016@17:33 ENTRY DATE: FEB 16, 2016@17:34:09 AUTHOR: SNYDER,LEE EXP COSIGNER: URGENCY: STATUS: COMPLETED *** Audiology 10100 Has ADDENDA *** NICHOLSON, MARK CONFIDENTIAL Page 18 of 30 Hearing Evaluation (60 mins) Nicholson, Mark, MALE, 572-31-9191 S: Vet came to the clinic for an audiometric re-evaluation of his known HL. The Vet identified himself by name and SS#. Vet describes a subjective, bilateral, constant tinnitus with an unsure onset. O: See Audiometric Evaluation in CPRS found in the Tools menu under Specialty Applications, under Audiogram Display. A: Audiologic evaluation was completed. Findings indicate: AD: Mild sloping to a severe HF SNHL. AS: Mild sloping to a severe HF SNHL. Physical Examination (Objective Findings): 1. Measured pure tone thresholds in decibels HL at the indicated frequencies (air conduction): Right Ear Left Ear A* 500 - 20 A* 500 - 35 B 1000 - 50 B 1000 - 50 C 2000 - 75 C 2000 - 70 D 3000 - 85 D 3000 - 80 E 4000 - 95 E 4000 - 85 **average 76 dB HL **average 71 dB HL * The pure tone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. **The average of B, C, D, and E. 2. Speech Audiometry Results: Speech Reception Thresholds were: 50 dBHL AD and 45 dBHL AS. Maryland CNC word recognition scores were: 56 % right ear 56 % left ear Comfortable listening levels were obtained. Bilateral BTE/RIC style hearing aids were ordered. Also ordered remote, ComPilot and remote Mic. P: Vet was counseled on test results, communication techniques and listening strategies. Vet to RTC for a hearing aid evaluation 3/14 @ 9:00 AM. /es/ Lee Snyder, MS Audiologist, Audiology Signed: 02/16/2016 17:40 NICHOLSON, MARK CONFIDENTIAL Page 19 of 30 02/19/2016 ADDENDUM STATUS: COMPLETED Hearing Aid Service S: Lt unit died while here for AE. P: Returned this unit to Mnfctr for repair. Holding EM in cupboard. call Vet or hold for appt. 3/14. /es/ Lee Snyder, MS Audiologist, Audiology Signed: 02/19/2016 14:32 03/03/2016 ADDENDUM STATUS: COMPLETED PT PICKED UP THE OLD/REPAIRED AID TODAY /es/ CAMPBELL,ANNEMARIE Signed: 03/03/2016 15:56 03/03/2016 ADDENDUM STATUS: COMPLETED Vet p/u repaired aid. /es/ DEBORAH M KUTZKEY Health Technician, Audiology Signed: 03/03/2016 15:59 Dat

