Jay Johnson

Well, keep in mind that what constitutes "new and material" evidence is very subjective from the VA's view point. I think folks with multiple rated problems have a much higher chance of being called in for a C&P after being found P&T because the VA can poke through medical records and/or use an appointment for something rated only 20% to justify opening a claim on a more severe, and permanent, 100% disorder. In my wife's case, when I pressed this issue because they reopened her P&T PTSD case, they said that they had new and material evidence because I sent in a letter from her primary care doc stating that she could handle her own finances (to get her off of that god-awful fiduciary program)....the letter stated ONLY that the doctor asked her questions regarding her finances and that she seemed capable of handling them (I made the doctor be VERY specific not to mention a single word about her PTSD). But, the VA had "something" and, therefore, covered their butts, but only AFTER I had complained about them rerating a P&T case did they mention this evidence (after we got the new rating). Perhaps the letter got their attention, but it certainly wasn't their real basis for lowering her and, eventually, sending her to another C&P. So, now I don't go within 10 miles of a VA facility. I pay for her psychiatrist out of pocket (because tricare sucks) and she will never talk to another VA employee again for the rest of her life. If they want "new and material evidence" they better get a subpoena:-) P.S. - The info was in regards to senate hearings about IU. I actually got the info from someone who had posted it to hadit awhile back (and used it in my CUE at the time). Here's the post(s) - http://www.hadit.com/forums/index.php?showtopic=1869&hl=

The VA should not be calling any veteran in that is P&T without new and material evidence to warrant it. It says so clearly in the regs, it's been handed down that way by the BVA over and over and the VA's top brass has made it clear in senate hearings. The only reason a P&T vet should be called in is if there is some reason to do so. If they do so, you need to fight it and get a senator involved...not only is it the regulation, but it's just common sense; if the medical evidence says that you are permanently disabled that doesn't mean you are permanently disabled but may get better. It means PERMANENT! Don't let them fool you with this nonsense...if they send you for a C&P for a P&T condition CUE it immediately and send them the reg saying they can't....if need be I'll dig up the senate notes in which several top VA folks said no future exams for P&T vets....this is a clear black and white issue!

I didn't get it either, but what can ya do:-)

My wife's C&P history: 1) Initial rating of 100% about two months after medical separation from the military (AmVets "fast track" program)....no C&P was given; they went off of civilian and military records. 2) She was increased from 100% to 100% P&T with A&A on a 15 min exam. 3) They lowered her from 100% to 70% because they "reviewed" her Cfile when she moved to a different RO.....they eventually gave her a 20 min C&P and was awarded 100% P&T with homebound. Now, all of those C&Ps came with a substantial body of evidence on my part from civilian doctors, but the C&P doctors were compeletely unaware of what was in her C-file. The last one even told me to be quiet or leave and that she, "didn't care about what other doctors said". I agree with John here...the process is compeletely subjective and totally without merit.

Sledge, My uncle was killed by the VA and the VA readily admitted it. He went to a VA hospital in the Chicago area and, during a surgery, they knicked his intestine and didn't notice. He developed severe infection as a result and had to have the majority of his intestines removed once they figured out the mistake. He lived through hell for the next few years (on a feeding tube in horrible pain) and eventually died because of the damage the infection caused to his descending aorta. Despite the VA admitting they caused the problem AND having documented proof of that fact, his family lost his tort claim against the VA. Tort is designed not to be won, so lawyers tend not to want to take them...the whole point of a tort is to NOT allow anyone to sew the government for the actions of individual screw-ups in the VA, or any other governmental branch. I wish you luck, but no tort claim is remotely close to a slam dunk unfortunately... even when the VA admitts it's their fault:-(

It probably did; just as a broken (or missing) arm, foot, etc. can lead to arthritis later in life. PTSD may prep your brain for other afflictions, but that's doesn't mean they are the same disorders. People with physical disorders get secondary diagnosis and compensation all the time, so why don't PTSD vets?

