drago

Thanks for your replies. EI Train: I am rated for PTSD 70%, and then was also rated at TBI, but PTSD and TBI were bundled together to be 70%. However, the original TBI exam wasn't real thorough. My incident was 30+ years ago too, and I never realized I had PTSD until the C&P a year ago. I can see the influence it had now that I'm seeing a counselor, but never realized how it had affected me (and still is). I did look up the MOCA, and actually found some images of at least the first page. I stopped looking though because I didn't want to develop some kind of practice effect. LOL pacmanx1: I checked out your link, and I didn't realize there were other descriptions/links to the left that also discuss polytrauma. Thanks for that

Hi All, Me again... another few questions that hopefully someone can shed some insight on. Over the last few months, as I've gotten deeper into the VA medical side, they have talked about a polytrauma referral, basically saying it could be helpful in me getting to a better place. I was involved in an incident and sustained a significant concussion. I agreed to the referral, and had an MRI that did not show any abnormalities other than something with sinuses. I'm now scheduled for a neuropsych exam. I'm not sure what all that entails, and I can't seem to find much "meat" of what polytrauma is about, other than kind of marketing info that it's "good". So the questions: Does anyone have any experience with poly-trauma, what it is, is it helpful etc? It is worth following up on and if not, are there any consequences to cancelling it out? Has anyone had any experience with poly-trauma evals affecting ratings? This may just be in my head (and probably is), but it's starting to feel like things with VA medical are just data collection for VA rating side, to look to show why a veteran is over-rated (rating is too high). I'm just not feeling good about how it seems the rating side of VA can access my medical records whenever they want. Thoughts from the group? *BTW... I am very thankful for everyone putting up with me, and continuing to hang in there with me.

FYI, I actually moved a couple of these questions to a new post. Seems like this thread was getting long and wandering a bit.

Hi All, Once again, hoping this is posted correctly. Not sure, but can't quite seem to get the hang of this particular version of a forum, so my apologies if I'm doing this wrong. Real quick background, I'm rated for PTSD/major depression/alcohol/TBI at 70%, kidneys 60%, bladder 10%, headaches 0%, and seems like something else I'm forgetting at the moment. Those were all completed about 13 months ago. Pending is a back issue, hypersomnia, hypertension, and heart disease. Total after VA math is 91% (maybe 92?). I was involved in a training in which another soldier died. Due to the hypersomnia claim, the VA has asked that I be reviewed for the PTSD and TBI. In preparing for those reviews, I've found various mistakes in both reports, some which seem immaterial, and some that may matter. For example: The report states I was cleared of charges at trial. That is inaccurate. I was cleared of charges during the investigation phase due to a malfunctioning piece of equipment. I was never charged (that I know of... 1st sarge got defense attorney involved pretty quick, so I kind of lost track of a lot of the process). I was in the brig for a while, and then on supervised house arrest until the investigation was over, which I told the examiner. Seems immaterial to the overall findings, but still not accurate. The report states that I was "dazed for 3-4 minutes". That is inaccurate. I was dazed for 3-4 days, not minutes. Depends on the clinical definition of dazed I suppose. I have zero recollection of the minutes following the incident (probably 3-4), and only wispy memories of the 3-4 days following the accident. Frankly, as I've thought about it over the past year, I'm not completely sure what is actual memory, and what is "recollection" based on what my squad members who were supervising me told me about the incident. I'd like to get those cleared up, but don't want to get tagged with a "veteran has changed his story" line somewhere. I guess the answer is they are inaccuracies, and I need to take them head on, but was interested in the thoughts of those who have more experience with this sort of thing. Should these inaccuracies be addressed in the these review exams, or is there a different and/or more appropriate process to challenge the inaccuracies?

brokensoldier244th: Thanks! Exactly what I was looking for. deedub: Thanks. I think I'm going to make all my notes on the copies of the original exams and take them along for reference. I'll offer to leave them with this examiner, and he can take them if he likes. Reviewing the docs is interesting, as I'm surprised by the lack of detail in them. The TBI eval was bounced back for more info by the VA, and even the second additional review (which I attended) did not have a lot of additional detail, and much of what I said was left out. Lots of check boxes left unchecked, such as endocrine problems. My throid blew out about 4 years after end of service. Specialist I went to at the time looked at blood work and immediately asked if I was in the Army. I asked why he asked, and he said if they see a male under 35 for hypothyroid, it's guaranteed they were in the army. "I don't know what they do to you guys, but it takes your thyroid right out"... Also, and this I hope someone can comment on this. Both reports have inaccuracies as to what I said. I don't think they are material to the findings but I A.) don't want trouble because it would be alleged I lied, and B.) some of it is painful and I would just like the record to be accurate. For example, one report describes the incident and says I was cleared of wrongdoing at trial. That is incorrect. I was cleared in the investigation phase and never went to trial. Like I said, I don't think it matters in terms of do I have PTSD/TBI, but it's inaccurate and frankly painful. I'll correct that with these new folks hopefully. Like I said, I just don't want to be accused of lying.