Hello, I am currently SC and rated at 10% Tinnutis & 20% bilateral hearing loss. Below is an examination and a review of that examination. I am not sure how to interpret it? Thanks for any help reading it. Social Worker Signed: 06/03/2016 17:04 Date/Time: 02 Jun 2016 @ 0824 Note Title: C&P Audiology 13294 Location: No CA Healthcare Sys-Martinez Signed By: BASS,ROBERTA Co-signed By: BASS,ROBERTA Date/Time Signed: 02 Jun 2016 @ 0824 Note LOCAL TITLE: C&P Audiology 13294 STANDARD TITLE: AUDIOLOGY C & P MULTIPLE EXAM NOTE DATE OF NOTE: JUN 02, 2016@08:24:04 ENTRY DATE: JUN 02, 2016@08:24:04 AUTHOR: BA…ROBERTA EXP COSIGNER: URGENCY: STATUS: COMPLETED Hearing Loss and Tinnitus Disability Benefits Questionnaire Name of patient/Veteran m…..Xxxxxx 1234 Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- 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. Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) XXXXXX, MARK CONFIDENTIAL Page 18 of 44 [X] CPRS This exam is for: Hearing loss and/or tinnitus (audiologist or non-audiologist clinician, using audiology report of record that represents Veteran's current condition) If using audiology report of record, date audiology exam was performed: 2.16.16 SECTION 1: HEARING LOSS (HL) ----------------------------- 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 30 | 50 | 75 | 85 | 95 | 105+ | 100+ | 76 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 35 | 50 | 70 | 80 | 85 | 105+ | 100+ | 71 | +=======================================================================+ * The puretone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. ** The average of B, C, D, and E. *** CNT - Could Not Test b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 56% | |=============+=========| XXXXXX, xxxxxx CONFIDENTIAL Page 19 of 44 | LEFT EAR | 56% | +=======================+ e. Appropriateness of Use of Word Recognition Score (Maryland CNC word list): Right Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. Left Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. f. Audiologic Findings Summary of Immittance (Tympanometry) Findings: +=============================================================================+ | | RIGHT EAR | LEFT EAR | |=====================+===========================+===========================| | Acoustic immittance | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal | |=====================+===========================+===========================| | Ipsilateral | | | | Acoustic Reflexes | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal | |=====================+===========================+===========================| | Contralateral | | | | Acoustic Reflexes | [ ] Normal [ ] Abnormal | [ ] Normal [ ] Abnormal | |=====================+===========================+===========================| | Unable to interpret | | | | reflexes due to | [ ] | [ ] | | artifact | | | |=====================+===========================+===========================| | Unable to obtain/ | | | | maintain seal | [X] | [X] | XXXXXX, MARK CONFIDENTIAL Page 20 of 44 +=============================================================================+ 2. Diagnosis ------------ RIGHT EAR --------- [ ] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3 [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: H90.3 [ ] Significant changes in hearing thresholds in service*** LEFT EAR -------- [ ] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3 [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: H90.3 [ ] Significant changes in hearing thresholds in service*** NOTES: * The Veteran may have hearing loss at a level that is not considered to be a disability for VA purposes. This can occur when the auditory thresholds are greater than 25 dB at one or more frequencies in the 500-4000 Hz range. ** The Veteran may have impaired hearing, but it does not meet the criteria to be considered a disability for VA purposes. For VA purposes, the diagnosis of hearing impairment is based upon testing at frequency ranges of 500, 1000, 2000, 3000, and 4000 Hz. If there is no HL in the 500-4000 Hz range, but there is HL above 4000 Hz, check this box. *** The Veteran may have a significant change in hearing threshold in service, but it does not meet the criteria to be considered a disability for VA purposes. (A signi ficant change in hearing threshold may indicate XXXXXXX, MARK CONFIDENTIAL Page 21 of 44 noise exposure or acoustic trauma.) 3. Etiology ----------- [X] Etiology opinion not indicated as: [X] Service connected condition [X] VBA did not request etiology 4. Functional impact of hearing loss ------------------------------------ Does the Veteran's hearing loss impact ordinary conditions of daily life, including ability to work: Yes If yes, describe impact in the Veteran's own words: DIFFICULTY HEARING 5. Remarks, if any, pertaining to hearing loss: ----------------------------------------------- PLEASE SEE PREVIOUS EVALUATIONS FOR FULL HISTORY. SECTION 2: TINNITUS -------------------- 1. Medical history ------------------ Does the Veteran report recurrent tinnitus: Yes Date and circumstances of onset of tinnitus: FROM 2.16.16 EVALUATION: "Vet describes a subjective, bilateral, constant tinnitus with an unsure onset." 2. Etiology of tinnitus ----------------------- [X] Etiology opinion not indicated as: [X] VBA did not request etiology 3. Functional impact of tinnitus -------------------------------- Does the Veteran's tinnitus impact ordinary conditions of daily life, including ability to work: No 4. Remarks, if any, pertaining to tinnitus:: -------------------------------------------- No response provided NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. NIC…., MARK CONFIDENTIAL Page 22 of 44

Thank you for those kind words. Do you think I should fill out a victim impact statement and upload it to my claim? Or was this a state document fir the rape? If so, where would I get one electronically? Thank you again, I still have four more weeks of Prolonged Exposure therapy. Mark

Good morning everyone, I the civil law practice, the defendant and plaintiff are required to share evidence that they plan to uses supporting or not supporting an outcome. Is this something that is done with respect to working on a claim for service connection with teh VA? Can I request the information that they have received, since I have provided them everything that I have receive? Just curious. Mark

