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How Does VA Rate Mental Health Conditions? Aside from eating disorders, the VA rates all mental health conditions using the same diagnostic criteria. Mental health conditions are rated at 0%, 10%, 30%, 50%, 70%, or 100% using the VA’s General Rating Formula for Mental Disorders. These ratings are based on the social and occupational impairment level a condition presents. For example, a veteran experiencing mild symptoms or whose symptoms are well controlled by continuous medication may receive a disability rating of 10%. Veterans with more severe symptoms—such as an intermittent inability to perform the activities of daily living or suicidal ideation—may receive a 100% disability rating. Veterans are not required to meet all, or even any, of the criteria in a rating level to qualify for that rating. Since mental health conditions can manifest differently per individual, the VA’s rating formula for mental health conditions is not binding. Symptoms listed in each level of the rating formula are examples of the types and levels of impairment commonly found at that assigned percentage rating. 38 CFR 4.125 Diagnosis of Mental Disorders (a) If the diagnosis of a mental disorder does not conform to DSM–5 or is not supported by the findings on the examination report, the rating agency shall return the report to the examiner to substantiate the diagnosis. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5), American Psychiatric Association (2013), is incorporated by reference into this section with the approval of the Director of the Federal Register under 5 U.S.C. 552(a) and 1 CFR part 51. To enforce any edition other than that specified in this section, the Department of Veterans Affairs must publish notice of change in the Federal Register and the material must be available to the public. All approved material is available from the American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209–3901, 703–907–7300, http://www.dsm5.org. It is also available for inspection at the Office of Regulation Policy and Management, Department of Veterans Affairs, 810 Vermont Avenue NW., Room 1068, Washington, DC 20420. It is also available for inspection at the National Archives and Records Administration (NARA). For information on the availability of this information at NARA, call 202–741–6030 or go to http://www.archives.gov/federal_register/code_of_federal_regulations/ibr_publications.html. (b) If the diagnosis of a mental disorder is changed, the rating agency shall determine whether the new diagnosis represents progression of the prior diagnosis, correction of an error in the prior diagnosis, or development of a new and separate condition. If it is not clear from the available records what the change of diagnosis represents, the rating agency shall return the report to the examiner for a determination. (Authority: 38 U.S.C. 1155) [61 FR 52700, Oct. 8, 1996, as amended at 79 FR 45099, Aug. 4, 2014] § 4.126 Evaluation of disability from mental disorders. (a) When evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the veteran's capacity for adjustment during periods of remission. The rating agency shall assign an evaluation based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination. (b) When evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation solely on the basis of social impairment. (c) Neurocognitive disorders shall be evaluated under the general rating formula for mental disorders; neurologic deficits or other impairments stemming from the same etiology (e.g., a head injury) shall be evaluated separately and combined with the evaluation for neurocognitive disorders (see § 4.25). (d) When a single disability has been diagnosed both as a physical condition and as a mental disorder, the rating agency shall evaluate it using a diagnostic code which represents the dominant (more disabling) aspect of the condition (see § 4.14). (Authority: 38 U.S.C. 1155) [61 FR 52700, Oct. 8, 1996, as amended at 79 FR 45099, Aug. 4, 2014] § 4.127 Intellectual disability (intellectual developmental disorder) and personality disorders. Intellectual disability (intellectual developmental disorder) and personality disorders are not diseases or injuries for compensation purposes, and, except as provided in § 3.310(a) of this chapter, disability resulting from them may not be service-connected. However, disability resulting from a mental disorder that is superimposed upon intellectual disability (intellectual developmental disorder) or a personality disorder may be service-connected. (Authority: 38 U.S.C. 1155) [79 FR 45100, Aug. 4, 2014] § 4.128 Convalescence ratings following extended hospitalization. If a mental disorder has been assigned a total evaluation due to a continuous period of hospitalization lasting six months or more, the rating agency shall continue the total evaluation indefinitely and schedule a mandatory examination six months after the veteran is discharged or released to nonbed care. A change in evaluation based on that or any subsequent examination shall be subject to the provisions of § 3.105(e) of this chapter. (Authority: 38 U.S.C. 1155) [61 FR 52700, Oct. 8, 1996] § 4.129 Mental disorders due to traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event is severe enough to bring about the veteran's release from active military service, the rating agency shall assign an evaluation of not less than 50 percent and schedule an examination within the six month period following the veteran's discharge to determine whether a change in evaluation is warranted. (Authority: 38 U.S.C. 1155) [61 FR 52700, Oct. 8, 1996] § 4.130 Schedule of ratings—Mental disorders. The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM–5) (see § 4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in § 4.125 through § 4.129 and to apply the general rating formula for mental disorders in § 4.130. The schedule for rating for mental disorders is set forth as follows: 9201 Schizophrenia 9202 [Removed] 9203 [Removed] 9204 [Removed] 9205 [Removed] 9208 Delusional disorder 9210 Other specified and unspecified schizophrenia spectrum and other psychotic disorders 9211 Schizoaffective disorder 9300 Delirium 9301 Major or mild neurocognitive disorder due to HIV or other infections 9304 Major or mild neurocognitive disorder due to traumatic brain injury 9305 Major or mild vascular neurocognitive disorder 9310 Unspecified neurocognitive disorder 9312 Major or mild neurocognitive disorder due to Alzheimer's disease 9326 Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder 9327 [Removed] 9400 Generalized anxiety disorder 9403 Specific phobia; social anxiety disorder (social phobia) 9404 Obsessive compulsive disorder 9410 Other specified anxiety disorder 9411 Posttraumatic stress disorder 9412 Panic disorder and/or agoraphobia 9413 Unspecified anxiety disorder 9416 Dissociative amnesia; dissociative identity disorder 9417 Depersonalization/Derealization disorder 9421 Somatic symptom disorder 9422 Other specified somatic symptom and related disorder 9423 Unspecified somatic symptom and related disorder 9424 Conversion disorder (functional neurological symptom disorder) 9425 Illness anxiety disorder 9431 Cyclothymic disorder 9432 Bipolar disorder 9433 Persistent depressive disorder (dysthymia) 9434 Major depressive disorder 9435 Unspecified depressive disorder 9440 Chronic adjustment disorder General Rating Formula for Mental Disorders View full record

Have you seen this article? Veterans and Artillery Blasts: The Battle with Invisible Wounds | CCK Law (cck-law.com) Does it apply to you? A little to me but not near as much as to those enclosed in a shipboard heavy gun mount or those who sent thousands of rounds out from heavy guns.