Hi Everyone, Me again...LOL, sorry to be a pain... I'll try to brief... Does anyone have a link to the TBI REVIEW C&P? I was able to find the PTSD review ver. March 2021 straightaway, and can find initial Initial TBI form, but can't find the review form...

I wonder then if a guy was very careful and very precise, it if would be beneficial? I can see how it could be a double edged sword, in that your words could be cherry picked, and then come back as "it's exactly what you wrote on your notes". I know my VSO typically does that as we have written to re-open things. "Using their own words against them" as it were...

Thank you both. Have either of you, or anyone, ever left notes with the examiner? Kind of a written confirmation of what was said?

Good info, thanks brokensoldier244th. I just had a moment of enlightenment, and thought I need to toughen up, stand tall, and prepare for these exams like I would anything else. Not "study" per se, because I think that could imply embellishment. But be prepared, so I called my VSO and asked for a few things. That way I can be prepared for when they ask a question, I can have examples and such ready as opposed to "oh, I don't know, let me think...". Because thinking in the moment like that is not my strong suit.

Hi Everybody, Please tell me if I should start this as a new thread, and I will, but it does pertain to the stuff already typed, so I'll keep it with this thread for now. I now other forums get very particular about what is in one thread and what should be a different thread. So, I've been looking around on Hadit and carumba... doesn't give one a reassuring feeling about the VA and their processes. Anyway, three main things I wanted to bring up... I read a post titled "requested increase, and they removed my service connection" which has some similarities to my situation, but not necessarily a ton. One thing stuck out from poster 63charlie about being sent to a general C&P physical exam (sorry I haven't mastered the art of quoting between threads yet). I thought this exam overall was for the ischemia., but now it sounds like maybe I would be well served to be prepared to talk about everything? I tend to be a "minimizer", so if I think I'm in a heart exam and someone asks about PTSD, I would be likely to say something like "well, I'm managing it" or "you know, some days good, some days bad, today is good" etc ESPECIALLY if they make it sound like an off the cuff comment/conversation. That makes me think maybe I would be well served to be prepared to talk about everything? Degen Disc Dis Issue-someone also mentioned in that thread (I think), about a first examiner from VA denying a claim, then the veteran getting a positive opinion. The overall take was it was 1:1 tie with opinions, and a tie goes to the veteran. After reading the letters I've been sent and seeing the reports on my back, the initial VA examiner said due to concrete lifting. We asked for another review, and a person I've not met did some sort of remote review, and confirmed that opinion and threw in some of the other facts listed above, including the erroneous or misinterpreted ones about treatment. I then submitted a buddy letter from my PT WHO HAS TREATED me, that said undoubtedly from service accident. Does that basically boil down to 2:1, I lose? I mean, that's kind of like a 3 Stooges "you lie and I'll swear to it" kind of thing, since the second remote reviewer had no new info! Does anyone know a good place to gain more than a basic bit of knowledge in all this? For instance, in the above referenced post, there are acronyms that I don't know the meaning of such as "CUE" and "NOD". I'm thinking like almost a playbook of what the VA does? For instance, I never thought about a general exam being a booby-trap, and maybe it's not. It certainly was explained to me that the "VA just likes to get a sense of how you are doing, make sure nothing is being missed". Which, I interpretted as "the caring folks at the VA, maybe they do have my back". I did have a moment of "but they could just check my VA medical to see that?" NOW, I think that "nothing is being missed" can equally mean not being missed in terms of you are being over-rated and over-compensated! Thanks everyone for all the help and support

