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So I did two C&P's down at Lee County, my dental went okay though I don't know if this dude copy and pasted my shit in.. These two facts have never happened that day (My blood pressure has never been near what he states, and if I had some shit in my mouth other than that little pokey thingy I would remember rinsing)Right now the claim is in Pending Decision I may get sleep disturbances, but obviously not apnea. Though if I can prove these have zero probative weight due to inaccuracies, should I start uploading some stuff right now that would point these facts out? Cause I'll get their attention if I have to upload 100 copies before they close it out lol (I'd think one would be sufficient, I think it won't let them close it until they review this fact). Should I let it close out and file a Notice of disagreement? Halpppp!!Two items - NEVER happened. (Doesn't matter they don't rate bruxism) See below.Preprocedural antibacterial rinse of 0.5 ounces Chlorhexidine Gluconatefor 30 seconds was done. Patient reports no previous adverse reactions toChlorhexidine Gluconate or other antiseptics.Vitals: Blood Pressure=134/96, Pulse=98/minutePEr my records, my pulse is RARELY under 110-100 BPM and that blood pressure is INSANE again nowhere any range I have ever had. Second issue - The heck? I never put anything in my mouth or rinsed. Most likely if you see his past C&P it will be the same BPM and same or similar numbers. I am concerned as I know this did not happen.Now sleep *Disturbances* and *Sleep Apnea*So, in the beginning, the doctor states: "A sleep study is already on record in the Veteran's claims folder." I had a sleep consultFurther down the following checkbox is marked: 5. Diagnostic testing---------------------a. Has a sleep study been performed?[ ] Yes [X] NoI raised a lot of hell for my initial claim about Ebenefits as an IT person I pointed out a lot of stuff and made my technical argument. I even received a response from the Director of the VA at the time.I emailed a contact I know works as a supervisor appeals, but kind wondering if I can wack these two C&Ps both less than likely due to inaccuracies. If you think I can, I'm super persistent, and a bit annoyed so I can be quite loud and cause a little ruckus. They usually well fix it quickly so I shut the hell up :).Anyways.. thoughts?

I am a high level Executive resource that does account turn arounds, and the sad part is they pay me in excess of 145K a year total of 190K with bonuses. So it can be tough as my sole job is to resolve P1 critical incidents and drive a team of 1200 technical resources to have our time to resolution under 2 hours. I finally have it under control we were at 40-50 per month now we were down to literally 4 last month with an average TTR of 1 hour and 35 mins. Kind of crazy I'm a glutten for punishment, and push the envelope. I can pretty much make my own schdule and accomodations as long as I get the job done. Like this 25 hours of work this weekend, I am now heading to the VA to get my blood work done and pretty much not doing anythign else today. It is just very stressful at times, and my patience gets short at times wit periods of no sleep after a while (trust me it's ugly, but I am still good at keeping composure). The problem is once I get to that point my bark is almost as bad as my bite. Though I shake things up, sometimes I have to wooosaaa get up and go see my counselor before I actually feel like I want to murder people as some engineers and technicians just piss me the xxxx off at their lack of due diligence and carelessness.

I currently suffer from PTSD and am rated at 70%. I also have sleep apnae and had a CPAP piror in the past. I am looking for those medical records to submit, but I wanted to know that if I do submit another claim will it elongate the decision for my increase claim? My current increase has been Preparation for Decision since 07/11/2018. If I submit another claim for sleep apnae will they hold closing or deciding the other claim until the next claim is decided? I want to submit some additional claims for sleep apnea and my teeth, I wasn't sure if that would cause a massive delay if I did. Thank you J

