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smith22

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About smith22

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  • Military Rank
    CPT

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  • Service Connected Disability
    90%
  • Branch of Service
    USA

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  1. Dfinnusmc, I am getting ready to file Sleep apnea secondary to PTSD also. I am very interested to see how your claim turned out. Also if you have an example of the Letters your doctor wrote? My doctor said he would write a letter but wanted to know the format. I wish you the best with your claim!!!
  2. I have been following the thread for Sleep Apnea secondary to PTSD. I am in a similar situation I am on TDIU and was just diagnosed with moderate to severe sleep apnea. I am trying to get sample nexus letters to my doctor so I can file claim. Do you have any sample nexus letter I can show my civilian doc. He asked me how it needed to be formatted etc.... Let me know how your case wound up
  3. All, few days ago I was awarded 90% being paid at 100% TDIU. Ebenefits says not P & T. I have 3 questions if someone could help me. My DAV rep was let go and now I have nobody to ask question about my claim. When I applied for TDIU she wrote increase for rating for my Lumbar DDD and PTSD which was 40 & 70% respectively. I have another 30% with both knees and tinnitus. Total rating of 90%. left and right knee is bilateral and radiculopathy is bilateral of left and right leg (not sure how those 4 ratings of 10% each are calculated)? Additionally, I was just diagnosed with moderate to severe sleep apnea and now using CPAP. I have a scar I never sought claim for which is in my medical records. I have high BP... rashes etc... never claimed that happened right after returning from Iraq. Unfortunately, I did not file or seek documentation. Question 1: My TDIU C & P was specific to determine employability which was stated in her notes. She also stated I had a separate and Comorbid diagnosis of MDD. Does that separate diagnosis effect my rating? Can MDD also be filed secondary to low back pain? is there anything I should do as far as claims for 100% SC based of this diagnosis? Question 2: Sleep apnea as 2nd to PTSD or aggrevated as a nexus for claiming sleep apnea even though I have been out 10 years. I have had it last five years before leaving army but never even heard of sleep apnea until recently. Yes, I have gained weight but PTSD dr in c & p stated my weight gain was because of my PTSD/MDD (I posted symptoms below). My question is: Should I file a claim Sleep apnea secondary to PTSD? I see some people said nexus should state PTSD and Sleep Apnea aggravated each other ???? I do not know what to do on this. any help would appreciated... question 3. I do not know how to add up the ratings. If I filed for Sleep apnea secondary to PTSD would that 50% rating take me over 100% sc threshold? I have scar for 10% that I could file that I never did. I know that is petty.... but they did cut out about 7 inches of meat out of my upper back.... left huge crater and scar. Question 4: Do I qualify for 100% SC P & T ? I was told the reason I did not receive 100% sc P & T when I filed for TdIU is because I did not state that in my claim. That I should have stated request for increase and 100% SC P & T rating instead of just TDIU. Really sorry for the long book.. I just do not know where to go and get answers to these questions. Everyone on here seems so knowedgable!!!!! I need your help!!! thanks you Current Diagnoses ------------------------------ If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder ICD Code: F43.10 Mental Disorder Diagnosis #2: Major Depressive Disorder ICD Code: F33.9 b. Medical problems relevant to the understanding or management of the mental health disorder(s): Physical health problems that he described as affecting his day-to-day functioning or requiring the use of daily medication or medical devices include back pain and sleep apnea. Just got a CPAP yesterday. Please see his medical records for additional information about his physical health conditions. 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: These conditions can co-occur, and there is some overlap in their symptoms and associated features, which precludes attribution of certain specific difficulties to one condition or another without resorting to speculation. Consequently, these conditions cannot be fully differentiated from each other. 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 [ ] Not applicable (N/A) 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: As these conditions cannot be fully differentiated from each other, their associated functional impairments cannot be differentiated without resorting to speculation. He has a service connection for PTSD, with a current rating of 70%. This examination was focused on his functioning since the previous examination on 4/xx/2017, although information regarding prior history was reviewed and obtained where relevant to the issues in question. Please see the report of the previous examination for relevant prior history. The present examination was based on a face-to-face interview with the Veteran and review of records as indicated above. Except where otherwise indicated, historical information