brokensoldier244th: Thanks for the reply... since headaches are their own condition, they probably can't just do a re-look with this set of re-evals since this set is for PTSD and TBI? Also, is it possible (not necessarily likely), that the hypersomnia could increase the overall PTSD/TBI rating? The original rating letter for PTSD describes what would have to happen for PTSD to go from 70 to 100, and it is pretty substantial. Would the same rules apply now that TBI is in with PTSD? I guess I'm thinking along the lines of "we didn't realize the sleep disorder (now we know it's hypersomnia) was this bad" so PTSD won't go up, but TBI will? Sorry to belabor this, but if I have an inkling of what *could* be the outcome, it's generally easier to deal with. As opposed to getting a letter saying "yup, you've got it, but we kind of took that into account, so no change". Hopefully that makes sense... Headaches, ironically, they aren't' worse, they were just never properly acknowledged in the first place LOL EDIT**-also, is there a place on the va.gov website to see everything a person is rated for? I've not found the website to be especially helpful so far.

So... after a lot if digging in my "VA binder", I came up with the following: Decision letter about PTSD with depression and alcohol statement that they assigned 70% based on a list of things including "chronic sleep impairment"-which is true, I haven't slept well since the accident, fitful, frequent waking, recurring dreams, etc Later there is a decision letter from VA that adds TBI to the list (so PTSD w/depr and alc and TBI). same statement of things they based the decision on Also a decision letter that rates headaches as 0% (forgot about that) 0% because I did not report prostrating headaches-not true, I did report prostrating headaches, the examiner would not write them down. Kept telling me, "so what you're saying is you don't have headaches that knock you flat on your back, can't move, can't do anything". Me; "well, I can move, I can get up to go the bathroom, but i end up sticking my head under a pillow to make it dark and laying there for 2-3 hours to make it go away." Him: "so you don't really have headaches then..." I can't find the actual examiner's report. So, be interesting to see if they feel hypersomnia falls under chronic sleep impairment, or if it is it's own thing. Then on degenerative disc disease They acknowledge I have it They acknowledge I had a qualifying event They deny based on I didn't seek treatment until 2012 Not accurate-I sought treatment in approx. 1990, just don't have those records-dr. retired and is now dead However they acknowledge that I said I told a dr. 3 years after separation ( 1990) that I hurt it lifting cement (I would tell you that shows acknowledgement at some level on their part that I did seek treatment) They further use that I told an ortho at 2012 appointment I hurt it lifting cement-true because I did say it. However, not being a doctor, I did not know that pain from lifting would not have been the cause of the condition, just a symptom. That's what the PT wrote the letter for. Sorry to ramble, reading some of this stuff is irritating.

I’ll have to reread the original TBI report, and then the follow-up. I don’t recall the evaluator mentioning my sleep at all in that report, but I’ll check. As I said, I know I told him about headaches and dropping things, but I don’t recall those being mentioned either. They may well be, as when I read that report within about the first two lines I was fit to be tied that he had not written what I said. And I would have been satisfied with “veteran reports blah blah, but it was not observed by this examiner”. Dropping things-never have been able to figure that one out. Basically, my hands will occasionally just pop open. Can be either one. The other had picked up the salt shaker, hadn’t started pouring or anything, just moving it toward my plate and boing- hand sprung open and dropped it. Walking across the living room the other day with they day talking on the phone…boing… hand sprung open and down the phone went. Things like that a couple times a week. Also, when standing, I will periodically tip over, always to the right. Momentary complete loss of balance, I have to take a step or two to avoid falling. ANYWAY… I know folks here know it, but frustrating to be at 91% and to seem like not moving forward. And the back thing is really a big let down. It just always hurts, and has right from the time of the accident, although not as much in the beginning as now. Then again, I feel like the whole thing is blood money, and that there are people who have been through so much worse. I have no right to feel frustrated. Kinda wish the whole thing would have never gotten churned up. But then my wife (who is awesome) reminds me that I had already started seeing an EMDR therapist a couple years before the VA was on the radar for some ideations. Whole separate topic, and I don’t want to hijack my own thread, but EMDR appears in the literature as a research based PTSD treatment, and I found it to be very effective. Right up until my therapist retired, and haven’t been able to find a new, good one.

I think my overall right now is 91% (rounds to 90) with 70% PSTD/TBI 60% Kidney 10% Tinnitus/hearing 20% bladder

brokensoldier244th; Funny, my VSO is actually moving positions and is taking a state level job. His county level job is open and I would LOVE to apply for it. It's right up my alley, as my other job dealt with state systems, federal regs, etc. I don't think I could in good faith say at this point I could do it, as far as going to work 5 days a week 4 weeks a month. When things are calm, like now, I'm ok. Last week, I would have made it to a job perhaps twice. Then add in the missed details and other mistakes, and I couldn't do that another vet.

