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Jay Johnson
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Posts posted by Jay Johnson
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I understand that, but that's not the point. The codes you listed have a physiological basis; whereas, your typical "mental" disorder does not (again, I would argue this, but in current medical terminology this is the case).
I'm not going to argue this with you further...I am in this field and you are not; try asking a doctor.
But, since you insist only playing semantics, here is the definition of dementia out of my abnormal psychology book:
Dementia (and other cognitive disorders) - Problems caused by known damage to the brain, including alzheimer's diseases, strokes and other physical trauma to the brain.
In fact, dementia is not even covered in abnormal psychology because it is not a "psychological disorder"; rather, it's a PHYSICAL one. If I know this as a student in psychology, I'm thinking the psychiatrists are well aware of this fact too (as are the raters). They get lumped under "mental disorders" because the VA's ratings system is antiquated and biased.
P.S. - That definition is out of the DSM-IV-TR by the way.
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Is that legal and under what authority do they have to give such drug screens without permission? Seems like a civil rights violation to me.......
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Unless you have some new issue that you feel was caused by the contamination there's not much you can do at the moment. However, I would get signed statements and records indicating that you were there and that there was a contaminant present. Cancer doesn't happen over night and there could be issues down the road (though unlikely mind you), so keep detailed records because we all know how the VA likes to conveniently lose records when said records are in the veteran's favor.
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Vincent van Gogh was a prolific painter during the period he sliced his ear off and was hospitalized, all the way until he shot himself in the chest. He was a total wreck "occupationally and socially" yet still very, very productive.
Artistic expression is not something most of us can do, nor would I deem it normal employment. Beethoven, Tchaikovsky and brahms were all "crazy", yet were some of the best composers the planet has ever seen. Robert Schumann was put in a mental ward at the end of his life. In fact, I would say that "good" art comes from pain and suffering and is often linked to people with mental disorders. Tchaikovsky's issues were that he was gay living in a homophobic world (likely molested as a kid), which was more common than you think in those days. Beethoven was believed to be bipolar and brahms had severe OCD.
But, does this mean we can write the next fur elise? Probably not:-) So, unless you have some super-genius latent talent that you haven't told us about, I wouldn't hold your breath to be the next Van Gogh........
Unless you're painting homes, "art" is not work.
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From a medical standpoint dementia and cognitive impairment are physical in nature 99% of the time and the VA views them as such. Now, there may not be a special category for those ailments to fall into, but it would be assumed that one will not get better with dementia and it would also be assumed that dementia is a disease that almost always gets progressively worse with age. PTSD does not fall into either of those categories (though I would argue that fact).
Dementia is most often associated with al zheimers and old age in general. Essentially, it is a deterioration of the brain. Cognitive functions can improve in purely psychological cases, but considering that the cognitive impairment is linked to dementia I would say that this is almost certainly a progressive, "physical" disorder.
Raters aren't stupid and they realize the difference (as do the docs), so don't think that they can't/won't make exceptions for cases that do not fit into the typical mold, but we're talking about something well outside of the norm. Most of the mental cases are PTSD related and, as such, ones ability to work is key. PTSD is an anxiety disorder so, by VA terminology, how can one be 100% anxious, yet lead a normal, productive work life?
BTW, you'll notice that each of the codes vike linked were of a physical nature; the problem is that the VA just hasn't made a proper category for them yet and there's a general prejudice in the field of medicine towards injuries that can be observed but not seen (IE - brain injuries). This does not mean, however, that raters and doctors are going to treat them the same as PTSD just because they are lumped into that category.
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Dementia and cognitive disorders are viewed as physical disorders by the VA and fall under a different ratings criteria. This thread is about PTSD (at least I thought it was) and, as such, you cannot work with that "mental" disorder. Also, schizo is a different beast as well and is deemed as chronic no matter what (whereas many would have us believe PTSD can get better). On top of that, gains in the market are not "gainful employment" no matter how much money you make, because one can earn 5 million one year and lose 6 million the next....it is NOT a fulltime job and is anything but secure employment.
I think you're trying to conflate a lot of different things into the typical category that folks with PTSD fall into. When someone gets an award (or denial) for PTSD they cite the ratings criteria word for word....it is followed to the letter.
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And none of that applies to mental illness because, as has already been listed, mental illness falls under its own guidelines. When an RO rates someone for PTSD they specifically cite that criteria (word for word) in their reasoning for denying/approving your claim and if you are not TOTALLY occupationally and socially disabled you DO NOT MEET THE 100% CRITERIA.
This is a well established precedent in the VA and I'm sure the other 99.9% of folks on hadit agree. If you work with a 100% PTSD rating consider that money gone upon the next evaluation, period.
Mental illness has its own ratings criteria and there is nothing in it about "averages", nor are there any exceptions (it does not say occupational *OR* social; it says occupational *AND* social).