Good luck sledge...finding a good lawyer who will take a tort claim is like finding a needle in a haystack:-)

This is incorrect and I would ask you to talk to ANY civilian psychiatrist on this topic to get their opinion. This is more evidence that the VA is hoping that the average veteran doesn't understand how psychiatry works. There's a few things one needs to understand about basic psychology before making these types of statements: 1) Problems like major depression and PTSD are NOT related; they're not even under the same category of diagnosis. The categories are as follows: A) Anxiety disorders - GAD, panic disorder, phobias, agoraphobia, OCD, PTSD, etc. Mood disorders - Major depression, bipolar, etc. C) Schizophrenia - Although categorized separately, many issues with hallucinations fall into this category. D) Dissociative disorders - DID E) Personality disorders - APD, BPD, etc. F) Other - Substance abuse and disorders not covered by the aforementioned. 2) Just because PTSD falls under the "anxiety" category doesn't mean that you cannot have another anxiety issue separate from PTSD. Many individuals with PTSD suffer from OCD, which is not linked to any type of stressor, but seems to manifest itself when the brain is damaged in some way from some other psychological problem...they are NOT linked. The VA's standard on this are completely insane and extremely bias. To say that a veteran with PTSD shouldn't have their major depression evaluated is nonsense....those two problems are completely opposite of one-another in how they work inside of our brains. The chemical process that causes anxiety (which *IS* PTSD) has nothing to do with the process by which hallucinations occur (dopamine issues). This would be like the VA saying to a veteran, "well you're rated for arthritis in your shoulder, so we can't give you arthritis in your knee, because you already have a diagnosis of arthritis".....that would cause a big issue if done that way I'm sure. It is flat wrong for the VA to require "total occupational AND total social impairment" to award 100% for PTSD alone....many 100% vet who are physically disabled have neither total social impairment, nor total occupational impairment. This is a blatant double standard as is trying to lump completely separate medical conditions into one all-encompassing super condition, to which no other medical professional on earth would agree with outside of the VA. P.S. - Major depression (mood disorder) is an issue dealing with serotonin in the brain (and other neurotransmitters). PTSD, an anxiety disorder, is treated with gamma-aminobutyric acid (GABA) increasing drugs such as xanax, valium, etc.....these lower the crisis responses in the brain (fight or flight) which are linked to anxiety/panic attacks. The ONLY difference between PTSD and generalized anxiety disorder (GAD) is that PTSD has a specific stressor and/or trigger...they are both merely anxiety disorders that the VA has twisted into some sort of super-disorder which simply does NOT exist.

By the way, 100% PTSD is rare, because the VA has ridiculous standards. Vike is right in that one must be practically institutionalized in order to qualify for that rating, which is blatant discrimination against vets with mental disabilities. A physically disabled vet can be 100% disabled while living a, relatively, normal life.

GAF is one's "overall" symtpoms and speaks directly to social and occupational impairment. It is also a method used around the world by the most respected psychiatrists on the planet. In short, it is *the* standard for psychological evaluations, but the VA likes to ignore it because psychiatrists tend to call it the way they see it. ALL of the symtpoms listed are conducive of a GAF below 40 and 25-31 sounds dead on by DSM standards (according to the symptoms you've listed).

I've said for quite some time that the VA should lock veterans into their highest rating (held for a period of time..say 1yr+) for PTSD regardless of any change. But, this "locked" compensation should be defered by any money the veteran is able to make while employed. Basically, if a 100% veteran finds that they are, after much treatment/time, able to hold a low-stress, low-pay job than that veteran will receive his current 100% compensation less any money earned through work. In other words, if compensation = $2500/mnth and he/she is able to make $1600/mnth, said veteran would then receive $900/mnth from the VA instead of the full $2500, but if said veteran should lose employment, at any time, he/she would automatically receive the full compensation amount again. This allows the veterans to "attempt" employment under very low stress conditions and accounts for relapses. It saves the VA money and helps the veteran in the recovery process. To be honest, I think a lot of IU and 100% vets would jump on this program and the current system actually works to keep those veterans reclusive. As for the GAF thing - I find it ironic that they say, on one hand, that a GAF is innacurate, yet, on the other hand, they say they need some sort of system that puts together the various symptoms that tend to go along with PTSD (which is what GAF is precisely for). The reason they want to do away with GAF is because it deals directly with VA ratings criteria and the VA has a tough time ignoring it (though they do and often). Essentially, a GAF is EXACTLY how the VA currently rates mental disorders...it's a numerical system that highlights occupational and social functioning (overall). So, a GAF of, say, 40 means, quite literally, total occupational impairment with severe social impairment....under current VA rating's criteria that should qualify as a 100% rating (or, at worst 70%+ IU), yet many veterans get far lower ratings based on that GAF. I also find it laughable that the VA thinks it can supersede the entire medical community and develop a system better than all of the greatest mind in psychology's history have developed to date. This part of the report can only end badly in my opinion.....

