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Jay Johnson
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Posts posted by Jay Johnson
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I've got ortho C & P for my left knee followed quickly by the one for PTSD. I am filling out forms tonight, all advice to this site and my personal e-mail appreciated, my first trip for either.
Few points on PTSD exam 1) Do not go out of your way to look good or impress anyone....dress as you normally would on a "down" day and act accordingly. 2) Make sure not to be over-friendly....do not make eye contact with the doc and keep the friendly chat to a minimum. 3) Do not highlite any of your good days or good behavior...only talk about your "worst" days and do not even hint that there are good ones. 4) Your childhood was GREAT...your parents were GREAT...you got plenty of hugs as a child, etc.... give one hint about an abusive past and your SC is gone.
I know this may sound a little like working the system, but the system is set up to help you fail. No one-time exam can give an accurate account of your PTSD and anything in your favor will be ignored in favor of anything against you ('tis the VARO way). Think of it as more of a testimony in a criminal case then an exam.... only speak of things that help your case and plead the fifth on everything else:-)
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I don't care for SO's because if they truly did their jobs they wouldn't be needed. Essentially, if the SO's would fight for veteran's rights on a national level they wouldn't be needed to fight for vets on the local level, because the VARO's would actually have to follow their own regulations.....if the VARO's followed their regulations 99% of vets wouldn't need to spend years appealing claims that are cut and dry.
The fact that a vet can have several evaluations for something like PTSD that give GAFs of 30-40 and sharp wording like "the veteran is unable to work", yet the RO can rate them at 30% should have every SO in the country filing law suites....but they don't because that would put them out of a job. It's kind of like the welfare system..they give just enough to keep vets coming back for more, but not nearly enough to fix the system and allow vets to stand on their own....it's a horrible system.
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Those are symptoms of a panic attack and you should either A) ask for some regular panic meds like klonopin, or B> ask your doctor for a good PRN med (as needed) like ativan. IMO, klonopin is the better of the two as it is less addictive and your body doesn't seem to build up a tolerance to it like ativan, but ativan works really well for certain people if you take it sparingly. Basically, you have an anxiety issue that can be controlled with meds....if your doctor doesn't agree, then he/she is an idiot and find a new doctor:-)
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YOu have to officialy release your school records at your prior to school any new schools you may be wantnig to attend....they are either lying, or there's a law suite in your future:-)
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Terry
What you have to realize is that there is NOT another military in the world whose veterans get the kind of benefits we do. Even with all the VA hassles we have to endure, to get what the law says is rightfully ours, we are still better off than the veterans of most other countries.
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That's simply not true....most countries like england, germany, spain, etc take very good care of their sick and elderly. Heck, china takes far better care of its citizens then we do....my dad is married to a chinese woman who taught kids at a chinese military base. She was able to retire at age 37 with 75% of her pay and a free house (mind you their pay sucks, but still).
Our country is actually one of the worst on earth at taking care of our sick and eldery....the all mighty dollar is worth more then human life here.
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B)
If I can read the Hanoi newspaper on line- I wonder what the Vietnamese think-since they can do the sameo on line to our news-
and they can see how the VA causes so much grief to veterans, who got injured there or got PTSD there , as well as the same AO problems they have healthwise, not to mention everywhere else the troops have gone.
Of course terrorists and all of the enemys we have in Afganistan and Iraq do that too- I guess Fidel is also on line-
It is a national disgrace as to what veterans put up with at the VA regardless of when and where or how long they served-and an embarassment to our nation when you consider how many other countries know this too.
Maybe this is in wrong topic area-then again we have citizens of the US of A who dont have a single clue as to what you all have to go through to get the acknowledgement of a grateful nation for your sacrifices known as VA comp.
They might watch movies Article 99 or Born on the Fourth- but bad as the VA looked there
ift does not even come close to the truth, does it? ( Unnatural Causes -AO movie- was the closest as it was based on fact)
(There really were rats at the Bronx VAMC- shame they couldn't be used to perform the C & Ps-those rats might have been a lot smarter than the VA dctors)
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Very well said and very true. I know I tend to ramble on about So's, but I truly feel these organizations are supposed to be the voice for veterans and they fail miserably at that function. I believe that the various SO's do this on purpose also, because it would only take a little bit of money and effort to bring the VA to its knees....I don't think a single american would sit idly by and allow this torutre from the VA on our serving men and women. The politicians would be forced to fix things or face being booted in future elections, 'cause democrats and republicans alike understand the value of a volunteer military and a volunteer military can only be maintained if it is desireable to join (and if america knew what they faced after service no amount of money in the world would get a kid to sign up).
