Berta

I just had my C&P, What do you think for my rating? I appreciate all you time. This was the worse thing to ever go through and glad it's finally done.

Does the Veteran have a diagnosis of PTSD DSM-5 criteria on today's eval?
 [X] Yes [ ] No
 2. Current Diagnoses,1PTSD 2Panic Disorder 3Agorophobia 4Major Depressive Disorder
 b. Medical diagnoses relevant. obstructive sleep apnea, fibromyalgia, hypothyroidism.
3. Differential
 a. Does the Veteran have more than one mental disorder diagnosed?
 [X] Yes [ ] No
 4. Occupational and social impairment
 [X] Occupational and social impairment with reduced reliability and productivity
 b. For the indicated occupational and social impairment, is it possible to
 differentiate which impairment is caused by each mental disorder?
 [ ] Yes [X] No [ ] Not Applicable (N/A)
 Vet has multiple co-morbid psych dx and therefore cannot differentiate level of impairment due to each mental disorder due to overlap in symptoms.
Does stressor meet Criterion diagnosis of PTSD)?
 [X] Yes [ ] No
 Is the stressor related to the Veteran's fear of hostile military terrorist activity?
 [X] Yes [ ] No
 Is the stressor related to personal assault, e.g. military sexual trauma?
 [X] Yes [ ] No
 Criterion A: Exposure to
  [X] Directly experiencing the traumatic event(s)
 Criterion B: Presence of
  [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
 [X] Recurrent distressing dreams
[X] Dissociative reactions
[X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic
 [X] Marked physiological reactions to internal or externalcues that symbolize or resemble an aspect of the traumatic
Criterion Persistent avoidance of
 [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated
 traumatic event(s).
 [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects,
Criterion Negative alterations
 [X] Persistent and exaggerated negative beliefs or expectations about oneself, others
 [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event that lead the
 individual to blameherself others.
 [X] Persistent negative emotional state
 [X] Markedly diminished interest or participation in significant activities.
 [X] FeelingsofdetachmentEstrangement
 [X] Persistent inability positive emotions
 Criterion E: Marked alterations  arousal
 [X] Irritable behavior angry outbursts
 [X] Hypervigilance.
 [X] Exaggerated startle response.
 [X] Problems with concentration.
 [X] Sleep disturbance
 Criterion F:
 [X] Duration disturbis more than month.
Criterion G:
 [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important
Criterion H:
 [X] The disturbance is not attributable to the physiologicaleffects of a substance
Criterion I: Which stressor contributed to the Veteran's PTSD diagnosis?:
 X] Stressor #1
 5. Symptoms
 [X] Depressed mood
 [X] Anxiety
 [X] Suspiciousness
 [X] Panic attacks more than once aweek
 [X] Chronic sleep impairment
 [X] Mild memory loss, such as forgetting names, directions or recentevents
 [X] Flattened affect
 [X] Impaired judgment
 [X] Disturbances of motivation a
 [X] Difficulty in establishing and maintaining effective work and social
 [X] Difficulty in adapting to stressful circumstances,including worklike setting
 [X] Obsessional ritualsInterfereActivities
 [X] Neglect personalAppearance hygiene
 DSM 5 Diagnosis:PTSD-Panic d/o with agoraphobia-Generalized Anxiety D/o
Vet meets the DSM-5 diagnostic criteria for PTSD as level of severity - severe. Relationship of mental disorders to each other Vet's MDD, recurrent,moderate is secondary to her PTSD.HerPanicDisorder, Agorophobia and FSAD are also secondary to her PTSD. It is my medical opinion that vet's MST stressor is as least as likely as not suppported by and consistent with the in service marker evidence. Her agorophobia preclude her from functioning satisfactorily in work environments.