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brokensoldier244th
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Posts posted by brokensoldier244th
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It could be most anywhere on the scale, depending on your GAF that day, your symptomology, and your associated conditions. There is no way to gauge a mental health rating without a professional.
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My sleep apena claim, started in Oct 2011 has been approved. My contention was that my apnea is aggravated by my weight caused by inactivity and drugs used for depression and chronic pain. When I get the decision I will analyze it and its relevant notes for the decision to see if I can identify anything that might be helpful to others. I was not diagnosed before discharge with apnea, nor was I receiving treatment in service. I didn't even get checked for it until September of last year, when a CPAP was issued. I've read so much on here about how difficult it is to get sleep apnea service connected, especially if you don't have an in service finding. Here's to hoping that my decision renders some insight into what their rationale was. Many others here and on VPN have tried to service connect apnea with varying degrees of success and failure, but the arrow seems to point more towards failure if there is no in service finding.
In True VA Fashion ™ it makes little sense. I submitted all sorts of documentation, because id read on here that it is such an uphill battle to get this service connected especially with no in service diagnosis.
My finding letter came, and despite the list of reviewed material, the actual Reasons and Basis is about 2 sentences long:
"We have assigned a 50 % evaluation for your obstructive sleep apnea based on:
0-Requires use of breathing assitance device such as continuous airway pressure machine."
Thats it, folks. No quoting my material, no quoting of things in my Dr's letter, not quoting of the record itself or the sleep tech's finding.
I claimed it secondary to weight gain, pain and inactivity due to chronic pain, depression, and intervertebral disc syndrome.
Ill post my Dr's letter below that was submitted. The rest of what I turned in was pretty standard. A statement from my wife, the sleep tech records, there was a C&P that was about 20 minutes long.
I had some treatment notes that had been submitted for ED that I mentioned my issues sleeping with her as well, but I can't find those.
Mr. Satterfield has been a patient of mine since October of 2000. The conditions that I examined him for are chronic lower back pain and sleep difficulties.I personally reviewed Mr. Satterfield's medical history including his service medical records from April 2001 to February 2002; and his VA rating decision rating decision C-file and C & P final report for service connection for degenerative disc disease dated September July 2002. His contention today is that he is having difficulty sleeping and that his wife says that he stops breathing several times a night during sleep. Mr. Satterfield was prescribed Elavil (10Mg) for sleep difficulties after his injury by Kenner Army Health Clinic, Ft. Lee, VA, and continued to take them after his discharge from service, and also takes Ultram, Flexaril, and Ibuprofen for pain, as prescribed by the VA. Currently he is prescribed Hydrocodone, Meloxicam, Gabapentin, Temazepam, Seretraline, and Omeprazole.It is my opinion that it is likely that Mr. Satterfield’s sleep difficulties are aggravated by his service connected degenerative disc disorder and chronic pain, and the weight gained because of it. I also feel that it is at least as likely as not that Mr. Satterfield’s continued obesity is aggravated by his service connected degenerative disc disorder and pain, since his continued efforts to consume fewer calories over several months have resulted in very little loss.Sleep disruption caused by obstructive sleep apnea can certainly be exacerbated by certain narcotic pain medicines, SSRI’s, and increasing weight. Mr. Satterfield has no prior symptoms of thyroid or metabolic issues, and had no reported sleep difficulties or weight related health problems prior to enlisting into the Army in April of 2001. He has been eating below maintenance for his weight and build, but continues to have difficulty losing weight. Because of these things, and the observations of his spouse it is likely that Mr. Satterfield has undiagnosed obstructive sleep apnea with an onset that started after his service connected injury and the weight gained as a side effect.Sincerely,CLAIM: Sleep Apnea W/CPAP secondarily aggravated by medications, pain, obesity, and depression due to service connected lower back injury.
In Aug 2001 I was diagnosed with a lower back trauma that was LOD directly to an injury incurred during training at Ft. Jackson SC. At that time I was still actively serving, under profile with a weight of 192-195 lbs. I was transferred to Ft. Lee, VA for AIT to await a decision about a MEB/PEB. As I was under strict PT restrictions and duty restrictions, and in a state of constant (albeit treated) pain, my activity level plummeted and my weight started to increase. Being that I was in a training environment at Ft. Lee my diet and activities were still restricted as that of any other trainee. I left Ft. Lee in January of 2002, still just under 200 lbs.
