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Found 55 results

  1. Just had my C&P last week. And, I've been trying to figure out if I will get the compensation benefits and at what percentage?..I was hoping some of my service family could help me with..Appreciate any input you guys or girls can give me. Thanks!! Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran: Taylor, David G. 0507 SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [X] Yes [ ] No ICD code: 309.89 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Other Trauma- and Stressor- Related Disorder ICD code: F43.8 Comments, if any: This is the DSM-5 diagnosis which applies when symptoms characteristic of a trauma- and stressor-related disorder cause clinically significant distress or impairment, but do not meet the full criteria for any other specific disorders within this category. In Mr. Taylor's case, criteria are met for categories A. (stressor), B. (intrusive symptoms), and C. (avoidance symptoms), but not catagories D. (Negative alterations in cognition and mood) and E. (Marked alterations in arousal and reactivity). Mental Disorder Diagnosis #2: Unspecified Depressive Disorder ICD code: F32.9 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A) If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: Mr. Taylor's Other Specified Trauma- and Stressor- Related Disorder includes situational symptoms which are activated by situations like thunderstorms. These symptoms are reported to include intrusive thoughts/fears/memories and accompanying states of anxiety. Mr. Taylor makes efforts to avoid encountering triggering stimuli. The Unspecified Depressive Disorder includes symptoms of sad and depressed moods, decreased energy and motivation, interpersonal withdrawal, feelings of hopelessness, and anxious distress. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [X] Yes [ ] No [ ] No other mental disorder has been diagnosed If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: The symptoms related to Mr. Taylor's Other Specified Trauma- and Stressor- Related Disorder are situationally circumscribed and seem to be mild or transient in nature. Symptoms of the Unspecified Depressive Disorder are more pervasive, resulting in occasionally diminished social and occupational functioning. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes [ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [X] Military service treatment records [X] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [X] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [ ] Yes [X] No 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Mr. Taylor was born and raised in Buffalo, NY. Family consisted of his mother and a brother five years older. Mr. Taylor's father was not involved in his upbringing. Growing up, "We weren't rich... single mom... towards (my) teenaged years she got addicted to some things... got pretty bad... brother was older, so I was kind of there by myself a lot." "I had a godfather that kind of watched me when my mom was working... He was there, which is more than what I could say about my dad..." Father had 15 children- "You can see why he wasn't around... came around to high school graduation... boot camp graduation... I forgave him... just the type of person he is... I have all these other siblings... call me when they need some money... Only time I talk to them is when I go visit... got a little sister who will call me once in a blue moon..." Relationship with his brother- "We're working on it... He was a little abusive... beating me up... one time I had to come at him with a knife... I was always doing the chores... wasn't really the best brother to have... Think he was probably a littl e jealous... He always had problems in school... I was kind of the smart one... He apologized to me... We're working on it..." First marriage- 1995-1997. From that relationship, "I had a daughter and a son (both are currently in Buffalo), same mom..." "My daughter, she's 20... pregnant now... with a man that's older than I am... I think it's because I wasn't there... looking for a father figure (Mr. Taylor is visibly, audibly sad, no longer making eye contact)... My daughter, that's awreck... She's staying over there with the guy... He's trying to control her... I talked to her about stuff, but kind of late, like 16, 17... Her mom and her got into it and her mom said she had to go... but too young to go... I just want to be there for her when she needs someone... If I was there, it could have been a little different..." "My son, I'm still working on him... I think he's a little mad... thinks I abandoned him... wasn't my choice... couldn't financially help him... I flew him down a couple summers ago... apologized to him for not being there... told him my thoughts... I got to be honest with myself, I could have done more for him..." "I was married (second) for about seven, eight years... two kids in that marriage... I was unfaithful, but she kind of forgave me... but I think that was more a way to get out.. I don't think I was really.. I get in so many situations I'm not comfortable... I'm not maybe the marriage type... getting married for no reason... I just left..." Current marriage of three years- "Terrible... I don't know if it's me... reason I'm here is maybe 50%... I think I moved too fast once again... When I left my first marriage, I was supposed to work on myself... I think it was more just having somebody there... She's kind of verbally abusive, and I think I allow it because... I can take a lot..." "I don't want to be a third time loser... but I think I need to be by myself... same thing over and over..." "She (current wife) thinks I'm just around now because it's comfortable... If I could afford to move, I'd have been gone... That's true... I bit off more than I could chew.... worst thing that could have happened to me... wrong relationship for me... I need to go, but I don't know how..." "My second kids... When they come over my house... feeling guilty because I left them... If I was there, they'd be living a little bit better... a little bit of order... I try to make sure when they come and see me that everything is good... got clothes... do things with them..." His current wife gets mad because they don't have more responsibilities when they visit. Friends- "I have friends... wife kind of chased them off... Now I'm embarrassed to even go... They know... certain changes... She throws temper tantrums... doesn't really have no respect for nobody..." b. Relevant Occupational and Educational history (pre-military, military, and post-military): School- "Very well... honor roll... played basketball." Pre-service work at McDonald's. Marine Corps- 1995-1999- Administrative Clerk- No deployments. Honorable discharge. "The reason why I got in... I had a daughter on the way when I was in high school... early entry program... didn't work out so well... She (wife) broke up... She was gonna go to school and come back... didn't hear from her for a while... back with her old boyfriend... caused my issues in the service... I told my commanding officer I needed to go home... try to save my marriage... I came back and they shipped me to another office... Headquarters Battalion... They were more focused on the job than some young guy focused on trying to save his marriage..." After the Marines, "A lot of call-center the first couple years... kind of moved down here because there wasn't a lot of good jobs where I'm from... I got laid off about a year ago... help desk... Carolinas' Associated General Contractors... about seven or eight years..." Currently, "I'm working at Lending Tree in Ballantyne now... going good... I'm always able to separate (work life)... from my personal life..." c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): Mr. Taylor says he took anger management classes during the service, following an altercation with his wife. No indication of any other mental health problems observed in STR, nor in military separation exam- June 8, 1999. Denies any mental health services before or after the military. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): During the service, "I got some anger management classes... Me and my ex-wife had got into it.. she kind of hit me first.. reactionary thing... I hit her back... I did get arrested for that think with my first wife... got restrictions for a week or two... money taken away..." Other disciplinary action, "Here and there... I'm not good at relationships I don't think... kind of got in trouble sleeping around with a... married woman... some other rules things... over-sleeping because I was drunk maybe a couple times..." Thinks he had two or three Article 15s. "I did get caught shop-lifting... When I was young... didn't have money to buy things... (in the service) video game card... got like 30 days restriction... like $400 in pay... maybe why I never got promoted beyond E-3... Most of the things happened during the first two years... kind of settled down after that." e. Relevant Substance abuse history (pre-military, military, and post-military): Alcohol- "Usually I'm just a social drinker... lately... kind of depressed... things ain't working out like they should have... expected more of myself... I might make two or three (drinks), maybe three, four times a week..." Sometimes more. No history of alcohol treatment. No history of illicit substances. f. Other, if any: Sleep- "I guess it depends... lately either I can sleep good, real deep... or I have... since I applied for this... sleep more off and on because I'm thinking about it... some periods I might have like restless leg syndrome... wife tells me... in and out of it..." "I try to work out now... try to help me sleep a little better... This bad relationship I'm in though, don't help me with my sleep..." Mr. Taylor says he gets "a good five" hours of sleep, "Then I toss and turn... had a surgery on my thumb... bulging disc in my neck... muscle relaxers... help me go to sleep..." Depression- "I've been depressed for a while... kind of live with it... I do have thoughts of maybe, you know..." Denies suicidal intent or plan. Wouldn't act on it because of his children. "I think I'm just hard on myself... The women, I don't really have emotional attachment with... my