justaspouse

Well, I called the BVA today and apparently they haven't made a decision yet. I guess I'm sort of confused since my status states that they made a decision and are mailing it to me and our representive.... so my question is the status wrong or did the guy just want to get me off the phone without an answer? I wish they would get their shit straight.

We logged into Ebennies today and after almost 7 years the Status changed to "Pending Case Dispatch. This indicates that a Veterans Law Judge has made a decision on your appeal, and that final administrative steps are being taken by the Board to ensure that you (and your representative, if any) are mailed a copy of the decision. Little nervous. Doesn't look like another remand. Not being sent somewhere, just a straight up decision with no change in my AB8 letter. Feels like a denial. Not sure if I even have a question for anyone. Just feeling pretty scared. Blah.

My wife is rated at 30% for asthma. She filed for depression and we looked at the copy of the C&P. The examiner left out many important testimony and seemed to paint a false narrative. Furthermore, I travelled to the C&P exam with her to provide secondary testimony and to my surprise they denied me access to the exam. We are rather stressed out from the outcome since my wife had to quit her job 8 months ago because of her asthma attacks (she was a manager at her employment for over 10 years) so things are a bit stressful. Anyway I will display the meat of the C&P hoping to get some good advice. Thanks everyone for your time. SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [ ] Yes [x ] No ICD code: If no diagnosis of PTSD, check all that apply: [x ] Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria [ ] Veteran does not have a mental disorder that conforms with DSM-5 criteria [x ] Veteran has another Mental Disorder diagnosis. Continue to complete this Questionnaire and/or the Eating Disorder Questionnaire: 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Adjustment disorder with depressed mood ICD code: Comments, if any: It is at least as likely as not that the veteran's adjustment disorder is related to her service connected asthma. The veteran does not meet criteria for PTSD as she did not report experiencing a Criterion A stressor. The veteran does not meet full criteria for a major depressive disorder. She did not report symptoms sufficient to satisfy criteria for a major depressive disorder. Her depressive symptoms are rather mild and a few symptoms (i.e., fatigue, poor sleep) are likely better accounted for as secondary to her physical health concerns. The veteran does not meet criteria for an anxiety disorder as she denied clinically defined anxiety criteria. She reported some anxious feelings when having trouble breathing or hyperventilating. Hyperventilation can mimic the effects of anxiety though this is not true anxiety in a clinical sense. The veteran has no history of mental health treatment to verify her claims. Her self-report was found to be credible for the current examination. Mental Disorder Diagnosis #2: ICD code: Comments, if any: Mental Disorder Diagnosis #3: ICD code: Comments, if any: If additional diagnoses, list using above format: b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): ICD code: Comments, if any: 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes [x ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [ ] No [x ] 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: If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [x ] Not shown in records reviewed Comments, if any: d. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [ ] No [x ] 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: If yes, list which symptoms are attributable to each diagnosis: 3. 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) [ ] No mental order diagnosis [x ] A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication [ ] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication [ ] 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 [ ] Occupational and social impairment with reduced reliability and productivity [ ] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood [ ] Total occupational and social impairment b. For the indicated level of occupat ional 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 [ ] No [x ] 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: If yes, list which 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 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: If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence Review ------------------ Evidence reviewed (check all that apply): [ ] Not requested [ ] No records were reviewed [ ] VA claims file (hard copy paper C-file) [X ] VA e-folder (VBMS or Virtual VA) [X ] CPRS [ ] Other (please identify other evidence reviewed): Evidence Comments: No history of mental health treatment. 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): The veteran was born and raised in Wisconsin by both parents; 1 older sister. Veteran reported having a good childhood. "I had good parents, a good life." She denied a history of abuse/neglect. She denied a family history of substance abuse or mental illness. She reported that she maintains a good relationship with her family. The veteran has been married for 16 years; 2 children. She reported that they have a good relationship. No abuse. She reported that she does not have any friends that she spends time with. "I'm always sick" which she explained as being problems with breathing, hyperventilating, and migraine headaches 1-2x a month. She reported that she has been having more frequent problems with asthma and breathing in the last 8 years. "They want to go out but I don't want to." No social groups. She said that she spends most of her time sleeping. b. Relevant Occupational and Educational history (pre-military, military, and post-military): Veteran graduated high school in 1996. She described herself as an A/B student. No learning or behavioral problems. After high school, she graduated from UMD in 2000 with a degree in criminal justice. Air Force 09/2000-11/2005; Hon DC, O3. Logistics Readiness. She was deployed to Oman (2002). The veteran was working at Super Value as a warehouse supervisor where she worked for 10 years. She quit her position because "I couldn't do it physically anymore." She was getting bronchitis frequently when she was in the refrigerated area. She said that she moved around a lot. Eventually she said that has not looked for employment saying that she would need a position that pays well and allows for "a lot of sick and vacation time." c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): No history of mental health treatment. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): No legal history e. Relevant Substance abuse history (pre-military, military, and post-military): Veteran reported that she does not drink alcohol. No drug use. Veteran does not drink coffee, rare soda, no energy drinks. No tobacco f. Other, if any: 3. Stressors --------------------------- The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors). NOTE: For VA purposes, "fear of hostile military or terrorist activity" means that a Veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury. Or a threat to the physical integrity of the Veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft. Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [ ] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [ ] No If no, explain: Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. b. Stressor #2: Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [ ] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [ ] No If no, explain: Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. c. Stressor #3: Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [ ] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [ ] No If no, explain: Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. d. Additional stressors: If additional stressors, describe (list using the above sequential format): 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 stress/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 (DMS-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [ ] 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 events(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. [x ] No criterion in this section met. 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: [ ] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [ ] 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). [ ] 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). [x ] No criterion in this section met. 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: [ ] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [ ] 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). [x ] 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. [ ] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [ ] Markedly diminished interest or participation in significant activities. [ ] Feelings of detachment or estrangement from others. [ ] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) [x ] 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: [ ] 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. [ ] Hypervigilance. [ ] Exaggerated startle response. [ ] Problems with concentration. [ ] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). [x ] No criterion in this section met. Criterion F: [ ] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. [x ] Veteran does not meet full criteria for PTSD Criterion G: [ ] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. [x ] Veteran does not meet full criteria for PTSD Criterion H: [ ] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. [x ] Veteran does not meet full criteria for PTSD Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [ ] Stressor #1 [ ] Stressor #2 [ ] Stressor #3 [ ] Other, please indicate stressor number (i.e., Stressor #4, #5, etc.) as indicated above: [x ] No criterion in this section met. 5. Symptoms ----------- For VA rating purposes, check all symptoms that apply to the Veterans diagnoses: [x ] Depressed mood [ ] Anxiety [ ] Suspiciousness [ ] 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 [ ] Chronic sleep impairment [ ] 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 [ ] Impaired judgment [ ] Impaired abstract thinking [ ] Gross impairment in thought processes or communication [ ] Disturbances of motivation and mood [ ] Difficulty in establishing and maintaining effective work and social relationships [ ] 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 [ ] 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 [ ] Neglect of personal appearance and hygiene [ ] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene [ ] Disorientation to time or place 6. Behavioral Observations -------------------------- Appeared alert and oriented. Grooming and dress were appropriate. Good eye contact. No apparent pain or distress. Friendly, cooperative, and good effort given. Good social skills. Adequate insight. Speech and thought content was unremarkable. Described mood as "tired, depressed." Affect was tearful throughout the exam. Energy described as "low, I just want to sleep." She described her sleep as "I have trouble breathing and have to prop my head up on a couple of pillows." She said that she does not get good sleep and wakes up tired most of the time. She will "sleep as much as I can if I can" during the day as well. "I get cranky if I can't sleep." Reported having adequate self-esteem, "I just wish I was healthy." Stated that she tends to stays positive about her future. Endorsed a few clinical symptoms of depression including: low mood and isolation. Denied anxiety. She said that she feels anxious if she starts hyperventilating. Denied manic symptoms. Denied obsessive/compulsive symptoms. Did not describe panic attacks. Described having adequate concentration and memory. "Sometimes it's not great. Maybe because I'm not getting adequate." Denied SI/HI or psychosis. 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X ] No If yes, describe: 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X ] Yes [ ] No If no, explain: 9. Remarks, if any ------------------ Test Results ---------------- MMPI2-RF: Validity: The veteran was attentive and consistent with her responses. There was no indication of random, confused, or defensive responding. Profile is valid and interpretable. Clinical Correlates: Individuals with similar profiles are reporting significant subjective distress. They are likely to describe themselves as discouraged and demoralized. They are at increased risk for depression. They lack positive emotional experiences, tend to withdraw from social settings, and are likely passive in relationships. Reliability and credibility of self-report ---------------------------------------------- No significant concerns noted The purpose of the evaluation and limits of confidentiality were discussed and the veteran gave informed consent. [Yes] Time spent in evaluation: ----------------------------- Clinical interview: 45 Record review: 45 Report preparation: 10 ------------------ NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.