presented above is taken from the interview. Results of the examination indicate that the Veteran's difficulties are consistent with current diagnostic criteria for PTSD. They also indicate that he experiences symptoms supporting a diagnosis of Major Depressive Disorder (MDD) at this time. These are considered to be separate, comorbid conditions which share some symptoms and a common etiology. Due to the overlap in symptoms and associated features of these disorders, it can at times be difficult to determine--and clinicians may reasonably differ regarding--whether the clinical picture might be better accounted for by a single diagnosis or by multiple diagnoses. Results of the examination indicate that as a result of his mental health conditions, he is experiencing significant impairments in a number of domains, including occupational functioning. As he is no longer working, his occupational functioning is inferred from his past work history, from his current social functioning, and from the nature and severity of his current symptomatology. He has not held paid employment since February 2016, when he lost his job due to irritability and angry outbursts. He indicated a previous history of work-related difficulties due to anxiety and panic. Taken together with fatigue, problems with attention and concentration, forgetfulness, intrusive thoughts, hypervigilance, discomfort in interpersonal interactions, and a propensity for social withdrawal and avoidance as a means of coping with stress, these difficulties would significantly limit his ability to secure and maintain gainful employment. He would likely experience challenges in adjusting successfully to a work environment due to difficulty establishing and maintaining effective work relationships, as well as to reduced reliability, productivity, efficiency, accuracy, and timeliness in attending work and fulfilling job responsibilities. --------------------------- Symptoms --------------------------- 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 more than once a week [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks [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 Other Symptoms --------------------------- Does the Veteran have any other symptoms attributable to PTSD and other mental disorders that are not listed above? [X] Yes [ ] No If yes, describe: [X] Irritable or angry mood [X] Loss of interest or pleasure in activities [X] Appetite disturbance [X] Weight disturbance [X] Fatigue or loss of energy [X] Difficulty thinking, concentrating, or making decisions [X] Feelings of worthlessness or guilt [X] Emotional numbing and detachment [X] Witnessing, in person, the traumatic event(s) as they occurred to others [X] 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. 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] 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] 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] 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] Hypervigilance. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the symptoms described above in Criteria B, C, D, and E is more than 1 month. Criterion G: [X] The symptoms described above cause 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.
  4. May 2016 I was awarded 70% ptsd along with in increase in lower back rating with total of 90% which was effective 1 June 2016. I was notified may of 2017 and in June of 2017 I filed for TDIU on the PTSD and lumbar back increase. I received notification today that I was awarded TDIU with an effective date of 1 June 2017. My question: I believe my effective date should be 1 june 2016 the effective date of my ptsd effective date. My file show I was let go from work in feb 2016. any help would be greatly appreciated.... NOTE: i was just diagnosed with moderate to sever sleep apnea. I need help trying to get a nexus letter to file claim for secondary to PTSD. Any help would again be greatly appreciated.
  5. Trapperx6, I appreciate posting your experience. Thanks.... I have also been scheduled an exam with SSDI for PTSD. I called the SSA office and told them I had just been diagnosed with Moderate to severe sleep apanea. She said make sure to fax test results in as well as my new C & P exam.
  6. All, I competed my C & P exam for TDIU claim for PTSD and Lumbar DDD. I am uploading the notes from my C & P exam for PTSD. The examiner stated I do not know why you are here because your last C & P was in March. If anyone has experience with interpreting the notes I would appreciate your help. I did delete her extensive notes about what I said about my family and events.... My previous C & P exam was 70% for PTSD and total rating of 90% 40 lumbar ddd and radiculopathy, 10% for each knee, 10% for tinnitus. Also I was just diagnosed with Moderate to severe Sleep apnea.... but I have not filed for disability. I would have to get a nexus letter from doc stating secondary to PTSD. If I am denied TDIU I will start that process.... I would like any advice on the results below and also what should I do with sleep apnea claim... I also have High BP... not sure if I should submit Sleep apnea claim and try to go for SC 100% Thanks in advance for your "time and your help" Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No SECTION I: ------------- 1. Diagnostic Summary ------------------------------ Does the Veteran now have or has he/she ever had a diagnosis of PTSD? [X] Yes [ ] No 2. Current Diagnoses ------------------------------ If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder ICD Code: F43.10 Mental Disorder Diagnosis #2: Major Depressive Disorder ICD Code: F33.9 b. Medical problems relevant to the understanding or management of the mental health disorder(s): Physical health problems that he described as affecting his day-to-day functioning or requiring the use of daily medication or medical devices include back pain and sleep apnea. Just got a CPAP yesterday. Please see his medical records for additional information about his physical health conditions. 