kids, I love my kids... feel like I've failed them... guilt... probably don't do what I need to do to handle it right..." Talks about his son acting out, being disrespectful to his mother, with Mr. Taylor feeling guilty/responsible for it. "If I was there, I know that wouldn't be going on." "My confidence in myself... kind of mumbling... I lost it somehow... It's embarrassing... Everything pretty much... I think my mom had more hope for me... kind of let myself and my kids down... especially my older kids..." Anger, "I can keep it in check, cause if I don't keep it in check, I don't know where it will go... That's the reason I don't discipline my kids... one time I did it... ended up (going too hard)... that's why I don't..." Anxiety, "I think I'm... I can tell by how my nails look, how I'm doing lately... I swear it has something to do with losing my hair... I kind of go in kind of a shell too... There's kind of a compulsive thing I do... I always got a remote in my hand... constantly going back and forth (does some numerical patterns with buttons/symmetry). "If it's raining... lightning... If I see that (memory of reported stressor)... even in the car... Even though when the lightning struck, we weren't near a tree... lightning hit the ground... I always had a wariness of... lightning... staying where I'm at, or make sure if I'm getting anywhere, I don't see no puddles of water... or passing by trees or metal... I know it happens... I was right there... I'm staying there until it at least slows down..." "Ever since I started coming here, I keep replaying it in my mind... wonder if it has anything to do with what's going on..." 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: "What they said and what happened are two different things... storms... rifle range... lightning hit the surrounding tree line... I'm like... 'That's real close... don't know why we were still there.'... As we were leaving... two formations... guys (other group) right behind me... I was in the back of mine... Drill sergeant was like, 'Cover your rifles with your ponchos.'... We were doing that... All the sudden... blue light... no sound... feel this heat on the back of my neck... several of us got down... As I turn around... see several guys down on the ground... Drill instructor is running up... eyes out of his head... 'Everybody get up to the... shelter!'... This one guy... just down... all this happened in probably no more than ten seconds... That heat... and you could smell it, like electrical burn... 'til I hear the boom, then I recognized what it was... My ears was ringing... One of the guys... He had died... hit him first, and came out and hit the people closest to him... We was in boot camp... didn't tell us anything... We went to his funeral... after that, we didn't do but ten or fifteen percent of the stuff... because it was raining a lot... lightning... We didn't do it after that... He could have been alive if we'd have left ten minutes earlier..." Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No If no, explain: Mr. Taylor was witness to another man being killed by a lightning strike during training. Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criteria A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Witnessing, in person, the traumatic event(s) as they occurred to others Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: No response provided. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: No response provided. Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Chronic sleep impairment 6. Behavioral Observations -------------------------- Mr. Taylor arrived about 15 minutes early for his appointment. He was neatly and casually dressed. No abnormalities of gate or posture were noted. He was cooperative with the interview process and made good eye contact. Mr. Taylor was fully oriented. Speech was clear and coherent, quiet at times. Mood was somewhat depressed. Affective expression was mild, congruent, sad at times. Thought process was logical and goal-directed. Thought content was relevant and with adequate detail. Gross concentration and memory were adequate. Insight and judgment are in tact. There was no evidence of perceptual disturbance. There was no evidence of thought disorder or hallucinations. Mr. Taylor relates that he has thought about suicide, but denies any intent or plan. Homicidal ideation is denied. 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, (including any testing results) if any -------------------------------------------------- Prior to beginning the interview, the undersigned examiner informed the veteran of the purpose of the evaluation, the role of the undersigned examiner, and the limits of confidentiality. The veteran indicated understanding of the aforementioned information. Per VA Memorandum titled Information Bulletin: Implementation Guidance for the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) use in Compensation and Pension Examinations, dated December 16, 2013, this examination was conducted using DSM-5 criteria. Of note, the DSM-5 no longer requires computation of a GAF score. Per 2507: "Please indicate in exam report the stressor(s) claimed by the veteran upon which a diagnosis of PTSD is based. **If a diagnosis other than PTSD is rendered, please state if that psychiatric condition is at least as likely as not (50 percent or greater probability) linked to the conceded stressor." Examiner's Response: Mr. Taylor does not meet DSM-5 criteria for a diagnosis of PTSD. However, he does currently meet criteria for Other Specified Trauma- and Stressor- Related Disorder. This includes situational symptoms including intrusive thoughts/fears/memories of the stressor event, with accompanying states of anxiety, which are triggered by situations like thunderstorms. Mr. Taylor makes efforts to avoid encountering triggering events. The Unspecified Depressive Disorder includes symptoms of sad and depressed moods, decreased energy and motivation, interpersonal withdrawal, feelings of hopelessness, and anxious distress. The symptoms related to Mr. Taylor's Other Specified Trauma- and Stressor- Related Disorder are situationally circumscribed and seem to be mild or transient in nature. Symptoms of the Unspecified Depressive Disorder are more pervasive, resulting in occasionally diminished social and occupational functioning. It is at least as likely as not (50 percent or greater probability) that Mr. Taylor's currently diagnosed Other Specified Trauma- and Stressor- Related Disorder is due to his having been witness to the lightning strike killing a fellow Marine during training. The reported stressor is sufficient for the potential development of a trauma- or stressor-related disorder. The symptoms of intrusive thoughts/fears/memories of the stressor, accompanying states of anxiety, and efforts to avoid triggers to memory of the stressor are meaningfully related to the stressor itself. It is less likely as not (less than 50 percent probability) that Mr. Taylor's currently diagnosed Unspecified Depressive Disorder is due to the lightning strike killing a fellow Marine during training. Mr. Taylor's problems with depression seem more likely due to historical and current difficulties with significant other relationships, difficulties and regret in his relationships with his children, and perhaps aspects of adverse circumstances during childhood.
  2. I am presently service connected for Tinnitus 10 % ; Bilateral Hearing Loss 80 % and TDIU 100 % P&T. Without going into a lot of discussion this was attained from 2001 through 2013. I am considering filing a claim for Heart Disease, Sleep Apnea, Hypertension, and Depression/PTSD. I feel if any of these claims prevail it will have to be secondary to my service connected hearing loss and loss of employment. I will try to explain this without having to write a book someone can give me some advice. My service connection disability had never been a factor for me until I was 48 years old and after working twenty two years in my chosen profession in law enforcement. I had never filed a claim for hearing loss mainly because my VA service rep twenty something years earlier told me they probably wouldn't be able to find my medical records and I wouldn't prevail. In 1992 at age 48 my agency demoted me, cut my salary, loss of other benefits and threaten to fire me due to my loss of hearing. I had just started wearing hearing aids so it made the hearing disability obvious. After this happened I became depressed, angry and still depressed to this day. I was ordered to see different psychologist and had to undergo weekly visits for six months. In addition I began to have hypertension problems, chest pain and marital problems. Priver or to the action related to my hearing I had never been treated for any of these problems and no hospitalization of any kind since I was very young. Before all of this I still was walking several miles a day and in excellent health. I ended up having to file suit to get my benefits back and prevailed in that regard. I have taken medicine for depression since 1992 and finally took an early retirement in November 2000 and moved back to my home state. I retired with two stents in my heart, high blood pressure, depression and frequent angina. I took a part time job as a US Marshal working in a federal court in my home state. Six months into the job I was medically terminated due to my hearing loss. In 2001 I filed my first VA claim for hearing loss. I was granted service connection with increases up until 2013 when I was granted TDIU. I had tried two different times for TDIU prior to 2013 and was denied. My depression is documented by VA medical records. Since 2001 VA has diagnosed seep apnea and issued me CPAP. I take VA prescribed meds for depression. In addition I have 15 stents in my heart, two heart attacks and quadruple by pass surgery after having a heart attack at VA medical facility in 2004. Sorry this is so long but is there anything secondary or otherwise I can hang my hat on in this information. I know I am blessed to have the TDIU but feel my heart condition and depression are both related in the chain of events over the years. I know I am not likely to die from hearing impairment but surely the heart disease will prevail.