I'll repost this for you since you seemed to keep missing the point:
100 %
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name
Now, show me another ratings criteria that has such specific guidelines and includes the term "total occupational impairment"? Just one....anything? Please?
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How 'bout you find a ratings guideline for a physical disability that requires a "total" occupational disability? And where did you get this nonsense about averages?
Heck, the recent independent review that the VA commissioned stated that it is unfair that mental disabilities are rated solely on one's ability to work (as opposed to physical disabilities which take into account quality of life issues).
One can be "totally disabled" without being totally "occupationally" disabled. Only mentally disabled vets are held to that standard.
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You all seem to be missing the point here, so I'll break it down:
Let's first define occupational....what does this mean??? It means WORK, EMPLOYMNET, JOB, ETC.
Now, let's define social.....what does this mean??? Your social life...how you interact with others, your family life, etc.
Ok, but what does total mean?.....
1) Of, relating to, or constituting the whole; entire. See Synonyms at whole.2) Complete; utter; absolute: total concentration; a total effort; a total fool.
Ok, so one must be completely, utterly and wholly occupationally disabled to be 100% (let's remember now, occupational = work) AND one must ALSO be completely, utterly and wholly socially disabled to be 100% (what does social mean again boys and girls?...ding ding ding...your social life).
So, in all seriousness, one CANNOT work while having a mental disorder rated at 100% and it is quite difficult to work with a mental disorder at 70% because the requirement for that is "severe" occupational disability (if one is severely occupationally disabled they really shouldn't be working).
Now, you can argue that this standard is wrong and bias (and it certainly is), but that doesn't change the FACT that this *IS* VA law and one cannot work, at 100%, with a severe mental disability.
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It could be anything from cancer to PTSD (repressed) to simple stress. I would keep getting him tested until they find a cause. The CBC (blood test) should help though...
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The wife takes seroquel in fairly high doses and does ok....her's is 25mg x4 day + 400mg at night (2x200mg). This effectively puts her on 500 mg/day and I believe the max allowed for seroquel per day is 800mg.
She took trazedone at one point, but it gave her nightmares and she tried to kill herself one night in her sleep. I'm sure that's not a typical reaction, but something to keep in mind regardless.
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The psych will give you all sorts of different diagnoses, but the VA will lump them under one category, which essentially boils down to "mental illness". MDD is not even in the same category of disorders as "anxiety", but, to the VA, it's all the same. So, no, you cannot file separate claims for each mental affliction....they will just lump them together and assess your overall level of functioning as it pertains to your ability to work.
It's a horrible and prejudice system, but it's all we got for the time being.
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I would compare your symptoms to the chart provided by Carlie, but, generally speaking, I wouldn't be happy with any rating under 70% unless your supporting documentation is VERY weak.
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Pete is right; it really depends on WHAT your condition is. If you're missing appendages, it's fairly safe to work, but if your physical disability is rated higher due, in large part, to your inability to work, it is more risky. In other words, if you are 100% for back pain/issues and you are able to be gainfully employed, that would certainly reflect on your next rating.
If you have a mental disorder at 100% (or even 70% in many cases) you are expected not to work...if you do, they will hold it against you.
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The bigger problem is that the military has, perhaps, the worst mental health program on the planet and I'm afraid this kid will only get worse and have no where to turn if he runs into rough times. This is further compounded by the fact that he chose the marines, which is probably one of the worst branches for "mental" issues. He'll be labeled with all sorts of stigmas if any of those symptoms manifest themselves.
I hate to say this, but unless the marines have a very positive impact on this kid, he'll probably be dead before too long:-(
As for the VA - My guess is that the military will bury any prior record of mental issues and ignore his problems...otherwise, they couldn't justify accepting him for liability purposes. I would get some sort of record that the recruiter KNOWS that he has recently had mental issues (record him if necessary), in order to bring a lawsuit down the road if they play stupid. The military has no business accepting a kid with known suicidal ideology, plan and intent.
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Thanks for responding. Yes I am working but finding it very difficult and will have to retire soon-probably in December...puts me close to SS. Should I get the VA Psy. Dr. to write a letter for me explaining that my depression, anxiety, high BP etc. is most likely secondary to the PTSD?
Depression and anxiety will be linked to your PTSD regardless (they really need to change mental disorder classifications). The high BP can be linked to PTSD, but the science on mental disorders causing physiological symptoms is limited at best. I'm not sure how serious the VA takes such claims, but I know it's merely guess work in the civilian world. Good luck.
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Aye, that certainly was not my intent:-) I was refering more to schools like the "University of Phoenix online", which tend to give degrees that one can utilize, but whose degrees do not typically meet college level standards and most of the credits earned will not transfer if someone decides to take a more specialized field after the 4 year degree (which means, essentially, you've wasted your money in that example).
