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marinevet1

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Everything posted by marinevet1

  1. Thank You SIR ! ! ! ! ! Yes that is the form i will fill out and submitt to the regional office Ron
  2. Hello I was awarded 100% PTSD P&T and tinnitus and hearing loss, im now currently married again I would like to add my family as dependence on to my benefits. Its been less than 1 year since my award. I'm confused, do i use form 21-526 or another form or are there other I need for each person? ? ? I have marriage certificate and birth and ss cards for all, just need to be sure what from to fill out. do I just mail them in or bring them to the regional office for processing. Is there anything else i need to bring and or form i need to complete And how long does it take before they start payments for the increase for the family ? ? ? ? Thank you for your time and help and guidance please. Bless All Marinevet1
  3. Fellow Veteran's I WAS AWARDED 100% ssdi and Christmas day 2010 all funds arrived in to my bank account from the VA I was awarded 100% PTSD, 10% Tinnitus and 20% Hearing loss for a total of 130% Permanent & Total Disability for life. I'm gratful I service my country as a Marine in Da Nang back in 69/70 did my time and am now paying the price for my service. At lease im set for the future with both SSDI and P&T disablity. Dont ever give up in your hopes to obtain both. I was persistance and hard headed just like and Marine in the end won my case in 357 days to funds arrived xmas day 2010 from the Los Angeles Regional VA Office. Now I'm now back on my feet, no longer homeless on the street thanks to the VA help and my service to my country paying me back now. NO matter what your issues are, there is always light at the end of the tunnel and a future. Its keeping your Dog in the fight that wins in the end. PTSD is not a cureable problem it only managed my meds and classes I attend for PTSD weekly Only a word of advise to all. Be lucky we have what we do and dont ever feel your left out in the street. Because im a example of one of the thousand who had nothing on the edge of dying and my country came to my aid gave me new life. Both SSDI and the VA made correct to me. So hang in there the best you can and have faith..never give up God helps the correct and righteous Semper Fi Recon Ron
  4. Yes I did it and they advised me they were going to the same thing, put them all into the same claim. Did all my C&P's together than rated and completed them all the same time also. Good Luck
  5. I will check in to it and also read read my rating info again, Thanks for all the info you all provided MarineVet1
  6. Hello I was awarded 100% PTSD 20% hearing loss 10% tinnitus I have ssdi and filed for TDIU but was given 100% P&T Does than mean I get this the rest of my life Where can I find information about P&T Is it perminate, tempertary ? Do I have exams in the future? Thanks
  7. Letter came today 100% P&T final rating 100% PTSD 20% Hearing Loss 10% TInnitus 12 months back pay
  8. Yes it read 100% PTSD 20% Hearing loss 10% Tinnitus Happy New Year MarineVet1
  9. THANKS to everybody on this site GOD BLESS YOU ALL ! Ron
  10. Today Christmas I wont it all. Sitting in my bank account a very very large sum of money deposited I wont TDIU & 100% I want to thank all who helped me and very much and send a THANK YOU TO BERTA You inspired me to do the TDIU claim before ratiing I will get back to help others after the holiday What a Christmas gift from the LORD on today christmas day The money was transferred at 1:33 A.M. xmas day into my account. I thank and wish everybody a happy holiday and Happy New Year MARINEVET 1
  11. Thank You Yes the whole case was done in 364 days from the filing date to rated finished date yes rating was done in 11 days for all 3 C&P's PTSD, Malaria, Hearing and tinnitus here at the Los Angeles RO. Now waiting for final letter and funds to arrive thanks. YES i have direct deposit from SSDI so its already in place, and i will take your advise and keep and eyes out on my account and the letter also Thanks to everybody who provided me assistance for helping make the process move so fast and smoothly and for Carrie for her help also she's a great attorney. And to Berta for your kindness and help in adivse for the TDIU info i submitted as part of my claim. Now to relax and enjoy a good Christmas its been a lonmg time in coming
  12. Need some past experience help. I had 3 C&P's November 2nd 2010, they went into rating in Los Angeles December 7th and when i called the 800 number today I was told my case was rated the 21st. My Questions is? What happens after rating and how soon do they mail me the results and how soon do they disburse funds. The women said they mail out notiification soon but do they answer this fast out of rating department She said she couldt give me the rating information since it was just rated over the phone. I had to be notificed by mail to recieve it. Is this true or when can I call to get it. Merry Christmas Happy New Year Thanks for your replies
  13. You need to see the result of what the doctor wrote from the C&P Hard to tell unless your conditioned became wrose than your last C&P and the review of your medical records by the raters. Until to soon to give any kind of reply back for it. Same with me I seen the C&P for my PTSD after reading it and figured out it looks that the doctor put me in the 70% rating but my case it at rating now so soon I will have the results and know. Good Luck.