will actually review my uploaded statements I did at the last minute. The claim is currently in Preparation for decision and has been that way since the 11th. Does it normally close out faster for a denial or approval? I know my previous claims closed out within days, though not sure the process for 100% P&T. I did not clam UI as my job works from home and solving technology issues is truly the only thing I enjoy at times. On the other hand I am really worried due to the depression and stress along with my temper I make a fatal mistep and lose it as I have in the past which almost got me fired from the job. Though by a stroke of luck, and because my personality at times works to motivate large groups of teams to resolve issues quicker and due to my ability tto push others to move forward and "encourage" folks to do their job I got promoted by saving an aboslute charlie foxrot of a situation and saving my company 2 million dollars. Though now the lack of sleep and stress I am having probems meetiing my new obligations and things are just crazy.. So I guess thoughts anyone? Odds of getting an increase to 100% without UI based on the notes below? Let me know if you need more information. 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [X] Yes [ ] No ICD code: F43.10 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Bipolar I Disorder, most recent episode depressed, moderate ICD code: F31.32 Mental Disorder Diagnosis #2: PTSD ICD code: F43.10 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): See medical record 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [X] No [ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: The pt has current diagnoses of Bipolar I Disorder, most recent episode depressed, moderate and PTSD. They have many overlapping symptoms and cannot be adequately seperated out. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational COPY MADE BY VARMC, ST. LOUIS FROM A RECORD IN VA'S POSSESSION and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [X] No [ ] No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: Both the pt's conditions cause his current level of social and occupational dysfuntion. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence Review ------------------ Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: Physical harrasment (see mental health history), military Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. The pt's face smashed into a locker, pushed into a wall, shaving cream in his boots, threatened etc if he told. He ultimately was dishcarged after a suicide attempt. The wife was physically abusive to him too 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criterion A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criterion A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violence, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Reckless or self-destructive behavior. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1 5. Symptoms

This was an increase claim so I don't think it has any of the other verbiage in it

I do not see any of that language on the award letter.. where would that be? Unless I'm blind.. it just says payment summary and explanation. I was told this from an internal person that works at the directors office that has insight to stuff like that. Because my claim was so jacked with some of the systems and i pointed out so many IT flaws (I'm an IT professional) while loosing my shit on them (ptsd and all) they assigned me a guy to shut me up. He is really cool and very helpful. I'm looking.: I don't see any verbiage like that. Tried to upload some pics from my phone but it wouldn't upload

Good info to know. Maybe its a misconception at the VA as well. I was told this by a higher level person at the VA that deals some of the most complicated claims. I guess the only thing certain in life are death and taxes. Thanks for the quick response!

A little history this has been an issue since 2001 and a hell of a ride, so I assume since 5 years will put me at 21 years it then will be a protected status. My original claim (15 years later) was 50%. I went for an increase about 10 months after.I went for an increase for my PTSD as things were progressively going downhill. It looked as I may have been granted 100%, though they came back with a 70% with no routine future exams stipulation. It was explained by my VA contact that this means I will receive this raiting until my death as long as I do not go back to try for any increase or attempt to as that could put me back in the line for a future exam. Has anyone heard of such a thing or the VA doing that with other claims? I would think the best bet is to let sleeping dogs lie, and never ask for an increase or at least wait until the 20 year mark has passed in the event the disability continued to worsen.Thoughts?