Military schools tend to offer a lot of online courses because, obviously, military people cannot regularly attend fixed classes, so they are the exception to the rule in most cases.
It's best, if possible, to attend a normal college that *offers* online classes, but doesn't *specialize* in them. All of the schools I've attended were regular schools, although I've gotten the majority of my degree(s) online and I haven't had an issue with credits transferring (other than the typical, "well, we don't give credit for that because that school isn't as good as this one" BS, you run into with every new college).
Anywho, I wasn't implying that Berta, or any other online school specifically, is a bad school; rather, I was simply pointing out that online schools are very hit or miss and that just because one wants to do distance learning does not mean that one needs to attend a "distance learning" college. Most colleges offer tons of online courses/degrees.
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Family Dr prescribed this to help me sleep. You take it 2 hrs before you plan on sleeping. You must take it every night. The drug is an anti-psychoic used for people with thoes issues. The sleep benifit is a side effect.
Anyone have experience with this med?
Joe
The wife has been on seroquel for quite some time now and it not only aids in the anti-psychotic stuff, but it also helps her sleep at night. She takes 25 mgx4/day and 2x200mg at night to help her sleep. Her's is a fairly high dose though given her PTSD and pention for psychosis.
Also, she is VERY sensitive to side effects and highly allergic to several medications and she has done fine with seroquel for about 2 years now. Everyone is different, but I would say it is fairly safe given the wife's history with meds.
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Jan,
Have you taken any out of state classes? Do you have to pay the out of state tuition fees when you are doinf internet/distant learning classes?
No, I haven't taken any out-of-state classes, but I would imagine out of state charges would apply even if you're taking distance learning (depending on where your place of residence is...I know a military person can live in, say, Texas, but claim residency in Florida and, therefore, get in-state fees for schools in Florida).
Also, how does the Pell Grant work? Is that based on finanacial need?
Pell grant is based on your family income and varies depending on what said income is. If you qualify, based on finances, you take your award to the school finance office and they deduct the pell grant award from your fees (books included) and whatever is left over is given to you in a form of a check (if there is any left over). Pell also stacks with the VA, so if your pell grant covers your entire tuition, you get to keep your Ch 35 payments as free cash:-)
The downside to Pell is that it *is* based on YOUR finances being that your son lives with you. So, he will only get the pell if you and your husband fall below a certain income level (which is fairly high mind you).
Are you paying 50% tuition because your state gives you a break on the fees?
50% tuition is a state law in Washington, just as many veterans get property tax breaks in other states based on 100% status. Each individual college can set their own policies also, so it may vary by state and college.
I'm in Texas and they don't give any breaks on tuition as far as I have been able to tell. I've been searching for information on that but havn't found any yet. Maybe someone on Hadit knows for sure.
Best thing to do is call around to the colleges and see if they have a veteran's office....I'm sure they'll know more about tuitions breaks than anyone else.
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My husband and I were talking about the education benefit.
He said, after he got home from Vietnam, and he went to college. His college (private college) tuition was the SAME as the GI School Benefit. Each time the GI Benefit was increased so was his tuition. I wonder if the internet schools are set up the same way. They know exactly how much the vets get for school and how much Chapter 35 benefits are.
The only way to find out fees for internet is to fill out all their information request then they will give you info. I really don't want to deal with the phone calls and emails right now. Anyone going to school through the internet, willing to share with us their fees for on-line tuition? I bet they are the same as the benefit.
Just wondering -Jangrin
Honestly, I wouldn't go to an "internet school". A lot of them are shady at best and the overwhelming majority of regular schools offer 99% of their course work online. I'm going to Washington State University, at the moment, and 100% of my psych degree is online and I still get the 50% tuition savings due to the wife being a 100% disabled veteran (as per state law here).
So, find a "good" local (or distant) college and see what they offer in terms of online classes. Some schools offer more than others, but I've been to 4 different schools in various parts of the country and most of them had a LOT of online classes. Thus far, I haven't had to take a single class at the campus.
As for cost - Since I'm paying 50% tuition, I end up banking about 60-70% of the Ch 35 money. If I had a pell grant I would be making 10K or so a year, EXTRA, to go to school. It's really a benefit that you can't beat. However, that is for a bach, but when I hit the masters+ level the cost per credit hour increases a ton and the Ch 35 benefits will likely not cover the full cost (even with the 50% reduction).
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A personality disorder is VERY rare and somewhat difficult to pinpoint. To say it's suspicious that the military, and VA, are finding SO MANY people with the disorder is putting it mildly in my opinion. To me, it's intentional and it's meant to keep people out of military retirement and/or the VA system. Also, it seems to stand in stark contrast to VA regulations on the subject...people are presumed to be "sound" when they enter the armed forces and a personality disorder is congenital. So, how can one go into the army perfectly healthy, go to war and come out of it with a personality disorder? It goes against medical facts and VA doctrine.