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: These conditions can co-occur, and there is some overlap in their symptoms and associated features, which precludes attribution of certain specific difficulties to JOHN DOECONFIDENTIAL Page 22 of 68 one condition or another without resorting to speculation. Consequently, these conditions cannot be fully differentiated from each other. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed Comments: Not applicable. d. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [ ] No [X] Not applicable (N/A) 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 [ ] Not applicable (N/A) 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: As these conditions cannot be fully differentiated from each other, their associated functional impairments cannot be differentiated without resorting to speculation. 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 and Virtual VA) [X] CPRS [X] Other (please identify other evidence reviewed): VistaWeb or JLV JOHN DOECONFIDENTIAL Page 23 of 68 2. History ------------------------------ Relevant Family and Social History: Relevant Mental Health History: EVALUATION AND TREATMENT HISTORY EMOTIONAL AND BEHAVIORAL PROBLEMS: SUICIDAL OR SELF-INJURIOUS IDEATION OR BEHAVIOR: Other Relevant History: None reported. 3. 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) JOHN DOECONFIDENTIAL Page 26 of 68 sexual violence, in one or more of the following ways: [X] Witnessing, in person, the traumatic event(s) as they occurred to others [X] 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. 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] 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] 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] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). JOHN DOECONFIDENTIAL Page 27 of 68 [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] Hypervigilance. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the symptoms described above in Criteria B, C, D, and E is more than 1 month. Criterion G: [X] The symptoms described above cause 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. 4. Symptoms --------------------------- 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 more than once a week [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks [X] Flattened affect [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships CONFIDENTIAL Page 28 of 68 [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting 5. Behavioral Observations --------------------------- The Veteran arrived on time for the appointment. His appearance was unremarkable, and his grooming and hygiene were appropriate. He was alert and oriented to person, place, time, and situation. The nature and purpose of the evaluation, the examiner's role in the disability claims adjudication process, and the limits of confidentiality were discussed with him. He verbalized understanding and consented to participate. He engaged well with the examiner, and his responses to inquiries were appropriate in content and level of detail. While no formal evaluation of his mental status was conducted, his cognitive functioning appeared to be adequately intact for the purpose of the present interview. His thoughts were logical, coherent, and goal-directed. His speech was clear and intelligible, and of normal rate, volume, and prosody. There was no evidence of significant expressive or receptive language impairments. There was no overt evidence of perceptual disturbances, delusional beliefs, or perseverative thoughts. His attention, concentration, and motor activity were unremarkable. His mood and affect were appropriate in nature, range, and intensity to the situation and to the topic of conversation. He was tearful throughout much of the interview. He denied current suicidal or homicidal ideation, intent, or plan. He appeared to be a reliable historian and credible informant, and there were no overt indications of malingering or of symptom overreporting or underreporting. 6. Other Symptoms --------------------------- Does the Veteran have any other symptoms attributable to PTSD and other mental disorders that are not listed above? [X] Yes [ ] No If yes, describe: [X] Irritable or angry mood [X] Loss of interest or pleasure in activities [X] Appetite disturbance [X] Weight disturbance [X] Fatigue or loss of energy [X] Difficulty thinking, concentrating, or making decisions [X] Feelings of worthlessness or guilt CONFIDENTIAL Page 29 of 68 [X] Emotional numbing and detachment 7. Competency --------------------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No If no, explain: Not applicable. 