Since some members of this forum visit or members of other veterans benefits discussion forums and often receive misleading advice from those other forums then I feel necessary to offer this correct advice to counter/offset the stubborn deliberately wrong advice given by lying former VA raters and VSOs. These chicken chit aos still say that PTSD, depression, etc does not cause or aggravate OSA and that OSA is only caused by overweight or obese vets. They also say that obesity is not caused by VA medications, etc. and they further lie by saying paid for doctors opinions/nexus imo letters are basically worthless and waste of money and that the VA/BVA are aware of these fee doctors and discount or ignore their medical opinions. Further the pukes say it is very rare for vets to win these types of claims. This is plain stubborn deliberate lying BS by these former VA/VSO pukes. To begin with and I will use myself as an example later the BVA and not the VARO raters in fact the BVA does often grant vets service connection of OSA as secondary to PTSD or Depression, etc. and further more they recognize and often agree with paid fee doctors medical favorable opinion that PTSD and MH has caused and/or aggravated OSA in vets that are also overweight or obese and BVA often agrees that certain MH and other medications cause vets to be overweight, etc. In 2022 I was granted on appeal to the BVA a 50% rating for OSA as secondary to both my Nam combat PTSD and VA medications for PTSD and I was also slightly overweight. Unlike the sorry VA C&P examiner and VA VARO raters the BVA also accepted my private doctor's paid medical opinion (nexus letter) stating that my PTSD and medications caused and aggravated my OSA and also caused me to be overweight. The BVA often grants appeals to vets based upon the medical opinions of this 30 year private (non VA) heart surgeon and he is well known by them. Over the years I have read hundreds of BVA appeals and know they often grant the above type of claim/appeal that the VA raters ignore the favorable evidence and deny the claim by saying the vet is simply overweight or obese. The former VA raters and VSOs on a particular forum are extremely biased against attorneys and private fee doctors IMOs helping for the vets. I suspect this is due to plain old American style jealously by government bureaucrats and retired military lifers who are the admins and moderators on that forum. They are very narrow minded and cause harm to some vets with this misleading BS IMO. Stick with this forum for more honest and accurate advice in addition to consulting with an experienced and qualified attorney or VSO with the right attitude. There is also a great deal of medical research by reputable well known medical institutes further stating that PTSd and mental health problems cause and aggravate OSA and that certain medications cause patients to be overweight or obese. My comment is not legal advice as I am not an attorney, paralegal or VSO.