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I think it would be best to get an individual medical opinion from a civilian doctor (or 2) and submit it as new evidence. Back pain, like PTSD, is very subjective.....opinions as to the degree of impairment can vary widely among different doctors. The more positive information you send the better your claim is and you have better control over civilian opinions as opposed to VA opinions.
Welcome to hadit and good luck:-)
Jay
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Another IMO can't hurt, but you should CUE this now rather then later. It is clearly a violation of the regulations given that the RO took one VA doctor's opinion (I'm betting it wasn't a psychiatrist either) over several other medical opinions that were done under 24hr surveilance as oppsed to a 30min C&P. The military also found SC and found for a diagnosis of PTSD. This is another clear example of a regulation violation....if only there were some organization that could help you...to bad they're aren't any /sigh.
P.S. - This case is huge...the VA's job is not to challenge the military against the vet..their job is to prove SC for the vet against the military. If the VA is allowed to question the military's word you will find that NO veteran suffering from sexual trauma will EVER get a SC and vets who were disabled on classified missions will have NO WAY of proving their SC. A SO should be all over this one, but that would involve caring for veterans to which SO's do not.
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I’m going to try and make this as short as possible, but I think this may apply to a lot of veterans and doesn’t seem to be argued in their claims much.
Case in point, A Veteran is diagnosed with a psychiatric disorder while nearing the end of his enlistment. During his enlistment, he had an enlistment physical and re-enlistment physical, two psychiatric evaluations, one found nothing towards which a diagnosis could be evaluated, the second time was during hospitalization for the psychiatric disorder, for which he was eventually, medically discharged from the service for.
Upon discharge he was transferred to a VA medical facility to await his final discharge papers. After an intake physical was administered, he was given a pass to return home, nothing untoward was noted except a history of the psychiatric disorder, still nothing of the Veteran as having a personality disorder. The Veteran was given his final discharge papers, while on pass at home.
Having applied for VA benefits, a C&P exam was conducted, were upon for the first time a personality disorder was diagnosed. Further the examiner noted that he could not fully support the findings of the Dr’s of the medical board, who had approved the findings of a psychiatric disorder and recommended his medical discharge. The VARO subsequately ruled that a alterative diagnosis had been made of a personality disorder and without stating so, found the diagnosis of a psychiatric problem as in error.
I’ve come up with several errors that may have been commited by the VARO in allowing this change in a diagnosis stand and to further use it as the basis to deny subsequate claim to reopen with new and material evidence.
1. Failure to give reason and basis for a change in diagnosis
I can name more reasons, but this one jumps out every time I read a BVA or COVA decision of this type. Nothing is mentioned about the evidence that showed clearly and undebatably that the original or subsequate diagnosis is the correct diagnosis. Why do I not see more cases of the question being made in BVA or COVA decisions. Wouldn’t you think that if an error was made in how the diagnosis was changed, would manifestly change the outcome of a claim, in light of their being the good chance of, if not evidence on record showing a diagnosis of a service connectable disability already.
This is not a question of a wrong diagnosis, this is a procedural error in how a change was made and how the change is supported by evidence.that shows it to be a proper change.
Discussion is appreciated.
Jim S. B)
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This is par for the course. If the tables were turned (IE - the military discharged him for a personality disorder and the VA doc said it was PTSD), you can bet that the RO would go with the military opinion. This is another case of SO's failing miserably at protecting veterans, because this is a common issue across the country of a rules violation. The regs clearly state that you have to prove a case by the preponderance of the evidence and that doubt should be in the veteran's favor...this clearly isn't the case these days and the RO's are going with the lower evaluation EVERY time even if there are several higher evaluations and the higher evaluations are done by doctor's who have more time in the field or are better qualified.
Until we snap these SO's into line you can expect the same thing over and over and over and over again.
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SSA called my deceased husband in 1992 and said they were declaring him incompetent for SSA benefits purposes due to PTSD and he could appeal it but he told her no he liked it as this stroke (from AO DM) made him unable to see change and denominations on bills and his PN caused him inability to write a check. He told the SSA woman -gee I have PTSD and now I am incompetent and also the VA said I have significant brain damage so now I know what to tell the Student loan people when they hassle me about the loan.(they called here day after day)
VA however had said he was competent.