8. Remarks, (including any testing results) if any: -------------------------------------------------- JOHN DOE: is a 45-year-old male who was in the Army, and who had a deployment to Iraq in xxxxxxx. He has a service connection for PTSD, with a current rating of 70%. This examination was focused on his functioning since the previous examination on 3/15/2017, although information regarding prior history was reviewed and obtained where relevant to the issues in question. Please see the report of the previous examination for relevant prior history. The present examination was based on a face-to-face interview with the Veteran and review of records as indicated above. Except where otherwise indicated, historical information presented above is taken from the interview. Results of the examination indicate that the Veteran's difficulties are consistent with current diagnostic criteria for PTSD. They also indicate that he experiences symptoms supporting a diagnosis of Major Depressive Disorder (MDD) at this time. These are considered to be separate, comorbid conditions which share some symptoms and a common etiology. Due to the overlap in symptoms and associated features of these disorders, it can at times be difficult to determine--and clinicians may reasonably differ regarding--whether the clinical picture might be better accounted for by a single diagnosis or by multiple diagnoses. Results of the examination indicate that as a result of his mental health conditions, he is experiencing significant impairments in a number of domains, including occupational functioning. As he is no longer working, his occupational functioning is inferred from his past work history, from his current social functioning, and from the nature and severity of his current symptomatology. He has not held paid employment since February 2016, when he lost his job due to irritability and angry outbursts. He indicated a previous history of work-related difficulties due to anxiety and panic. Taken together with fatigue, problems with attention and concentration, forgetfulness, intrusive thoughts, hypervigilance, discomfort in interpersonal interactions, and a propensity for social withdrawal and avoidance as a means of coping with stress, these difficulties would significantly limit his ability to secure and maintain gainful employment. He would likely experience challenges in adjusting successfully to a work environment due to difficulty establishing and maintaining effective work relationships, as well as to reduced reliability, productivity, efficiency, accuracy, and timeliness in JOHN DOECONFIDENTIAL Page 30 of 68 attending work and fulfilling job responsibilities. ***This DBQ was completed solely for the purpose of a disability evaluation, and does not represent the results of a comprehensive clinical or forensic evaluation of this Veteran. It represents the information and impressions which could be gathered and reported within the constraints of the time allotted for interview, review of records, and documentation, and within the constraints of this mandated format. DBQs are completed in highly specialized ways that conform to the requirements of the disability claims adjudication and appeals processes. Some items may be left blank or diagnoses may be omitted where the symptoms or disorders might actually be present but, for example, cannot be attributed to a specific cause or etiology, cannot be attributed to the specific condition for which the C&P examination was requested, or cannot be linked to the Veteran's military service on the basis of evidence that conforms to the required standards. The conclusions and opinions documented on this form were based upon the information available to the examiner at the time the evaluation was completed, and may differ from those of professionals who have evaluated the Veteran in a clinical setting and/or from the findings of any previous C&P examinations. New or additional information might result in changes to the examiner's interpretations, conclusions, or opinions as documented on this form.*** NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.
  7. All, I have requested TDIU and my ebenefits updated from needing further information to: GSO no longer needed previously it stated awaiting information from Social security. I am scheduled to get exam from social security on the 12th. So, I figured they would wait until after that exam. Any thoughts on why status changed? my tdiu was PTSD 70% lower back 40% , knees, and tinnitus for another 30% total 90%. Is this a good sign or not?
  8. Gastone, C & P explanation letter I received for award: We have assigned a 70% evaluation for you PTSD based on: Difficulty in adapting to stressful circumstances, suspiciousness, Depressed Mood, Suicidal ideation, Impairment of short and long term memory, disturbances of motivation and mood, anxiety, Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), Difficulty in establishing and maintaining effective work and social relationships, chronic sleep impairment, panic attacks more than once a week. The overall evidentiary record shows that the severity of your disability most closely approximates the criteria for a 70% disability evaluation. Note: the VA sent me to a contractor for my C & P exam. I do not see my C & P exam notes in ebenefits/healthevet. I have submitted a request for my C-file and exam evaluations, but have not received them yet. I did not see anything about being inferred.