History, Going on for over 12+ years since left the militray .First raiting 50% Went for increase this was from my DBQ C&P .. Thoughts all? See below Is this 70 (most would say 70). could it sway 100%? If you think 100% do you believe sched or temp? I did not apply for IU but I am told they have to consider it anyways. The doctor also used some verbage that was interesting It is not possible to differentiate what portion of each symptom is attributable to each diagnosis because all of the veteran'schronic PTSD and bipolar symptoms have been chronic, progressive, biologically and behaviorally interactive, and thesymptoms are concurrent and overlapping. The veteran’s alcohol abuse is in remission but was a result of maladaptive copingand dealing with the PTSD an bipolar symptoms.Per DSM-5 Individuals with PTSD are 80% more likely than those without PTSD to have symptoms that meet diagnosticcriteria for at least one other mental disorder (e.g. depressive, bipolar, anxiety, or substance use disorders) (p 280)It is not possible to differentiate what portion of the impairment is attributable to each diagnosis because all of the veteran'schronic PTSD and bipolar symptoms have been chronic, progressive, biologically and behaviorally interactive, and the symptomsare concurrent and overlapping. The veteran’s alcohol abuse is in remission but was a result of maladaptive coping and dealingwith the PTSD an bipolar symptoms. [X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinkingand/or mood. 3. PTSD Diagnostic Criteria Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors.) Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 – “Other symptoms”. Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) Witnessing, in person, the traumatic event(s) as they occurred to others Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related No criterion in this section met. Page 6 of 8 Contractor: VES Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). No criterion in this section met. Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). No criterion in this section met. Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,:” “No one can be trusted,:” “The world is completely dangerous,:” “My whole nervous system is permanently ruined”). Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) No criterion in this section met. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. Reckless or self-destructive behavior. [X] Hypervigilance. Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). No criterion in this section met. Criterion F: [X] Duration of the disturbance (Criteria B, C, D and E) is more than 1 month. Veteran does not meet full criteria for PTSD Criterion G: [X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The PTSD symptoms described above do NOT cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Veteran does not meet full criteria for PTSD Criterion H: For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often Panic attacks more than once a week Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks Memory loss for names of close relatives, own occupation, or own name Flattened affect Circumstantial, circumlocutory or stereotyped speech Speech intermittently illogical, obscure, or irrelevant Difficulty in understanding complex commands [X] Impaired judgment Impaired abstract thinking Gross impairment in thought processes or communication [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a work like setting Inability to establish and maintain effective relationships Suicidal ideation Obsessional rituals which interfere with routine activities [X] Impaired impulse control, such as unprovoked irritability with periods of violence Spatial disorientation Persistent delusions or hallucinations Grossly inappropriate behavior Persistent danger of hurting self or others [X] Neglect of personal appearance and hygiene [X] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene Disorientation to time or place IF YOU HAVE PROVIDED ANY ADDITIONAL DIAGNOSES, OR IF THE ESTABLISHEDDIAGNOSIS HAS CHANGED IN ANY WAY, PLEASE SELECT AT LEAST ONE FROM THEFOLLOWING:A. THERE IS NO CHANGE IN THE SERVICE CONNECTED DIAGNOSIS AND NOADDITIONAL DIAGNOSES HAVE BEEN RENDERED.B. THE NEW DIAGNOSIS IS A CORRECTION OF THE PREVIOUS DIAGNOSIS.C. THERE IS A WORSENING OF THE VETERAN’S SYMPTOMS HOWEVER NO CHANGETO THE SERVICE CONNECTED DIAGNOSIS AND NO ADDITIONAL DIAGNOSES HAVE BEENRENDERED.D. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE DIRECTLY DUE TO ORRELATED TO THE SERVICE CONNECTED DIAGNOSIS (I.E. A PROGRESSION).E. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE UNRELATED TO THESERVICE CONNECTED DIAGNOSIS (I.E. A NEW AND SEPARATE CONDITION).***FOR OPTION E, PLEASE SPECIFY WHICH OF THE VETERAN’S SYMPTOMS AND/ORFINDINGS CORRESPOND WITH EACH DIAGNOSIS, IF FEASIBLE.***F. THE SERVICE CONNECTED DIAGNOSIS HAS RESOLVED. Answer Question 1: C. There is a worsening of the veterans symptoms however no change to the service connected diagnosisD. Additional diagnosis is alcohol use disorder in partial remission which is a new and separate conditionbut is related to the service connected conditionsAdditional Question 2: FOR OPTIONS OTHER THAN A AND C PLEASE PROVIDE YOUR MEDICAL RATIONALE. Answer Question 2: D. It is related as alcohol use disorder is often secondary to his PTSD and bipolar disorder and is currentlyin remission but was a result of maladaptive coping with his symptoms in the past and he still hasoccasional relapses./ THE VETERAN’S ESTABLISHED DIAGNOSIS IS POST-TRAUMATIC STRESS DISORDERWITH BIPOLAR DISORDER .IF YOU HAVE PROVIDED ANY ADDITIONAL DIAGNOSES, OR IF THE ESTABLISHEDDIAGNOSIS HAS CHANGED IN ANY WAY, PLEASE SELECT AT LEAST ONE FROM THEFOLLOWING:A. THERE IS NO CHANGE IN THE SERVICE CONNECTED DIAGNOSIS AND NOADDITIONAL DIAGNOSES HAVE BEEN RENDERED.B. THE NEW DIAGNOSIS IS A CORRECTION OF THE PREVIOUS DIAGNOSIS.C. THERE IS A WORSENING OF THE VETERAN’S SYMPTOMS HOWEVER NO CHANGETO THE SERVICE CONNECTED DIAGNOSIS AND NO ADDITIONAL DIAGNOSES HAVE BEENRENDERED.D. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE DIRECTLY DUE TO ORRELATED TO THE SERVICE CONNECTED DIAGNOSIS (I.E. A PROGRESSION).E. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE UNRELATED TO THESERVICE CONNECTED DIAGNOSIS (I.E. A NEW AND SEPARATE CONDITION).***FOR OPTION E, PLEASE SPECIFY WHICH OF THE VETERAN’S SYMPTOMS AND/ORFINDINGS CORRESPOND WITH EACH DIAGNOSIS, IF FEASIBLE.***F. THE SERVICE CONNECTED DIAGNOSIS HAS RESOLVED.Answer Question 1: C. There is a worsening of the veterans symptoms however no change to the service connected diagnosisD. Additional diagnosis is alcohol use disorder in partial remission which is a new and separate conditionbut is related to the service connected conditionsAdditional Question 2: FOR OPTIONS OTHER THAN A AND C PLEASE PROVIDE YOUR MEDICAL RATIONALE.Answer Question 2: D. It is related as alcohol use disorder is often secondary to his PTSD and bipolar disorder and is currentlyin remission but was a result of maladaptive coping with his symptoms in the past and he still hasoccasional relapses.

