IMEF-Gunny

Rating came in, 70% anxiety. I do attend therapy and take medication for Depression and anxiety. I am diagnosed with PTSD, major depressive disorder and anxiety secondary to IBS. I am rated only on the anxiety.
Total rating is IBS 30%, Fibromyalgia 40%, Hearing 0%, Tinnitus 10%, Anxiety 70% - Total 90%

The best way to deal with a lousy C & P exam is what veterans do not often want to hear.....
They need to get an Independent Medical Opinion from a doctor with enough expertise in  the field of  the disability to combat the faulty C & P exam.
They must follow the IMO criteria here at hadit and attach a CV (Curriculum Vitae) and give a strong medical rationale.....
I dont give advise on IMOs without having done that myself.
My lay medical opinion and evidence was enough to win a FTCA case, but that is only because I dealt with OGC lawyers and VACO and these high level VA people can read.( and I was a very agressive claimant,keeping on my issues all the time ) In those days I could not find any IMo doctor  or even any lawyer would would help me.
But for my DMII AO claim I got 3 IMOs. 4 thousand for 2 of them and a freebee, and I knocked down their last C & P 
myself and sent my rebuttal to the BVA-and BVA concurred with me.
I have not been able to comprehend WHY veterans have not fought aggressively against the VA's C & P system.
It is an utter conflict of interest ( as they get paid by the VA) and of course their exam results are the basis of countless denials amd therefore a main reason for the backlog.
As anyone can see by reading BVA awards (RO awards are not public), many denials are overturned by a Real 'non Va -doctor's opinion.
Is that fair? Of course not because many of those opinions are very costly.
But until vets themselves start complaining directly to Shulkin and Trump and the H/S veterans Affairs Committees and to any Congressman/woman or Senator who sits on those committees or the sub committees on Disability, the VA wil continue to deny claims, solely based on a VA medical opinion.
When I knocked down the last posthumous C & P exam (which the BVA had ordered) The BVA had asked for a cardio opinion, and I then paid for another IMO, and stressed to the BVA  in an immediate rebuttal, that the opinion was done by a PA and the BVA already knew ( from my past FTCA/1151 awards,) I knew more cardio than the PA did and that his opinion was too speculative.
I didnt have the 4th IMO yet. Soon after sending my rebuttal to the BVA ,a big brown BVA envelope came and I firgured it belonged to someone else ( I had already received 2 decisions from BVA over the years and had to contact their POAs because the decision was not for my claim.One was an award but the other was a denial and I emailed the POA how they could  fight the denial.)
A few days later I finally opened the BVA envelope and was shocked because it was an award, for my AO DMII claim! I called the forensic firm who had sent my IMO stuff to their cardio doc and they refunded about half of my fee, because the IMO had not been prepared yet and I didnt need it.
When will veterans  ever unite and decide to do something serious about these lousy C & P exams??????
 
 
 
 
 

"The presumption of sound condition has not been addressed. The VA has to show that the MDD was NOT resolved before you entered the service. Did they do that? I dont see it."
Actually, I spoke with a corpsman for 5-10 minutes in bootcamp and the "opinion" came from someone with a science degree after review the corpsmans notes. The last line in those papers were "Deemed fit for duty, return to company".
I posted the info on the comp & pen forum for Berta in a post titled My letter refuting VA........

The VA sent back for a medical opinion, since their doc said I was MDD pre-existing, to inquire about possible aggrivation.......here is his response. Seems denial is imminent.....bear in mind, NO WHERE in my history, records, buddy statements, etc is there evidence of being "relatively symptom free" for 25 years.....quite the contrary, the Pre-existing opinion was based on (2) minor incidents with alcohol as a teen, that was not addressed at MEPS.....but two weeks into training at bootcamp......and I saw a navy corpsman and a his superior who was not a psychologist. ........and they wonder why vets get frustrated and go ape shit......
 