In the later part of 2001 I was prescribed Elevil to help with sleep disturbance issues by either Doctor _________ (Kenner Army Health Clinic) or Dr. ________(Kenner Army Health Clinic). I was not diagnosed with sleep difficulties prior to this time-having been married before enlistment, this would have been noticed by my wife. This prescription for elavil was filled to excess before I processed out of Ft. Lee, VA so that I would have time to set up civilian or VA health care. I continued to take Elavil for sleep disturbances, along with Ultram, Flexaril and Ibuprofen for pain until my prescriptions ran out a few months later. In that time I received a C&P for my lower back injury which was ruled service connected. During this time my weight continued to increase due to inactivity and pain. In my initial C&P examination by PA-C J_______ I was noted to be obese 4/29 /02. In December of 2002 . I sawcivilian _________ Medical center (Dr. _____) to refill current medications for pain and sleep issues, including elavil. In a later examination by PA-C __________, Lincoln VAMC I was noted in January 2003 to weigh 257 lbs when I saw him about pain and medications for pain. I declined to add elavil to my VA medications at that time, hoping that my sleep issues would work themselves out with better pain management.
My psychology treatment records by Dr. R_______ indicate sleep disturbances, and my struggles with weight loss/gain as well, and they are incorporated into my overall rating for depression. Inactivity due to pain is also noted throughout, and prior history is established that I was active prior to military service (theater/music) and obviously during service until my injury. I currently weight (10/15/2011) 312 lbs.
Post service I have struggled with my weight due to inactivity or due to medications taken for pain that have side effects of weight gain. I may lose 5-10 lbs on a severely restricted diet, or an increase in activity, but pain, motivation issues, and depression issues cause me to gain it back. I take one medication, Hydrocodone, in a direct attempt to BECOME more active to try to lose weight but thus far it’s results are unquantifiable because of the myriad other issues contributing to my weight.
In October of 2011 I was diagnosed at the Omaha VA Hospital with Sleep Apnea, and, on the basis of the sleep study, issues a CPAP machine (thank you!) This has helped control my apneic sleep disturbances that I feel are a result of my weight gain from my medications, depression, and lower back injury. It may be that since Elavil was not prescribed until after my injury in 2001 that the beginnings of sleep apnea extend to that point where I started to gain weight before discharge from the Army, and have steadily increased since. PA-C D_______ (Omaha VAMC) opined during counseling that Sleep Apnea is a result of either genetics/physical jaw issues, medications, Psychological issues (PTSD, etc), or obesity, and that it can be caused by, or CAN contribute to obesity and depression, and that my issues with both most likely come at least in part, from this etiology. He also advised to “avoid etoh/sedative/narcotics (do not increase hydrocodone dosage)”. His advisement directly contravenes my attempts to be more active to lose weight, by reducing the options available to me for pain management. However, dying slowly in my sleep is not an attractive option, either, and so I am inclined to follow his reasoning. In doing so, however, I must limit my activity.
My psychology treatment records, military medical records, and treatment records from Lincoln VAMC are in my CFile. My consult from Johnson County Medical Center is in my CFile. My Omaha records from my sleep study are in VISTA. Please find and adjudicate accordingly. Per prior rulings by the DVA, with sufficient evidence, Sleep Apnea post discharge has been granted service connection in cases as secondary to obesity , MH issues, and medication when one or more of those are service connected.
Citation Nr: 0905272
Decision Date: 02/13/09 Archive Date: 02/19/09
DOCKET NO. 04-16 673A ) DATE
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On appeal from the
Department of Veterans Affairs Regional Office in St.
Petersburg, Florida
Thank you. Here is what I filed:
- Jim MAC, foreveryoung, Rocket1949 and 2 others
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5
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80% to 90%
Married w/1 child + 3 dependants
Granted 17OCT
Retro amount-926
Amt direct deposited this AM (Memo) for 1APR - 1875.00
Shouldn't it have been at the new rate (2109.00) and not the old rate?
Retro would have covered Dec, Jan, Feb (Oct doesn't count, Nov, Dec, Jan pay) and 1APR would be the start of the new rate, right?
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Well, crap. Im out, then, since it was in October. Grrr...There were no forms at the window, and hardly anyone in the hospital. The Psych DID tell me to check travel pay on the way out, though. Usually my docs never mention it.
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I had a Saturday C&P a few weeks ago, and no one was at the pay window. How do I go about requesting Travel Pay for that appointment?
CAS
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Here is where I got the information from. Perhaps they did not arrange it as well as they could have. Sorry for any confusion caused.
http://www.alphadisability.com/surviving-spouses/
Incorrect.