Funny, from the director of the Seattle RO, "The VA has been a bit liberal, of late, in granting 100% for PTSD and many 100% ratings should be 70% or lower." (in response to why they attempted to lower my wife from 100% to 70%). Furthermore, a friend of mine in the Oregon RO (schedules and works with BVA for that RO...or did, until he retired a few years ago) had told me, "with all of the vets coming back from iraq, the ROs are cracking down on PTSD cases". To boot, we have an independent commission which, in effect, said that the VA is not properly rating PTSD cases. On top of that, the VA's own regs, on this matter, are clearly being violated here and in most cases. Stop apologizing for them. As a side note - What enables the VA to low-ball PTSD claims (aside from vets working against vets) is that PTSD is episodic in nature. Now, the VA is "supposed" to take the veteran's low points and assess how often those low points occur; instead, they cherry pick the high points and use it as a basis to brow beat the veteran into a lower claim. I've seen this happen in almost every PTSD claim I've ever seen, including my wife's. It's a horrible, inhuman tactic with the expressed purpose of low-balling veteran's with PTSD. John’s opinion on this is exactly the problem stated above and shows just how much we’ve allowed the VA to beat PTSD vets down. Just because a veteran can do yard work (or any other periodic work, including seasonal paid work) is NOT a basis for a lower rating. PTSD is fraught with highs and lows and most PTSD vets are able to do such things from time to time. The VA “should” be looking into how often the vet relapses into severe depression/anxiety/etc and THEN figure out whether reasonable employment is likely. A veteran that relapses even once every 6 month is NOT going to be able to maintain gainful employment….no employer is going to let an employee take a week or two off every 6 months because they’re anxious/depressed/angry etc. Anything under a 40 GAF is total occupational disability by DSM standards, which should qualify any veteran for IU, but the VA often ignores GAF scores and/or takes only the highest GAF on record into account. This is a blatant, and intentional, disregard for a veteran’s condition and no psychiatrist on the planet would think otherwise. P.S. – My current psych professor used to work for the VA. He quit to teach because he was, “sick of working for them….there was constant pressure to word things in ways to keep claims low and they would often ask me for opinions about patients that I’ve never seen, nor had any business diagnosing……..they just wanted my signature in order to deny a claim”. I’m sure this isn’t the case in every RO, but it happens and happens often (this guy worked in two separate ROs in his time working for the VA).

Vasolas, Couple things here: 1) Unless I'm reading you wrong, you're primary evidence is from a "psychologist" and NOT a "psychiatrist"? If so, the RO will give this little to no weight regardless of how many opinions that doctor sends in. You need a psychiatrist to make that diagnosis (especially if using an IMO). 2) The VA is getting killed with PTSD claims and they are discriminating against PTSD vets imo. They attempted to lower my wife from 100% to 70% with a 10GAF, but we appealed and won. So, it sounds like you have a solid claim for 100%, but you're applying in a time when I think the ROs are being pressured into not paying out what they should. But, as the recent independent report on PTSD showed, there is blatant discrimination against vets with mental disorders....lose an arm or leg in the military and your claim is golden...you can be 100%+ and work and live a great life......ruin your most vital organ and they put you through hell, call you a liar and low-ball claim after claim all while you live a horrible life in which you can't work, can't be social and often become separated from friends/family. Appeal the claim and don't stop until you get that 100%...if anything, from the sound of your symptoms/diagnosis, you should be 100% + homebound. Good luck.