b. The claimed condition, which clearly and unmistakably existed prior to
service, was not aggravated beyond its natural progression by an in-service
 
event, injury or illness.
c. Rationale: It would be speculation to determine the presence of
aggravation due to any trauma occurring during veteran's military
service.
This conclusion is based on the following: 1) Veteran has multiple
established factors increasing the likelihood of depression including
relationship difficulties, early family risk factors, and alcohol abuse.
These established factors are likely associated with significant aspects of
veteran's depression. Separating out the portion of depression
attributable
to trauma in the presence of these other larger factors would be a
questionable exercise at best. 2) The literature to establish a connection
between trauma and depression does not exist in a way that allows
application
in this situation. PTSD and Major Depression likely have some level of
concordance (having one diagnosis increases the likelihood of having the
other diagnosis); however, even this literature has not established firm
levels of concordance depending on the severity of trauma, family history,
and other risk factors not to mention the more than 25 years between the
trauma and current functioning such as exists for the veteran. In addition,
this literature is about diagnosed PTSD, not just a trauma having occurred.
Similarly, there is literature on connection between general stresses and
depression but again not in a manner that allows the assessment of a 25 year
lapse between stress and current depression. 3) Veteran's depression is
very
mild. The mildness of the depression suggests that any portion of
depression
attributable to aggravation would be very small. Smaller than the accuracy
of current psychological strategies to measure.
*************************************************************************

So, I'm discussing the VA with an associate of mine. He was Air Force, Operation Southern Watch 1996 Kuwait. He comments that he doesn't have VA benefits because he had to get out with a General (under honorable conditions) discharge. He was told this by the local VSO back in 1996-1997.
I was shocked that he went all these years believing that he did not qualify for benefits from the VA. The VSO took one look at his discharge papers and said "Can't help you, you don't qualify".
Moral of the story.......We are our brother's keeper. If you travel the path, down the rabbit hole if you will, of navigating the maze that is the VA......pay that experience forward and assist your fellow veterans......As we were in the 40's, 50's, 60's, etc.....we are all in this together!

My interpretation would be "clarification" of your previous diagnosis (Actually reading as symptomology of PTSD), he alludes to stressors....I'd say he is saying proper diagnosis would be PTSD, rather that a culmination of anxiety, depression and adjustment disorder. Just my .02

Had a MH appointment yesterday at my VAMC. They upped my meds......which was definitely needed. My therapist strongly disagreed with the C&P doctors assessment/diagnosis. She said, she's been doing this a long time and has treated a lot of PTSD vets over the years......she said "I know it when I see it"!
She's a very nice lady, but seemed perturbed < sp by his opinion.
Still in prep for decision......funny thing is, I don't care about the money aspect of GWI or MH.....I'd just like the government to have the integrity to admit they knew what we were subjected to and they were willing to sacrifice us for their end goal......like agent orange.....they knew, they covered up, denied, destroyed records........maybe someday!

So, Ebennies is a hard habit to break for a vet with anxiety....we all know that, but it NEVER updates, so I call Peggy "somewhat" frequently. Sometimes you get very polite folks who dig and look, sometimes you get a bolo!
I call yesterday, right off, this guy sounds like he has the enthusiasm of a tortoise traveling through a marshmallow cream field in 130 degree heat.....I'm sure (in his defense), he has answered 1,000 questions since 8am, but he's no "people person" by 4pm!
He says (with a very preturbed tone) "Shows here that you just called 2 days ago for a status update, and you want another one already?"......."I seriously doubt anything has changed in 2 days, but i'll look"......"no, nothings changed" ....."anything else"?
Think he's frustrated.....try being a vet 360 days into an initial claim...a Vietnam vet who is STILL fighting for "Presumptive" conditions.........hell, who knows.....maybe he is! Alas, I digress.....
- Carry on
 

