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Thank you, Berta! Within your "Getting an IMO" post you reference a SMR. What is that? Is it advised to have copies of every medical file, or does it not matter because the VA will request from the doctors anyway? Have a good weekend.

Good advice. Thank you. No. The girlfriend did not know me before the accident. But we have known each other for 18 months now. Actually, the VA research group I briefly referenced has requested to speak with her, too. What and on what form does she need to make a statement? Would it help to have family members submit statement about the changes they have noticed? Or would they be considered too biased? I also have my current roommates who could write statements. Why is this sort of step advisable? Oh... The MMPI just intimidates me some. Not the questions, but the answers. While I want and need the validation, it is difficult to hear this sort of stuff about oneself. How did Rod handle this? It must have been difficult, and I do worry about the secondary stress it creates for my loved ones. And since I am placing so much effort into collecting documentation, I do worry that the psychiatrist might try to do too much or too little with it. In your opinion, what other opinions/documentation should I be collecting? How does my claim for an increased rating unfold (generically)? Does the VA review my material, and then send off for their own copies from all of the doctors, and then have me do the CP. Geez. If so, that could take a long time. **Just discovered that my original psychoneurological examination by the military includes a diagnosis for OCD. However, I was never rated on this. I also did not enter Service with it. What do I do with this, if anything?

Thank you for the responses. Berta, I am sorry for the suffering associated with the death of your husband. Thankfully, you have channelled some of that energy into helping others. I hope to be so lucky one day. Yes. They clearly linked the DI to my parachute accident. The internist clearly stated that the causes of DI are: 1) familial, which appears in childhoos as failure to thrive, 2) primary tutors, metastatic carcinomas, lymphomas, and 3) head trauma. She then proceeds to rule out tumor based upon MRI results and that the onset was adult. She provided definitions for this stuff as she proceeds. She states that based upon the documentation, and that a known head trauma within the military is known to have occurred, that the cause is clear. I did speak with a DAV rep. He encouraged me to gather paperwork for the emotional components, and that is really where I am seeking more advice. I literally JUST started with this doctor. I don't have nearly enough documentation... Actually, I don't know what she needs to write or how. Are there specific points she should be addressing? My internist has a good bit of savvy to her. I am unclear about the psychiatrist, yet. And yes, she is working from the position of major depression with anxiety, though the testing might change that. She told me about the MMPI-II. Not sure what to think about it or how to approach it. She is also talking about medications... Gosh. I'm on vassopressin and provigil, with history of heavy neurontin and depakote. Pretty mixed about that, too. The DAV rep also suggested to take a long-view approach given probable cognitive deterioration. He thinks that if the DI doesn't rate to 60% immediately, it will in time, and then I file for unemployability. While that thought stinks, I cannot speak for what I will or will not be able to do in the future, nor if I will be able to provide for my loved ones. It really scares me. I've had a difficult time adjusting to all of this since 2002. Much of that time was without the validation that something was actually going on with me. But family and girlfriend kept insisting, and then I stumbled upon this internist, who also serves as my primary. Anyhow, how does the time since my service-connected discharge effect my chances of an increased rating? Also, I am currently a category 2 within the VA system. Obviously, I am interested in moving to a category 1, and also having these medications and treatments paid for. Currently, much of it is out of pocket. Also, is my concern for some inconsistency between the doctors something to worry about? I really don't know much about nystagmus other than that both the internist and neurologist seem to think I have it. I am able to drive. I have lots of problems at work. Unfortunately, my manager misunderstands much of what is going on with me, though I think she would write a letter in support. What does she need to address? What else can I do? This is an exhausting and confusing process.

I need some assistance. I was medically separated from the military in 2002 due to a non-combat parachute jump. I incurred a head injury and was dischared with post-concussive syndrome and right sural nerve damage. I received a 20% disability rating. I presented to my current internist fatigue, difficulty with concentration and short-term memory, polyuria with 3-4 per hour voiding, and polydypsia to the point of near continuous thirst. I have acquired paperwork from this board-certified internist (medical school at Yale, published, and 30+ plus years experience) and an endocrinologist stating that I have diabetes insipidus. I have extensive paperwork stating that I have this condition. I was also referred to a memory disorder clinic. The clinic did an extensive neuropsychological work-up concluding that I have difficulty finishing tasks, recalling recent events, concentrating, focusing, neuropathic pain, change in behavior, masked facies, headaches, bilateral gaze-evoked nystagmus, and diabetes insipidus. My intellectual functioning was all above expectations, except for working memory. Memory was below expectations in most areas. Of particular concern was immediate and delayed recall of pictured events. Also, my performance on visual motor constructional tasks was well below expectations given my IQ (which has actually dropped almost 8 points since the military's doctor conducted the same testing). The final diagnosis was closed head injury with post concussive syndrome. The internist also wrote a letter for my file stating that I face lifelong limitations due to this (the military accident) traumatic brain injury, including: 1) any situation in which he becomes unable to sense thirst or unable to respond by drinking, 2) the memory deficit has created a lack of confidence and profoundly effects inter-personal relationships, 3) treatment with vasopressin for one year at higher than expected doses has produced less than opitimal responses, cannot drink coffee, tea, colas, and any other diruretic beverage, restrictions within my diet that also effect my ability to socialize, 4) career choices will be limited to positions that allow frequent absence from the desk/workstation and close proximity of fluids and restrooms. She continued by stating that I have attempted to maintain functionality with exercise, no alcohol or tobacco, etc. She concludes that since the accident that created the traumatic brain injury, is likely as not that there will be a continued decline in function and working memory which will impact my way of life, potential livihood and inter-personal relationships. She including supporting attachments. The neurologist at the memory disorder clinic recommended provigil to counter the chronic fatigue and referred me to a research study group at the local universty aimed at helping folks like me improve daily functioning. I also received documentation from that professor. Another neurologist recently placed me on depakote, though the internist took me off of it immediately because I gained almost 20 pounds within a week and half. I recently visited a psychiatrist to get documentation to support the existence of emotional problems. She thinks I have major depression with anxiety and wants me to take the MMPI-II and begin psychotherapeutic work. Oh. I was also referred to a VA research group. Part of my problem is that some of the paperwork is inconsistent. One doctor states this or that about me and my condition, and another doctor states something else. My internist and psychiatrist attest to serious effect on my daily life, while the memory disorder clinic's neurologist states otherwise, though notes the short-term memory, etc. Also, while I have many symptoms with decent documentation, the results on the physical signs are negative or inconclusive (which contributed to the initial VA rating), other than the diabetes insipidus stuff and some results from a PET scan reporting decreased uptake in the cerebellum and thalmi (which I have no clue what it means). But all the doctors acknowledge that there is something going on that they cannot completely figure out. Read: I have no actual brain lesion. I also have the real problem that I am attractive, fit, very articulate, employed (though this requires a lot of additional work - mnemonic devices, extreme difficulties with coworkers and consequential lower performance ratings), and have graduate education. I think this will potential hamper my claim despite the documentation that I have collected. And you know what, I am very fortunate compared to many folks, but my level of intellectual functioning has decreased (>99th to 91st) and most probably will continue to decrease, not to mention that my working memory is currently around the 50th percentile, which is far removed from where I should be given my intellectual functioning. So, I still function far better than the majority of healthy folks, but it is a real decline for me darnnit! and frustrates me to no end because I find that I am unable to perform or remember the way I once was. I don't really know how to proceed in regard to completing my file for a claim. I requested and received miltary and personnel records via the Privacy Act. I am doing my best to collect more documentation for the emotional component of this claim, but am virtually clueless how to proceed. Please help. Advice? Thoughts? Border