Hurry, I'm sorry my friend, but I'm done posting here again. These places always have their handful of members that run rough-shot over anyone who dares question their methods and I really don't care to deal with that nonsense. I wish you the best in your case and please feel free to email me directly at jay_1699@hotmail.com. P.S. - Please don't listen to anyone who tells you that you "have no claim" or "shouldn't file". They are haters and VA apologizers and they don't have veteran's best interests at heart. G'luck, Jason To Tbird, Vike is popular here and I know how the popularity game works, so feel free to ban the account. Thanks from trying to provide a good forum for veterans and god speed. - Jason

At first, I thought you were just a bit overly presumptuous in your opinions, but now it's clear that you have issues with being questioned; just as many in the VA do , as well as, many SOs. I resend my former adulations to you, as you are nothing more than a stubborn know-it-all. It's folks like you that tried to tell my wife that she couldn't have A&A...you're so full of yourself, and hateful towards those whom would question you, that you would actually tell a veteran not to make a claim based on your loose interpretation of a law to which you really have no concrete knowledge about (nor do I or, I'm guessing, anyone else here). By the way, who the heck cares whether or not the VA is backed up? How horrible of an excuse is that? I don't care if they are backed up for the next 1000 years; a veteran should use EVERY opportunity to get what he/she DESERVES. The politicians need to hire more people to lower the case load; that's not a disabled veteran's responsibility. I won a few cases on PTSD and was the first person to get A&A for PTSD in the Philadelphia RO, so, by your logic, that makes me an expert on all things PTSD and A&A, right? I’m speechless…..

100% SC means the VA is paying him for a disability caused, or exaggerated, by his military service. As for A&A - It really depends on what his problems are, but the long and short of it is that he needs the assistance of another person in order to function. There's lots of thing that make up "assistance" though. Bathing, feeding oneself, etc are more obvious ones, but there's other things like having a spouse administer medications via a doctor's supervision. I would suggest looking up the regs Berta listed and talk to the VA in his area. You may even want to contact someone like amvets (service organization) for some help, being that you're so new to the process. Good luck.