I have had an ongoing appeal for the last 11 years with the VA regarding a mental health claim. It has went to the BVA three times and been sent back for more development each time. The most recent action was a letter in the mail that states LHI will be doing an mental health evaluation. I have done similar things two other times where I interviewed in person. It appears that this one will be done via records. I sent in a statement a few days ago to the BVA using the ID.me portal regarding my claim prior to getting this letter today. Will this psychologist see this statement? Do I need to send it to the compensation people as well? It is critical to my argument of service connection that the evaluator reads this before rendering an opinion. I know that the Judge will see it as I sent it to the BVA. So at a minimum before he finalizes the order he will/should review it. The crux of the problem is I am having is that the VA keeps stating my problems were not caused by service but rather divorce, alcoholism, a child with ADHD, homelessness. In this statement I have attempted to connect that dots. I will attach my statement below to give a better understanding to those who answer. I appreciate your time and thoughts. To whom it may concern: I am writing to you today because I have not previously been allowed to describe how my experiences in the military has affected my everyday life and how these experiences directly relate to my claim for depression and anxiety. Even though I have been evaluated 3 times by 3 different evaluators, none of the evaluators allowed me the opportunity to share my specific military experiences with: My service-connected disabilities A physical assault led by my own platoon mates My witness to a horrifying and devastating accident My current mental illness and self-well-being as it relates to my military experience Each of these experiences are described below. Please note that during all 3 evaluations, I asked to share my experiences but was denied due to time restrains and the need to get through a formatted process – which included answering questions that focused on my pre-service history. This made no sense to me, but I proceeded to answer the questions as instructed during each evaluation. Initial Evaluation by Dr. ====: During my initial evaluation by Dr.====, I attempted to share the assault, I wanted to share my paranoia, my depression and my fear and anxiety. I was told that there was only a limited amount of time allowed for the process and there was a format to be followed. Dr. ==== only focused on my pre-service history and dismissed any connection to my service injuries and mental illness. Evaluation by Dr. ====: A few years later I was evaluated by Dr. ====. He focused on my pre-service drinking history and that I had attended treatment prior to enlisting in the military (I am proud of myself for attending treatment and achieving sobriety during this time). I once again tried to share the assault, the accident, and my service-connected disabilities, but he did not allow me to do so stating there was a format to be followed. Please note that the military allowed me to enter only after being cleared by a MEPS psychologist who granted me a waiver for enlistment. Dr. ==== only focused on my pre-service history and dismissed any connection to my service injuries and mental illness. Evaluation by Dr.====: The most recent evaluation was with Dr. ====. She also only focused on my pre-service history. When I asked to share what happened to me during my time in the service, she stated that my file had hundreds of pages and she only had a limited amount of time to review. She followed the same format as the others. This was my third attempt asking to be heard and my third time being denied. I was angry. My military experiences: During basic training, I suffered a shoulder injury that followed me throughout my military career, and still does to this day. I have numerous buddy letters in my file on how this injury has impacted my ability to fully perform certain tasks. During my service, I lived in constant fear of reinjury to my shoulder, guarding it and knowing it could easily "pop-out" again. Because of this guarding, I was often bullied and called a "broke dick". To this day, I still guard my shoulder, especially when performing overhead tasks. Along with this service-connected injury, the history of being bullied contributes to my overall mental illness. Soon after at my first duty station, I was physically assaulted by my own platoon mates. Some call it an “initiation” – but this was not that, rather this was a traumatic assault that has caused permanent life altering mental damage that cannot be undone. Against my will, I was held in physical bondage, physically beaten, and sexually threatened. This assault permanently altered my mental health and physical well-being. I was left in a depressed and anxious state suffering from panic attacks followed by rage, anger, hatred, and fear. Alcohol became my coping mechanism. To this day, I live in constant fear. I have become a VERY angry person. WHY DID THIS HAPPEN TO ME? I DID NOT DESERVE THIS! This experience traumatized me FOR LIFE! To this day, I am being treated for paranoid personality disorder, depression, and anxiety. At my next duty station, I shattered my leg and ankle. I became angrier and more depressed, isolating myself from others. I missed schools and promotions, and the bully label of "broke dick" followed me around everywhere. I did my best to perform in the hi-intensity environment at Fort Irwin where we conducted mock battles 2 weeks straight every single month, over 37 times. I xxxxxxx tried my best! This additional injury and constant reminder that I was a “broke dick” contributed to my continued alcohol coping abuse and growing mental illness. During my time at Fort Irwin, there was a horrifying accident while we were out on the battlefield, several soldiers were KILLED and multiple injured when several Bradley fighting vehicles went over a cliff. These soldiers had my same MOS and during that mission we were directly opposing them. That terrified me and every time thereafter when we would do night missions, I would live in fear until daylight. I have a letter in my file from SGT ==== describing these missions in detail and the effect they had upon us soldiers. This experience contributed to my continued alcohol coping abuse and declining mental health. To this day, I suffer from terrifying nightmares for which no medications can help to control. Once at Fort Hood, I was assigned to staff. It was well known that if you were a combat arms soldier you DIDN'T WANT TO BE ASSIGNED TO STAFF. I felt I was being "blacklisted" by my unit and was not even given the chance to perform. Paranoia, anxiety, rage, anger, hatred, and fear followed me. I was only worthy of the broke dick label which had slapped onto my back years ago. By now my mental health and drinking had spiraled out of control. My thoughts where not always rational, even when sober. I was drinking off-duty wherever possible. This was my pattern during my time in Korea and in Fort Hood. I felt victimized at every turn and basically screwed. I was angry! On staff I was assigned as the squadron commander's gunner on his Bradley fighting vehicle. I was soon up for reenlistment and planned on asking for an assignment elsewhere so I could get out of staff. About 6 months before I was to reenlist, I attended a squadron function where alcohol was provided and, on the way back to the barracks I received a DWI. My last six months of military service were a living hell. I had just spent almost 8 years of my life for nothing. I was in a daze; I would alternate between wanting to kill myself and wanting to kill others. I had been abused, traumatized, and suffered painful injuries for nothing! I was humiliated and ashamed. My dreams were crushed. I felt I had been robbed of my life and had become an “broke dick” alcoholic. My life after serving the military: One of the most painful calls I had ever made was to my father – telling him I was kicked out of the military, and to ask if I could come back to live with him again. I was no longer a superhero to my father, to my brothers, or to my mother. All I knew is that I was programmed to be an angry broke dick alcoholic miss fortunate soldier, too ashamed, embarrassed, and proud to share the assault that happened to me. When I first enlisted in the military, I dreamed of a life-long career. My life before may not have been perfect, but I was healthy and OK. My life after the military was drastically different. I left the military full of rage, hatred, pain, injury, mental illness, and alcoholism. I have statement letters in my file from both my brother and mother testifying to my character change. Prior to my military service I had no problems getting jobs and certainly was not a mean or bitter person. But since I left the service, I have had over 10 jobs and terminated from each of them due to failure to get along with others and performance. I was called abrasive and angry by my employers. I was unable to interact well with my co-workers or customers. These were jobs in the HVAC industry that paid well and were sought after jobs. Getting the job wasn't the problem. It was keeping them after I was hired. My first marriage dissolved due to my anger, rage and drinking. My children were afraid of me, my wife couldn't understand what was wrong with me. On Aug 8th, 2011, I put a gun in my mouth in front of my 8-year-old son and was a hair trigger away from ending my misery. I have now been sober for over 10 years. Aug 11th, 2022 marks my 11th year of sobriety. I see my VAMC psychiatrist ====, regularly, and have for many years now. I have shared the assault and the other experiences with him. He has stated in my file that these military service experiences have a direct connection to my mental illness. However even with all these years of sobriety and years in therapy at the VAMC (which I am grateful for!), I am still a very depressed and angry person, a paranoid, fearful and anxious person, and continue to suffer from mental illness due to my military experiences. I routinely have vivid nightmares about how I was injured, the assault I suffered, the horrible accident at Fort Irwin, and the shame of being forced out of the military. I routinely suspect strangers of wanting to cause me or my family harm, I am always on high alert. When things go wrong or something changes for the worse, I feel despair and hopelessness, there is no way out but only down. In closing: These experiences have been life damaging to me and traumatic to my mental health. These experiences have forever changed my personality and outlook, how I view others and life in general. I feel that the VA refusing to take this information from me is almost as traumatic as the events themselves. I feel frustrated and angry every time I am told that my assault and service-connected disabilities have no effect on my mental illness. I do not see how my claim for service-connected depression and anxiety can be fairly decided until the entire picture is looked at and understood, not just my drinking history, but my entire history to include my time serving the United States Of America. Below is my VA doctors notes relating to this. Note LOCAL TITLE: MH PSYCHIATRIC EVALUATION & MANAGEMENT STANDARD TITLE: PSYCHIATRY E & M NOTE DATE OF NOTE: FEB 16, 2022@10:53 ENTRY DATE: FEB 16, 2022@10:53:34 AUTHOR: ==== EXP COSIGNER: URGENCY: STATUS: COMPLETED PSYCHIATRIC EVALUATION AND MANAGEMENT FOLLOW UP VISIT Duration: 25 minutes phone Time spent performing psychotherapy services: 16-37 minutes INTERVAL HISTORY: Mr.==== reports that he's contending with a sore shoulder and neck that came on suddenly for no obvious reason. He's had chiropractic treatment and a deep tissue massage (that was quite painful), and he's using a lot of ibuprofen and naproxen to get through it. He contacted his mother on her birthday and read a letter to her that recalled good times from his childhood. He says while there were rough times, he knew she cared about him and regretted her limitations as a parent, so they have repaired their relationship and have been close for some time now. He enjoys seeing the grandchildren occasionally. His mood and temper are reasonably good as long as he stays on the sertraline. ==== is anxiously waiting to hear back on his SC claim. He says he applied for service connection for depression and anxiety as being caused by his experiences as a cavalry scout in Germany, and then later as an OpFor scout at Fort Irwin. He forwarded to me an account of the initiation ritual he was subjected to in Germany, which clearly was a traumatic event that fits his history of the onset of a depressed, hostile and anxious paranoid orientation ever since then, persisting to this day. He says that he didn't make an official report at the time, as that could have made things worse, but it changed his mood and personality decisively. ==== says that a C&P examiner many years ago attributed his depression and anxiety to a rough early childhood, but he says he was functioning well despite that, up until the point of the initiation trauma when things got really bad, and never recovered. The experiences at Fort Irwin were of a different sort; he wasn't targeted personally any more than all the scouts were, but the prevailing attitude was that no one's safety or life mattered all that much. That only confirmed the depressed, helpless and paranoid position he'd developed when in Germany. CURRENT MEDICATIONS: Active Outpatient Medications (including Supplies): Active Outpatient Medications Status ========================================================================= 1) AMPHETAMINE/DEXTROAMPHETAMINE 30MG TAB TAKE ONE ACTIVE TABLET BY MOUTH EVERY MORNING 2) SERTRALINE HCL 100MG TAB TAKE TWO TABLETS BY MOUTH ACTIVE EVERY DAY 3) SIMVASTATIN 40MG TAB TAKE ONE-HALF TABLET BY MOUTH AT ACTIVE BEDTIME TO REDUCE CHOLESTEROL -IF TOLERATED AFTER 2 WEEKS, INCREASE DOSE TO ONE TABLET (40MG) AT BEDTIME AND NOTIFY PROVIDER 4) ZINC OXIDE 20% OINT APPLY MODERATE AMOUNT TOPICALLY ACTIVE TWICE A DAY AS NEEDED FOR SCROTAL RASH Pending Outpatient Medications Status ========================================================================= 1) SERTRALINE HCL 100MG TAB TAKE TWO TABLETS BY MOUTH PENDING EVERY DAY Active Non-VA Medications Status ========================================================================= 1) Non-VA ASPIRIN 325MG TAB 325 MG MOUTH EVERY DAY ACTIVE 6 Total Medications STATUS EXAM: mildly depressed mood, affect moderately broad range, normal flow of thought ASSESSMENT: depression; paranoid personality. In my opinion Mr==== depression, irritability, anxiety and paranoia are substantially attributable to his traumatic military experiences, and are much more pervasive and strongly held than what would reasonably follow from a childhood that wasn't great, but wasn't terrible either. RISK: Risk of self harm appears low, with protective factors including his family ties and willingness to seek treatment. Risk factors include persistence of symptoms. PSYCHOTHERAPY PROVIDED THIS VISIT: Supportive PLAN: RTC about 3 months. /es/ ====, M.D. STAFF PSYCHIATRIST Signed: ============ Thanks for reading and offering your thoughts everyone.