  3. Here are the results from my C&P exam for depression, let me know what ya'll think, and what my possible rating might be. Thanks These are blue button download notes, so not in exactly easy to read format. Print Done T========================== Date/Time: 03 Nov 2015 @ 0800 Note Title: COMPENSATION & PENSION NOTE Location: Lebanon VA Medical Center Signed By: VONRAGO,LAWRENCE L Co-signed By: VONRAGO,LAWRENCE L Date/Time Signed: 03 Nov 2015 @ 1032 ------------------------------------------------------------------------- LOCAL TITLE: COMPENSATION & PENSION NOTE STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: NOV 03, 2015@08:00 ENTRY DATE: NOV 03, 2015@10:32:49 AUTHOR: VONRAGO,LAWRENCE L EXP COSIGNER: URGENCY: STATUS: COMPLETED Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire Name of patient/Veteran SECTION I: ---------- 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes[ ] No If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Major Depression, chronic Comments, if any: Patient reports that he has been depressed throughout his military career and never felt depressed prior to joining the military. After leaving the military, he remained with chronic clinical depression which is never resolved. He never received day treatment until recently. Mental Disorder Diagnosis #2: history of alcohol use disorder in partial remission versus full remission b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes[X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[X] No[ ] Not shown in records reviewed 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[ ] No[X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes[ ] No[X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ a. Medical record review: Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes[ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes[X] No If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [X] Other: cprs and vbms were reviewed. b. Was pertinent information from collateral sources reviewed? [X] Yes[ ] No If yes, describe: cprs and vbms were reviewed. 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Re: Section 2.0, please refer to section 6.0 below b. Relevant Occupational and Educational history (pre-military, military, and post-military): No response provided. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): No response provided. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): No response provided. e. Relevant Substance abuse history (pre-military, military, and post-military): No response provided. f. Other, if any: No response provided. 3. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Chronic sleep impairment [X] Disturbances of motivation and mood 4. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [ ] Yes[X] No 5. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No 6. Remarks (including any testing results), if any: --------------------------------------------------- Please note the following regarding Compensation and Pension exam documentation: 1. The examiner is a poor typist and no longer has access to a transcriptionist for dictating reports; however, parts of the report will be automatically typed via transcription software or dragon software. This dragon software is prone to error, therefore there may be typos in the body of the report. Important documentation considered vital, such as diagnosis and recommendations, will be proofread before submitting. 2. In order to maximize face-to-face time with the veteran the following measures will be taken: 1.) with regards to the grammar, syntax, structure, etcetera in this report, only the assessment, diagnostic formulations, and conclusion of the report will be thoroughly proofread. The non-essential parts of the report will NOT be thoroughly edited and WILL contain typographical and organizational errors (the body of the report may not be well-written, 2.) select parts of the exam may be dictated in the spoken language of the veteran or will be paraphrased; when the author types in the first person, assume the sentence is likely a quotation. When deemed essential to understanding the context of a statement, quotations will be included in the report. 3. An ACE examination was not completed today. The veteran was present for this examination. Acronyms used in report: hx =history abuse x 3 = physical/sexual/verbal abuse pt = patient asap = as soon as possible sx = sympto m bc = because fx = function d/a or D&A = drug and alcohol fxing (functioning) s/p = status post si/hi = suicide homicide cfs = pt is able to contract for his/her safety CIP/cip = crisis intervention protoco mh = mental health hs = high school or at bedtime avh = auditory visual hallucination c/o = complains of FH = family history c/w = consistent with Rx = medication rship relationship dx = diagnosis nm= nightmares N= no Y= yes s = without c = with re: = regarding XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX IDENTIFYING DATA: . He presents today for a compensation and pension exam. He offers no cc. He provides a document in support of his argument that his chronic depression is caused by his chronic pain which is caused by a leg injury he had during the military. PAST PSYCHIATRIC HX: 1. Inpatient psychiatric treatment? none 2. Counseling hx? + 3. Psychiatric Rx Tx? no 4. Family psych. Hx? none known 5. Legal Hx? non 6. Drug Abuse Hx? 7. Alcohol abuse/dependence? He abused alcohol most of his military career per patient. I "think I started drinking regularly for sleep?He then reported excessive drinking throughout the military and he had one article 15 for etoh abuse. He has not been drunk since 22 years old. He continues to use etoh as a "sleep aid". I only drink 2 beers nightly. Denies cage and problematic drinking patterns. 8. Behavioral Hx? neg 9. SI/HI Hx? He tried to cut himself in the military. He talked to a chaplain, but had no mh treatment otherwise. He has suffered from chronic suicidal. SUICIDE HX: The veteran presents a chronic history of suicidal ideation. He indicates that in the context of his pain primarily, and his resultant depression, he was on the verge of cutting his wrist in order to end his life. Just when he was about to do this, someone intervened. He has not subsequent had suicide attempts, but he reports that he has suffered from chronic, intermittent, suicidal ideation, which she reports waxes and wanes. He reports that this seems to present with stress but can occur out of the blue. He has been able to contract for his own safety with his current counselor and he denies any current intent, plans, wishes, or goals to harm himself. He expressed an excellent understanding of crisis intervention protocol (cip) and expressed a good understanding of how to initiate cip if need be. The patient is able to contract for safety and will not act on any SI/HI if it subsequently presents. If the patient exhibits warning signs/symptoms of worsening MH problems, e.g. becomes increasingly depressed or anxious etcetera, the veteran promises to notify the treatment team. The patient reports he is safe and does not need to be in the hospital and indicates that this is been going on for years. The patient appears reliable at this time regarding the above and seems aware of which symptoms warrant contacting the treatment team so that the risk of si/hi is minimized. The patient is seen as lower risk for acting out, but in the context of this being so chronic, one would be advised to monitor this for worsening. In the context of the obtained clinical history and the mental status examination, there are no significant signs of acuity today that would suggest or indicate that the veteran is in imminent risk for acting out regarding si/hi. On exit interview, the veteran did not appear to be in any acute distress nor was suicidal/homicidal issues deemed to have been provoked. The veteran denied any acute SI/HI symptoms at the conclusion of the evaluation. Re: guns/weapons, the veteran was counseled to avoid any access to firearms and other dangerous weapons/devices, etc., due to the increased risks associated with access. PAST MEDICAL HISTORY: see chart/records CURRENT STRESSORS: "dealing with the VA". He had a couple claims denied. They were mostly resolved. " Life in general". CURRENT FUNCTIONING: 1. INTERPERSONAL- FRIENDS, FAMILY: Per patient, he has less than adequate relationships in general, which he believes is related to his depression. He says that he has no true friends. He admits to having acquaintances. 2. WORK HX : good relationships at work. Good work hx. he has never been officially fired. 3. TYPICAL DAY : I don't do anything for fun. I go home, I work a 10 hour shift. When I am off I sit around. I like doing yardwork. He report watching TV. He and his wife are financially struggling so they don't go out to eat much. He reports no friendships. He had no true friendships in childhood either. "I was a military brat". I don't do social events. He has only recently started counseling despite the fact that he has been depressed most of his life. He has a 9 yo and a 14 yo. He will do activities with his children. His relationship with his wife is , well, it is not great but not horrible either. He variably indicated that he argues a lot with her. Counseling records seem to describe the relationship as being strained MATERIALS REVIEWED? VBMS was reviewed. CPRS was reviewed. The veteran was examined. The computer records were reviewed. Military Hx: no combat hx. Served in the military x 6 yrs. HPI : The veteran self-reports that he was a fairly normal kid. He indicates that he never had any kinds of mental health problems whatsoever. He was easy-going. He does not recall having any problems sleeping or being a nervous anxious person etc. He seems to have excellent mental health per the patient. Once he got into the military and injured his leg, everything seemed to go downhill. He indicates that he injured his leg and needed to wear a brace for about 8 days. He indicates that ever since that time he developed problems sleeping which she then self-medicated with alcohol. Because he self-medicated with alcohol to sleep this then caused his alcohol problem. Although he never sought any treatment for his depression, he believes the depression directly resulted from his leg pain and his insomnia, the latter of which caused was the cause of his alcohol problems. He does not take personal responsibility for his alcohol problems, indicating it was a result of his insomnia. He indicated that he wore a leg brace for 8 days and then was sent back to active duty. He reports that he has suffered from a lifetime of pain which is caused his problems. He indicates his pain ranges and now he has pain in the number of different places. He indicates his pain average to be falling in the range of 6 through 8. The veteran currently reports feeling depressed and indicates that he has been depressed throughout his military career and throughout his life. Although he feels strongly that his leg pain caused his depression, he does admit with questioning that there were other stressors. One of the stressors he indicated was the fact that there was stress in the military. He was in the Marines I believe and indicated that they had strict standards. At one point he was afraid that he was going to have to buy new uniforms because of something a commander said to him.. He reports that would take a full paycheck. He believes this was the trigger when he was going to commit suicide by cutting his wrists. With further questioning, he did admit that he had a girlfriend who developed cancer. Psych clear what happened but her family lied to