As additional detail, I would also add that I retired early from work. Full pension would have been 35 years, but I retired at 31 years and took a penalty on pension. I retired due to attention issues (not getting things done and things that were done and had mistakes), memory issues, and poor judgement (as my boss stated). I thought it best to retire, as I was beginning to have meetings with my boss and HR. At the time of retirement (before VA was even on my radar), I attributed it all to the stress of the job. After retirement, those things have not improved, and a civilian doctor recently asked me if I had ever had a TBI.

I completely understand. I have tried to keep a positive attitude about what I call "VA rating side". I like to think of folks at the VA rating side as being there to help, but they are probably overworked government employees who simply need check boxes filled to move a file on, and that none of it is personal or mean spirited. MY VSO who has obviously much more experience rolls his eyes and says "if that helps you sleep at night...". Given this hadit.com, I'm guessing many folks have had less positive experiences also. My back claim though seems to be the "set on denying" one, because they haven't taken my word into account for anything else, but "I hurt it carrying concrete" is the one they listen to. There has not been any movement on that claim since the PT letter was sent. There is also pain/numbness/weakness in my right leg which is waiting for the back to be rated, and then the plan is to add radiculopathy.

PacmanX1: SInce hypersomnia is already claimed (but not decided) as secondary to TBI, would an alternative or better approach be to "amend" the claim, if that is even possible to be a stand alone claim? Let me add, that I know no one can tell me exactly how to handle any of this, as there are too many details to fill in, and all cases are different. My VSO is pretty sharp, although WAAAYY busy. I would certainly discuss any ideas with him. I just kind of "don't know what I don't know", and so anything that helps me understand or talk to him better is greatly appreciated.

Lots of interesting information, so thank you all. Folks keep mentioning not knowing about my situation. In a nutshell, 40ish years ago I was in an accident. Another soldier died. From the time of the accident I have only remembered fragments of what happened. I was locked up immediately following the accident until my 1st sargent came to get me. I don't remember receiving treatment except for someone in the few hours after the accident telling me I had a concussion. There is however documentation that I was treated at the ER at some point after the accident and I was released documenting head aches and back pain. I spent a few years in the bottle following discharge (honorable). Back pain and headaches never went away. I stopped drinking for a while, and during that period I ended up in the ER for severe back pain. I told the doc at the time that I was lifting bags of concrete when it hit me. Back pain and head aches persisted over the years with periodic ER visits for the back. Briefly prescribed some meds for the headaches but many side-effects so just lived with it. Ironically, as I tried to put the accident behind me, I never attributed any symptoms to the accident. Thyroid went kaputs almost immediately from discharge also. Fast forward to about three years ago, i was in PT for my back. PT was talking about what caused it, and I said lifting sacks of cement. He said wouldn't have happened that way, would have been from a trauma somewhere along the line. I described the accident, and he said that was almost definitely the cause. Fast forward to last year, and in conversation with my father-in-law who is a Viet Nam vet, he showed his new VA hearing aids. I had recently bought my own, and he said I HAD to get hooked up with the VA, they're hearing aids are the best, yada yada. Ultimately, I went to my VSO fully expecting to hear "nice try but no, and thank you for your service". Instead, he talked me through hearing loss and tinnitus, PTSD, TBI, and back. Started with those, immediately rated at 70% for PTSD with alcohol, 10% tinnitus, 0% hearing, and denied on the back. Turns out the decision on the back was based on my statement of "hurt it lifting concrete"-of course THAT record still exists from all those years ago. My PT wrote a buddy letter (I think might be the nexus letter mentioned earlier). It is now sitting as "deferred" I think. Added in chronic kidney failure which was rated at 60% due to alcohol. Also added in overactive bladder at 10%. I urinate 19 times a day. Currently "out there" as claimed is hypertension related to PTSD, Ischemic heart disease which we claimed as chemical exposure, hypertension secondary to PTSD, and hypersomnia claimed as secondary to TBI. Chemical exposure is due to a range I was assigned to, so its a long shot, but I have no family history of ischemia and it is an effect of some of the chemicals that were there. Hope that is not too much personal info. brokensoldier: So, if the hypersomnia as secondary to TBI is "substantiated" (my word) meaning the VA says yes I have it and it's related to the accident, the VA could then say the hypersomnia is not in addition to TBI, but is incorporated in TBI? As in PTSD/TBI/hypersomnia and still be 70%? And I've always thought of VA medical benefits as separate and distinct from VA claims/rating (mostly because it was explained to me that way). Does that mean the VA claims can pull info directly from my records with VA medical? If so, that is probably a good thing as they could see my therapy notes regarding the PTSD, and also my blood pressure readings from various appointments.