  14. Yeah My PTSD was 3 hours and 3 written Exam test Combat Exposure Scale and MMPI and PCL of my 3 C&P exam. the Malaria was 1 hour and the audio metrices was 1 hour 30 minutes PLus the fact of answering questions but the Psy doctor did it by the book exacty like i read it from the Manual Good Luck.. 34 days later here in Los Angeles it alreay at the rating team it went into rating 34 days after C&P December 7th it started now to see how long it takes for them to be done I heard it take 14 to 27 days that make it a early January completion. Take Care Bless have a Happy Holiday MarineVet1
  15. Enclosed is a copy of my C&P results PCP doctor listed the following URGENCY: STATUS: COMPLETED SUBJECT: Statement for Claim DEPARTMENT OF VETERANS AFFAIRS GREATER LOS ANGELES HEALTHCARE SYSTEM 11301 Wilshire Blvd. Los Angeles, California, 90073 Statement for Mr. XXXXXXXX XXXXXXXX Mr. XXXXX XXXXXX served a standard tour(8/69-9/70) in Vietnam as a Combat Medic, he left the service as a Lance Corporal. Although listed as a rifleman,he served as the combat medic for his assigned unit. During this period of time he saw and treated many of his fellow soldiers for severe injuries including lost limbs, decapitations, and destroyed bodies. He also witnessed the deaths of many of his fellow soldiers. To care for these wounded soldiers,he exposed himself to enemy fire, exploding grenades, machine gun fire while under enemy assaults. Mr. XXXXX performed valiantly in his capacity as a well trained Marine. After leaving the military, he has continued to have nightmares, flashbacks and feeling of guilt about his Vietnam experience. He also continues to have emotional numbing with profound sadness and depression. While coming to the Veteran's Affairs hospital he has also been treated for Migraine Headaches, Traumatic Arthritis associated with jumping out of helicopters with a heavy load of equipment and medical supplies, Hypertension,controlled with medication ringing in the ears associated with close proximity to loud noises and PTSD. He has actively participated in the PTSD treatment programs, his mentors are pleased with his performance. While in country he was treated for an episode of Malaria, his condition remains stable. MR.XXXX XXXXX is on time for his appointments and takes his medication as prescribed. The following conditions should be connected to his military service: Agent Orange Exposure Post Traumatic Stress Disorder, combined w/ Bipolar Disorder Hypertension Traumatic arthritis, pain in the right shoulder and neck Tinnitus Malaria Erectile Dysfunction, has elevation of the HGB A1C, w/ early Diabetes , as a by product of taking medication for HTN and possible Agent Orange Exposure Made part of my Medical file of the VA This is followed by my C&P Exam November , 2010 Los Angeles LOCAL TITLE: COMPENSATION & PENSION EXAMINATION REPORT STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: NOV 02, 2010@13:43 ENTRY DATE: NOV 02, 2010@13:44:43 AUTHOR: XXXXXXXXXXX E EXP COSIGNER: URGENCY: STATUS: COMPLETED C-FILE WAS: Reviewed MEDICAL RECORDS WERE: Reviewed OTHER MATERIAL REVIEWED: Psychometric Tests and Questionnaires, DD-214, Other Records/Documents WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes DATE(S) OF OUTPATIENT TREATMENT: Began outpatient treatment in 2009 after and began medications and psychotherapy; began VA treatment at West LA and Sepulveda in 12/2009. CONDITION(S) AND LOCATION OF TREATMENT: Bipolar disorder; Post-Traumatic Stress Disorder; Chronic SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER: Veteran is part of the psychosocial group treatment module at the POST, at VA West Los Angeles Medical Center and also is managed by Dr. Warren-psychiatrist from POST. He attends groups twice weekly, Medic PTSD and is compliant with medication by his report, notes from his psychiatric record also indicate his compliance with treatment. CURRENT TREATMENT(S): Anti-manic MEDICATION SIDE EFFECT(S): Drowsiness, Fatigue, weight gain GROUP THERAPY: Yes INDIVIDUAL PSYCHOTHERAPY: Yes EFFECTIVENESS OF THERAPY: fair ---------------- Veteran was staioned in Da Nang, Vietnam attatched to 1st Marine Div., 1st Recon Battalion, Charlie company 2nd platoon, team 1; MOS was 0311 and 8651-primarily Recon: carrying medical supplies, save lives at all expense, exposed to serious injury, called medi vacs and give morphine; saw and killed VC; save soldier lives; DATE(S) OF SERVICE: 4/1969-09/70 BRANCH OF SERVICE: Marine Corps HIGHEST RANK OBTAINED: E3 TYPE OF DISCHARGE: Honorable RANK AT DISCHARGE: E3 MILITARY OCCUPATIONAL SPECIALTY: MOS: and 0311; Rifleman; 8651 Reconnaissance medic, went on patrols and fire-fights, called in artillery strikes; cobra and naval gunships in Da Nang; DECORATIONS AND MEDALS AWARDED: Combat Action Ribbon; Cross of Gallantry w/ Palm Frame; Presidential Unit of Citattion; National Defense Service Medal; Vietnam Campaign Medal; Good Conduct Medal DISCIPLINARY INFRACTIONS AND ADJUSTMENT PROBLEMS: None. DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes WERE COMBAT WOUNDS SUSTAINED: No LOCATION AND DATE OF COMBAT EXPERIENCE: Da Nang 11/17/69 to 07/30/70; INSIGHT: Patient understands that he/she has a problem. DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in his sleep; TYPE OF HALLUCINATIONS: None DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? Yes INTERPRETS PROVERBS APPROPRIATELY? Yes DOES THE PATIENT HAVE OBSESSIVE/RITUALISTIC BEHAVIOR? No DOES THE PATIENT HAVE PANIC ATTACKS? Yes ------------- STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC: Combat experience DESCRIPTION OF STRESSOR: Combat experience DATE AND LOCATION: 11/1969 to 07/1970 Da Nang Vietnam. TRAUMA OCCURRED: During Military Service INTENSE FEAR: Yes FEELING OF HELPLESSNESS: Yes FEELING OF HORROR: Yes OTHER REACTION: Yes DESCRIBE OTHER: Dissociation ADDITIONAL COMMENTS: Veteran served as a medic in Vietnam combat zones, with multiple exposures to seriously wounded, dying soldiers that he attempted to save. Witnessed horrific trauma involving severed limbs, gun shots wounds and multiple injuries. TRAUMA EXPOSURE TESTING ----------------------- TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE: Combat Exposure Scale, Trauma Questionnaire RESULTS OF IDENTIFIED TRAUMA EXPOSURE TESTING: Veteran experienced intensely traumatic combat episodes as a medic in Vietnam as evidenced by his documented receipt of the Combat Action Ribbon which corroroborates his DD-214 citation as well as his report of extreme combat trauma while serving as medic in Vietnam between 1969-1970; He also received the Cross of Gallantry with Palm and Frame and the Presidential Unit of Citation. OVERALL LEVEL OF TRAUMATIC STRESS EXPOSURE: High PTSD SYMPTOMS ------------- PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY: multi times per month PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA AND NUMBING OF GENERAL RESPONSIVENESS: Efforts to avoid thoughts, feelings, or conversations associated with the trauma, Efforts to avoid activities, places, or people that arouse recollections of the trauma, Inability to recall an important aspect of the trauma, Markedly diminished interest or participation in significant activities, Feeling of detachment or estrangement from others, Restricted range of affect Sense of a foreshortened future PERSISTENT SYMPTOMS OF INCREASED AROUSAL: Difficulty falling or staying asleep, Irritability or outbursts of anger, Hypervigilance, Exaggerated startle response, reliving experiences. THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN SOCIAL, OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: Yes DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND: Veteran experiences severe symptoms of PTSD that occur weekly and that have lasted for 40 years. Upon examination, Veteran reports that he is bothered at least several days each week by intrusive, avoidant and hyperarousal symptoms of post-traumatic stress. DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? Yes AXIS I: 309.81 PTSD-chronic, 296.00 Bipolar NOS Moderate to severe IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. AXIS II: 799.99 AXIS III: Degenerative Disk; Malaria AXIS IV: Heavy Extreme Combat Exposure AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING ---------------------------------------- SCORE: 45 TIME FRAME: Current functioning Combat Exposure Scale Score: 32 INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD: PTSD Symptom Scale QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY: PTSD Checklist for Combat and Non-Combat Trauma, Trauma Symptom Inventory PSYCHOMETRIC ASSESSMENT SCORES: Veteran was administered The PTSD Checklist (PCL), which is a 17- item questionnaire also designed to assess symptoms associated with combat related PTSD. On this administration of the PCL scale, he obtained a score of 68, which exceeds the score of 50 that is consistent with a diagnosis of PTSD in military populations. Of note, he reported within the past month being very bothered by disturbing memories, thoughts and images of his combat experiences, feeling cut off from other people, avoiding activities or situations because they remind him of stressful military experiences, being super-alert, watchful and on-guard, feeling irritable and having angry outbursts, feeling jumpy and being easily startled, insomnia and feeling emotionally numb. Additionally, he was also administered the Trauma Symptom Inventory, a 100-item questionnaire designed to appraise symptoms of posttraumatic stress disorder, clinical depression, affect regulation and dysfunctional behavior. He produced a valid, interpretable profile, with no exaggeration of unusual symptoms. There were clinically significant elevations on the Tension Reduction Behaviors (T = 93), Intrusive Experiences (T = 98) and Defensive Avoidance (T = 83) and Dissociation (T = 86) scales. He also meets criteria for PTSd based on PTSD Symptom Scale (Foa) as evidenced by at least one re-experiencing symptom (nightmares), three avoidance symptoms (avoiding, thoughts, feelings, detachment from others) and two hyperarousal symptoms (insomnia and pronounced irritability). Thank You
  16. 10% FOR MALARIA WAITING FOR OUTCOME OF ALL VA CLAIMS FILED THANK YOU
  17. My case started rating DECEMBER 7th in Los Angeles. has anybody been rated lately and how long did it take any replies would be apprciated. Last my C&P for PTSD should bring me about a 70%.. I filed also for TDIU since I havent worked since 2006 and im on SSDI since March 2010for DDD. If the 70% comes for the PTSD and if i filled for TDIU 3 months ago will they consider me for TDIU with 70% if i cant work ? ? my SSDI is for DDD since 1983 and the doctor doing my C&P for PTSD state my DDD has been in my medical records since 1983. Will the rating people get me the 100% schedular since i have or should get 70% for the PTSD or will they consider TDIU since i filed with the PTSD ? Not sure how it works to get P&T..or TDIU. with PTSD 70%. from the result of my C&P it look to be 70% But they could low ball me and than file and NOD since i have a very good detailed C&P report by the doctor. It looks as if he helped me not hurt me as part of the exam. Any suggestions would be grateful.. Thanks to all Happy Holidays & Bless All
  18. Thank You Berta ! ALl the report not here it was 17 pages I just put what i thought the site would needed. The SSDI & DDD from SSA was for the SSDI awarded March this year. If I can get the 70% well maybe.... Yes hand carried and date stamped SSDI award letter to RO myself Yes I submitted for TDIU and did as you spoke above checked #18 yes, so yes explained as you said. The PTSD came first after seeing and being diagnaos for PTSD later like 3 month later VA Psy told me the BIpolar disorder was due to the PTSD. No family records of anybody in family having it anywhere. VA doctor said help supports my PTSD and that 25% of people with PTSD have a bipolar disorder along with it. This C&P was just the reports, I also had a Malaria and Hearing and TInnitus C&P also now wait for the ratings in 2 or 3 month I hope. Much thanks for the info. i need all the help I can get. Yes went to the DAV Bless You
  19. Thank You This was my PTSD C&P, other C&P's I had hearing, Ma.laria, DDD I understand your coment. I have 2 other GAF 39 from VA Psy, & my own personal Psy of 39 to 42 within the last 6 months the RO has both of my nexus and reports rendering my 2 GAF scores and now my C&P. So if your say i could possibly get a 50% to 70% plus the others GREAT ! I have not been rated yet this was just the report from the C&P. Just wondering on the coment given. Also Yes SSDI was for PTSD & the DDD. Just was wondering what both could give me from the ratings. Since i cant work since 2006 and over age 61 Submitted for TDIU already with this claim..do not know if i could get it or P&T also My questions was how do i qualify for TDIU and or P&T.. Bless you ! ! ! Thank You