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Do one of two things:
1) Tell your civilian doctor that your are filing a PTSD claim with the VA and that they tend to low ball claims. So, let him know that he cannot do the typical good day/bad day stuff...he MUST focus ONLY on your low points and give a new GAF that best reflects how bad you can be. In fact, ask him for s thorough evaluation that says how occupationally and socially impaired you currently are (at your low points).
2) Hire a new doctor if #1 doesn't work:-)
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My FTCA claim is for $1,250,000 based on the damages I listed before and anticipating additional medical care. Right now, its value is somewhere between $0 and $1,250,000. The Regional Counsel has finally engaged and we are in the negotiation stage. We have about two and a half months to reach a mutually acceptable settlement. If no settlement is reached before Sept. 2, 2007 and we do not agree to an extension, we will file a suit in Federal District Court and the Regional Counsel will be replaced by the local US Attorney. Both the Regional Counsel and I have indicated our desire to avoid court and negotiate a settlement. We have also agreed to have an impartial third party mediate the negotiations. So you see, Jay there are opportunities to arrive at a fair and just settlement of an FTCA claim.
Herein lies the problem. You are using local rules because you are at the local stage (which really isn't an FTCA; it's a VA thing). If you do not get the award you want it becomes an FTCA that is handled under FTCA rules in federal court and you no longer fall under state guidelines. Now, perhaps Illinois has a different set of laws at the local level and perhaps they were not offered a reasonable sum at that level, but once in federal court one cannot sue for pain/suffering; it's clearly written in the FTCA regulations.
So, I think we're both right here....you may get some money based on local laws, but that sum will likely change when you reach the federal level. But, then again, what incentive do the local folks have knowing your case changes once it reaches the federal level? My guess is that 1.25 million is a reasonable sum with or without any pain/suffering factored in, but had you asked for a rather large sum (like 5 mil+), they would have just passed you right to the federal system.
Either way, I wish you luck....in the end, people *deserve* the money whether the VA will pay it or not.
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I'm not saying it is impossible; rather, it's just highly improbable. The way the system is set up, they are only supposed to award for lost wages and/or medical expenses. If the VA awards 100% than they are not losing wages (unless the VA's amount is less than their normal yearly income) and medical expenses are nil because the VA covers them (though, again, lost private insurance could mean lost medical expenses for the rest of the family). In essence, a tort claim against the US is an occupational issue, as opposed to a civilian tort claim, which is both occupational AND social. Also, one does not get a jury trial with a FTCA, so you lose the sympathy of the public.
So, this example says that the individual was paid 2.5 million (which sounds like a lot), but why was he given 2.5 mil? Could it be that they figured 20 years of employment at around 90K a year with 35K in yearly medical expenses? Probably.
In civilian tort claims one can win on pain and suffering, which is where the big payouts come and what most people think of as real malpractice suites.
My uncle lost his case because 1) The VA had already compensated him at a level above his current income level. 2) My uncle had some tax issues and owed a lot of money to the government, so he wouldn't likely be making much money for his family in the near future. 3) He had NO dependents at the time of the incident (all grown + he was divorced) 4) The VA had offered to cover his future medical expenses via his 100% rating. So, what could an FTCA do for him? The answer is nothing.....there was no lost wages and no lost medical expenses and his family was already compensated via a DIC claim.
Tha's my basic point here - You can file a tort claim and you may win, but don't go into thinking you're getting some large sum of money above and beyond your earning potential. In order to do that you need to prove that the malpractice was a matter of VA policy (IE - they instructed their doctors, VA wide, to use inferior equipment, which led to your death). In cases like this, tort may not apply and bigger money can be won. At least that's my understanding of the law pertaining to tort....
Can You Be Rated At 100% Comp And Still Have Be
in VA Disability Claims Research
Posted
Few observations of why nothing stated here is "off topic":
1) The original question was about working and 100% and that's all that has been covered.
2) Someone stated that people with mental disorders at 100% can work; we know this to be untrue. However, he was trying to put a very specific and wrongly categorized diagnosis into the much broader and common category that includes PTSD. Dementia may fall under the "mental" category, but it is a physical disorder.....a 1st year med student can tell you this.
3) I don't care for vike and I think I've made that clear in other threads. I love opinions and I encourage folks to give their opinions, but I don't care for being brow beaten by someone who takes their "opinion" as fact. I will continue to challenge his notion on this because he is wrong, so boot me from the forum, close it or let us continue...either way, I really don't care, but I haven't said anything derogatory towards him and don't intend to. I am being matter-of-fact, which I feel is right on his level.
Fin.