Vike, I must applaud your work for veterans over the last couple of decades; regardless of my disagreeing with you, we're still on the same side. Don't forget that. As for the particulars - The VA is MUCH like the military command structure; when it works, it works well, but when there's ONE bad apple, it can cause havoc to hundreds/thousands of veterans. As I stated in the other thread, if you were to take a claim and give it to every RO in the country I guarantee you would get dozens of different ratings. Whether it is bias on the rater's part, ignorance via lack of proper education on the law, or willful malice doesn't really matter; it all has the same net effect. But I digress... As for my wife's claim - she would have been handled the same in most places, because the VA doesn't deal well with stuff that is out of the ordinary, which leads me to why I'm upset with your statements on this matter: It's one thing to say, "your claim is weak in my opinion"; it's all together different to say that, "your claim isn't a CUE". One gives an honest opinion based on, what appears, to be a substantial knowledge base. The latter is dissuading a veteran from filing a claim which I think is a horrible thing to do. CUE is anything but black and white and not even the VA knows how to properly apply it in most cases, so it is wise for anyone to at least attempt it to see what they get. In this particular case, the veteran's doctor *may* have made a diagnosis that "no reasonable mind" would agree with.....it's one thing to use discretion; it's another to say that a veteran isn't missing an arm that is clearly missing an arm. To claim that a condition is "congenital" there has to be some basis for such an opinion. The problem, in this case, is that we don't know, for sure, what that doctor based that decision off of, nor do we know, as the veteran has stated, whether or not there was clear evidence to the contrary. Also, who cares whether or not a given claim has never been won before? The BVA sets precedent all the time and any case can be a precedent setting case, so never, ever discourage a veteran from pursuing ALL angles available to them. The worst the VA can say is NO, which is no worse than not filing at all. I don't mean to be rude in any way, but several of the SOs I spoke to about my wife's case had decades of experience (which they threw in my face) and had done hundreds of PTSD related cases; yet they all told me that I was crazy for filing for A&A. The guy I called at the RO in philly had gone so far as to start yelling at me and said my wife was a "greedy whore". Now, does that mean that everyone working for the VA is bad? Heck no, not by a long shot. But a lot of one's experience in the VA depends on your knowledge of the system and who you get on your side during your trip through said system. A few years ago, I was able to reach the head of psychology for the VA in Maryland (head of psych in the state) about my wife's problems, at that time, with suicidal ideology and that doctor made one phone call to Perry Point and they sent an ambulance (3 hrs) to get her, gave her presidential treatment and brought in special psychs JUST for her from 2-3hrs away. Would the same thing have happened had she just walked in? I don't know; but the VA CAN be quite good when properly motivated and/or when you meet "good" people. As for CUE in general - It's not pointless to file a CUE during appeals because it puts another set of eyes on your claim (handled by different people at the RO) and the more people you can poke and prod the better. Also, CUE is a very grey area; the only thing we know, for sure, is that a CUE claim must be based on LAW, not opinion (though some opinions and laws mix, which is why CUE is so grey). I will summarize what the director at the Seattle RO told me when I asked about CUE. He said, "A CUE is a matter of law; nothing more. If you want to file CUE for your wife you should". He went on to say that CUE was handled in a different department and was completely separate from her appeal. When I talked to the folks on "team 1" they said that anything that violates VA regulations is considered a CUE, but CUEs are very hard to prove and need to be very specific. The above information, coupled with the regs on CUE, BVA decision, etc. have lead me to believe that FAR more is CUEable than what many believe. That doesn't mean you'll win your CUE, but it's far broader then many people realize. The problem is that there isn't a lot of precedent on the issue because many vets are discouraged from submitting CUEs. Personally, I would tell EVERY vet that gets a negative rating to CUE their claims (along with appeals) if there's even something remotely resembling a broken regulation. This will help establish more precedent on the matter and give clearer regs on CUEs in general. There’s simply NO reason for them not to. So, if your opinion is that his CUE claim would be a tough sell, so be it, but don’t tell him he doesn’t have a CUE when the VA cannot even properly assess what is and isn’t CUE. Try rereading those things you posted and think about them a bit further….if CUE is a violation of a regulation, than just about anything the VA does falls under those guidelines. If not, why have regulations in the first place? Did congress make those laws as loose guidelines for raters to interpret as they see fit? I’m thinking not so much….. But, all of this is irrelevant; the only thing that matters is that this veteran *should* have gotten a SC 34 years ago and, for whatever reason, did not. Whether or not it was the RO’s fault really doesn’t matter…this veteran feels it was and he deserves our support. He needs to get his C-file and see what, exactly, was said and why and what information the RO had and when…neither of us should be telling him he doesn’t have a CUE claim without those very vital facts.

It really depends on your definition of "cure". One can get their symptoms to a point in which they have little or no impact on their lives, so I guess you could call that a cure; however, they typically still have nightmares, anxiety and other symptoms, but they've learned to control them better. The problem with throwing around "cure" (and I don't mean this against you in any way..more of a VA tactic) is that it makes one think that the affliction is entirely gone. What I've noticed, even in the most improved of people with PTSD, is that any gains are largely dependent on their surroundings. A vet may be able to live a somewhat normal life, after being 100% PTSD, but that life usually doesn't include work (or, at least, the dependency of work). Once you place that veteran, or anyone else with PTSD, back into a high stress situation there's a fairly high chance for a relapse. As for xanax - My wife just started on xanax about 8 months ago and has done quite well. She's on the slow release kind (1mg x4 day) and it seems to keep her more "even" than any other anxiety med she's tried (and she's tried them all). Also, it doesn't make her tired, which was a common side effect of previous drugs. Right now, she's on a combo of Xanax, Lexapro and Serequil with ativan as a PRN med. This combination seems to be the most effective to date, which is great. By the way, I'm not a huge fan of psych docs either; despite wanting to go into the field. If anything, the lack of good, caring psychs is WHY I want to learn more and pursue the field. The problem, as I see it, is that those docs feel a need to "make you better" and psychology simply doesn't work like that. They often set goals that are too high and down-play serious symptoms. One of the better psychologists that my wife saw was in a VA hospital. They brought the psych in JUST for her from a city about 1 hr away (Baltimore). The psych specialized in sexual trauma and was quite candid with her. Rather than do the typical "we'll get you all better" nonsense, she told my wife that we should "shoot" for getting 10% better and ultimately hope for a slight increase in quality of life. There was no push for her to work, or rejoin society immediately. It was the first time my wife said, "someone finally understands".