I have submitted a claim for PTSD-MST back in November of last year. Should I also claim SMC-K for ED now or wait until the original PTSD gets decided and rated (if any) I have been prescribed Viagra for ED for many of the years I have been service connected with my hearing loss. However in my records it just says its for ED Do I need to speak to my VA doctor to see if they believe it is the result of me getting raped in the army. I also took Viagra as a civilian post military, but I could not afford it as it is extremely expensive. The medicins I now take for PTSD make it absolutely and completely impossible to have sexual relations with my wife or even myself. It doesnot work at all any more... :( Lexipro 20mg - Mood maximum amount Thorazine 25 mg 2 X per day PANIC ATTACKS OMG this stuff helps Prasosine 1 or 2 MG nightmares / sleep Trazadone 50 mg nightmares / sleep Ambien 10MG Sleep (after I wake up at midnight) Simvastatin 20 MG High Cholesterol (I am not heavy and used to be athletic) , but have high Cholesterol and strange blood pressure 150/119 is common, so is 90/60 depending om my anxiety. On last thing, what is the difference between a hand written, signed and dated statement form my mother, father and sister vs a SWORN statement? Thanks

Thank you for your message and I appreciate you and\d everyone one else on this forum. As I mentioned before, if it were not for TBird, I would likely be just a memory. You had mentioned a eating disorder, can you tell me about that? I do not have a eating or OCD disorder, however I do weigh myself at least three time per day in order to stay withing a two pound target weight. I am 56 years old and athletic, 5'11" and I remain at and feel good at 162 - 164 (age and gender factored BMI 22.7). I would feel better about myself if I would move that window to to 158 - 160, but doing so causes me to be excessively preoccupied about everything I drink and eat, to the point it effects others. But in a perfect world, 155lbs (age and gender factored BMI 21.6) would be the exact - perfect weight I would want to be every single day for the rest of my life. I was nearly at my perfect world weight of 155 at the end of my seven day inpatient BH-ICU stay due largely to the not so good "hospital chow". However, when I was released I ballooned up to 164 almost instantly....kind of a buzz kill. Anyway, please tell me more about your eating disorder> Thanks Mark

Vync, As usual, you have provided me the exact information I needed. Also, my VSO has submitted an application for temporary compensation based on unemployability. I am not sure if I qualify though? However, my VA psychiatrist has filled out the state of Ca. SDI forms for severe mental illness (she did not say military sexual truama on this form, but is is most certainly in her weekly treatment forms that I can see on Blue Button download). Ive been off work for this condition since 1/6/2016, and saw a VA regulation somewhere that if my non-service related unemployable is related to MST, that I may possibly qualify for Temp 100% thru the VA? What do you think? Thank you very much.... Mark Nicholson Former Army, Combat Medic - 1983-1986 1/94 FA MLRS C-BTY, Federal Republic of Germany

I was recently an inpatient a VA medical center BH-ICU lock down unit for Suicidal Ideation with multiple actionable plans and means to complete. Based on my non service connected (yet) but currently VA treated PTSD- Military Sexual Trauma for 7 full days. During this inpatient visit, I was given at least 6 individual pills per, day ranging from panic, sleep, mood, more different panic, different sleep ect..ect... each day until they found the best fit for me. Currently I am service connected for 20% hearing loss & 10% tinnitus = 30%. That makes me a a priority group 2 and I pay $8.00 per prescription (from 30 day supply down to 1 pill). $ 8 bucks. Pretty simple. Based on my inpatient BH-ICU stay, that would total up to (6pills per day $8 each = $56 cost per day X 7 Days = $392). I have not worked since Jan 4th 2016 and am burning thru my savings and retirement money to support my family of four. Since getting VA treatment for PTSD-MTS in November of last year 2015 and filing a claim shortly afterwards with a VSO, I have paid for all of my medical co-pays at $8 which were significant but nothing like the 7 day inpatient amount will be. However, I did see this article on a VA website: Basic Business Rule No extended care copayment when income is below pension single rate threshold. *Copayment Free Care and Medication for treatment of Service-Connected (SC) disabilities, SC 50% or more, former POWs, Catastrophically Disabled Veterans, VA pensioners, and those under Special Authorities (e.g. PG 6, military sexual trauma, nasopharyngeal radium irradiation) Since getting treatment for PTSD-MTS in November of last year 2015 and filing a claim shortly afterwards with a VSO, I have paid for all of my medical co-pays and am waiting for the big bill from inpatient medications & maybe hospital care as well? What is my best option at this point...... I am a wreck emotionally and am having trouble sorting thru thius mess? I am grateful for the care I get and the support of the forum members. Especially TBird.Mark Combat Medic 1983-1986 30 Hearing loss SC PTSD-MTS pending VA RO