  9. Background: 90% rated 70% PTSD with C & P exam date of April 2017 20% DDD Lumbar spine 20% radiculopathy left leg 10% left knee 10% right knee 10% tinnitus I am applying for TDIU and SSDI. Just filed both as of two weeks ago. I also attended my first treatment for PTSD with VA. She is recommending Prolonged Exposure treatment which I am not sure about yet. Not sure if I can handle that just yet. The notes from first appointment states: Clearly has PTSD and would make a good candidate for prolonged exposure treatment. Lumbar back: MRI results: Severe DDD L4-S1 & L2-L3, bulging disc throughout and mild to moderate stenosis. I have had back issues since 1998 and have done acupuncture, chiropractor, meds, message therapy and have records showing treatment up until about 2008. I got frustrated with VA and quit going. So I have a lapse in treatment records. I finally got enrolled in choice and was able to get an MRI and awaiting neurology appointment to see what type of treatment. Have not worked since Feb 2016 when I was fired for anger outburst with my boss. He fired me over phone while driving to VA hospital couple hours away. He stated I snapped on him. I worked for them for 6 months. In May of 2017 I was awarded 70% for PTSD and increase in lumbar spine. When I filed TDIU form I put I was not in treatment because I had not started yet even though I had appointment setup and was waiting to be seen. Question: Should I send in a self report stating my limitations and also notify in writing that I am now in treatment? Also, I have contacted Pat Clifford of "cliffordvocationalservices" to review my medical records and possibly write a vocational rehab assessment. Should I consider having him conduct an assessment? Has anyone used his services? For SSDI: I sent in a self report and used the template that I found on site (Patrick self -report). I am not sure if I should contact a lawyer now? I do not want to get stuck in the appeals process for ever. If I need to add self report to TDIU claim: how can I add that to file? Also any recommendations on getting the vocational assessment from Pat? I appreciate any advice. thank you
  10. Buck, Really Appreciate all the information. I am processing what you have written. I have not signed up with a doctor yet for PTSD. I have my annual physical Friday and I planned on going to the mental health clinic and getting signed up to see what I need to do. I live an hour from there so it is difficult to get there so I hope it is not a regular therapy program.... Below is my C & P explanation that was sent from VA: We have assigned 70% evaluation for you post-traumatic stress disorder based on: difficulty in adapting to stressful circumstances- suspiciousness- Depressed mood- Suicidal ideation- Impairment of short- long-term memory- distrubances of motivation and mood- anxiety- Occupational and social impairment with occasional decrease in work efficiency (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal) - Difficulty in establishing and maintaining effective work and social relationships - chronic sleep impairment- panic attacks more than once a week. the overall evidentiary evidence shows that the severity of you disability most closely approximates the 70% evaluation. Buck, during my C & P I was out of state visiting a fellow vet in Maryland and did not have my record with me. So the C & P Examiner did not have my recent MRI for my back and Knees. She had the ones from back in 2006. My recent back MRI result went from mild DDD to SEVERE DDD L4-S1 L2-L3. Not sure that would help any raise my rating but I sure with it was there when she was checking me out. I understand the back is just on range of motion???? so maybe the MRI results might not of helped. I am not sure if my C & P results are enough to file for SSDI or should I wait and get enrolled in treatment? I want to file for IU but again do not know if I should wait until I get enrolled with mental health and get vocational rehab results? Also I was wondering if I should file a NOD to get the Date of June 16 as the Date for IU since that was the date for PTSD claim award and I was unemployed at that time and I still am.
  11. Last month I went in for an increase for my back & Knees and new claim for tinnitus and PTSD. My overall rating went from 30% to 90% Breakdown as follows: 70% PTSD 40% DDD & radiculaphy of lumbar 10 % L Knee 10% R KNee (stayed the same) 10% Tinnitus (stayed the same) My effective Date is JUne 2016 for the above and received my letter in May 17 that I was rated 90%. I am not sure what I should do? I embarrassed to say but I am unemployed and have been for several years. I will stick to facts and not life story. We all have our demons! My questions: 1. Should I just file the form 8940 thru my VSO and see if they award the TDIU? Or should I file a NOD and file form? Not sure what to do ? I have called the VSO but they wont pick up their phone. I am planning a trip there this week to talk her. 2. I have not entered into treatment for my PTSD but plan to when I go to my next DR. appointment with VA. (I am not sure if this will be a negative on my case). I do not like doctors... I do not like talking to people in general.... Especially about my feelings. Additionally, I have a personal belief of not taking medication because that is how my father died from opioid abuse. So, I just wont take meds..... I know everyone on here says you must show medical proof by seeing the doctor and meds you are on etc.. I just am not sure I can deal with a psych doctor.. NOt sure what to do here.... 3. I have not filed for SSDI because it is hard for me to admit that I am disabled. I am not sure that my rating would even qualify for SSDI (I am 45). Criminal justice degree. My lower back is really jacked up and recently broke my tailbone when knee gave out. At the C & P exam the Dr did not have my records and MRI results showing Bulging disc, stenosis. She awarded off of range of motion. My questions should I file for SSDI ? The combination of physical and mental has taken a toll on my me. 4. I would like to know if anyone else has had similar case as mine and what they recommend I do. Also have two young kids and would like to ensure my family is taken care of with benefits. I appreciate everyone's service and your willingness to support each other in this forum. My only friends are buddies I have served with! thanks again
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