Hello, reading that VA rates all mental health conditions using same diagnostic criteria. Throughout my files I have diagnoses of a dozen mental health issues such as Major Depressive Disorder, but connected only for PTSD. (Separately I am connected for TBI). I read vets with, ex. 50% PTSD and 30% Major Depressive disorder would have them combined under one diagnostic code for 70% for one condition (per CCK website). In this case, is it possible to file separately for each of my mental conditions? If you had a bunch of mental issues, and they combined to reach 100%, would that be considered a single disability that you could add to another 60% to apply for SMC(s) (non housebound) ? As it stands I am 100 p*t schedular with another 60, but do not qualify bc it is schedular. Thank you!

Hi everyone! As usual I appreciate everyone's input and opinions on all the subjects I read about here. Now on to my question. I have been seeing a VA Doctor for about 6 months now for a couple of MH issues I've had. Some are related to my hearing loss (service connected) and depression and some are related to an event when I was on active duty. The VA doc gave me a diagnosis of "unspecified traumatic stress disorder", insomnia and anxiety. My PCP based off of the phycologist opinion prescribed me a med to control the anxiety, stress and depression. My question is if I decide to file a claim for VA compensation should I wait awhile longer seeing as I have only been seeing a doctor for about 6 months or does that really matter? Second I felt comfortable filing a claim on my own for my hearing issue and knees on my own but I'm a little hesitate on this one. Should I use a VSO/DAV group or just move forward with all my current evidence like I have in the past. I'm comfortable filing the claim I just want to make sure I don't miss anything important. Thank you again for your help.