For a survivor to be granted DIC:
1. The veteran must die as a direct result or a service connected condition. In fact, it's entirely possible to receive 0% and yet the spouse may be eligible for DIC. OR,
2. The veteran dies from sumpin' else, and a service connected condition contributed to his demise. Generally, this must be listed on the death certificate as a contributing factor. OR,
3. The veteran held a total disability rating (100% or TDIU) for 10 years, and ....well, the veteran just dies, from anything, service-connected condition or not.
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DIC requires 100% disabled, and death from a service connected disability.
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The rating and the diagnosis are two separate things. The diagnosis isn't going anywhere. If they changed your rating when they upped it, your clock starts over on the rating.
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If the symptoms change, yes, they can rate you under PTSD vs. Anxiety. Its not a doctor's change of your diagnosis, its whatever fits best under their applicable reg in the rating criteria.
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Another term for sciatica, or partial paralysis of the sciatic nerve.
What is radiculopathy and maybe I should be ok cause the doc told me my range of motion wasnt the best.
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my range of motion sucks, and there is 10% on there for radiculopathy.
hey if you dont mind me asking how did you get 40% for your DDD as i have DDD in my L345 S1 and I am curious how to what I may be rated for that.
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That's just the way USAA shows up. The routing number/acct number are the important part. how the bank identifies itself in VA's database (could just be a category, not your bank's actual name) doesn't matter to the DoT.
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the VA could care less about the amounts due-they don't write the checks, so they have no vested interest in shorting veterans for things. The adversarial "VA is out to Get Me ™ " meme is kind of tired. For every few hundred or thousand vets that don't have a satisfactory resolution, hundreds of thousands more have been adjudicated just fine. I don't disagree that there are problem areas, but adopting the stance of 'woe is me' like the VA is camped on your lawn waiting to get you is just emotional baggage.
CAS
Errors are almost always on behalf of the VA and benefit the VA's bottom line. They are not random errors.
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Not really. With the length in time that claims seem to take, all sorts of dependent changes could take place between the time you submit and the time the claim is granted. Would you rather get the money now, and then have them recoup, or wait a little and get what is actually entitled?
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VA disability is not income. It is not taxable. Therefor there is no reason to report it. Certain agencies (food stamps, medicaid) require it to be reported, but they specifically note that, in addition to income.
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If they remanded it, it went backr to your RO.
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It says that during the evidence gathering period. Have you had your C&P (s)? you can always contact them waive any more evidence to submit.
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Im the worst (or best) kind of personality. I fixate on things that engage my brain, so in the line of work im in (software testing/client support/forensic accounting) I get sucked into what I do. I like helping people get their issues fixed, but over the last year and a half even softball fixes don't give me any *whoo hoo* moments, and I relish the days when I can test and don't have to deal with clients at all. We aren't a helpdesk type of environment, so I have no one else to punt issues to, and being promoted to 'lead' means, more and harder work. :-) I identify a large aspect of my life with my job, though. Im a geek through and through. I don't know what I would do if I lost this, you know? Im in school as a means to stay engaged and involved with what I do. Im not sure what i would be like if I was just home all day.
Broken, I was in a similiar situation as you...A lot of missed work, flattened affect etc...Based on what I was reading I was fully expecting to recieve a rating of 50% for my PTSD with MDD...I was pleasantly shocked when my letter came and I was awarded 70%.And I am still working..It is difficult at times, and I miss more work than I should but so far have managed to hold onto my job.It is a job where I have limited contact with others, I have my own office that I sit in for 8 hours a day and some days I am JUST HERE....They sent the TDUI form with my rating but I see no reason to send it in as since I am employed it would be denied..I will submit it when I can't work anymore..So wait for your decision and hope for the best.....As Carlie said each person that looks at your claim might think that you should be a certain percentage and they may all differ.......I am proof positive that you can be rated at 70% for PTSD and be employed...........grid
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That's okay, Carlie-this is the very meat of the issue. "Occupational impairment, loss of efficiency, etc" What the hell does that mean, anyway? I have a friend that is working on his doctorate in psychology right now and he's looked at my symptoms, the rating scale, my therapist notes, and what not ,and he just laughed and shook his head, glad that he is not constrained by this type of rating system that picks and chooses how to quantify the DSM IV.
Many claimants are iffy on many different DC percentage evaluations
because VA owns the scale on how the weight is assigned.
This is especially true with MH evaluations as the majority of symptomology
is subjective rather than verifiable, by means of objective testing.
A great example of this relates to factoring in GAF scores, etc...
It appears that my prior posts were not understood, with the intent aimed for.