So, Ebennies is a hard habit to break for a vet with anxiety....we all know that, but it NEVER updates, so I call Peggy "somewhat" frequently. Sometimes you get very polite folks who dig and look, sometimes you get a bolo!
I call yesterday, right off, this guy sounds like he has the enthusiasm of a tortoise traveling through a marshmallow cream field in 130 degree heat.....I'm sure (in his defense), he has answered 1,000 questions since 8am, but he's no "people person" by 4pm!
He says (with a very preturbed tone) "Shows here that you just called 2 days ago for a status update, and you want another one already?"......."I seriously doubt anything has changed in 2 days, but i'll look"......"no, nothings changed" ....."anything else"?
Think he's frustrated.....try being a vet 360 days into an initial claim...a Vietnam vet who is STILL fighting for "Presumptive" conditions.........hell, who knows.....maybe he is! Alas, I digress.....
- Carry on
 

My VAMC MH diagnosed me with PTSD after several sessions, reading my letters, files, buddy statements and interviewing my spouse. I refused that diagnosis. I am being treated (finally agreed to take medication) and it has helped me a lot. However, I have not filed a PTSD claim. I feel like, compared to a lot of my brothers out there ie; Vietnam veterans (God bless all of them), who seen, on average 20+ days of combat action per month, my actions, incidents were trivial in comparison.
For 26 years I drank, occassionally cried/melted down, nearly lost every job I'd ever had, never fit in (nor want to), haven't slept a full night, had/have no friends to speak of, and have & continue to be viewed as "intense and or intimidating" by all who know or meet me. 0 family relationships outside my wife & kids, wrestle with alcohol use and I have few real emotions anymore......but I'm trying. In the last 3 years, things have intensified 100 fold.......felt like my mind was breaking. I got to where I distanced myself, even from my kids and sat on many occassions, alone drinking with a 9mm in my lap.
 My next step will be visiting the Vet Center, maybe, for a group session. Baby steps.......but I still will likely never file a PTSD claim.

I'm a Gulf War Vet, Marine Corps
So, here's my timeline:
Filed June 6th 2016 (Gastro-intestinal distubances (Alt. diarrhea/constipation, bloating, leakage), sleeplessness,Short term memory issues, bi-lateral shoulder pain, bi-lateral arm pain)
January 2017 - First C&P (lasted about an hour, DBQ, x-ray, hemmoroid check)
Awarded 30% for undiagnosed illness (Gastro-intestinal)
All other items deferred pending further evidence gathering
VSR added stool incontinence to my claim based on C&P results
January 13,2017 - Found out through myhealthevet VA notes that the C&P exam was sent back to doc (VA hospital) as incomplete as he was suppose to conduct a screening of all contentions
January 20, 2017 - VA doc responds to request that "Vet only complained about his stomach and his hemmoroid" "Vet denied any other issues"
Uploaded a letter to my claim disputing his response (He asked if I had any other issues, I said yes and explained all of them to him, he asked if I had hemmoroids, I said "Not that I am aware of"
April 2017 - Request showing request 1 (VA medical facility) (Found out they were awaiting STR's and IANG records from Records Management)
April 2017 - Uploaded complete STR's and IANG records, in my posession, that I FOIA'd back in December 2016
May 2017 - Pushed the "Decide my claim now" button
No movement since. Call Peggy.....decision made, awaiting signature. Call next day, gathering evidence stage & waiting on STR's, IANG records. Has been the same responses.....one person will say done, just waiting on signature, next will say gathering evidence, no decision made.....every call is a different answer...ah, anxiety + Ebenefits = Zoloft
Currently being treated for PTSD via local VAMC (Zoloft, Prazosin, Bupropion + therapy)
My STR's show Gulf War service, med call for lower lumbar injury, no (in country med reports I'm aware of....happens with Corpsmen in theater), no private records from 1990-2007 (Doctor's office threw them all away in 2014 per state law's retention policies).....so, all I have is, DD214's/DD215's, buddy statements and C&P's to prove my issues.
I feel pretty fortunate though....they could have denied me across the board after the C&P docs answer (He was a very nice guy, an 87 year old Iranian General Practioner/Family Medicine doctor at the VA hospital.....probably the memory issue that caused the discrepancy at my C&P)