Just wanted to share this with everyone as I prefer to give credit where it is truly due: After I won my recent claim, with this forums help for my mental health my brother-in-law, an Air Force vet, began to look at his mental health more seriously. With guidance I received via these forums, I helped by advising him on how to develop his claim and he submitted everything on Jul 1 2020. Today, he received a lump sum deposit from VA. Upon later review of his VA.gov account, it had been updated to reflect his mental health as secondary to his current back claim and was awarded 70%. Bringing him to 80% combined (30% for back). My sister and her family are greatly appreciative of everyone here who has contributed to the forums, as I explained to them where my new found knowledge had come from. You guys are the real helpers!

May-1. Filed for increase on mental health condition (Depression 2nd to Tinnitus)2. VES exam, didnt go well, got reduced. Examiner said I had another condition, it wasn't service related, etc, etc. July-3. Filed a supplemental with a DBQ from a private psychologist (looked like 50-70 percent)August-4. New exam from QTC, went well, probably around 70 percent 5. VSO told me a few weeks ago they sent it back to examiner for medical opinion. I know the QTC examiner had mentioned that they did not ask for one in which he thought was odd during my exam in August. September- 6. VSO told me today that they sent it back to the VES examiner from May, and the examiner basically regurgitated the same thing he already said. He already provided a medical opinion previously in May. Examiner said I had OCD (never been diagnosed by anyone in 5 years). I am confused to why they sent it back to the VES examiner and not my most recent examiner? Could this be a mistake? Thanks. Not sure how this will pan out.

Hello everyone, So my story is that I filed for an increase, ended up getting reduced from 50 to 30. Overall rating wasn't effected. I filed a supplemental with a DBQ from my private doctor so now I have an upcoming CP exam with QTC. I have read that some people on the forums say " tell them about all your mental health issues (PTSD, anxiety, etc..). However, I am only S/C for depression secondary to tinnitus. So should I just only talk about depression? For my last exam in May I elaborated on all my mental health issues and it got me reduced. Thanks

For Starters, I want to thank anyone who takes the time to read this and give me a little perspective. I just got my final C&P results after a series of claims. Currently I am 94% combined rating if I include my Sleep apnea claim (The Dr. wrote it was medically neccesary to use the CPAP, so I do expect the 50%. This C&P below was conducted to separate my anxiety disorder from my TBI disorder. Currently I have a 70% rating for Anxiety with residuals of TBI. I was wondering if anyone could read this and tell me if they think I can expect a separate rating for TBI memory loss based on the Dr's opinion stating that my issue is 80% anxiety and 20% TBI (see note 2b below). If I can get at least a 10% for TBI in addition to the 70% for anxiety, It should push me over the threshhold of 100% schedular. The only edits I made to this was to remove names. Again, thank you for your time and expertise 70% Anxiety (Trauma with TBI residuals) 50% Sleep Apnea 20% Degenerative Disc Disease 20% Upper Neuropathy Right / 20% Upper Neuropathy Left 10% Lower Radiculopathy Right / 10% Lower Radiculopathy Left 0% TBI Migraines LOCAL TITLE: COMP AND PEN NOTE STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: JAN 28, 2019@14:30 ENTRY DATE: JAN 30, 2019@11:11:26 AUTHOR: *********** E EXP COSIGNER: URGENCY: STATUS: COMPLETED Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire Name of patient/Veteran: ***** Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No 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 ICD code: 300.00 If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Unspecifed Anxiety disorder, chronic, severe disorder. ICD code: 300.00 Comments, if any: Vet had been seen initially on 2/11/18 for Mental Health C+P exam done by Dr. *****(which proposed "Anxiety disorder, NOS" then, while f/u C+P exam on 2/16/14 had proposed Other specified trauma and stressor related disorder(as vet had been in IED blast in 2006 - see Mental Disorder diagnosis #2 below. Unspecified anxiety disorder is synonymous with Neurosis - which vet is already 70% SC for, in combination with residuals of TBI apparently). I am therefore not intending to change his Neurosis condition now, but Unspecified anxiety disorder is most accurate diagnosis consistent with DSM-V, as I see it now. Mental Disorder Diagnosis #2: Cognitive disorder due to Closed Head iInjury(CHI), due to 6/1/2006 "double-attacked anti-tank mine" IED blast. ICD code: 294.9 Comments, if any: Vet was in 2nd Iraq combat deployment - out of 3 tours he served there - when 6/1/06 IED hit his heavy equipment vehicle(which vet had referred to as 'palitizing loading system'). b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Vet is already 0% SC for migraine headaches. Comments, if any: Vet is already SC for migraine headaches. Vet is already 20% SC for Intervertebral DIsc Syndrome, 20% SC for Paralysis of musculospiral nerve(x2), 10% SC fo paralysis of sciatic nerve(x2). Vet also apparently had a 2/15/18 sleep study done that indicated a mild sleep apnea condition. 2. 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 Symptoms(i.e., anxiety, sleep problmes) are due to Unspecified anxiety disorder, while symptoms(memory problems, headaches) are due to Cognitive disorder due to CHI. 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 TBI and any non-TBI mental health diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A) If yes, list which symptoms are attributable to TBI and which symptoms are attributable to a non-TBI mental health diagnosis see 2b above. 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] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or mood b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [X] Yes [ ] No [ ] Not Applicable (N/A) If yes, list which occupational and social impairment is attributable to each diagnosis About 80% of vet's current occupational and social impairment is due to Unspecified anxiety disorder while about 20% is due to Cognitive disorder due to CHI. c. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [X] Yes [ ] No [ ] Not Applicable (N/A) If yes, list which impairment is attributable to TBI and which is attributable to any non-TBI mental health diagnosis see 3b above. SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence Review ------------------ Evidence reviewed (check all that apply): [X] VA e-folder [X] CPRS [X] Other (please identify other evidence reviewed): Vet broiught a 4 page typed letter 1/12/19 done by himself describing in detail his current ongoing issues("I did not want to forget to tell you something important"), and vet admits it took him severalhours to complete(and which he kept revising many times). He brought a 2 page letter dated 1/27/19 done by his wife ******, a 2 page typed letter dated 1/17/19 done by mother ********, and a 1 page typed letter dated 1/27/19 done by vet's friend/combat comrade(served together in Iraq) named *******, and all 4 letter were reviewed by me. Evidence Comments: CPRS was reviewed by me and included my(***** MD) 12/5 18 Review TBI C+P exam report, as well as 5/16/14 C+P exam report done by Dr *****(sa well as Initial 2/18/11 MH C+P exam aslo done by Dr. ******. VBMS was reviewed by me and included vet's Army DD-214 signed b ***** which included MOS(88M30) Mortor Vehicle Operator,as well as E-6 discharge rank. His medals included CAB - among others, and he had Iraq combat dates of 1/03 - 7/03, 8/05 - 8/06, and 3/08 - 6/09 - for his 3 seperate Iraq combat tours. 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Vet is married ****(and they have 2 sons(around ages 5 and nearly 7). b. Relevant Occupational and Educational history (pre-military, military, and post-military): Vet has been working in his current Passport Agency job since 2015(was at an administrative clerk(for a different agency) before that. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): Vet has been on sertraline 150mg since 9/10/18 - it takes the "edge" off my problems, but he apparently has been having some sexual side effects(delayed ejaculation) related to that . d. Relevant Legal and Behavioral history (pre-military, military, and post-military): Vet has had no legal problems(and no jail time) since the 5/14/16 C+P exam report date. e. Relevant Substance abuse history (pre-military, military, and post-military): Vet has had no alcohol misuse disorder problems sicne 5/16/14. He has used no street drugs since 16/14. 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] 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] 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] Obsessional rituals which interfere with routine activities 4. Behavioral observations -------------------------- Vet was totally genuine at the 1/28/19 Review Mental Health C+P exam. 5. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [X] Yes [ ] No If yes, describe: Vet admits to having anger difficulties, 'spacing out' at times, and general feeling of being confused/overwhelmed. He reports having lost his social "filter" abilities. He reports previously having been very "easygoing" prior to the military. Vet still gets nervous if seeing sandbags lying on the side of the road - left by construction crew(as that is what he looked for over in Iraq as being a potential IED.) He has to reorganize plates/trays a certain way, either at home or when leaving a restaurant, respectively. He denies having any suicidal thoughts("No, I'm addicted to life, I love breathing".). 6. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 7. Remarks (including any testing results), if any: --------------------------------------------------- Vet owns a pistol. He does not hunt - only tried it once, but did not get anything then. He denied having any current active suicidal or homicidal ideation.