  20. Hi Here is my C&P for PTSD...I 'm also was awarded SSDI and I'm 61 How or do i qualify for PTSD & P&T or how do I get P&T Here my review back for the PTSD, and what my rating next What's my next step in the process???? LOCAL TITLE: COMPENSATION & PENSION EXAMINATION REPORT STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: NOV 02, 2010@13:43 ENTRY DATE: NOV 02, 2010@13:44:43 AUTHOR: XXXXXXXXXXX EXP COSIGNER: URGENCY: STATUS: COMPLETED C-FILE WAS: Reviewed MEDICAL RECORDS WERE: Reviewed OTHER MATERIAL REVIEWED: Psychometric Tests and Questionnaires, DD-214, Other Records/Documents WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes DATE(S) OF OUTPATIENT TREATMENT: Began outpatient treatment in 2009 after and began medications and psychotherapy; began VA treatment at West LA and Sepulveda in 12/2009. CONDITION(S) AND LOCATION OF TREATMENT: Bipolar disorder; Post-Traumatic Stress Disorder; Chronic SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER: Veteran is part of the psychosocial group treatment module at the POST, at VA West Los Angeles Medical Center and also is managed by Dr. Warren-psychiatrist from POST. He attends groups twice weekly, Medic PTSD and is compliant with medication by his report, notes from his psychiatric record also indicate his compliance with treatment. CURRENT TREATMENT(S): Anti-manic MEDICATION SIDE EFFECT(S): Drowsiness, Fatigue, weight gain GROUP THERAPY: Yes 2 INDIVIDUAL PSYCHOTHERAPY: Yes EFFECTIVENESS OF THERAPY: fair ---------------- Veteran was staioned in Da Nang, Vietnam attatched to 1st Marine Div., 1st Recon Battalion, Charlie company 2nd platoon, team 1; MOS was 0311 and 8651-primarily Recon: carrying medical supplies, save lives at all expense, exposed to serious injury, called medi vacs and give morphine; saw and killed VC; save soldier lives; DATE(S) OF SERVICE: 4/1969-09/70 BRANCH OF SERVICE: Marine Corps HIGHEST RANK OBTAINED: E3 TYPE OF DISCHARGE: Honorable RANK AT DISCHARGE: E3 MILITARY OCCUPATIONAL SPECIALTY: MOS: and 0311; Rifleman; 8651 Reconnaissance, went on patrols and fire-fights, called in artillery strikes; cobra and naval gunships in Da Nang; DECORATIONS AND MEDALS AWARDED: Combat Action Ribbon; Bronze Star Presidential Unit of Citattion; National Defense Service Medal; Vietnam Campaign Medal; Good Conduct Medal DISCIPLINARY INFRACTIONS AND ADJUSTMENT PROBLEMS: None. DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes WERE COMBAT WOUNDS SUSTAINED: No LOCATION AND DATE OF COMBAT EXPERIENCE: Da Nang 11/17/69 to 07/30/70; INSIGHT: Patient understands that he/she has a problem. DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in his sleep; TYPE OF HALLUCINATIONS: None DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? Yes INTERPRETS PROVERBS APPROPRIATELY? Yes DOES THE PATIENT HAVE OBSESSIVE/RITUALISTIC BEHAVIOR? No DOES THE PATIENT HAVE PANIC ATTACKS? Yes ------------- STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC: Combat experience DESCRIPTION OF STRESSOR: Combat experience DATE AND LOCATION: 11/1969 to 07/1970 Da Nang Vietnam. TRAUMA OCCURRED: During Military Service INTENSE FEAR: Yes FEELING OF HELPLESSNESS: Yes FEELING OF HORROR: Yes OTHER REACTION: Yes DESCRIBE OTHER: Dissociation ADDITIONAL COMMENTS: Veteran served as a medic in Vietnam combat zones, with multiple exposures to seriously wounded, dying soldiers that he attempted to save. Witnessed horrific trauma involving severed limbs, gun shots wounds and multiple injuries. TRAUMA EXPOSURE TESTING ----------------------- TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE: Combat Exposure Scale, Trauma Questionnaire RESULTS OF IDENTIFIED TRAUMA EXPOSURE TESTING: Veteran experienced intensely traumatic combat episodes as a medic in Vietnam as evidenced by his documented receipt of the Combat Action Ribbon which corroroborates his DD-214 citation as well as his report of extreme combat trauma while serving as medic in Vietnam between 1969-1970; OVERALL LEVEL OF TRAUMATIC STRESS EXPOSURE: High PTSD SYMPTOMS ------------- PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY: Multi times per month PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA AND NUMBING OF GENERAL RESPONSIVENESS: Efforts to avoid thoughts, feelings, or conversations associated with the trauma, Efforts to avoid activities, places, or people that arouse recollections of the trauma, Inability to recall an important aspect of the trauma, Markedly diminished interest or participation in significant activities, Feeling of detachment or estrangement from others, Restricted range of affect Sense of a foreshortened future PERSISTENT SYMPTOMS OF INCREASED AROUSAL: Difficulty falling or staying asleep, Irritability or outbursts of anger, Hypervigilance, Exaggerated startle response, reliving experiences. THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN SOCIAL, OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: Yes DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND: Veteran experiences severe symptoms of PTSD that occur weekly and that have lasted for 40 years. Upon examination, Veteran reports that he is bothered at least several days each week by intrusive, avoidant and hyperarousal symptoms of post-traumatic stress. QUALITY OF PEER RELATIONSHIPS AND SOCIAL ADJUSTMENT: Pre-military, Veteran claims he was outgoing, had many friends, rode motorcycles; reports having a great social life and that he had lots of friends. When he came back from Vietnam, he was living in Westminister, near Little Saigon, believes he started to have ptsd (shell shock) symptoms and then his former, highschool friends also began moving away, resulting in a serious change in his social interaction. Veteran reports that he began isolating at that time which has persisted to the present; Veteran states that he currently has no real friends, finds it difficult to manage his anger and emotional responses when in crowds or large groups; prefers to be alone because he feels safer; does nothing for recreation; watches television primarily, avoids reading newspapers or other sources of written information. Unable to work due to the DDD. DESCRIPTION OF DEGREE AND QUALITY OF SOCIAL RELATIONSHIPS AND WORK: Can't work has DDD, SSDI from SSA, has very few friends, doesn't socialize; spend most of his time in the Haven Senior Program at West LA VA. DESCRIPTION OF ACTIVITIES AND LEISURE PURSUITS: Watched TV; plays with computer; HISTORY OF SUICIDE ATTEMPTS? Yes COMMENTS AND ADDITIONAL INFORMATION: Took aspirin in attempted suicide because he was having flashbacks of vietnam. Disclosed to family doctor; re-experiencing related to what else he could he have done to help injured and dying on the battlefield. HISTORY OF VIOLENCE/ASSAULTIVENESS? No SUMMARY STATEMENT OF CURRENT PSYCHOSOCIAL FUNCTIONAL STATUS: Veteran is not very social, isolates and prefers to stay alone, avoids crowds, ISSUES ASSOCIATED WITH ALCOHOL USE: No use ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE: No use PSYCH EXAM COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in DATES, CURRENT TREATMENT, AND OTHER SIGNIFICANT DETAILS OF NON-PSYCHIATRIC ISSUES: 1996- L shoulder surgery; 1969 Malaria in Vietnam; High blood pressure treatment in 2005. Severe Degenerative Disk diagnosed in 1983 at Kaiser related to Military medical records his sleep; Satellite TV Technician for Direct TV as Supervisior. IS THE VETERAN CURRENTLY EMPLOYED? No