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Nah, no need. I know the mental regs pretty well-ive done a lot of research into it. They are pretty adamant on that 'total incapacitation", at least for IU. I wouldn't want to push those regulations with the excuse of "but im working at 'under marginal employment income......" you know? I may someday end up at 100% but its all piddly this and piddly that. All of it singly isn't completely debilitating, but on a bad day it all just seems to rear up at once. It sucks. :-)
I didnt know about the ED medication working = no SMC. Ive read a lot of guys that get levitra but still get SMC-K, mostly from reading at VBN. Based on that I thought it was weird that having SC ED but taking a medication to allow erections (or a pump, or injections)= denial, at least for me. Pumps/meds doesn't cure it. The 'loss of function' is still there, it'd be like telling someone with a brace or prosthetic that they weren't disabled, either.
If the ED medication works then they don't pay the SMC-k. My Uncle Billy lost his appeal on that one. Also, just for the record 100 percent mental health vets that hide their school involvement are committing fraud. Because the rating is for total occupational and social impairment, If the VA knows about it then it is not. This isn't an opinion call the VARO and ask them.
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No offense intended on either side, I just didn't want this to devolve into a pissing match over who has or is entitled to receive benefits. I see that sometimes over at VBN.
Ill agree that the disability process seems to be quite arbitrary. I have ED, take levitra, yet ive been denied for SMC-K and its currently on appeal, even though my ED is SC and secondary to nerve impingement in my lower back.
CAS
I think you misinterpreted my honorable defense of you. And, I can see where your going to school it's on your signature. You'll know in a few months. You know how screwed up you are. I know you've told me how screwed you are, so lets hope everyone at the VARO agrees you're a hot mess and gives you an appropriate rating.
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I see. I wasn't trying to be too defensive, just pointing out that im not aiming for an MBA or something with a high sociability context.
I agree with you Broken. I think that attending graduate school doesn't bar you from a higher rate. I think you should get one.
My post was in reply to Carlie's post about your chances. She pointed out the graduate school. I stated my experience with vets at 100 percent mental health in grad school.
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Okay. Im in a distance graduate program-all my work is online, via video recorded lectures, or self reading. All my assessments/work/projects are emailed. I speak with my advisor on the phone once every week to 2 weeks. My graduate major is info security which is about the most paranoid, antisocial major there is. It allows me to continue to be in IT (the basis of my Voc Rehab paid undergraduate degree from a few years ago) but now Ill be able to maybe offer some assistance to local LE since they have little tech background in Nebraska. I used voc rehab to educate out of the security/military/LE field because the physical pain issues.This gives me a way back into the fold, as it were. The Depression came much later over time since my discharge in 2002, as my PCP finally suggested that I go talk to someone about some of the things I was feeling. That was in April of last year.
The graduate program was already in the works for 1JUN, and thus far I have completed my first term with low B's and a hell of a lot of work re-re-re reading and writing down EVERYTHING. If I can complete it, my antisocial tendencies shouldn't be nearly as much of a detriment to getting out of customer support (even highly specialized) as it is to trying to move within my current career. As it is now, many of the things I do are almost auto pilot after 6 years. I have not learned to code/support the new computer program back end that a few of our clients are getting because doing so stresses me out and I can't retain information, and unless I can do it on autopilot I (nor my employer) trust me running amok in the clients databases. In a year or two my legacy software will no longer be used by our clients, thus I will be out of a job. SO-that is why im in school, to try to preserve some independence as the current sole earner so my wife can stay home with our kids. Im not tryinig to game anything. I don't like that clients that have been mine for 6 years don't want to work with me except through an intermediary, and I don't like jepordizing my current employment. Its not like on a whim I came into work one day and said "xxxx off" to someone and then applied for disability. My co workers all know me and my traits pretty well, we are a really small company-less than 20 people. They would see through that. A few of them I am in daily contact with outside of work, 1 of them ive known for 13 years, and I helped get him is job, there. We're a pretty knit bunch. Thats why there are so many allowances for me and my idiosyncrasies. The balance is im one of about 3 people that know our old software product, code, and database structure so if it breaks Im one of the three go-to's. That is why they keep me around.
Yes graduate school. I love the fact that so many veterans rated at 100 percent for mental health solely P an T attend graduate. I know of two. And here Broken just wants a mere 50 percent. It's isn't equitable that others get 100 percent, and he is iffy for 50.
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Well, to be honest I only got 2 of the three words that he asked me. Im not suicidal, but when he asked me if I had suicidal thoughts or thoughts of hurting others I said no suicidal thoughts, but I get really angry and upset with people and think about punching them out, but im not clock tower material yet....
Mood Disorders Ratings
in VA Disability Claims Research
Posted
When did they do that? I was rated last year with depression due to chronic pain and my GAF was one of the many things they took into consideration in my decision letter.