him and told him that she died. He subsequent found out that that was alive. Regarding the patient's depression, he feels depressed, chronically, and admits to neuro vegetative symptoms of depression such as feeling angry and irritable frequently, having trouble concentrating and focusing, having no desire to do things at times. He indicates it's hard for him to enjoy things. He has trouble sleeping at night which he relates is secondary to his mind racing. He does not endorse bipolar problems. He does not endorse psychotic problems. He does not endorse drug problems. He does indicate that he has had alcohol abuse problems, but he self-reports now that all he drinks are to light beers per night, no more low less. He reports that he had been clearly abusing alcohol in the military and in fact received an article 15 for alcohol related charges. He described out of control drinking, drinking most days of the week and really feeling out of control. He was able to stop this when he left the military at some point and currently has maintained a pattern of only 2 drinks per night to, per patient, help him fall sleep. He denies any abuse. He denies people being concerned about his drinking patterns, or other him symptoms suggestive of alcohol problems. No history of panic. He does describe feeling stressed and anxious but does not feel he is a worrier. He does not endorse social phobias or any other type of OCD/anxious based disorder. No other comorbidities were noted. There is no history of significant trauma. Regarding the patient's history of insonmina he does suffer from chronic depression which most often is connected with sle with sleep problems. The veteran does not recall having any sleep problems whatsoever as a child or adolescent. His sleep problems began when he joined the military, as did his clinical depression. He has been diagnosed with sleep apnea, and vividly recalls being a heavy snorer when he was in the military. He does not recall having any problems with being us nor prior to joining the military. I don't see any clear military connection for sleep apnea although he reports that his sleep apnea may have started in the military as well. Since there was heavy drinking during this time period and again there is no documentation, I do not believe there is any grounds to suggest that his current sleep apnea is military related. Sleep apnea could itself be one of the many risk factors for development of depression. PERSONAL HX: CHILDHOOD, SCHOOL, PARENTS The veteran reports having an unremarkable (history seems to fall WNL) childhood hx. 1. Hx of abuse x 3 : n 2. Hx of MH problems : n 3. D/A hx : n 4. Academic hx: n MSE: unremarkable. No si/hi/avh/del. 1. Is the examiner concerned with imminent si/hi ? N 2. Is the examiner concerned re: avh/del/psychomotor agitation/mania/mixed/manic sx's? N 3. On exit assessment, are there any imminent concerns noticed that need acutely addressed? N 4. Re: safety issues, is the examiner sufficiently concerned re: reliability of the candidates hx? N General Overview re: Compensation and Pension exam-- In this checkbox formulated template report, although a veteran may endorse experiencing certain symptoms, one may not see a symptom checked off on the provided diagnostic checkbox list of symptoms. Any symptom reported by the veteran but not checked off on the checkbox list indicates that the symptom(s) is not deemed to be clinically significant. This means that the symptom(s) reported has not been determined to represent psychopathology (an aberrant symptom(s)) but rather, the symptom is deemed to fall within the normal limits of human experience). The examiner's role in this process is to determine which symptoms represent abnormal or pathologic mental health states vs. those symptoms that fall within the normal limits of human experience. The presence of psychological symptoms can be considered "normal" depending on various factors. For example, it is not necessarily pathologic (a mental illness) for one to feel sad, angry, anxious, depressed, etc. Experiencing such symptoms does not mean that one is suffering from a clinical depression or has mental illness ( e.g. psychopathologic depression). It is within the range of normal human experience to feel "emotional", sad, angry, or even anguished at times when thinking of friends, fellow soldiers, or innocent victims that have been injured or killed; merely experiencing such an emotion does not constitute psychopathology. In some individuals, feeling intermittently emotional about past traumatic experiences can fall well within normal limits, even if symptoms surface on and off for many years. Feeling strong emotions at times does not necessarily mean that you are mentally ill (experience psychopathology). Discussion: The veteran feels strongly that his clinical depression which has been present throughout most of his adult life has been caused by a leg injury that he had in the military. He did not seek out any help for his depression in the military because he was ashamed. When he left the military, even though he continued to be remain moderately to severely depressed dailiy, he never sought any form of treatment and has no documentation of clinical depression. He only recently started clinical treatment. Findings: The veteran describes chronic depressed mood, with no history of meaningful clinical improvement and certainly no remission. He reports feeling depressed daily, and ranks his depression as being moderate (7 on a scale of 1-10 for depression). He describes neurovegetative symptoms of depression including problems with chronic suicidal ideations. Typically, depression is considered to be multifactorial. There can be genetic influence often times but not always. Clinical depression is very common in general oftentimes there are multifactorial elements, which play a role in so far as etiology. In this veteran, there is no documentation supporting that he suffered from depression while he was in the military. He indicates that he was so severely depressed that he had been seconds away from attempting suicide but never sought any treatment throughout. He did indicate that he talked to religious counselor once I believe. There is no evidence of any specific cause of his depression which hes has felt throughout his adult life. There are multiple clinical factors that are believed to be prominent triggers for depression such as of low self-esteem, unfulfilling relationships, chronic use of alcohol, which we know now is a risk factor for depression. Although the veteran believes his pain has specifically caused his clinical depression, however depression is most often determined to be multifactorial. In the examiner's opinion, there is insufficient evidence to suggest that in this particular case his clinical depression is solely secondary to his leg pain. That is, the examiner believes that there is a greater chance than not that other factors played substantial roles in his chronic clinical depression and in the absence of clinical evidence i.e. documentation, to suggest otherwise, there is not sufficient evidence to support his own belief that his pain is ultimately the sole cause of his chronic depression. By his history and per records there've been multiple stressors throughout his life that could play a significant etiologic role. With regards to there being a military stressor large enough to provoke clinical depression while in the military, it is unlikely that a minor injury (an injury that required a leg brace for 8 days and then back to duty) would be sufficient grounds to cause clinical depression, particularly since there were numerous stressors including relationship issues and legal problems. xx /es/ LAWRENCE L VONRAGO M.D./STAFF PSYCHIATRIST Signed: 11/03/2015 10:32 -------------------------------------------------------------------------
  4. Hey everybody, just a quick update on me. On Friday I had a joint C&P exam for my R ankle and hips for secondary claims. Ankle was found Dorsiflexion of 0-5 and Plantar flexion of 0-40 Hips were found flexion: 0-40 extension: 0-20 Abduction: 0-20 Adduction 0-20 Rotation, external 0-20 and internal 0-20. Examiner opined that the ankle was at least as likely as not caused by already SC L ankle, but the hips were found less likely as not caused by current SCDs. X-rays of hips showed nothing. Ok, now hear this...he suggested/advised that I call my PCP and request for an MRI for my hips for further evaluation and treatment. Is this his way of saying that my pain and reduced ROM are for real and should be further investegated that I may then be SCd? He also said in his opinion it seems more likely that the soft tissue of the pelvis/hip region is inflammed which is causing my pain and reduced ROM. And that I may need to see a Rheumatologist for treatment. Not sure what that is implying, but I have heard of rhuematoid arthritis, is this what he may be hinting at? Ok PTII, today I had a C&P for depression secondary to chronic pain... One of my worst ever exams!!! When he was done(VA phyc) I felt that I shouldn't have even filed that claim. He was very nice and polite, but every twist and turn he kept trying to lead me outside of my AD time and the years since. He kept asking about before I went in the Marines. I kept redirecting by saying these things and symptoms all started after my enlistment began. He kept repeating the same questions over and over, waiting for me to slip up. I knew what he was doing, and yet still felt like I was the one in the wrong. Then he went on some spiel about how 30% of the general population is depressed and most of them don't have suicide ideations and such. And that most of us are biologically predisposed to things like depression. He wanted me to try to explain why I think I don't have any friends, even though I had told him that my state of mind keeps me from doing that. I went into detail about my chronic sleep impairment and drinking, and he made it sound like it's the normal thing no big deal. I told him that I did not grow up with these things in my life or family. And that they all began to manifest after I was in the Marines. I told him that on my 5th day of boot camp, when I fell down the stairs, is the initiation point. Then he said he will have re-review my record to see if he really could find some way to SC this. Funny, it was supposed to be for secondary to chronic pain. He asked about current SCDs and I told him what they were and the ratings, several of which are listed as pain conditions. Is this normal? Or am I looking at a long road of NODs and BVA land??? I sure hope all that was just his way of trying to trip me up into screwing myself by saying the wrong thing. I did have a written statement covering things I wanted to make sure were covered, and I told him that a copy of same will be submitted into evidence for my claim, to ensure nothing from it gets left out. He made a funny face at that, but said it was a good idea to be prepared like that. Anyway, thanks for letting me ramble on. Andyman
  5. Hello all, I got a phone call at the end of work yesterday afternoon, can I come down for a C&P exam on Tuesday, the 3rd of November...what is this for...my claim for depression, yes I will be there. Anyone go through an exam for depression as secondary to chronic pain? Or even just depression, that can give me some pointers? What should I not mention, besides life before my service? How much detail should I give? Should I mention my night sweats, and nightmares along with my chronic sleep impairment? How long will this type of exam take? 1 hour, 2 hours, or longer? Semper Fi. Andyman.