IS VETERAN RETIRED? Yes IS VETERAN DISABLE? Yes DATE OF RETIREMENT: 12/30/2006 Primary Care Physician Mr. XXXX is on time for his appointment and takes his medications as prescribed. The following conditions should be connected to his Military Service Agent Orange Exposure Post Traumatic Stress Disorder, combined w/ Bipolar Disorder Hypertension Traumatic arthritis, pain in right shoulder and neck Tinnitus Malaria Erectile Dysfunction, has elevation of the HGB A1C, w/early Diabetes, as a by product of taking medications for HTN and possible Agnnt Orange Exposure INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD: PTSD Symptom Scale QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY: PTSD Checklist for Combat and Non-Combat Trauma, Trauma Symptom Inventory PSYCHOMETRIC ASSESSMENT SCORES: Veteran was administered The PTSD Checklist (PCL), which is a 17- item questionnaire also designed to assess symptoms associated with combat related PTSD. On this administration of the PCL scale, he obtained a score of 68, which exceeds the score of 50 that is consistent with a diagnosis of PTSD in military populations. Of note, he reported within the past month being very bothered by disturbing memories, thoughts and images of his combat experiences, feeling cut off from other people, avoiding activities or situations because they remind him of stressful military experiences, being super-alert, watchful and on-guard, feeling irritable and having angry outbursts, feeling jumpy and being easily startled, insomnia and feeling emotionally numb. Additionally, he was also administered the Trauma Symptom Inventory, a 100-item questionnaire designed to appraise symptoms of posttraumatic stress disorder, clinical depression, affect regulation and dysfunctional behavior. He produced a valid, interpretable profile, with no exaggeration of unusual symptoms. There were clinically significant elevations on the Tension Reduction Behaviors (T = 93), Intrusive Experiences (T = 98) and Defensive Avoidance (T = 83) and Dissociation (T = 86) scales. He also meets criteria for PTSd based on PTSD Symptom Scale (Foa) as evidenced by at least one re-experiencing symptom (nightmares), three avoidance symptoms (avoiding, thoughts, feelings, detachment from others) and two hyperarousal symptoms (insomnia and pronounced irritability). DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? Yes AXIS I: 309.81 PTSD-Chronic, 296.00 Bipolar NOS Moderate to Severe IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. AXIS II: 799.99 AXIS III: Degenerative Disk; Malaria, No longer can work AXIS IV: Heavy Extreme Combat Exposure AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING SCORE: 45 TIME FRAME: Current functioning WAS A MEDICAL OPINION REQUESTED? No /es/ XXXXXXXXXX, Ph.D. CLINICAL PSYCHOLOGIST Signed: 11/16/2010 09:30
  21. Hi Here is my C&P for PTSD...I 'm also was awarded SSDI and I'm 61 How or do i qualify for PTSD & P&T or how do I get P&T Here my review back for the PTSD, and what my rating next What's my next step in the process???? LOCAL TITLE: COMPENSATION & PENSION EXAMINATION REPORT STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: NOV 02, 2010@13:43 ENTRY DATE: NOV 02, 2010@13:44:43 AUTHOR: XXXXXXXXXXX EXP COSIGNER: URGENCY: STATUS: COMPLETED C-FILE WAS: Reviewed MEDICAL RECORDS WERE: Reviewed OTHER MATERIAL REVIEWED: Psychometric Tests and Questionnaires, DD-214, Other Records/Documents WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes DATE(S) OF OUTPATIENT TREATMENT: Began outpatient treatment in 2009 after and began medications and psychotherapy; began VA treatment at West LA and Sepulveda in 12/2009. CONDITION(S) AND LOCATION OF TREATMENT: Bipolar disorder; Post-Traumatic Stress Disorder; Chronic SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER: Veteran is part of the psychosocial group treatment module at the POST, at VA West Los Angeles Medical Center and also is managed by Dr. Warren-psychiatrist from POST. He attends groups twice weekly, Medic PTSD and is compliant with medication by his report, notes from his psychiatric record also indicate his compliance with treatment. CURRENT TREATMENT(S): Anti-manic MEDICATION SIDE EFFECT(S): Drowsiness, Fatigue, weight gain GROUP THERAPY: Yes 2 INDIVIDUAL PSYCHOTHERAPY: Yes EFFECTIVENESS OF THERAPY: fair ---------------- Veteran was staioned in Da Nang, Vietnam attatched to 1st Marine Div., 1st Recon Battalion, Charlie company 2nd platoon, team 1; MOS was 0311 and 8651-primarily Recon: carrying medical supplies, save lives at all expense, exposed to serious injury, called medi vacs and give morphine; saw and killed VC; save soldier lives; DATE(S) OF SERVICE: 4/1969-09/70 BRANCH OF SERVICE: Marine Corps HIGHEST RANK OBTAINED: E3 TYPE OF DISCHARGE: Honorable RANK AT DISCHARGE: E3 MILITARY OCCUPATIONAL SPECIALTY: MOS: and 0311; Rifleman; 8651 Reconnaissance, went on patrols and fire-fights, called in artillery strikes; cobra and naval gunships in Da Nang; DECORATIONS AND MEDALS AWARDED: Combat Action Ribbon; Bronze Star Presidential Unit of Citattion; National Defense Service Medal; Vietnam Campaign Medal; Good Conduct Medal DISCIPLINARY INFRACTIONS AND ADJUSTMENT PROBLEMS: None. DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes WERE COMBAT WOUNDS SUSTAINED: No LOCATION AND DATE OF COMBAT EXPERIENCE: Da Nang 11/17/69 to 07/30/70; INSIGHT: Patient understands that he/she has a problem. DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in his sleep; TYPE OF HALLUCINATIONS: None DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? Yes INTERPRETS PROVERBS APPROPRIATELY? Yes DOES THE PATIENT HAVE OBSESSIVE/RITUALISTIC BEHAVIOR? No DOES THE PATIENT HAVE PANIC ATTACKS? Yes ------------- STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC: Combat experience DESCRIPTION OF STRESSOR: Combat experience DATE AND LOCATION: 11/1969 to 07/1970 Da Nang Vietnam. TRAUMA OCCURRED: During Military Service INTENSE FEAR: Yes FEELING OF HELPLESSNESS: Yes FEELING OF HORROR: Yes OTHER REACTION: Yes DESCRIBE OTHER: Dissociation ADDITIONAL COMMENTS: Veteran served as a medic in Vietnam combat zones, with multiple exposures to seriously wounded, dying soldiers that he attempted to save. Witnessed horrific trauma involving severed limbs, gun shots wounds and multiple injuries. TRAUMA EXPOSURE TESTING ----------------------- TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE: Combat Exposure Scale, Trauma Questionnaire RESULTS OF IDENTIFIED TRAUMA EXPOSURE TESTING: Veteran experienced intensely traumatic combat episodes as a medic in Vietnam as evidenced by his documented receipt of the Combat Action Ribbon which corroroborates his DD-214 citation as well as his report of extreme combat trauma while serving as medic in Vietnam between 1969-1970; OVERALL