(actually soon after that he got his student loan written off due to permanent and total disability-we found a law that showed -if he had made one single payment after his disabled date, he could not have gotten the write off. )
A vet I helped get 100% was declared incompetent. His retro was well over 100 thousand clams and he would have spent it in day.
But it took many long months for them to interview and send his wife the money and here after waiting for years at NSC,for SC , he ended up waiting and waiting again.
It can be a two edged sword- Congrats -you did VERY well on your claim!
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Berta,
Well, there's a big difference between brain disorders (like what your husband encountered due to stroke) and declaring someone incompetent because they have a severe psychiatric disorder. A lot of people in this country, and the VA, believe you must have some level of retardation if you have a psychiatric disability....this, obviously, isn't the case at all and if someone has the where-with-all to find and post to this forum then they can easily spend 20 minutes a month paying some bills when they are having "good" days.
I have also noticed that the VA expects a veteran with severe PTSD to be severely disabled ALL of the time. Even though the regs make it clear that psychiatric disorders have "highs and lows", if a rater gets wind that a veteran was able to do something somewhat "normal" you can bet a low-ball rating is not far behind.
I have done extensive research on this topic and I can assure you that there is NO connection between psychiatric disorders and spending problems. I came across a few studies that suggested that even people with disorders synonymous with spending sprees (like bipolar) do not over-spend simply because of the disorder.. the studies suggested a genetic predisposition towards spending problems and the disability just caused it to worsen some.
The VA abuses this program regularly and uses it as a means to spy on vets with PTSD and to give impromptu inspections to ensure that they are as disabled as they say they are....why else would the fiduciary have a policy of making surprise visits on vets that are terrified of change and "surprise" visitors? They "claim" it is to make sure the vet isn't being abused, but their role is not to ensure the safety of vets..they are there to make sure the vets bills are getting paid and their money is being used to support the veteran. This can easily be established by credit reports, bill summaries from creditors, bank statements, etc...whether or not a veteran's house is clean has nothing to do with it.
Personally, I take great offense to this program because there is SO much potential for abuse to veterans. It is, by far, the worst program the VA runs and the SO's can't praise it enough:-(
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My guess is, by what has been described here, that you cannot file for retirement if you are not enlisted, but there's a catch...when you enlist you typically enlist for active duty for, say, 4yrs, but you also agree to 2-4yrs of inactive reserves. I'm betting that they will allow you to file for actual retirement after discharge based on the fact that you are still "technically" contractually bound to the military. I would find it hard to believe that the military would give out money if they had no contractual obligation to the veteran...that would be the VA's responsibility. Just a guess though:-)
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Not one single psychiatrist in the greater portland area accepts either medicare, tricare or champVA....these are among the worst insurance companies in the country and, if I were a doctor, I wouldn't accept them either. Next time you get one of those "this isn't a bill" letters from tricare/medicare/etc, take a look at exactly how much they pay for services....I remember one in which tricare was billed about $3000 and they only paid $19. Often times, there will be several charges on the list that are just flat refused and nothing is paid...would you accept those terms as a doctor?
Unfortunately, the doctors who tend to accept these insurances are often some of the worst doctors in a given area, because the good ones won't work for scraps.
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I've been complaining to much and now I need an honest answer on what happens during and after a C&P ? How long does it take after the C&P before you hear the results and I'm curious if They will do a C&P for PTSD since I was in the PTSD Clinic in Denver for 6 weeks. My record from the clinic stated I had extreme PTSD and unemployable. These may sound like silly questions to some of you folks but I've always believed there's no such thing as a silly or stupid question. Except for the one you didn't ask.
Thanks
Gordon
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I'm not 100% sure by your post if you are already SC for PTSD or not...it's sounds that you're not, but could be, in which case I would not hold my breath waiting on the VA to evaluate and rate your PTSD. You will need to open a claim specifically for PTSD and follow the typical guidelines.
As far as time is concerned, you won't get a definitive answer from anyone here, because every RO is different and every case within an individual RO takes different amounts of time to process. It is best that you play an active role in the process and follow your C-file from the RO to the doctor and back, getting copies where you can. It also helps to make some contacts within the RO to expedite your claim and to ensure that it touches the least amount of hands (IE - mailing evidence to general addresses means several other people, including the raters, will touch your file at some point)....my contact in the RO takes my wife's evidence directly from us to the raters via fax.