  6. So here it is going on 4 years since I was honorably discharged from the military. Since I have been out, I seem to hit these depressing slumps of missing the military, wishing I could go back in (unable to go back in on account of a medical issue), having adjustment issues to not having the structure in my life as well as I am always "military minded" about how I deal with stress, people, other issues. I expect everyone have the same mentality from my family to my friends. I was treated once for anger issues while in the military, but this depression crap has me completely off the wall at times. I lose control when people make simple mistakes as well as ask me what I consider to be simply self explainable question. Am I even able to explain this to a VA Counselor or psychiatrist and have it service connected? Any input or advice is welcome positive or negative it is appreciated.
  7. Back on the 14th I had my C&P Exam for my reopened exam. I must first say this is the first time I was asked in the claim form to identify stressors or past stressful events that I participated in while serving. I went in for the exam, it lasted about 2 hours, and I just recently downloaded his report. He marked no for ptsd, but identified three other mental disorders and found them to be more likely than not to be service connected, While strikes me as odd is, he says no to ptsd, but at the end of the report he checked almost every box indicating ptsd? Based on your experience, is this guy trying to help me out, or is he just refusing to find ptsd? also, I was asked nothing in the interview about social or occupational issues that have arisen due to the depression and anxiety. Should I write a letter explaining those issues that seem to be missing from the report, or should I just wait for the decision? Thanks for reading. I look forward to participating here.
  8. Can anyone tell me what specific form must I provide to my private mental health doctor to file with my TDIU claim? Or, does she need to provide a letter stating how my my SC mental health conditions has affected my unemployability and if so does a VA form DBQ still has to be completed as well? This all so confusing Thanks
  9. I wasn't sure what to title this and where to put it. timeline: November 2011, rated 70 % SC for MH. Including PTSD, Bipolar, yadda yadda. 2011-Present time, Lots of counselings and changing of Meds. About a month ago, I went to my regular physical doctor at VA. I told her that I still have suicidal thoughts. She made me see the counselor. I talked to counselor in October, and she made an appointment for me on Nov 10, 2014. She said I can bring my wife if I wanted to, and I did. We shot the bull and talked about how things were getting better for us, etc. I am trying to get back in shape and started walking/jogging a while back. Also, I need to add, that my VA psychiatrist changed my drugs from one thing to Lithium. I told the counselor that I believe the drugs were a good thing, so far. I noticed on my BlueButton MyHealtheVet, that she marked that I was doing better, etc, etc, etc.. Well, for one, I don't want to talk about all the bad stuff when my wife is sitting next to me. Because everything I say will be used against me (trust me). I get a call this Monday, (17 November) from the C&P people. They said I need to come in for a C&P re-evaluation or a yearly evaluation for my MH claim. 19 November, I showed up at this C&P reevaluation, and the Dr. asked, Do you know why you are here? I said no ma'am. And she explained that the VA was making sure that I was being properly taken care of, and that my benefits didn't need to be bumped up. When I was in the office with this Dr., my body felt like it was on fire. My chest started beating fast. My hands were shaking. I was crying, etc. She asked me to tell her what the following meant, "Don't Count your chickens before they hatch". I just repeated it like a fool like 5 or so times. I honestly believe that the new drug that they gave me started to kick in. She wanted to put me in the Mental Jail, But she kept asking me if I wanted to go there, but I told her, I prefer not. She said, what if I make you? I said, you got to do what you go to do, but I Prefer not. Those people in the mental ward are literally crazy people. I'm depressed and act all weird, but I'm not "crazy" like some of those. In the mental ward, there was this one guy that kept shitting on everything. I'm not like that. I'm glad that she seen me in my bad times, since it was a C&P exam. But, I am so Scared that they are going to re-evaluate me and say that I don't deserve the 70% that I get. I already feel as though I am using the system, and it makes me feel really bad for having to "prove" my insanity. I wish I could go back in time and not ever go to the VA. I want life to be like it was before I went to Afghanistan in 2011. Anyway, if these post are supposed to be in the form of a question, What is the chances of them downgrading my % ?
  10. Good morning. This is my first post here. This site has been very helpful since I started reading it. I applied for PTSD starting back in June 2013. I was in Sadr City, Iraq in 2004-2005. I waited 8 years to claim, but my wife and parents were pushing me to claim it. I was awarded last month 50% for MDD. While I was applying for compensation, I was fixated on just getting the PTSD/MDD taken care of. Now that is over with, I am considering filing for the patellar femoral syndrome that I was diagnosed with back in 2008. At that time, I was called up to re-activate from IRR. I was released from that due to my patellar femoral syndrome, which I believe is service connected. It is intermittent pain and causes me difficulty walking at times. I'm not sure how much success I will have though, considering I was never treated for it while I was active duty, and it comes and goes, so I'm not sure how a C&P exam would go. I do have medical records however from my civilian primary care giver and orthopedic specialist showing that I have PFS. Any thoughts or advice? I don't want to waste my time if I don't have a chance of getting a rating. Thanks
  11. Hi, I am in the process of starting an appeal. I have been denied an increase for ptsd and depression, and denied SC for my Neck and Back. I am currently at 30% for ptsd w/ Depression, unemployed, and on SSD. What is the best way to go from here? Should I file a NOD, or just a Formal Appeal? I submitted new information, including a personal statement, the last time I filed, but was still denied. I have documentation from the medical center from while I was enlisted for my neck and back, but it was not a chronic issue back then, but with the lack of proper care/treatment from the va, it has gotten to the point where I can no longer function. I have been diagnosed with Bulged Discs, Calcification of Ligaments, Loss of Curve. Have frequent Headaches. The Pain Medications I have been prescribed from the va don't help. I was misdiagnosed with Personality Disorder when discharged from the Army, and later diagnosed with PSTD and Depression. I filed a request for earlier effective date, due to the misdiagnosis, and that was also denied. I have documentation from my Psychiatrist stating that I have been under her treatment since "2012 until present for PTSD, Prolonged. Characterized by Chronic Anxiety, Depressed Mood, Social Isolation, Insomnia, nightmares, flashbacks, hyper vigilance, startle response, avoidant behavior, and inability to deal with day to day stressors". She also states that my "chronic mental illness clearly interferes with my day to day functioning and ability to function in a work environment with other people." She adds that she does not see any symptoms of me having a Personality Disorder. This Is My Problem! They Double Talk Themselves. When I filed for an increase for PTSD, they denied it stating, "The examiner opined that my history of mood changes, sometimes several times a day, and pattern of conflicted relationships, is more consistent with a diagnosis of personality disorder than PTSD. The examiner again noted that my personality disorder was mostly the source of my occupational and social impairments, and that my clinical presentation is more consistent with a personality disorder than ptsd.! THEN, When I filed SC for Aggravated/Exacerbated Personality Disorder by my ptsd and military service, it was denied stating that my doctor did not see symptoms of Personality Disorder.! So, in one paragraph, I have a Personality Disorder, and not PTSD... and in the very Next paragraph, I have PTSD, and Not a Personality Disorder...? Please Help...