LEVEL OF TRAUMATIC STRESS EXPOSURE: High PTSD SYMPTOMS ------------- PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY: Multi times per month PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA AND NUMBING OF GENERAL RESPONSIVENESS: Efforts to avoid thoughts, feelings, or conversations associated with the trauma, Efforts to avoid activities, places, or people that arouse recollections of the trauma, Inability to recall an important aspect of the trauma, Markedly diminished interest or participation in significant activities, Feeling of detachment or estrangement from others, Restricted range of affect Sense of a foreshortened future PERSISTENT SYMPTOMS OF INCREASED AROUSAL: Difficulty falling or staying asleep, Irritability or outbursts of anger, Hypervigilance, Exaggerated startle response, reliving experiences. THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN SOCIAL, OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: Yes DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND: Veteran experiences severe symptoms of PTSD that occur weekly and that have lasted for 40 years. Upon examination, Veteran reports that he is bothered at least several days each week by intrusive, avoidant and hyperarousal symptoms of post-traumatic stress. QUALITY OF PEER RELATIONSHIPS AND SOCIAL ADJUSTMENT: Pre-military, Veteran claims he was outgoing, had many friends, rode motorcycles; reports having a great social life and that he had lots of friends. When he came back from Vietnam, he was living in Westminister, near Little Saigon, believes he started to have ptsd (shell shock) symptoms and then his former, highschool friends also began moving away, resulting in a serious change in his social interaction. Veteran reports that he began isolating at that time which has persisted to the present; Veteran states that he currently has no real friends, finds it difficult to manage his anger and emotional responses when in crowds or large groups; prefers to be alone because he feels safer; does nothing for recreation; watches television primarily, avoids reading newspapers or other sources of written information. Unable to work due to the DDD. DESCRIPTION OF DEGREE AND QUALITY OF SOCIAL RELATIONSHIPS AND WORK: Can't work has DDD, SSDI from SSA, has very few friends, doesn't socialize; spend most of his time in the Haven Senior Program at West LA VA. DESCRIPTION OF ACTIVITIES AND LEISURE PURSUITS: Watched TV; plays with computer; HISTORY OF SUICIDE ATTEMPTS? Yes COMMENTS AND ADDITIONAL INFORMATION: Took aspirin in attempted suicide because he was having flashbacks of vietnam. Disclosed to family doctor; re-experiencing related to what else he could he have done to help injured and dying on the battlefield. HISTORY OF VIOLENCE/ASSAULTIVENESS? No SUMMARY STATEMENT OF CURRENT PSYCHOSOCIAL FUNCTIONAL STATUS: Veteran is not very social, isolates and prefers to stay alone, avoids crowds, ISSUES ASSOCIATED WITH ALCOHOL USE: No use ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE: No use PSYCH EXAM COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in DATES, CURRENT TREATMENT, AND OTHER SIGNIFICANT DETAILS OF NON-PSYCHIATRIC ISSUES: 1996- L shoulder surgery; 1969 Malaria in Vietnam; High blood pressure treatment in 2005. Severe Degenerative Disk diagnosed in 1983 at Kaiser related to Military medical records his sleep; Satellite TV Technician for Direct TV as Supervisior. IS THE VETERAN CURRENTLY EMPLOYED? No IS VETERAN RETIRED? Yes IS VETERAN DISABLE? Yes DATE OF RETIREMENT: 12/30/2006 Primary Care Physician Mr. XXXX is on time for his appointment and takes his medications as prescribed. The following conditions should be connected to his Military Service Agent Orange Exposure Post Traumatic Stress Disorder, combined w/ Bipolar Disorder Hypertension Traumatic arthritis, pain in right shoulder and neck Tinnitus Malaria Erectile Dysfunction, has elevation of the HGB A1C, w/early Diabetes, as a by product of taking medications for HTN and possible Agnnt Orange Exposure INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD: PTSD Symptom Scale QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY: PTSD Checklist for Combat and Non-Combat Trauma, Trauma Symptom Inventory PSYCHOMETRIC ASSESSMENT SCORES: Veteran was administered The PTSD Checklist (PCL), which is a 17- item questionnaire also designed to assess symptoms associated with combat related PTSD. On this administration of the PCL scale, he obtained a score of 68, which exceeds the score of 50 that is consistent with a diagnosis of PTSD in military populations. Of note, he reported within the past month being very bothered by disturbing memories, thoughts and images of his combat experiences, feeling cut off from other people, avoiding activities or situations because they remind him of stressful military experiences, being super-alert, watchful and on-guard, feeling irritable and having angry outbursts, feeling jumpy and being easily startled, insomnia and feeling emotionally numb. Additionally, he was also administered the Trauma Symptom Inventory, a 100-item questionnaire designed to appraise symptoms of posttraumatic stress disorder, clinical depression, affect regulation and dysfunctional behavior. He produced a valid, interpretable profile, with no exaggeration of unusual symptoms. There were clinically significant elevations on the Tension Reduction Behaviors (T = 93), Intrusive Experiences (T = 98) and Defensive Avoidance (T = 83) and Dissociation (T = 86) scales. He also meets criteria for PTSd based on PTSD Symptom Scale (Foa) as evidenced by at least one re-experiencing symptom (nightmares), three avoidance symptoms (avoiding, thoughts, feelings, detachment from others) and two hyperarousal symptoms (insomnia and pronounced irritability). DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? Yes AXIS I: 309.81 PTSD-Chronic, 296.00 Bipolar NOS Moderate to Severe IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. AXIS II: 799.99 AXIS III: Degenerative Disk; Malaria, No longer can work AXIS IV: Heavy Extreme Combat Exposure AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING SCORE: 45 TIME FRAME: Current functioning WAS A MEDICAL OPINION REQUESTED? No /es/ XXXXXXXXXX, Ph.D. CLINICAL PSYCHOLOGIST Signed: 11/16/2010 09:30