Also, you may want to be more specific about your condition so I, or others, can give you some specific pointers on what to expect during your exam and help you to best represent your symptoms (every disorder has a different C&P exam).
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I am at a loss. If a veteran has been given a GAF of 45 for the past two years by his VAMC psychiarist, why would it be expected of the vet to have IMO's and C & P exams. If they do not consider the opinions and diagnosis of their own doctors, then why are the veterans being sent there for care?
Bev.
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They do take their own doctor's opinions....IF it means a lower rating. As I said in my reply, if this veterna's situation were reversed (IE - he got the higher GAF from the civilian rather then the VA doc), then the RO would have taken the IMO over the VA opinion to justify the lower rating. As pete said, these people are trained to make the process as difficult as possible and they will almost ALWAYS go with the evidence that is in the VA's favor, despite the fact that the regultions state then the VA should award in the veteran's favor. The regs are great, the problem is that the VAROs don't have to follow them.
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Gee Jeff, lots of questions come to mind after reading your post.
Mainly though, why did the examining physician have the opinion that you were incompetent? What evidence was he aware of at your C&P that indicated your inability to handle funds? Whether a finding is made by VA or civilian authority, my understanding is that you are deemed competent unless there is clear and convincing evidence to the contrary. (Note--EVIDENCE, not OPINION--though a competent medical opinion should be based on evidence.)
Plus I have some simple questions...for example, in your own opinion, are you incompetent to handle funds? Do your living conditions indicate probable cause for this finding? Do you keep your VA appts. and if so, how do you get yourself there?
I can understand the doctor recommending hospitalization now, and at times, possibly in the future based on your medical diagnosis. But I agree with the other responses above and being declared incompetent by the VA, or any authority, is serious business with lifelong repercussions. If it's warranted, fine. If it is not true, do NOT go along with it simply for rating purposes. Disagree and present evidence to the contrary in an NOD.
The idea that the VA can render an incompetency diagnosis for it's own purposes still astounds me. But the operative words here are "for it's own purposes). JMHO.
--Susan
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MY wife was found incompetent upon her initial claim to the VA. She was never even seen by a VA doctor and recieved a 100% rating with incompetency based on civilian and military documentation. I put the package together with a SO from amvets and the only mention of competency was from her AF pscychiatrist which said, "she is competent to handle her own affairs". In fact, we didnt even find out about her incompetency until 1 year after she was initially rated and her case manager showed up, unannounced on purpose, on our door-step and told us that he was there to evaluate her "incompetency. When I asked how and when she was found incompetent I was told that "she was 100% which usually automatically qualifies her to be incompetent".
Also, when my wife filed for A&A I was told that she HAD to be incompetent in order to even be considered for A&A. To my knowledge, there is no exam for competency in the VA system aside from cognitive tests. They do not care if you are able to handle your funds or not, they directly link the severity of your condition with incompetence. As I said earlier, the fiduciary program is the single worst program in this country for vets or otherwise....it is corrupt beyond belief and is currently well outside the bounds of congressional law, but no one cares:-(
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I really, really, really hate this program:-) The fiduciary program, like most other VA programs, started out with noble goals...they wanted to help veterans that were being taken advantage of by family and friends (IE - people taking their money) and to help vets who clearly could not handle their own finances. Now the fiduciary program is nothing more then another tool used to spy on vets with PTSD. I'm sure there are a small minority of vets who actually need this program, but most don't and the guidelines that the VA's uses to determine incompetency is so far from what the regulations states it's not not even funny.
You have entered the horrible world of an enigma wrapped in a contradiction. The VA truly believes that someone who has severe PTSD must be incompetent and allows doctors to make the call on incompetency based solely on the level of disability of the veteran, but the regulation states that incompetency is purely a financial affair and has nothing to do with the level of disability. I find it ironic that the VA does not use a veteran's credit score or credit history to determine incompetency.....a credit card company can pull your credit for no reason whenever they want, but the federal government can't event ASK you for a credit score or ask you to provide your bills to see if you're paying them on time?
This program has NO oversight...not even the regional director can take someone off of the fiduciary program unless the head of the program gives the ok. These people have ABSOLUTE power over the veteran's and treat them as if their competency is a privaledge that THEY can revoke whenever they see fit. My wife was routinely threatened by her case manager when she was on supervised direct pay and, when the fiduciary people could find no reason to appoint a fiduciary due to her being able to pay the bills, the RO took that as "she must be doing better then" and forced her into a C&P despite being found P&T just 8 mnths earlier.