Vike, So, this is why I stopped posting here. Neither you, nor myself, are experts on this matter. We do not have degrees in VA litigation, nor do we have any knowledge that would grant us an absolute monopoly on this, or any other, VA matter. In your write up you say a claim must have exhausted all appeals to be CUEd....this is FALSE. A CUE calls for a claim to be "final" not "finally adjudicated" (there's a BIG difference). The RO accepts CUEs while a claim is STILL in appeals for god's sake. Now, this isn't to say that a CUE isn't a tricky beast; it is. But, in short, it is nothing more than an argument of law and law can be anything pertaining to title 38. If anything, the laws on CUE are still being written as we speak, because I'm not even sure the VA properly understands how to use it at this point and I'm willing to bet that CUE, 10 years from now, will be much different than it is today. I can't help but remember the last vet's forum I was on (and booted from). I got into a nice long debate with the board admin over whether or not my wife should apply for A&A with, only, PTSD and he, and several others, proceeded to brow beat me and ban my ISP for even claiming such a ridiculous notion....my wife was granted A&A for P&T 1 month later. This was against the "all knowing" internet veteran guy's opinion...it was against EVERY vet agency in the state of Delaware's opinion....it was AGAINST the advice of the folks I spoke to at the 800#...it was against EVERYONE I had ever spoken to that ever had anything to do with the VA. Yet, I had a 1994 BVA decision saying a veteran could, indeed, get A&A for PTSD with the spouse being the primary caretaker (which I attached to my claim). So, just because someone says something here, or anywhere else, doesn't make it so. I have gone over CUE myself before on this forum and even highlighted the regs pertaining to "final" and "finally adjudicated (to which it doesn't say anywhere in the CUE information I've seen), yet I was beaten by those here last time and told I was wrong; despite the RO telling me to file CUE while the claim was still in appeals (and this was the acting DIRECTOR of the Seattle RO, not some nobody who answers phones). Voice your opinion on the matter and state your point...god knows you seem very knowledgeable on this, and many other topics, but that does not give you license to supersede my opinions, nor act as the final authority on this topic. Best of luck to you, - Jason

I'm sorry to hear that Josephine:-( I think another big problem with the VA is accountability. They break their regs ALL the time at the RO level and, to be honest, I think they knowingly do so some of the time. They violate these regs to justify lower claims, which take years to appeal and when the veteran wins the case (as they should when the BVA properly uses the regs) NOTHING is done to the original RO who clearly violated those statutes. How many times have we heard a veteran say they have 3 doctors saying they are 100% disabled, but the RO uses the ONE descending voice (typically the MD the RO set up for a quick C&P) in order to lowball the claim....how is this not a direct violation of reasonable doubt? By VA law if one sees 4 equally qualified doctors and two say the veteran is 100% and two say the veteran is 70%, the RO should give the benefit of the doubt in favor of the claimant and award the 100%, but they don't; time and time again. As with the gentleman who had his rating dropped recently (in another thread) JUST because the RO opened his case (without new evidence) and let some doctor "review" it without even seeing the veteran....this should be criminal, but they will get away with it and, as a result, they will do it again and again and again, because our VA representatives have failed us miserably and are scared to stand up to these people and call them for what they are; criminals. VA law *IS* the law...they are laws mandated by the congress of this great country and I am dumbfounded that someone can knowingly ignore a direct mandate from congress and not even get a slap on the hand. Until we hold them accountable, cases will be mismanaged and the process will depend on whether, or not, you get a good, honest reviewer; NOT the merits of your case.