  22. Hi Here is my C&P for PTSD...I 'm also was awarded SSDI and I'm 61 How or do i qualify for PTSD & P&T or how do I get P&T Here my review back for the PTSD, and what my rating next What's my next step in the process???? LOCAL TITLE: COMPENSATION & PENSION EXAMINATION REPORT STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: NOV 02, 2010@13:43 ENTRY DATE: NOV 02, 2010@13:44:43 AUTHOR: XXXXXXXXXXX EXP COSIGNER: URGENCY: STATUS: COMPLETED C-FILE WAS: Reviewed MEDICAL RECORDS WERE: Reviewed OTHER MATERIAL REVIEWED: Psychometric Tests and Questionnaires, DD-214, Other Records/Documents WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes DATE(S) OF OUTPATIENT TREATMENT: Began outpatient treatment in 2009 after and began medications and psychotherapy; began VA treatment at West LA and Sepulveda in 12/2009. CONDITION(S) AND LOCATION OF TREATMENT: Bipolar disorder; Post-Traumatic Stress Disorder; Chronic SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER: Veteran is part of the psychosocial group treatment module at the POST, at VA West Los Angeles Medical Center and also is managed by Dr. Warren-psychiatrist from POST. He attends groups twice weekly, Medic PTSD and is compliant with medication by his report, notes from his psychiatric record also indicate his compliance with treatment. CURRENT TREATMENT(S): Anti-manic MEDICATION SIDE EFFECT(S): Drowsiness, Fatigue, weight gain GROUP THERAPY: Yes 2 INDIVIDUAL PSYCHOTHERAPY: Yes EFFECTIVENESS OF THERAPY: fair ---------------- Veteran was staioned in Da Nang, Vietnam attatched to 1st Marine Div., 1st Recon Battalion, Charlie company 2nd platoon, team 1; MOS was 0311 and 8651-primarily Recon: carrying medical supplies, save lives at all expense, exposed to serious injury, called medi vacs and give morphine; saw and killed VC; save soldier lives; DATE(S) OF SERVICE: 4/1969-09/70 BRANCH OF SERVICE: Marine Corps HIGHEST RANK OBTAINED: E3 TYPE OF DISCHARGE: Honorable RANK AT DISCHARGE: E3 MILITARY OCCUPATIONAL SPECIALTY: MOS: and 0311; Rifleman; 8651 Reconnaissance, went on patrols and fire-fights, called in artillery strikes; cobra and naval gunships in Da Nang; DECORATIONS AND MEDALS AWARDED: Combat Action Ribbon; Bronze Star Presidential Unit of Citattion; National Defense Service Medal; Vietnam Campaign Medal; Good Conduct Medal DISCIPLINARY INFRACTIONS AND ADJUSTMENT PROBLEMS: None. DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes WERE COMBAT WOUNDS SUSTAINED: No LOCATION AND DATE OF COMBAT EXPERIENCE: Da Nang 11/17/69 to 07/30/70; INSIGHT: Patient understands that he/she has a problem. DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in his sleep; TYPE OF HALLUCINATIONS: None DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? Yes INTERPRETS PROVERBS APPROPRIATELY? Yes DOES THE PATIENT HAVE OBSESSIVE/RITUALISTIC BEHAVIOR? No DOES THE PATIENT HAVE PANIC ATTACKS? Yes ------------- STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC: Combat experience DESCRIPTION OF STRESSOR: Combat experience DATE AND LOCATION: 11/1969 to 07/1970 Da Nang Vietnam. TRAUMA OCCURRED: During Military Service INTENSE FEAR: Yes FEELING OF HELPLESSNESS: Yes FEELING OF HORROR: Yes OTHER REACTION: Yes DESCRIBE OTHER: Dissociation ADDITIONAL COMMENTS: Veteran served as a medic in Vietnam combat zones, with multiple exposures to seriously wounded, dying soldiers that he attempted to save. Witnessed horrific trauma involving severed limbs, gun shots wounds and multiple injuries. TRAUMA EXPOSURE TESTING ----------------------- TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE: Combat Exposure Scale, Trauma Questionnaire RESULTS OF IDENTIFIED TRAUMA EXPOSURE TESTING: Veteran experienced intensely traumatic combat episodes as a medic in Vietnam as evidenced by his documented receipt of the Combat Action Ribbon which corroroborates his DD-214 citation as well as his report of extreme combat trauma while serving as medic in Vietnam between 1969-1970; OVERALL LEVEL OF TRAUMATIC STRESS EXPOSURE: High PTSD SYMPTOMS ------------- PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY: Multi times per month PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA AND NUMBING OF GENERAL RESPONSIVENESS: Efforts to avoid thoughts, feelings, or conversations associated with the trauma, Efforts to avoid activities, places, or people that arouse recollections of the trauma, Inability to recall an important aspect of the trauma, Markedly diminished interest or participation in significant activities, Feeling of detachment or estrangement from others, Restricted range of affect Sense of a foreshortened future PERSISTENT SYMPTOMS OF INCREASED AROUSAL: Difficulty falling or staying asleep, Irritability or outbursts of anger, Hypervigilance, Exaggerated startle response, reliving experiences. THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN SOCIAL, OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: Yes DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND: Veteran experiences severe symptoms of PTSD that occur weekly and that have lasted for 40 years. Upon examination, Veteran reports that he is bothered at least several days each week by intrusive, avoidant and hyperarousal symptoms of post-traumatic stress. QUALITY OF PEER RELATIONSHIPS AND SOCIAL ADJUSTMENT: Pre-military, Veteran claims he was outgoing, had many friends, rode motorcycles; reports having a great social life and that he had lots of friends. When he came back from Vietnam, he was living in Westminister, near Little Saigon, believes he started to have ptsd (shell shock) symptoms and then his former, highschool friends also began moving away, resulting in a serious change in his social interaction. Veteran reports that he began isolating at that time which has persisted to the present; Veteran states that he currently has no real friends, finds it difficult to manage his anger and emotional responses when in crowds or large groups; prefers to be alone because he feels safer; does nothing for recreation; watches television primarily, avoids reading newspapers or other sources of written information. Unable to work due to the DDD. DESCRIPTION OF DEGREE AND QUALITY OF SOCIAL RELATIONSHIPS AND WORK: Can't work has DDD, SSDI from SSA, has very few friends, doesn't socialize; spend most of his time in the Haven Senior Program at West LA VA. DESCRIPTION OF ACTIVITIES AND LEISURE PURSUITS: Watched TV; plays with computer; HISTORY OF SUICIDE ATTEMPTS? Yes COMMENTS AND ADDITIONAL INFORMATION: Took aspirin in attempted suicide because he was having flashbacks of vietnam. Disclosed to family doctor; re-experiencing related to what else he could he have done to help injured and dying on the battlefield. HISTORY OF VIOLENCE/ASSAULTIVENESS? No SUMMARY STATEMENT OF CURRENT PSYCHOSOCIAL FUNCTIONAL STATUS: Veteran is not very social, isolates and prefers to stay alone, avoids crowds, ISSUES ASSOCIATED WITH ALCOHOL USE: No use ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE: No use PSYCH EXAM COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in DATES, CURRENT TREATMENT, AND OTHER SIGNIFICANT DETAILS OF NON-PSYCHIATRIC ISSUES: 1996- L shoulder surgery; 1969 Malaria in Vietnam; High blood pressure treatment in 2005. Severe Degenerative Disk diagnosed in 1983 at Kaiser related