If you truly feel that you cannot handle your finances and trust the VA to handle them for you, then don;t argue it, but if you believe you can handle your finances I would NOD the decision and give a detailed review of your financial history with a credit report(s)...and NOD it all the way to the BVA!
P.S. - Just because the VA appoints your wife as a fiduciary doesn't mean the ordeal is over.....they will interview your wife from time to time and, depending on the region, there are VERY strict limitations as to what your wife can do with the money...for instance - she can't buy big ticket items like a car/central air for your house/stocks (if you want to invest your money), etc...she will have to call the VA and ASK for permission to do so. It is a HORRIBLE program and it sickens me that the SOs haven't gone after it yet.
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I read somewhere that the VA must consider you at your lowest GAF score in order to find a "low point" in your functionality and determine how often you reach that "low point". This RO, as many do, took the highest GAF they saw in order to give you a lower rating. Believe me, if the VA doctor said you had a 30 GAF your RO would have used the IMO of a 45 GAF.
Here's what you should do - Get the credentials of the doctor(s) that did your IMO and compare them to the VA doctor (my guess is that your IMO was far more qualified). Ask your civilian doctor for a full evaluation and give them a brief summary on what the VA is looking for (IE - occupational and social imparement, severity of the disorder, employability, etc). Take this evaluation (if it's in your favor) and send it in with your NOD...also, put in the NOD that you have seen these independent doctors for X amount of months and point out that they have a far better knowledge of your case and that they are far better qualified to evaluate you. Wouldn't hurt to throw in the regs on accepting IMOs and fit YOUR symptoms into the criteria for a given rating (IE - there is specific requirements for each level of rating..10%..20%..30%.....100%, and try to match your exact symptoms to the highest rating you can).
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Wild,
You can call Dale White at (206)220-6124 (ask for Dale White), or you can call "Frank I." at the same number and punch in his direct extension of x2927. If they give you any trouble from the 220-6124 number then say you got it from Chris Arnold (the director of the regional office)...both men work for team one or something and act as direct go between men for the raters (they collect and bring all your information to the raters)...hope it helps:-)
P.S. - You can say I sent you.. they hate me:-)
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Wild,
I have a phone number to the guy who takes information to and from the raters...if you would like I will give you that # and name and you can call and make him hate you as much as he hates me:-)
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In the case I am thinking of my buddy was 70%TDIU when he applied for HB. They then bumped him up to 100% schedular and granted HB. He did not have a new C&P exam. The VA said the claim for HB was a new claim. I think if they are going to grant HB they will make you 100% first just like if they are going to grant TDIU they will bump you up to 70% and then grant the TDIU. That way they stay within their guidelines so the can cover their asses. This is just what happened in the case I know about personally.
How much is HB in dollars anyway? Is it worth reopening your claim to evaluate you rating? If you are TDIU what do you have to lose since unless you have gotten a job in the meantime all they can say is "NO' housebound. Am I right or wrong?
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I think the VAROs have come up with a good system...they can take away TDIU at the VARO level even know they completely understand that the BVA will reverse the decision, but what do you do for income in the years it takes to get a BVA decision? Answer - you go to work to cover the huge loss in pay or loose everything..now the VARO has PROOF that you can work and the case will be sent back to the VARO in which new evidence of employability will back up their original claim.
When an organization has NO checks or balances and is not accountable for their actions in any way this type stuff is bound to happen...with that said, some VAROs still have directors with an ounce of integrity and who actually care for veterans, but they seem to be the increasing minority these days.
The question of 100% vs. TDIU is a real one, because in order to be SO disabled that you are agoraphobic the VARO is going to want you to prove that you are completely disabled (IE - 100%). On the other hand, as berta said, you can be considered to be medically agoraphobic, but your symptoms, while in a safe environment (home), are relatively minor...the trouble is proving that you are only 70%ish at home, but 100%+ outside of your home. It's a very fine line to walk and, as I said previously, you will want to have an evaluation in hand before you start this process.
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I wouldn't just send in a letter to the VARO stating that you want HB...this WILL lead to a C&P exam in which they WILL review your 70% TDIU/P&T, and you could end up worse then when you started. It would be best, IMO, to get an individual medical opinion that gives a FULL evaluation of your current condition AND says that you are agoraphobic. Anything short of that could open a can of worms (this administration frowns on PTSD and now isn't the time to play around unless you have your ducks in order).