Hi there! Long time member here but been MIA for awhile. Life has been busy and I have been dealing with health issues. Long story short, I went through a battery of tests to find out what is wrong with me. I did an ANA-TITER test, and it was positive for an auto immune disease. Was referred to the RA doctor for further testing to see if I had lupus. The RA doctor did blood tests and determined I don't have lupus. We did additionally physical exam at the VA back in May and he determined I had Fibromyalgia and diagnosed me with it. We discussed that my Fibromyalgia co-exists with PTSD/MST and IBS. We also discussed that Fibromyalgia can be secondary to my already service-connected PTSD/MST or even maybe my IBS. I discussed this with my representative and we decided to file a claim for Fibromyalgia (non-service connected disability) to an already service-connected disability. Either PTSD/MST or IBS and we asked that they evaluate either causation or aggravation. We filed in July and I had my C&P exam in September. The examiner was asked by the rater to give his medical opinion as to the Fibro being secondary to my PTSD/MST. The rater did not ask if it was possible to be secondary to my IBS like we requested. The examiner did a C&P DBQ for Fibro and that was positive. I do have Fibro, that isn't the issue. The medical opinion is what was disturbing. I was with the examiner for less than 5 minutes. He stated he physically examined me when he did not and he seemed very unknowledgeable about Fibro/PTSD-MST/IBS as co-existing and determining either causation or aggravation. Of course the medical opinion stated, "less likely than not". I was floored, so I went to work for my claim. I contacted my RA doctor and we talked with my representative on the phone as well. By the end of the call he was confident enough to link my PTSD/MST as aggravation to my Fibromyalgia. He wrote a one/two paragraph letter on my behalf. We sent that to the rater. Then I spoke to my MH provider last week and she too wrote me a very good NEXUS letter. That was sent to the rater yesterday. Both my doctor's are at the VA and both stepped out on a limb for me. I am hoping their medical opinions outweigh the negative C&P medical opinion. I am attaching the C&P exams (redacted), the two medical opinions (redacted) - I am hoping I am successful because this will make me 100% scheduler. I am currently 94% overall rated. C&P _Redacted.pdf nexus 2_Redacted.pdf redacted.pdf redacted2.pdf