Navy4Life, Tomorrow when I get caught up on some finances, I will answer you message. TBird, You know how I feel. I consider everyone on Hadit.com important and a friend in some way or another. Bye Mark

Hello everyone, First of all, I wanted to thank everyone for the great advice and comments. But most importantly, I wanted to mention a life saving chat session I had with "TBird" on this website early this month. I chatted with TBird at a time of "extreme crisis" I was having. She made me feel comfortable, calmed me down, chatted with me about my needs and then provided me with both the VA Crisis Line chat URL and phone number. We chatted for quite a while, but she encouraged me to contact the Crisis people right away. Minutes after my online chat with TBird, I online chatted with the VA Crisis people for about ten or twenty minutes. They asked for my phone number which provided and the chat person stayed online with me until I was I immediately called on my cell phone by a Crisis line operator. After a about five minutes of discussion, I was asked if wanted to be transported by a family member, an ambulance, police car, VA shuttle or any other means to the Mather Hospital BH-ICU unit, located in Sacramento California. I remember her name as Susan and she asked to speak with my wife after I woke her up, to confirm I had transportation. She explained that it was imperative that I see someone as soon as possible and that she would call in fifteen minutes to ensure I was on my way. She did in fact call as me and my wife were leaving the house. I called Dr. Seeger at my local VA ti make sure she concurred with this treatment plan... which she immediately said yes....go right away. After reaching Mather VA hospital, I was immediately admitted to the BH-ICU (Behavioral Health ICU - Lock Down unit) for extreme PTSD-MTS with a friendly police escort. I received round the clock EXPERT CARE for seven full days. After six days I wrote and submitted a development plan for myself which asked for permission to return home which was approved after multiple interviews and meetings. I just returned home about six hours ago, listed as high risk PTSD, however low risk S, I now which was not the certainly not the case when admitted. The VA BH-ICU doctors have submitted applications for me to go to long term specific PTSD-MST facilities in Virginia, Kentucky, Denver and several other out of state programs for long term care. With treatment duration's ranging from thirty days to six months, depending on progress. The VA will also be flying me to and from the treatment center ultimately chosen which should happen in about two weeks. I am so tired right now,m but I wanted to mention a few things that need to be said. #1) TBird, thank you...you saved my life. #2) Crisis Line Chat and Live, you saved my life. #3) BH-ICU Mather California Staff -everyone-), you saved my life with incredible psychiatric treatment, very frequent group and one on one meetings. Also the organized ongoing out of state treatment to fix this thirty year problem I have suffered with. Dr. Salter, Dr. Summers: You are extraordinary by any measure. OMG, what else can a person as for? #4) My Local VA BH department, for consistently awesome support, treatment, medication, direct contact numbers and weekly guidance. Another life saving #5) Hadit.com Admins and users, thank you for your support and kind messages. I have missed you all. #6) Lastly, the Inpatient Vets I met in the BH-ICU which many still remained for further expert treatment. Those courageous men and women provided me with many important things. Tears, laughs, hugs, handshakes, card games, even musical entertainment. You name it....we shared and experienced it together. I will NEVER EVER forget this time in my life or the fine dedicated people I met. Thank you Soldiers, Airmen and Marines! I gotta go to bed now, I'm bushed. :) Respectfully Mark Nicholson PS, sorry for the bad spelling and grammar, its been a tough but very productive week.

I am waiting on a phone call right now... Thank you Tbird