History, Going on for over 12+ years since left the militray .First raiting 50% Went for increase this was from my DBQ C&P .. Thoughts all? See below Is this 70 (most would say 70). could it sway 100%? If you think 100% do you believe sched or temp? I did not apply for IU but I am told they have to consider it anyways. The doctor also used some verbage that was interesting It is not possible to differentiate what portion of each symptom is attributable to each diagnosis because all of the veteran'schronic PTSD and bipolar symptoms have been chronic, progressive, biologically and behaviorally interactive, and thesymptoms are concurrent and overlapping. The veteran’s alcohol abuse is in remission but was a result of maladaptive copingand dealing with the PTSD an bipolar symptoms.Per DSM-5 Individuals with PTSD are 80% more likely than those without PTSD to have symptoms that meet diagnosticcriteria for at least one other mental disorder (e.g. depressive, bipolar, anxiety, or substance use disorders) (p 280)It is not possible to differentiate what portion of the impairment is attributable to each diagnosis because all of the veteran'schronic PTSD and bipolar symptoms have been chronic, progressive, biologically and behaviorally interactive, and the symptomsare concurrent and overlapping. The veteran’s alcohol abuse is in remission but was a result of maladaptive coping and dealingwith the PTSD an bipolar symptoms. [X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinkingand/or mood. 3. PTSD Diagnostic Criteria Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors.) Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 – “Other symptoms”. Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) Witnessing, in person, the traumatic event(s) as they occurred to others Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related No criterion in this section met. Page 6 of 8 Contractor: VES Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). No criterion in this section met. Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). No criterion in this section met. Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,:” “No one can be trusted,:” “The world is completely dangerous,:” “My whole nervous system is permanently ruined”). Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) No criterion in this section met. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. Reckless or self-destructive behavior. [X] Hypervigilance. Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). No criterion in this section met. Criterion F: [X] Duration of the disturbance (Criteria B, C, D and E) is more than 1 month. Veteran does not meet full criteria for PTSD Criterion G: [X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The PTSD symptoms described above do NOT cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Veteran does not meet full criteria for PTSD Criterion H: For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often Panic attacks more than once a week Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks Memory loss for names of close relatives, own occupation, or own name Flattened affect Circumstantial, circumlocutory or stereotyped speech Speech intermittently illogical, obscure, or irrelevant Difficulty in understanding complex commands [X] Impaired judgment Impaired abstract thinking Gross impairment in thought processes or communication [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a work like setting Inability to establish and maintain effective relationships Suicidal ideation