My wife was granted HB for 100% PTSD, but, in her case, it was a reduction from A&A, so we are fighting it. What I've heard is that VAROs are being instructed to give out HB more often then A&A to save a couple hundred dollars/mnth. So, if your claim is in order and you have SOLID medical opinion(s) stating that you are indeed still unemployable and home-bound, I would go for it, but if you get an evaluation that is less then concrete, do NOT file for an increase.
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I watch the lawyers on TV at night- am addicted to legal stuff- one point they make-
demeanor of a victim after a rape changes and those who notice this are witnesses to the radical change due to the trauma of rape-
I would think- and hope- that the VA considers this too- Buddy statements as to a serviceperson's behavior and personnel records as to any change in job performance or personality comparing before and after could be very effective in helping establish a nexus.
I have a local vet who just won a claim - I helped him by highlighting how, during his service, his behavior suddenly changed. It was documented in his personnel reports and we found record of a Capts mast. This was a mental disorder and not due to rape but still
his VA shrink agreed that the service period showed drastic changes that could only be from first manifestations of mental disorder.
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Logically speaking you are correct, but the VA rarely uses logic:-) The VA could easily deem that the PTSD was caused by unspecified reasons and the claim is unsubstantiated in almost every rape case it sees. Also, some disorders can have no "triggers"....bipolar, mood disorders, personality disorders, etc could all be blamed for these incodents. Also, PTSD often has delayed onset, which they could attribute to issues before military service (or at least speculate as to such).
Up 'till now the VA and the military have been fairly good about taking a veteran's word in regards to rape and one can only hope they continue the trend, but I see this group of people as the most vulnerable under the current set of regulations in regards to stressers.
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not to upset you but to explain how it works, or at least worked in my case, I have been under constant treatment since Jan 2003 for PTSD, my GAF scores have averaged from 45 to lows of 30, mostly 30&35's for the past 2 1/2 years I even had a letter from my treating psychiatrist stating that I was permanently and totally disabled by my PTSD and that since I had lived with it for 31 years he did not think I would improve anytime in the future and I was unemployable. The C&P exam was done by a pyschologist who gave me a GAF of 52 and then had to get an MD to co-sign it to give it validity, and the VARO dismissed almost 3 years of treatment and awarded me a 50% SC, yes I am appealing it to the BVA, this was an obvious lowball and I feel it was done because they were mad at me for writing the White House and my Senator and Congressman. The appeals go on, just don't quit.
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This is another reason why these *&^* SOs need to do their job! The BVA and federal courts have made it quite clear that a rater is not allowed to make a "medical" opinion. They are only there to interpret the evidence. If a doctor(s) says a vet is unable to work and is totally disabled and a rater gives a 50% rating they are asserting THEIR medical opinion over a qualified doctor. This is a blatant misuse of power and a crime based on the regulations...yet, they keep doing it and the DAV/AMvets/etc sit by and do NOTHING.
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Can be either, but most likely your psychiatrist...in fact, I would ask to see your records as I'm sure your psychiatrists has given you GAFs in notes without you knowing.
P.S. - You'll find that, with the va, a low GAF means almost nothing, but a high GAF almost certainly means a low-balled rating....they only use GAFs when it seems to help "their" cause. Best thing you can do is get some civilian opinions to help get a feel for where they think your GAF is, 'cause whatever a VA doctor gives you is final....also, it's always good to get more then one opinion.
P.P.S. - In your particular case I wouldn't worry much about the GAF...I wouldn't put it past a bad RO to pull some stupid stuff, but, in the end, you'll keep your money as long as you haven't been able to work...IMO, you're fairly safe.
Ptsd Claim
in VA Disability Claims Research
Posted
Pete,
Get more information from your private doctors and check the background of your VA C&P examiner. In a lot of cases the VA examiner is not a psychiatrist (and often not even a psychologist). As I have told others in the past, you need to treat your case as if it were a law suite...collect as much evidence as you can that not only shows your true level of disability, but aslo collect information that discredits any negative information. You may want to get a copy of your C&P and bring it to your civilian doctor and ask him/her to rebutt it point by point. As berta said, you need a solid paper trail and the more evidence you get the stronger your case is (and the less likely the RO is to screw you).