Hello, So recently I called the VA to make a mental health appointment. Up to now, I had been using a private psychiatrist, but now I'm dirt poor so I have to rely on the VA. Well, I called them up to make the appointment and the lady (turned out to be an RN) asked me, "Okay, so, any thoughts of suicide, any self-harm, stuff like that?" I took that to mean recently, as in, am I in a dire state right now. I answered "no" because I haven't had any of that going on in the last few months. The records I looked at state that she asked that to determine how soon I should be seen. It was then signed off on by a psychologist. So I was right about the whole "dire state" thing, right? When I read my records however, the entry said, "Have you ever had thoughts of suicide? No." "Have you ever engaged in self-harm? No." That is not what I was asked! Both of those are completely wrong! Those questions were not asked! Instead, her question was phrased ambiguously. I also needed transportation to the VA, and she said "We don't do that but maybe I can get you some help" and gave me two phone numbers, and nobody answered either one. I then googled it and found the transportation person for my local VA (different phone number) and had a ride scheduled within 10 seconds. Can I include this as evidence of her incompetence? I'm about to submit my claim for a decision (but not until this is taken care of). How should I handle this? Should I put in a statement in support of claim mentioning this? - Phil

Hello everyone, It has been a while but I finally received my C&P examination for mental health. Currently am 50% for Major Depression, seeking 70%. I went to my examination in stained sweats, faded shirt, flip flops, unshaven, and hair frizzy and not brushed. For some reason, I believe my C&P examiner was wishing I did not come so she could go to lunch early based on her reaction to my arrival and her BSing with the receptionist prior. Anyway, I feel angry after reading her assessment and would like to know what you all think. I think she checked the box for 30% which is a decrease but all the symptoms are 70% looking. It feels really bad she is trying to make me out to be a liar when she doesn't know how I really feel. I have been suicidal, I have made attempts, I have researched the best methods, made plans, etc. The closest I have come is purchasing roper, tying it in a noose, and testing out a bar at work to see if it could support me in hanging myself. But I have really been feeling like crap and feel I have to fight really hard to not let my thoughts become the truth. All things she did not ask. What do you think will happen based on the below exam results? I thank you for your time and responses. CaliBay Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No SECTION I: - - - - - - - - - - 1. Diagnosis - - - - - - - - - - - - a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder? [X] Yes [ ] No ICD code: F33.2 If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Major Depressive Disorder, severe, recurrent ICD code: F33.2 Mental Disorder Diagnosis #2: Generalized Anxiety Disorder, with panic attacks ICD code: F41.1 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): severe sleep apnea 2. 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 Depression - depressed mood, not feeling pain, poor motivation, nightmares, few friends, feel worthless and helpless. Anxiety: doesn't like to leave his house, uncomfortable in crowds, some paranoia shakes 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] 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? [ ] Yes [X] No [ ] No other mental disorder has been diagnosed If no, provide a reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: symptoms of GAD and MDD overlap and it is nearly impossible to differentiate between disorders. 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 - - - - - - - - - - - - - - - - - - Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 2. History - - - - - - - - - - a. Relevant Social/Marital/Family history (pre-military, military, and post-military): The veteran has been married for 25 years, and they have 4 children ages 17, 12, and 7. His father lives at their home, but he is self-sufficient and assists caring for the children. His spouse works at Kohls. b. Relevant Occupational and Educational history (pre-military, military, and post-military): He works for the Federal Government as Transportation Specialist at the GS-11 pay grade. He stated that his supervisor has made a verbal accommodation for his mental disabilities to let him come and go as he pleases including arriving late and leaving early for work for appointments. He states he does not know exactly what he does at work but feels like a government worker that is unqualified for his position and got lucky to obtain his current job. He states he answers email correspondence all day and surfs the Internet. He stated that his duties are not really defined and much of his job requires little effort mentally or physically. He creates spreadsheets in Excel and analyzes financial data for travel. He works from 8:00 am to 5:00 pm. He stated that he has used his all of his vacation and sick time because of his disability. He was out of work on FMLA for three months to receive mental health care and has returned in May 2017 with difficulty adjusting. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): He stated that he was feeling better during for two months in a 12-month period. Since he returned to work, his depression has increased and has frequent panic on a daily basis. He stated that he feels paranoid that someone is out to get him. He feels like he is worthless at work even though his managers have never told him his performance is poor. He does not recall periods of remission and stated that he only remembers all the bad things that have happened to him. He uses a CPAP machine but states he rips it off his face every night due to nightmares. He has always had nightmares of when his daughter passed away and escorting human remains off of military cargo planes. He estimates waking up every hour to check on his children to see if they are still alive. He self-admitted to a Mental Health Hospital for 3 months. He was suicidal and very depressed. He has not seen a Therapist but he has spoken to his Psychiatrist. Nightmares: never decreased, nightly or every other night. His nightmares are of the same theme. No exercise Medical records review: DBQ from private provider Statement from veteran Treatment records from Private Hospital Treatment records from Mental Hospital These records are consistent with a diagnosis of Major Depressive Disorder, and Generalized Anxiety Disorder. Many medications have been tried. He is at low risk of suicide at this point. Current Medication: Wellbutrin Abilify Prozac d. Relevant Legal and Behavioral history (pre-military, military, and post-military): None e. Relevant Substance abuse history (pre-military, military, and post-military): He drinks occasionally and states he is a “light weight” in consuming alcoholic beverages. Sometimes he inhales CO2 from whip cream to get a temporary high. 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] Anxiety [X] Chronic sleep impairment [X] Flattened affect [X] Disturbances of motivation and mood [X] Suicidal ideation 4. Behavioral observations - - - - - - - - - - - - - - - - - - - - - - - - - - No response provided. 5. Other symptoms - - - - - - - - - - - - - - - - - Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [ ] Yes [X] No 6. Competency - - - - - - - - - - - - - Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 7. Remarks (including any testing results), if any: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - This 45-year-old veteran still struggles with depression and anxiety. I cannot diagnose him with PTSD because it appears to be secondary to MDD. He has not seeked therapy other than admitting himself to a Mental Health Facility. The veteran has been advised to get help for his symptoms and he has not complied. There doesn't appear to be any changes in his mental health status. The fact that this veteran continues to work without incident suggests that he may be functioning better than what he is showing. I recommend that this veteran receives intensive therapy and be re-evaluated after a year of consistent treatment.

