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Braincloud

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  1. I was awarded 70% for PTSD and have the option to apply for IU. I was wondering if I would start getting pay for my 70% along with retro or will they wait for me to submit my IU form? I normally wouldn't mind the wait, but I am homeless and my claim went from prep for notification back to gathering of evidence. Thanks
  2. Thanks everyone for or your advice, but what does "This condition is more likely than not (greater than 50% probability) related to military service. Rationale: Traumatic stressors resulting in PTSD occured while active duty and inthe line of duty."
  3. This is my initial claim, so will requesting my c-file actually help. I am also using e-benefits for my completion date and info, but spoke with someone on the benefits who stated that my claim was complete. My mental DBQ is below. 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: 309.81 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD ICD code: 309.81 Comments, if any: This condition is more likely than not (greater than 50% probability) related to military service. Rationale: Traumatic stressors resulting in PTSD occured while active duty and i the line of duty. Mental Disorder Diagnosis #2: Major Depressive Disorder, severe ICD code: 296.32 Comments, if any: This condition is more likely than not (greater than 50% probability) related to military service. Rationale: Veteran was seen for Psychiatric counseling with depressed mood while active duty. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 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: Due to the overlapping and intricately interwoven symptoms of PTSD and Major Depressive Disorder it is not possible, without resorting to mere speculation, to differentiate what portion of each symptom is attributable to each diagnosis. The two diagnoses have a strong clinical association and likely exacerbate each other. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood 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: Due to the overlapping and intricately interwoven symptoms of PTSD and Major Depressive Disorder, severe, it is not possible without resorting to mere speculation to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis. 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 2. History ---------- not connect well with others, experienced "mood changes". Veteran lost a mentor, Lt Col Joseph A. Hoelscher who died April 26, 2006 at Eglin AFB. The mentor was doing a physical fitness test and became unresponsive, Veteran was a first responder and was unable to save him. Wonders now what the mentor's family thinks. Also went to 2-3 month course twice in Maryland, University of Maryland in trauma ER and ambulance training in Baltimore. He had a lot of DNR calls and "watched them die". He also had multiple calls on trauma resessitations, including children. Had been married and got divorced. b. Relevant Occupational and Educational history (pre-military, military, and post-military): Stayed with parents when out of military, could not work with people, became reculsive. Worked five months at a job that brother got for him as an assistant pressmen. Missed a lot of days and then just quit, could not deal with being around people. Wife suggested they come back to Alaska, he got a job working in a warehouse, pulling lines, but quit after two weeks due to depression. c. R elevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): Wanted to seek help at Eglin but being a medic he feared others could see his records. In England saw a social worker for therapy and Dr. Talon. REF Upwood in England for a year. Hospitalized in Providence Hospital in 2015 for a week due to suicidal ideation, started on Prozac and rimron,switched to Effexor 225mg and rimron 15mg and klonipine for panic attacks, which he took 3-4 times a month. With rimron he was able to get some sleep. Continues to have night sweats and nightmares, which have to do with not being able to save people. He did attend group therapy and saw SW for therapy. Currently has tremendous difficulty with motivation. He recognizes that he has avoided therapy due to fear. Now that wife is working there are days Veteran does not get out of bed at all, wife directs him to take showers, change clothes. He does talk with Mom and brother on the phone, feels he needs a lot of time alone, goes on walks, smokes a cigarette. No social life here, no friends, just spouse. Continues to not be comfortable around people. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): In veteran's court for domestic violence. Finished Vet Court and eight months of treatment for PTSD and domestic violence, took 8 months instead of 6 months because had difficulty getting out of bed, depressive symptoms. e. Relevant Substance abuse history (pre-military, military, and post-military): Use to drink some and that seemed to have a relationship to the domestic violence, which did involve alcohol, now very seldom uses alcohol. Continues to smoke. f. Other, if any: Admitted to Providence Psychiatric Unit 10/13/2015 - 10/19/2015 with diagnosis of Major Depressive Disorder, severe; PTSD, and Social Anxiety Disorder. Medications: bupropion 300 mg 24 hr tablet Commonly known as: WELLBUTRIN XL Take 1 tablet by mouth Daily. Cholecalciferol 2000 UNITS Tabs Commonly known as: VITAMIN D-3 Take 2 tablets by mouth Daily. mirtazapine 30 mg disintegrating tablet Commonly known as: REMERON SOLTAB Take 1 tablet by mouth nightly for 30 days. 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: First responder at the death of his mentor, Lt Col Joseph A. Hoelscher who died April 26, 2006 at Eglin AFB. The mentor was doing a physical fittness test and became unresponsive, Veteran was a first responder and was unable to save him. Felt he received no debriefing or support. 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? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No b. Stressor #2: Also went to 2-3 month course twice in Maryland, University of Maryland in trauma ER and ambulance training in Baltimore. He had a lot of DNR calls and "watched them die". He also had multiple calls on trauma resessitations, including children who died. 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 If no, explain: Working in Baltimore ER for training in ER medicine, 4-6 months total, while active duty, C-STARS class. 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] Witnessing, in person, the traumatic event(s) as they occurred to others 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 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). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: 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 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: [X] 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). [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] 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. 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] 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 [X] Stressor #2 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Panic attacks that occur weekly or less often [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Flattened affect [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 worklike setting [X] Neglect of personal appearance and hygiene [X] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene
  4. Hello, I am new here. I just received a rating of 10% for my back with a completion date of 10/01/16. However my PTSD claim states deferred. My C&P exam shows that I have in-service stressors and have been diagnosed with PTSD. Anyone know why this is happing?
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