Obsessional rituals which interfere with routine activities [X] Impaired impulse control, such as unprovoked irritability with periods of violence Spatial disorientation Persistent delusions or hallucinations Grossly inappropriate behavior Persistent danger of hurting self or others [X] Neglect of personal appearance and hygiene [X] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene Disorientation to time or place IF YOU HAVE PROVIDED ANY ADDITIONAL DIAGNOSES, OR IF THE ESTABLISHEDDIAGNOSIS HAS CHANGED IN ANY WAY, PLEASE SELECT AT LEAST ONE FROM THEFOLLOWING:A. THERE IS NO CHANGE IN THE SERVICE CONNECTED DIAGNOSIS AND NOADDITIONAL DIAGNOSES HAVE BEEN RENDERED.B. THE NEW DIAGNOSIS IS A CORRECTION OF THE PREVIOUS DIAGNOSIS.C. THERE IS A WORSENING OF THE VETERAN’S SYMPTOMS HOWEVER NO CHANGETO THE SERVICE CONNECTED DIAGNOSIS AND NO ADDITIONAL DIAGNOSES HAVE BEENRENDERED.D. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE DIRECTLY DUE TO ORRELATED TO THE SERVICE CONNECTED DIAGNOSIS (I.E. A PROGRESSION).E. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE UNRELATED TO THESERVICE CONNECTED DIAGNOSIS (I.E. A NEW AND SEPARATE CONDITION).***FOR OPTION E, PLEASE SPECIFY WHICH OF THE VETERAN’S SYMPTOMS AND/ORFINDINGS CORRESPOND WITH EACH DIAGNOSIS, IF FEASIBLE.***F. THE SERVICE CONNECTED DIAGNOSIS HAS RESOLVED. Answer Question 1: C. There is a worsening of the veterans symptoms however no change to the service connected diagnosisD. Additional diagnosis is alcohol use disorder in partial remission which is a new and separate conditionbut is related to the service connected conditionsAdditional Question 2: FOR OPTIONS OTHER THAN A AND C PLEASE PROVIDE YOUR MEDICAL RATIONALE. Answer Question 2: D. It is related as alcohol use disorder is often secondary to his PTSD and bipolar disorder and is currentlyin remission but was a result of maladaptive coping with his symptoms in the past and he still hasoccasional relapses./ THE VETERAN’S ESTABLISHED DIAGNOSIS IS POST-TRAUMATIC STRESS DISORDERWITH BIPOLAR DISORDER .IF YOU HAVE PROVIDED ANY ADDITIONAL DIAGNOSES, OR IF THE ESTABLISHEDDIAGNOSIS HAS CHANGED IN ANY WAY, PLEASE SELECT AT LEAST ONE FROM THEFOLLOWING:A. THERE IS NO CHANGE IN THE SERVICE CONNECTED DIAGNOSIS AND NOADDITIONAL DIAGNOSES HAVE BEEN RENDERED.B. THE NEW DIAGNOSIS IS A CORRECTION OF THE PREVIOUS DIAGNOSIS.C. THERE IS A WORSENING OF THE VETERAN’S SYMPTOMS HOWEVER NO CHANGETO THE SERVICE CONNECTED DIAGNOSIS AND NO ADDITIONAL DIAGNOSES HAVE BEENRENDERED.D. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE DIRECTLY DUE TO ORRELATED TO THE SERVICE CONNECTED DIAGNOSIS (I.E. A PROGRESSION).E. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE UNRELATED TO THESERVICE CONNECTED DIAGNOSIS (I.E. A NEW AND SEPARATE CONDITION).***FOR OPTION E, PLEASE SPECIFY WHICH OF THE VETERAN’S SYMPTOMS AND/ORFINDINGS CORRESPOND WITH EACH DIAGNOSIS, IF FEASIBLE.***F. THE SERVICE CONNECTED DIAGNOSIS HAS RESOLVED.Answer Question 1: C. There is a worsening of the veterans symptoms however no change to the service connected diagnosisD. Additional diagnosis is alcohol use disorder in partial remission which is a new and separate conditionbut is related to the service connected conditionsAdditional Question 2: FOR OPTIONS OTHER THAN A AND C PLEASE PROVIDE YOUR MEDICAL RATIONALE.Answer Question 2: D. It is related as alcohol use disorder is often secondary to his PTSD and bipolar disorder and is currentlyin remission but was a result of maladaptive coping with his symptoms in the past and he still hasoccasional relapses.