Thank you for the replies. So it seems then it is according to Hoyle, and I’ll simply plan on going. I ended up calling the VA directly before either reply, and the person on the phone said generally what GBArmy had said. I must say that my experience with the VA folks has been positive, but it’s about 3/5 on the third party evaluators. I think that is partly where my angst comes from. I still seem to be very symptomatic of the PTSD, and I would also say symptomatic of a TBI. The first third party evaluator for TBI told me when I first sat down he could tell I didn’t have a TBI because of how I walked and my speech, “but we’ll do the form anyway because that’s what they want”. Someone at the VA actually sent his report back asking for more info on headaches and a couple other things, and he did the same thing again, not using my statements and minimizing my symptoms. I wanted to complain and file an appeal, but my VSO said something similar to the your replies, that 70% PTSD and TBI was about as high it would reasonably go and there wasn’t a point in going further when I had other claims that were clear. GBArmy: Thanks for your reply. I think if I get impartial evaluators it should be fine. With the PTSD I continue to have ideations, as recently as this past weekend. As far as TBI goes, I have symptoms of that as well, although some are a little less clear, and some don’t have supporting documentation. For instance, headaches have been a problem since the incident and I was treated at various times for them. BUT, in both cases, it was a while ago, and the doctors are retired and the records are long gone. Also have some problems with dropping things etc for which I was evaluated for MS with a nerve test, but those records also long gone. There are other symptoms as well that indicate TBI in the civilian world, but not sure how an evaluator and the VA will see them. Things like teeth grinding and significant memory issues (which the initial evaluator were probably related to “OAD”, “old as dirt”). But enough sour grapes… is it possible to roll back a claim once it is made? I can’t imagine it would be viewed favorably if I cancelled the claim out to avoid a re-eval? broken soldier: Thanks for your reply as well. You both spent some time on your answers and I appreciate that. When you say VAMC and VA Medical file, do you mean records that I’ve had sent in, or records pulled from VA treatment? The 35% figure came from a website, maybe one of the attorney websites, and was supposed to be from an OIG report in 2017 or 18. Does that mean that PTSD/TBI would most likely be lumped together (as they are at 70% right now) and even if hypersomnia is added (attorney websites say it usually 30 or 50) they will all still stay at 70%? Meaning it would then become something like PTSD/TBI/hypersomnia =70%? Or would it be PTSD/TBI=70% and hypersomnia=30% so 70%+30%=(VA math) so like 79%?

Hi All, I’m new to the VA system and new to the forum so please accept an apology in advance if I’m doing this wrong. In a nutshell, I’m 57 years old, and received a VA rating of 70% for PTSD, and a subsequent rating for TBI for injuries that happened in the Army 35 years ago. The TBI is lumped in with the PTSD because they say it is hard to say what is PTSD and what is TBI. The rating was given just over a year ago when I was 56. I was under the impression that since I was over 55 years old, the rating would be “locked”, and would not be revisited/re-examined/re-evaluated unless I asked for an increase. I have a claim that is progressing for hypersonia that a civilian doctor diagnosed and said is “definitely” related to the TBI. QTC robo called and said to get in touch with them to schedule an appointment. When I called them back, they said the appointment is for a re-eval for the PTSD and TBI, and did not mention hypersomnia. I can’t find anything that says that PTSD/TBI is an exception to the age 55 rule, but perhaps I misunderstand that rule. So two questions I’m hoping someone can help with: 1. Does the re-eval seem correct? I read somewhere in my research that upwards of 35% of VA re-evals are not required and are actually mistakes. And 2. Would there be any harm in calling the VA to talk it through? I also read that the VA “writes EVERYTHING down” and I don’t want to create extra problems for myself with a phone call. Ultimately, I’m not opposed to a re-eval, as overall I’m in worse shape than I was a year ago, but going through the process of recounting things led to a bad few days, and I simply don’t want to do it again if not necessary. Also, I had a bad experience with the TBI evaluator not reflecting what I actually said, and that’s concerning for this re-eval. Thoughts from the group?