  12. A Gulf War veteran friend showed me this decision he just received: "1. Service connection for the purpose of establishing eligibility to treatment for generalized anxiety disorder, panic disorder and adjustment disorder with depressed mood is established." "2. The previous denial of service connection for post-traumatic stress disorder is confirmed and continued." "6. The previous denial of service connection for major depressive disorder is confirmed and continued." "9. The previous denial of service connection for anxiety disorder is confirmed and continued." We determined that the following conditions were not related to your military service so service connection remains denied Post-traumatic Stress Disorder Anxiety Disorder Major depressive disorder *Reasons For the Decision ( #1): A determination of service connection under 38 U.S.C.1 702 is for the purpose of providing eligibility for hospital and medical treatment for veterans of World War II, Korean Conflict, or Vietnam era; or for Gulf War veterans who develop an active psychosis or any active mental illness during or within two years from the date of separation from such service or within two years of the end of the war period, which ever is earlier. The veteran was discharged on May XX. 201l . A psychosis/mental illness was first diagnosed on June XX, 2012. Entitlement to treatment is established because a psychosis/mental illness was diagnosed within the required period of time. ----------------------------------------------------------------------------------------------------------------------------------------------------- It appears then that service connection for treatment for generalized anxiety disorder, panic disorder and adjustment disorder with depressed mood was OK'd, but, apparently denied for compensation purposes. Not even a 0% rating. Anyone ever heard of such a thing? Seems like a contradiction as 38 USC 1702 provides for a presumption of the mental illness disability being incurred from military service. The mental illness disability must therefore be service connected. No C&P exam(s) whatsoever were provided to this veteran. A claim for PTSD was denied even though his VA mental health doctor diagnosed it and provided a nexus letter which was mentioned in the decision but apparently not considered. -Any help appreciated
  13. Hi all. I'm new to the forum and this is my first post, hope it's in the right spot. I am a former Marine who is currently 40% SC for a spinal injury. I finally had my C&P for my PTSD and this is the note the examiner wrote. I'd appreciate any insight into the note, and how any potential award would combine with my existing 40%. Thanks. LOCAL TITLE: C&P EXAM STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: JUL 14, 2014@08:00 ENTRY DATE: JUL 14, 2014@09:32:44 AUTHOR: XXX EXP COSIGNER: URGENCY: STATUS: COMPLETED Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran: XXX, JAMES L SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DMS-5 criteria based on today's evaluation? [X] Yes [ ] No ICD code: 309.81 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD CHRONIC SEVERE ICD code: 309.81 Mental Disorder Diagnosis #2: MDD RECURRENT SEVERE WITH PSYCHOTIC FEATURES ICD code: 296.34 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): NONE 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [X] No [ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis: This veteran's MDD is in response to and caused by his PTSD. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [X] Yes [ ] No [ ] Not shown in records reviewed d. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [X] No [ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis: SYMPTOM OVERLAP 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Total occupational and social impairment b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes [X] No [ ] No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: This veteran's MDD is in response to and caused by his PTSD. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [X] No [ ] No diagnosis of TBI If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: SYMPTOM OVERLAP SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes [ ] No Was the Veteran's VA claims file reviewed? [X] Yes [ ] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: C-FILE/VBMS/VIRTUAL-VA; CPRS If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [ ] Yes [X] No 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): This veteran reports being raised in an abusive family. Pre-Military, he describes an active social life and engaging in many pleasurable leisure time activities. Post-Military, the veteran describes: Avoidance of People and Places, Social Isolation, Restricted Affect, Anhedonia, Episodes of Uncontrolled Anger and Rage, Depressed Mood, and Feelings of Worthlessness and Guilt. He reports few friends, limited leisure time activity, and a very limited social life. He is currently homeless, living in a VA domicile. b. Relevant Occupational and Educational history (pre-military, military, and post-military): This veteran last worked in IT in 2012. He reports losing more than 6 positions due to his psychiatric symptoms. He reports that the following symptoms have had a detrimental impact upon his ability to function in the workplace: Episodic Auditory Hallucinations, Flashbacks, Episodes of Anxiety and Panic, Social Isolation, Chronically Disturbed Sleep, Episodes of Uncontrolled Anger and Rage, Difficulty Concentrating, Obsessive Hypervigilance, Exaggerated Startle Response, and Depressed Mood. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and postmilitary): This veteran reports working in psychotherapy which he finds palliative. He reports taking medication at this time for these symptoms which he finds palliative. He reports the following psychological symptoms: Episodic Auditory Hallucinations, Flashbacks, Nightmares, Episodes of Anxiety and Panic, Avoidance of People and Places, Social Isolation, Restrict ed Affect, Anhedonia, Sense of Foreshortened Future, Chronically Disturbed Sleep, Episodes of Uncontrolled Anger and Rage, Difficulty Concentrating, Obsessive Hypervigilance, Exaggerated Startle Response, Depressed Mood, Fatigue, Psychomotor Sequelae, Passive Suicidal Ideation, Feelings of Worthlessness and Guilt, Suppressed Appetite, and Avoiding Thinking of Traumatic Events. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): This veteran reports behavioral and/or legal difficulties prior to and on leaving the military associated with the above noted psychiatric symptoms. e. Relevant Substance abuse history (pre-military, military, and post-military): This veteran reports heavy alcohol and or substance use prior to and on leaving military service in an attempt to manage the effects of the psychiatric symptoms noted above. f. Other, if any: No response provided. 3. Stressors ------------ a. Stressor #1: The veteran's location was the target of mortar, rocket, RPG and/or small arms fire. During these experiences the veteran was terrified for life and horrified by the aftermath of the experience. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No b. Stressor #2: This veteran was engaged in return of fire with the enemy which was terrifying and horrifying. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No c. Stressor #3: This veteran witnessed and broke up a gang rape on a young child who was seriously harmed. He found this terrifying and horrifying. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do not mark symptoms below that are clearly not attributable to the criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 - other symptoms. The diagnostic criteria for PTSD, referred to as Criteria A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DMS-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violatrion, in one or more of the following ways: [X] Directly experiencing the tramuatic event(s) [X] Witnessing, in person, the traumatic event(s) as they occurred to others Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event (s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Reckless or self-destructive behavior. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. 5. Symptoms ----------- For VA rating purposes, check all symptoms that apply to the Veterans diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks that occur weekly or less often [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Impairment of short- and long-term memory, for example, retention of only highly learned material, while forgetting to complete tasks [X] Flattened affect [X] Difficulty in understanding complex commands [X] Impaired judgment [X] Impaired abstract thinking [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Inability to establish and maintain effective relationships [X] Suicidal ideation [X] Obsessional rituals which interfere with routine activities [X] Impaired impulse control, such as unprovoked irritability with periods of violence [X] Persistent delusions or hallucinations [X] Neglect of personal appearance and hygiene 6. Behavioral Observations -------------------------- No response provided 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, if any ------------------ This veteran meets the criteria for DSM-IV and DSM-V Diagnoses of PTSD CHRONIC SEVERE and MDD RECURRENT SEVERE WITH PSYCHOTIC FEATURES. This veteran's MDD is in response to and caused by his PTSD. He reports the following psychological symptoms: Episodic Auditory Hallucinations, Flashbacks, Nightmares, Episodes of Anxiety and Panic, Avoidance of People and Places, Social Isolation, Restricted Affect, Anhedonia, Sense of Foreshortened Future, Chronically Disturbed Sleep, Episodes of Uncontrolled Anger and Rage, Difficulty Concentrating, Obsessive Hypervigilance, Exaggerated Startle Response, Depressed Mood, Fatigue, Psychomotor Sequelae, Passive Suicidal Ideation, Feelings of Worthlessness and Guilt, Suppressed Appetite, and Avoiding Thinking of Traumatic Events. This psychiatric condition was caused by the veteran's military experience and/or combat exposure. The reported stressors are directly related to the veteran's fear of hostile military and/or terrorist activity. This veteran's GAF score represents serious symptoms and deficits in social, work and personal functioning. (GAF: 42) Due to the level of the symptoms discussed above, and the manner in which they disrupt the veteran's ability to relate to superiors and coworkers; and the degree to which they impair the veteran's ability to accomplish tasks for which the veteran is being paid; it is at least as likely as not that this veteran would be unable to secure or maintain any kind of reasonable employment at this time. Despite having serious functional deficits, this veteran has been able to manage finances over the past year. The veteran demonstrated knowledge of financial resources and obligations, and the cognitive wherewithall to appropriately discharge financial obligations. This veteran is considered competent to continue independent financial management without the assistance of a conservator. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. Thanks again for any thoughts.
  14. I'm looking for the best VA disability sleep loss and depression claims forum relating to SC tinnitus. Can you help me?
  15. Hello all! While I have referenced these forums before while filling out my paperwork, I haven't used them. My husband had his c&p exam today. I could use a little advice and perspective. We submitted the ptsd claim paperwork in January. [After much encouragement.] My husband is unable to maintain work, has difficulty in all social situations, has regular mood swings, trouble with anger, nightmares to name a few, very regular symptoms. Today, he had his c&p exam and I wasn't sure about the whole experience. The curator was gruff and very short. He told me that he needed to speak to my husband alone. [which I respected, assuming he would need to speak to me afterwards] My husband was with him for about 10-15 minutes. When my husband came back into the room he was really shaken. I understand this exam can be difficult, but my husband isn't very easily shaken. He was sweating, I mean like a lot. I realized after a few minutes that we were excused, the curator never came back into the waiting room. I asked the woman behind the desk to speak with him and he came into the waiting room to talk to me. [luckily there wasn't anyone else there] I could barely get out the things I wanted to make sure he knew. [Like the fact that my husband has such restless sleep that I have to sometimes lean on his chest while he is asleep until he calms down] Things my husband wouldn't know to tell him. He basically told me that my husband has severe depression. That we need to call the va to get him on different medication and they can look at his notes on the record. I understand that they have to be through to ensure they are giving to those who need it, I couldn't help but feel like this guy brushed us off. I couldn't get a whole sentence out. I am not a psychologist and I don't mean to questions someone who does this for a living but I am pretty sure my husband has ptsd not just depression, from all of the things I have read. My question is, is it common for the va to diagnose depression instead of ptsd? Is this how most c&p exams go? Also, do we have to fill out a second claim now for the depression? Thank you all for your help. This has been quite a process. I just want to make sure that my husband is able to get help and is taken care of in case anything were to ever happen to me. Thank you!