to Military medical records his sleep; Satellite TV Technician for Direct TV as Supervisior. IS THE VETERAN CURRENTLY EMPLOYED? No IS VETERAN RETIRED? Yes IS VETERAN DISABLE? Yes DATE OF RETIREMENT: 12/30/2006 Primary Care Physician Mr. XXXX is on time for his appointment and takes his medications as prescribed. The following conditions should be connected to his Military Service Agent Orange Exposure Post Traumatic Stress Disorder, combined w/ Bipolar Disorder Hypertension Traumatic arthritis, pain in right shoulder and neck Tinnitus Malaria Erectile Dysfunction, has elevation of the HGB A1C, w/early Diabetes, as a by product of taking medications for HTN and possible Agnnt Orange Exposure INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD: PTSD Symptom Scale QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY: PTSD Checklist for Combat and Non-Combat Trauma, Trauma Symptom Inventory PSYCHOMETRIC ASSESSMENT SCORES: Veteran was administered The PTSD Checklist (PCL), which is a 17- item questionnaire also designed to assess symptoms associated with combat related PTSD. On this administration of the PCL scale, he obtained a score of 68, which exceeds the score of 50 that is consistent with a diagnosis of PTSD in military populations. Of note, he reported within the past month being very bothered by disturbing memories, thoughts and images of his combat experiences, feeling cut off from other people, avoiding activities or situations because they remind him of stressful military experiences, being super-alert, watchful and on-guard, feeling irritable and having angry outbursts, feeling jumpy and being easily startled, insomnia and feeling emotionally numb. Additionally, he was also administered the Trauma Symptom Inventory, a 100-item questionnaire designed to appraise symptoms of posttraumatic stress disorder, clinical depression, affect regulation and dysfunctional behavior. He produced a valid, interpretable profile, with no exaggeration of unusual symptoms. There were clinically significant elevations on the Tension Reduction Behaviors (T = 93), Intrusive Experiences (T = 98) and Defensive Avoidance (T = 83) and Dissociation (T = 86) scales. He also meets criteria for PTSd based on PTSD Symptom Scale (Foa) as evidenced by at least one re-experiencing symptom (nightmares), three avoidance symptoms (avoiding, thoughts, feelings, detachment from others) and two hyperarousal symptoms (insomnia and pronounced irritability). DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? Yes AXIS I: 309.81 PTSD-Chronic, 296.00 Bipolar NOS Moderate to Severe IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER: The symptoms of PTSD and Bipolar depression do overlap to a large extent particularly as it relates to unrelenting presence of persistent, bothersome, intrusive symptoms of re-experienced thoughts, images and feelings associated with the trauma and hypervigilance manifesting as insomnia and startle response, It appears in this case that the veteran is experiencing both chronic anxiety and a significant, complex mood disorder, hence both diagnoses are indicated. AXIS II: 799.99 AXIS III: Degenerative Disk; Malaria, No longer can work AXIS IV: Heavy Extreme Combat Exposure AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING SCORE: 45 TIME FRAME: Current functioning WAS A MEDICAL OPINION REQUESTED? No /es/ XXXXXXXXXX, Ph.D. CLINICAL PSYCHOLOGIST Signed: 11/16/2010 09:30 Thank You
  23. Hello I called the VAMC C&P department and gave name and last 4 and they gave me the time and dates. if you dont have a VAMC.than the best bet is the 800 number than next go to your RO or service vet and have them let you know. Good Luck.. :) :)
  24. Hello While serving on tour in Vietnam as a team Aid Man I encountered many injuried and death. I blocked out as much as I could all my life totally. I have a self letter for my PTSD C&P next week. It detailed my life, before, during and post military years. My Company Commander Capt Mc Vey USMC was MIA never to be found or his body to this day. MIA 3/2/1970 SN 521448976 Here the site info http://www.1streconbnassociation.org/KIA.List.htm I was close to him as he was our team leader. I never forgot his efforts. But along the way the others injured an death i seem to some how blocked out in my life all these years, names KIA and WIA I cant bring them to remember. All my issues and medical probelms related to this has created my severe Bi Polar and PTSD problems. (POST) I'm in PTSD classes, a MEDIC'S and regular PTSD session 2 times and week. at the VA....I just cant unlock them. My questions is how do i explain this when im asked to give detail of my patrol and missions and death an carrying of body bags all that goes along with explaining to him. I have prepared a letter like a self nexus of my life i wish to submit to the VA this next week to have part of my case. I dont know if its alright to submit it HERE..but it's 4 pages long and explains the best I can... I dont feel good explaining it. It took me many hours of preparing this, maybe more than 100 hours. Can I just give it to HE/She I can write it while being alone but can 't talk to others of it. Any help is welcome. If i cant what and frezze up and just cant open and speak much. I have to try ..but what if i cant..Cant he read my VA Psy report and know what med's and know what my Psy said and know already in my C file? I know he can see me and know I have issues. but wooow im really stressed out and in 8 days I will never sleep the few days before I go. Anybody have this problem ? Last does any body know where to fine June 1970 After action mission reports for the 1st Marine Reconnassance Battalion..1st Marine Division Charlie Co daily mission reports If i can find i can find and give the info to help me remember. I found all months for 1970 but i cant find anywhere June.. I have tried the 1st Recon Bn USMC Vietnam, Everywhere Found here everything but June 1970.. 1st Marine Division 1st Reconnassance Battalion Charlie Co. 2/1 69/1970 http://www.clemson.edu/caah/history/facultypages/EdMoise/marspec.html This is the month i need. does any body know a link to anywhere for this for me PLEASE provide its the only link i need to bring back the info to read and remind me. I found a buddy on the same team. but he dont want any reminder of it or to help me with a buddy letter..I have his name rank and service number and other reports of us being on patrols together..But it was bad and he to doesnt want nothing to do to in remembering it. if i can just fine it they will see my patrols and KIA and WIA reports from our Patrols and i can get and try better remembering it, it been 40 years since June and blocked out.. Im stuggling the best i can Marine Vet 1
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