Not really much else to say, but if you want to discuss something you can email me at jay_1699@hotmail.com. But, this wasn't off topic, so I don't see why we couldn't discuss it here. You cited a study on PTSD and so I gave some medical background on PTSD in order to debunk it. "Research" in the field of psychology is limited at best, so it's better to educate oneself on what, exactly, PTSD is to better weed through what can often be very misleading evidence on psychological disorders. And just to give you a reference point on why this type of research is sketchy at best: A "good" experiment typically involves what researchers call a "representative sample" of people. This sample is anywhere from 100 to a couple thousand strong and typically comes from a single community. Now, ask yourself this - If you were to ask 500 wealthy people from San Francisco a given question, do you think they would "represent" 500 poor people from a predominantly black neighborhood in Alabama? Not a chance! And this is in the same country.....think about asking a sample of Americans as compared to Iranians, Chinese, tribal Africa, etc.. Right off the bat I would question how this study you're talking about came to determine the IQ of its representative sample...do you know that some researchers believe there are several forms of IQ? How do hormones relate to sex characteristics? Are the results the same for females and males? Are the more intelligent service members just more likely to report their PTSD, or do they actually get PTSD more often; how could you even measure that if the lower IQ members aren't reporting their symptoms honestly? Was this research done using self-reporting statements (which many are and they are useless imo), or did they actually do field or clinical studies? The point is that most studies are overly generalized, yet try to make specific claims and, from the sound of it, this is one of those pieces of research. This is not uncommon at all by the way....how much do we here on TV that obesity causes diabetes, heart disease, etc? Now, even a basic knowledge of physiology tells us that obesity has NOTHING to do with heart disease, diabetes, or any other disease...it is simply the act of taking in more calories than the body burns, thus depositing fat stores. However, how one becomes obese CAN **contribute** to various diseases (IE - if you got fat eating sugary donuts, you have an increased risk for diabetes), but, even in this case, it does NOT cause disease as many lead us to believe. So, having that basic knowledge of anatomy allows one to sift through the nonsense in order to get a real idea of how to eat healthy....this is why I listed the PTSD stuff; so people can look at a study and think, "this doesn't seem to make sense...it's overly generalized". But, if it's emails you want, so be it:-)

Vike, You say accuracy is not CUE, but that's just not true in this case. CUEs are won all the time when doctors misdiagnose someone or grossly misinterpret the facts in the case. To establish his disorder as congenital (as per my research on his affliction) would mean that the doctor would HAVE to find some sort of boney malformation that was present BEFORE service. This is IMPOSSIBLE to do after the fact. His diagnosis is a very common one and is, essentially, just fancy terminology for a "slipped disc", which is caused 99.9999999% of the time by physical stress on the lower back. Also, a malformation in the back (congenital defect) cannot, in and of itself, cause an injury. Some sort of triggering event must accompany it in order to cause the slippage of the disc. Age related issues can cause the injury, but that is associated with the elderly and decalcification of the bones later in life....a healthy 20something year old should not have discs slipping "just because". So, one may not be able to CUE a matter of opinion, but they can CUE something that no reasonable mind could argue and, if presented correctly, there is NO WAY any doctor on this planet is going to argue that his condition was not caused, or at least aggravated, by military service. Either way, he needs to look at his C-file to se what, exactly, the RO had in 1973. If any of the information he claim to have is in there, it's an open and shut case in my opinion. I don't mean to sound rude here, but to even hint that a slipped disc is a congenital defect in which his extremely physical job in the military played NO role is completely absurd. I'm willing to bet the farm that this doctor did not note the "boney defect" required to even suggest an inborn disorder. My guess is that medicine in the 1970's was junk and this doctor was clueless. My god, lower back injuries have to be the most scrutinized injuries on the planet. It’s the number 1 cause of civilian injury claims world wide and the research on it is incredibly extensive. If every time someone slipped a disc an insurance company/employer could say it was congenital, they would, and I’m sure they’ve spent billions trying to come to that conclusion over the years.