Still waiting on my envelope, and figured I'd ask the crew.

Hardcore alcoholic for 11+ years (functional we may say) Couldn't get help was working as a military contract and always travelling on the road Baker Act for 6-7 suicide attempts over 6 private opinions gaf no higher than 50 Attempted Short term disability in 2012 and could not continue $2000 a month in child support unable to stop working to seek help because of state sanctions they imposed. Most recent biopsych eval done week and a half before C&P Exam shows GAF of 45 dx of PTSD, anxiety, depression, BiPolar I So basically when I'm in a good mood or things are going well I am fine, when things are stressful and things goes wrong I'm a complete charlie foxtrot I welcome your opinions. See link to download redacted doc and tell me your thoughts http://expirebox.com/download/a9ed3eaf4f89d076241678f1d60d8adf.html

@broncovet my contract vehicle is ending on december 16 so i will be unemployed unforunately I also submitted a letter stating that fact. With me breaking down due to all the stress it has made things 10x worse in my own head..I have more details if you want to take a gander. Maybe we can take this offline in PM'

In recently received my C&P exam and here is a summary of the results. What do you believe my raiting would be? This was done using the DSM 5 standards.The examiner found that you do have a diagnosis of PTSD that meets the DSM V criteria. He also opined that your PTSD was at least as likely as not incurred in or caused by the claimed in service stressor event. It was also noted that your primary diagnosis is bi-polar Veterans Diagnosis: Depressed mood Anxiety Suspiciousness Chronic Sleep Impairment mild memory loss, such as forgetting names, directions or recent events disturbsncea in motivation and mood difficulty in adapting to stressful circumstances including work or work-settings suicidal ideation impaired impulse control, such as unprovoked irritability with periods of violence i do well when I work and worry if I get 100% if I cannot continue my contracting for the military which would really hurt my kids support and make things more stressful. Though I have difficulty working when things get bad, Is it possible to be 100% without unemployability? just would like some feedback and opinions Sincerelrey Just Some POG

I did receive documentation from my visits, I had an injury stress fractures in my legs, and i had reported these events. I also had a pysch diagnose me me with the following.. You can click on the link below to see what they put in my file. Take a peak let me know. DIAGNOSIS PRINTOUT SNIPPET

Yes I have been on antidepressants since I got out in 2000. I have been baker acted 8 times or more. I have requested all those medical records and am waiting on few to trickle in. I have been getting treatment recently but through out the last 15 years have had STD claims for mental health, assessments for substance abuse etc.. I am currently in treatment for substance abuse.