  16. I am seeking advice. I would appreciate any constructive advice given. I am currently SC at 20% - 10% for unspecified muscle issues in each leg. 0% for knee, 0% for tinnitus, 0% for eardrum. I joined the Army in 1991. I have always been a big guy 5'11 185-200 pounds. They always had to perform a BMI test because I never matched the height/weight standards. Still I was in really good shape and ran sub 13 minute two miles on the PT tests. I hurt my legs after about a year at my first duty station. I told my chain of command that I was hurt and had a hard time running and exercising. They did not believe I was hurt and proceeded to increase the damage by adding more and more stress to my legs. The assigned someone to run it out of me. The physical and mental abuse continued for a long time. They eventually broke me. I refused to do anymore. I told them I would report to sick call everyday. They suck me in the company mail room and continued their mental games but did not force me to do PT anymore. However, by that time the damage was done. My weight started to increase because of the stress and the fact I could not exercise. I quickly exceeded the BMI limits and was sent to weight management. They discharged me because I could not bring my BMI in line with the Army standards. I quickly balloned from the 230s at the time of discharge to the 290s. I lost jobs because I could not stand for long lengths of times. However, because of my SC I received voc rehab. and got a desk job. However, my weight continued to climb. I am currently in the 360's and have not been below 300's since 1995. One of my legs gave out last Oct and I thought I might have broke my arm. I went to the VA to get it on record in case my arm was broken. I had a mental melt down at the VA and was referred to MH. My new PHP thought I was suffering from PTSD and sleep apnea. I have not slept well in 20 years but I had no idea what sleep apnea was or its effects. I also did not believe I had PTSD although my I had most the symtoms. I recently went through the sleep study at the VA and it was confirmed that I have sleep apnea. My MH doctors told me to file for benefits for depression. Which I did with the DVA. I amended my claim today to add sleep apnea, increase for knee, increase for ear, hyper tension. The DVA rep said that he didn't think sleep apnea would be SC because I didn't complain about it in the service. I believe that it should be secondary to my leg problems which in turn contributed to me becoming overweight while I was in service and finally discharged for being to fat. Being fat is what causes sleep apnea and my diabetes and a host of other problems. To me there is a clear line that started in the service. Also before anyone chimes in with the whole eat less and don't be fat I would like you to know that I have tried. It isn't always that simply. I also think it is niave to think it is that simple. Ask a drug addict or an alcholic to have a little bit of drugs and alchol every day but keep it under control. I have to eat to live but mentally I have not been able to keep it under control and I am just starting to figure out why. The Cpap machine is a godsend. I really had no idea what a difference it would make. Any advice from someone that has been in my situation or knows someone that has been in my situation and won their claim would be greatly appreciated. I have a healthy distrust of the VA doing the right thing.
  17. My husband is a Vietnam era Marine Corp. veteran. He filed for disability for Membranous Glomerulonephritis /Stage 3 kidney disease, depression and tinnitus. The kidney disease was diagnosed through his private kidney doctor and the tinnitus through VA. The kidney disease we feel can be linked to the contaminated water at Camp Lejeune. Everything was across the board, denied. This was filed through a veterans service officer who seemed a bit clueless to the proper way to do it. There was no Nexus letter included. My husband plans to appeal or whatever we need to do now (just not sure.) He hasn't asked his doctor to give him a letter yet but will do so this week. Trying to get enough supporting evidence together to show the doctor so he will understand but not overwhelm him. My husband has no other factors to cause the kidney disease. I wonder if it would be a good idea to make an appointment with a VA kidney doctor to review his records also. We probably will get an IMO done also. The tinnitus was VA diagnosed, so not sure why that was denied. My husband claimed depression because he just knew he was miserable in so many ways but didn't know why. Now, very recently, he has been diagnosed with PTSD with major depression (still amazed that this could happen so many years after the fact but looking back through the years, there were a lot of clues.) When he took the PTSD test, he was told that he was extremely bad. The diagnosis was made by a VA clinical nurse specialist and clinical social worker. Doesn't it need to be diagnosed by a psychologist or psychiatrist? The nurse said it needs to be someone specially trained in PTSD treatment such as the social worker. They want him to do drugs (which he hates) and therapy. Could PTSD now be added as part of the depression he originally claimed or would it need to be an entirely new claim with a new start date? I appreciate any thoughts you are able to give me on this. Thanks, Kate
  18. Hello Hadit Family. After reviewing my Navy Vet friend I'm assisting service treatment records (STR), I recommended he file several claims that are fully documented in his medical records, to include depression due to alcohol dependency (he is still in denial). BLUF he is a tractor-trailer trucker/driver and his spouse says he is still drinking and confirmed that he has been using 2 to 3 bottles of Nyquil a week for over the last 5 years or so when he is at home and not on the road (I suspect due to the alcohol content in the Nyquil, JMO, though). Some items in his STR during 11 years of Navy service, mostly at sea: enrolled in Track II due to drinking till he "pass out"; tried to commit suicide by taking "lots of pills" while deployed (had stomach pumped); a year or so later then enrolled in Track III; put on anti-buse meds, transferred from OCONUS ship location twice for impatient treatment at CONUS military hospitals; everything while inpatient states the diagnosis "alcohol dependency due to severe depression"; successfully completed AA program in service or equivalent program; ultimately he was honorably discharged 6 months after completion of treatment in the early 1990's. He recently had several C&Ps (same day) earlier this month; informed (MH) Doctor that he started back "drinking some" about 5 years ago when his father passed, but not to the point where he "passes out". So the VA decision stated this (which is confusing): 1. Service connection for treatment purposes only under 38 USC Chapter 17 for adjustment disorder with depressed mood and alcohol use disorder, in full sustained remission (38 USC Section 1702) is granted. 2. Service connection for adjustment disorder with depressed mood and alcohol use disorder, in full sustained remission is denied. Just trying to see what I need to do for him next as this has me stumped on their ruling; doesn't make sense to me; thanks. P.S. He has been diagnosed with sleep apnea by his private doctor and is on the cpap machine too.
  19. God been through hell and back twice.. not going to go into details. Brief history 10 years military 6 years honorable and 4 years OTh by admin board for a civilian conviction. I was not given a c p exam for any of my conditions, my wife has tricare and I have been seeing navy/ civilian phyc docs since seperation. Here is just some of my medical evidence, my honorable ended 2006. I was still on active duty 2008 had a sleep study done and this is what the front says. I have tried to upgrade it didn't work out. i think they can still use this plus i have conditions like this listed in my honorable period of service. Mr X came to louisiana sleep diagnostics for an evaluation. He presented complaints of loss of energy, irritability, and short temper, anxiety and depression, trouble concentrating, mood and behavior changes, heavy snoring daytime somnolence, heartburn, dry throat, and an irresistible urge to move his legs while falling asleep, leg jerking, waking feeling partially rested or completely unrefreshed, a deviated septum and heartburn. He is currently using Flonase. His Epworth Sleepines Scale score is 8.