Vike is right; you don't "need" an IMO, but I always prefer them because you have more control over the process that way. You can review the IMO before submitting it and shop around until you find an IMO that best represents what you think your symptoms are (and, no, that doesn't mean buy a favorbale decision...it means finding a doctor that words things most appropriately for a VA case). But, you can go with your VA records; the only down side is that you can't take back what they write...it only takes one doctor being a jerk to make life difficult in VA terms.

What causes spondylolisthesis? There are six types of spondylolisthesis, the most common are due to aging or a the bony defect described above. Degenerative Spondylolisthesis Degenerative spondylolisthesis is by far the most common cause of spinal segments slipping on top of eachother. Over time, aging causes changes to the tissues of the body, including the bones, joints, and ligaments that hold the vertebral column together. Isthmic Spondylolisthesis Isthmic spondylolisthesis is due to a specific bony defect in the spine called spondylolysis. Spondylolysis is a defect in a specific region called the pars interarticularis. A pars defect is most commonly the result of repetitive microtrauma during childhood. Some sports are thought to make children more susceptible to developing spondylolysis, including gymnastics, diving, and football. As stated previously, spondylolysis is the word used to describe the problem in the bone of the vertebrae. Spodylolysis is not the slippage of the vertebrae; again that is termed spondylolisthesis. Other causes of spondylolisthesis include congenital (inborn) anomalies, trauma, tumors and bone diseases, and surgical procedures. Quick Search gave me what I wrote above. This tells me two things: 1) Your condition is likely NOT congenital and 2) Even if it is congenital one would need to aggrivate the "defect" in order to become severely symptomatic. This rater is wrong, period.

I have a degree in this field and I'm working on a degree in psychology at the moment, so I'll tell you what I know: Pete is right, to an extent. Hormones don't "cause" PTSD, nor do they continue symptoms (though they play a role). It's a very complex issue dealing with a lot of fancy terms like classic conditioning, autonomic nervous system, etc.. But, to simplify, something has to happen (as Pete stated), this, in turn, leads to a memory, but not of the ordinary variety. Memories associated with traumatic experiences are stronger (flash bulb memory) because hormones are stimulated at the moment of the trauma, which force a stronger imprint on the brain (think of a normal memory as a love tap and a PTSD memory as a punch in the face). These memories are coupled with autonomic response (fight or flight), which put the body in states of excitement (floods of hormones that amplify feeling/mood and cause severe anxiety). Drugs like lexapro hinder serotonin, which negates some of this "excitement" and keeps you more "even", but it's like a bandaid on a broken arm; it doesn't really "fix" anything. Hallucinations, on the other hand, are linked to dopamine levels in the brain to which most antipsychotics level out as well, but, again, it's not a fix. To "fix" PTSD one would need to unlearn the event, which is impossible. So, we instead try to reduce the impact of the event by therapy, drugs and, most importantly, time, but none of those are cures. To use the broken arm analogy again, it's like permanently putting the broken arm in a sling and giving the patient pain meds....it will make life much easier, but, unless you reset the arm and "fix" the problem, you'll always have that broken arm. That's the short version of PTSD:-) The real key to PTSD is not hormones (that's more of a side effect); rather, it's in our learning process and how we adapt to situations (classic conditioning type stuff). A great example of this type of conditioning is when you touch a hot stove......we know to be extremely cautious around a hot stove, despite only being burned once; so, statistically speaking, why do we exercise caution evey time we touch a stove? Now, what if you were "burned" in combat (burned being loosely used for rape, death, shot, etc)? This would translate to a fear of people even though 99.9% of the people you meet are good, just as 99.9% of the stoves are cool, but our bodies still tell us to stay away and be cautious. This is compounded by an overreaction of chemicals in the brain that over-exaggerate the situation and leads us to want to "fight" (lash out, yell, etc) or "flight" (hide, retreat, suicide, etc). Anyway, that's PTSD in a nut shell.....If I can clear it up further, please ask...it's kinda tough to break it down like this without specifics:-)