BEFORE YOU READ THROUGH ALL MY BULLSHIT - I AM JUST LOOKING FOR OPINIONS ON IF YOU THINK I WILL BE SUCCESSFUL IN MY CLAIM - THERE IS NO DOCUMENTATION OF DISABILITY (Other than ADHD) OR TRAUMA/MENTAL HEALTH ISSUES Prior to enlistment.So in a nutshell here is how shit went down.Enlisted at 17 - unmedicated person with ADHD paying attention to detail well? (Anyone with ADD/ADHD know thats a xxxxxxx pipe dream)Made it through basic - End of Blue phase viictory forge, get stress fractures.Rolled back to another company, stress fractures worsen, and sent to PTRP -Now during my time in service as you can imagine I was always xxxxxxx up. So had many people get physical with me, punch hit, shove, and generally torture me throughout training. I once had a full canteen slammed against my head from across the room due to my punishment keeping everyone up all night. Needless to say it wasn't fun. So Transfer to 1/87, and then over to PTRP. I didn't fit in well, and apparently I still had a knack for getting everyone punished. I got an ass whooping from a couple vets, and constant harrasment. Them xxxxxxx up my boots, uniform, bunk. Basically bullshit you'd think would come out of a highschooler. They were pissed at me, and they got back at me through physical violence and other ways. They made my life hell.So all that bullshit aside, shit got unberable, I attempted suicide to get away from these fucks. Was diagnosed with Adjusted mood disorder with anxiety and depression.*Note* I am not a successful contractor, and have been for the military since 2005 and have worked on hundreds of installations, as well as the Pentagon and CENTCom. I have always tried to make up for my lack of service in one way or another, and it still affects me to this day.So let me get down to the skinny of things. When I got out, life sucked, I felt like a failure (BOTH parents had 10+ years of Army service and were NCO's). Dad thought I was a failure etc... So that sucked, then the hell they put me through I couldn't get off my mind and the shame and failure of letting my country down. Since I got out of the service I was always on anti-depression medication. I developed a drinking problem over the years, and shit got worse. I 2002-2007 shitty marriage that was affected by my drinking, depression, anxiety etc.. 2007 I spiral out of control emotionally Baker act here, probably about 8 or more times in the last 10 yeas.So from early 2000's after my discharge until now I had multiple different problems diagnosed. The follow conditions I have medical records for: Chronic depression, Bi-polar disorder, axiety disorder with acute exacerbation, alchohol abuse, mood disorder. Lastly I was diagnosed in April of 2016 with PTSD after seeing a licensed mental health therapist. I had issues with staying employed due to anxiety, depression, anger issues. I have had multiple employment issues due to my drinking, anxeity, anger, deperssion. I have been able to keep it together for a while, I was very proficient technically, but I always seem to have a major issue after a year or two. I haven't held down a job for over 2 years since 2009. Though I made good money contracting, my skills are valuable, as well as my clearance so I could always jump from contract to contract, and make at least 6 figures in 6-8 months to support myself. I have records when I took short term disability for deperession, alcoholism/alcohol abuse. I have al the records from every baker act and evaluation from every pysch I saw I attached to my claim. So basically I have probaby 30 documents after my discharge that show I have had issus since the early 2000. I have provided them with my list of medications from my current doctor, and the combination of vyvance, trentillix, ativan, and sleeping pills seem to level me out. I have an article I also attached to the case that I wrote for a friend that wrote a paper while in FBI school in reference to mental health, and addiction. I also attached a response from my girlfriend (OIF 1 and 3 VET 70% disabled) with her persepctive for them to review. All in all I can function well medicated, but have had a SHIT TON of issues since leaving the service and reliving the hell those fucks put me through. Now I know this compares to NOTHING that others have gone through in reference to PTSD, some may view my issue as weak, but I did my best and I am still doing my best to service my country as a contractor. Something about getting the absolute shit beat out of you a couple times by some pissed off soldiers can cause you to be pretty angry and xxxxxx about things. Anyways.. So online in Ebenefits I filed for the following disability ratings. I am looking to see what the general opinion is on whether I may be able to get granted a disability compensation claim.My Service Record Verification Letter says this and below are my pending disabilities. So What say you all smart people? Branch of Service Entered Active Duty Discharged Character of Service Army July 22, 1999 January 14, 2000 Honorable (You may have additional periods of service not listed above.) So does it all bode well for me or am I relatively xxxxxx? Pending Disabilities Disability Submitted Type Actions Major Depression 08/30/2016 NEW Alcohol Abuse 08/30/2016 NEW Bipolar Disorder 08/30/2016 NEW Stress Disorder 08/30/2016 NEW Stress 08/30/2016 NEW Mental Disorder 08/30/2016 NEW Anxiety Condition 08/30/2016 NEW Personality Disorder 08/30/2016 NEW Post Traumatic Stress Disorder (ptsd) Personal Trauma - Mental Disorders 08/30/2016 NEW Stress Disorder 08/30/2016 NEW Unemployability 08/30/2016 NEW Mental Disorders (related To: Ptsd - Personal Trauma) 08/28/2016 NEW Anxiety Condition 08/28/2016 NEW Depression (related To: Ptsd - Personal Trauma) 08/28/2016 NEW Post Traumatic Stress Disorder (ptsd) Personal Trauma - Mental Disorders 08/28/2016 NEW Post Traumatic Stress Disorder (ptsd) Personal Trauma - Mental Disorders 08/28/2016 NEW Mental Disorder 08/28/2016 NEW Ptsd Personal Trauma 08/28/2016 NEW Unemployability 08/28/2016 NEW Post Traumatic Stress Disorder (ptsd) Combat - Mental Disorders (related To: Ptsd - Personal Trauma) 08/26/2016 NEW Anxiety Condition (related To: Non-ptsd Personal Trauma) 08/26/2016 NEW Major Depression (related To: Ptsd - Personal Trauma) 08/26/2016 NEW Depression (related To: Ptsd - Personal Trauma) 08/26/2016 NEW Mental Disorder (related To: Ptsd - Personal Trauma) 08/26/2016 NEW Ptsd Personal Trauma 08/26/2016 NEW Unemployability 08/26/2016 NEW Mental Disorders (related To: Ptsd - Personal Trauma) 08/26/2016 NEW Ptsd Personal Trauma 08/26/2016 NEW