  20. Seems the VA can on occasion consider obesity merely as a "symptom"* and perhaps even the type of symptom that the VA alleges is caused by the Veteran's own willful misconduct of overeating or being inactive so it can deny the claim. However, since the American Medical Association ( AMA ) recently in June of 2013 has officially declared that "obesity is a disease", might that allow disabled veterans whose service connected condition(s) led to excessive weight gain to now find more success claiming obesity as a ratable secondary medical condition or a disease aggravated by the Veteran's service connected condition(s)? *"Obesity Service connection is not warranted for obesity. Claiming service connection for obesity amounts to claiming service connection for a symptom, rather than for an underlying disease or injury which may have caused the symptom. In this respect, obesity, in and of itself, is not a disability for which service connection may be granted. The United States Court of Appeals for the Federal Circuit (Federal Circuit) has defined "injury" as "damage inflicted on the body by an external force." See Terry v. Principi, 340 F.3d 1378, 1384 (Fed. Cir. 2003), citing Dorland's Illustrated Medical Dictionary 901 (29th Ed. 2000). Thus, obesity caused by overeating or lack of exercise is the result of the veteran's own behavior, and as such is not an "injury" as defined for VA purposes. See Terry v. Principi, 340 F.3d 1378, 1384 (Fed. Cir. 2003) (defining "injury" as "damage inflicted on the body by an external force"). The Federal Circuit also defined "disease" as "any deviation from or interruption of the normal structure or function of a part, organ, or system of the body." Terry, 340 F.3d at 1384, citing Dorland's at 511. Obesity that is not due to an underlying pathology cannot be considered to be due to "disease," defined as "any deviation from or interruption of the normal structure or function of a part, organ or system of the body." Id. The body's normal storage of calories for future use represents the body working at what it is designed to do. It is well settled that symptoms alone, without a finding of an underlying disorder, cannot be service-connected. See Sanchez-Benitez v. Principi, 259 F.3d 1356 (Fed. Cir. 2001)." - from a BVA 2009 Decision ---and--- "Obesity or being overweight, a particularity of body type, alone, is not considered a disability for which service connection may be granted. See generally 38 C.F.R. Part 4 (VA Schedule for Rating Disabilities) (2009) (does not contemplate a separate disability rating for obesity). Rather, applicable VA regulations use the term "disability" to refer to the average impairment in earning capacity resulting from diseases or injuries encountered as a result of or incident to military service. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); 38 C.F.R. § 4.1 (2009). The question is thus whether the current obesity is a disability-i.e. a condition causing impairment in earning capacity. In this case, there is no such evidence. The veteran has not asserted that obesity causes impairment of earning capacity; instead he asserts that his obesity has caused other disabilities to manifest. There is also no other evidence that the claimed obesity is a disability. Inasmuch as the Veteran does not have a disability manifested by obesity and obesity is not a disease or disability for which service connection may be granted, the Board concludes that obesity was not incurred in or aggravated by service and may not be presumed to have been so incurred. This claim is not in relative equipoise; therefore, the Veteran may not be afforded the benefit of the doubt in the resolution thereof. Rather, as a preponderance of the evidence is against the claim, it must be denied. 38 U.S.C.A. § 5107(b) (West 2002)" - from a 2010 BVA Decision But didn't the VA as early as 2006 already characterize obesity as a disease? "Obesity is a complex and chronic disease that develops from an interaction between the individual’s genotype and the environment." - http://www.healthquality.va.gov/obesity/obe06_final1.pdf "The AMA's decision essentially makes diagnosis and treatment of obesity a physician's professional obligation." - Los Angeles Times http://www.today.com/health/obesity-disease-doctors-group-says-6C10371394
  21. Hi to all. Appreciate all the good work the veterans here at Hadit are doing. I’m considering putting in a claim for depression. I’m wondering if I need to try to get a psych consult before filing a claim. Do I do this through my PCP? I am currently SC for DMII - 20%, IHD - 60% , PN - 4 X 10%, ED - SMC-K. So far nothing the Va has tried has helped my ED. My eGFR is at about 40 so kidney problems are probably not far off. That along with the pain, frustration and side effects of the meds has me down. Also, let me say I was diagnosed with DMII in the late 1980’s and had a heart attack in 1998. I’ve been dealing with this for quite a while. Does the prescribing of anti depressants and anti anxiety medications imply a diagnoses of those disorders? I am currently on 50 mg of Trazodone at betime and 1mg of Clonazepam twice a day. Any advice would be greatly appreciated. Dave
  22. I'm doing some initial research regarding possible claims so I wanted to toss this out to the Hadit team to see if anyone has any advice or recommendations. I am SC for chronic allergies and depression secondary to chronic joint pain. Last year I started having problems with urticaria (hives), angioedema, and cellulitis. All of it began within a few weeks of each other and I have had problems since. Urticaria/Hives The hives start out as itchy areas on my torso, arms, legs, or in crevices (under arms, groin). Eventually I get raised whelps which are warm to touch and itch like crazy. They begin to expand and literally make their way across my body. Some are up to a foot in length. They subside after a few days, but usually pop back up and the cycle repeats again. Angioedema During or after the hive breakouts, I have had swelling of my fingers, hands, wrists, and my throat (landed me in intensive care for almost a week). Cellulitis So far, this has been limited to my groin area and has occurred a few times causing swelling and pain. I sought treatment from the VA allergy specialists and they took me off of a lot of my medications, upped my antihistamines, added prednisone, and I tested negative for hereditary angioedema. Even after being off the meds, the problems persist, so the docs are slowly working me back on my regular medications. My wife noticed that when I am stressed, which is mostly due to the chronic pain, I tend to have more episodes. We have been documenting the episodes and have taken photos. I know that if I wanted to file a claim, I would need a nexus from a doc saying these are related. I will need to go back through my service records to see if I have and related records. Does anyone have any experience or recommendations regarding claims for these issues? Thanks
  23. I apologise for the length of this post, I've never been good at condensing information. A little information about myself first. My name is Joshua I'm 31 years old I'm an OEF/OIF Veteran I was honorably discharged from active duty Army in 2005 I have a PTSD and depression diagnosis by civilian doctor after a suicide attempt earlier this year. I'm now alcohol and drug free after years of abuse and self medication. I have many physical and mental problems which I attribute to military service. I Started my VA Claim 2 years ago yet it's somehow still in the gathering of information stage. I recently received a letter from the VA stating that they can't find my medical records. Because the VA couldn't find them they told me that I should do it. I at first laughed and thought to myself, if the Military can't find my Military Records, how am I supposed to do it? This was insanity, but I tried anyway. I've called my last duty station and they don't have them. They don't know where my records went nor do they care. I've called The National Archives and sent them letters in St. Louis, they don't have them and don't give a damn. I've applied to receive my records online, they sent me dental records and an apology. I went in person to the records keeping of my last duty station and was politely asked to leave. Because my records are lost, they have asked for the following information which doesn't exist or is impossible for me to get: Buddy letters: It's been 7 damn years, all of my military friends are LONG gone I've had no contact with any of my old friends from the military. I do not have Buddy letters and I honestly have no means to get them, I've tried everything I can to get in contact with anyone that knew me in the service for many years. People move on, they leave the military, they PCS, they die, they disappear, this is a fact of life that the VA doesn't understand apparently. civilian medical records for the last 7 years: I have none, They do not exist. I was living under a bridge, I had no income, I was eating garbage out of dumpsters, going to a doctor was the least of my worries. Only recently this year (April) did I become registered in the VA medical system. (They haven't yet provided me with a PCM so I can't make non-mental health appointments), I've tried to make appointments and I get the same answer every time, NO. The only records I have are already in the VA medical system. Statements from military medical staff, I have none. If they exist they would be in my somehow non-existent records. State or local accident and police reports: None exist. Employment physical examinations: I don't have these because I've been unemployed since military service. Any jobs I've applied for haven't gone past the interview stage. (What is your address? Employment rejected) Letters written during service: The few I did write were destroyed by an angry ex-wife Photographs taken during service: None Pharmacy prescription records: please refer to the first point in this list. Insurance examinations: yeah, right... I went to a VSO to help me with my claim which proptly closed it's doors, shut down and destroyed all records and paperwork within a month of me signing over a power of attorney. The VA won't talk to me, they don't have my records, they won't let me see a VA provider, they won't send me any information about my claim. I've been scheduled 3 appointments with the VA in the last 3 months. EVERY SINGLE APPOINTMENT has been an intake class for people new to the VA system. These appointments have also been scheduled in a city 40 miles away from where I am, even though there is a VA clinic 2 blocks from my apartment. I've taken the same class and filled out the same paperwork 3 times. Yesterday I got a notice advising me of a new appointment. Guess what it's for? New patient intake... What the hell is the VA doing here? Am I going insane? Who is running this rag-tag system? What do I do here? Should I just give up? I'm running out of time here. I can't live in this apartment forever. They are starting to tape notices to my door asking for money I don't have. I'm about to head back under my bridge and say the hell with it. What a disaster.
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