Voiceless Veterans We arrive, angry, confused, hurt, untrusting, extremely defensive, with a strong tendency for coming off "rudely direct" and somewhat scatter brained. By the time, we finish speaking, we've likely already "pissed off" our intended receivers. Then, we receive our threat of VA police intervention, unless we comply, and speak with respect. Who are we? We are the "voiceless members" of the "highest VA risk group" known as "mentally challenged veterans". We perhaps impact the high rate of suicide, more than any other group, found among veterans, past and present. Everyone is concerned for our well fair and rightfully so. Yet..... We all witnessed a veteran act out and take the lives of five Dallas police officers. We all read about the veteran taking his life the day before thanksgivings in Tennessee. We watched again as a veteran drove his car into a crowd in New Jersey. These were all members of my group. They each acted out in horrible ways. They acted with purpose. Each were previously rejected help, by the VA! Replace the acronym "PTSD" with "HULK" and everyone will understand us better. PTSD, as in my case, has not diminished intelligence, it clouds my use of it. The CCVA, addressed the plight of the mentally challenged veteran in Clemons v Shinseki, 2009, emphasizing the inability of a mentally challenged veteran, to narrow their own claims, before a more knowledgeable and experienced VA employee. We would have hoped a ruling from the highest VA court, would have produced a wide range of assistance and protections for us mentally challenged veterans. The court declared it to be enough that a veteran apply with a mental health claim to trigger the special attention required under Clemens. What good are CCVA decisions when VBA directors have no responsibility to follow them, at least that's the way the Tennessee region applies it. Rulings are muted, as veterans in my group have no way to address them. We are threatened with police action, by the VA, defenseless before the DOJ, ignored by politicians, called crazy by caretakers, and all is well, once again, in the life of a stressed out government employee. Our lives are ripped apart, stress increased beyond belief, we end up living in a shed for years, waiting on the VA to respond. We once believed ourselves more than just a veteran, we thought we answered the call for something, more than that. We stood the ground assigned and completed our small part in the defense of our Nation. We stood for all of our nations people. We stood for our own constitutionally protected rights and believed ourselves protecting them. From one Generation to the next, less than 3% of Americans have served their country and even less during time of war, is it to much to ask for a voice? Is it to much to ask that we not be required to sacrifice everything we had worked so hard and so long for. The wars we fight are not in your neighborhood. If you let the 2% keep getting treated this way, the next one will be. I'm a Vet, too, has become an excuse, not the badge of honor it was intended to be. We stood up when you called and we came home different. Will you not stand up for what our families are loosing, because we chose to defend you? To quote the late Paul Harvey " Now you have, the rest of the story." Stand on Clemons and force the VA to address all of the material facts. Now read Bevins and six unknown narcotics agents and the new VA accountability law. This will force the VA to address the whole disability picture the first time they touch the record or they fail Clemons. Do not pursue the adjudicator, pursue the signing authority as they have a written obligation to ensure the law has been followed. The new accountability law is specifically positioned to tag these individuals for failing their signing obligation, therefore failing Clemons. My claim went from 50% to 100% based on the same medical evidence. No new exams, no bull, claim Clemons and point to your Disagreement, then let them assume liability for failing Clemons.

Hello all. I am looking for some thoughts on how much of an impact a VA psychiatrist note in my record. I am filing for aggravation of mental conditions the pre-existed prior to service. I had a special waiver signed prior to joining where the military doctor granted me permission to enter because I had been taking lithium trials. The psychiatrist note from 2016 therapy session that states "In brief, -------- has contended with depression, anxiety, and anger as far back as teenage years. There were aggravating circumstances during his time in the Army (1988-96), though he was not in combat, and for quite a period of time alcohol misuse exacerbated his symptoms, but he says today he's been sober since 2011, when he went through treatment in the VA hospital. He doesn't attend AA; he just knows he's better off not drinking. -------- has contended with hostility and paranoid perceptions and ideation for many years. When it's been bad he'll use Abilify to counteract those symptoms. I have been seeing the VA doctors for mental health problems since 2009 and have an extensive history in my VA records of meds and groups etc. Do I have a nexus? I have been appealing this for years. Happy to provide more info if needed. Thank you

I have a secret to tell. I am afraid of falling down the stairs. A few weeks ago, I was going down the steps at home, carrying my 13 pounder aka 5 month old foster babygirl., and I felt a near blinding pain in my R foot, which made me nearly finish my trip down the stairs in stunt person style. So, here's the problem, ever since then, every time I am faced with going down any flight of stairs, I keep seeing the stairs I fell down during boot camp. Is this something to be concerned with? It sure bugs the crap out of me. I was always leary of stairs ever since that boot camp fall...but not like this...especially now since I have various foot, ankle, and knee issues, both SC and non-SC. I didn't want to even mention it here, but I keep hearing a voice in my head telling me that I need to speak up, so someone can tell me that I'm not crazy, or...at least, not as crazy as I think I am. Should I tell my VA MH at my next therapy session? Is this something not even worth mentioning? Now I feel so dumb and childish for having mentioned it...

My psychiatrist of over 10 years transferred last December. Protocol with him was always call and I got in within a week or two. He let me know before he transferred and said to just call a few weeks before I needed to be seen. In January, I had an appointment at the hospital 3 hours away and had a severe panic attack in the waiting room. I called my local mental health clinic for an appointment afterwards and I was told the wait was at least 4 months. They assured me that I could see a pharmacist to "bridge" my medications. I have seen her twice and had an appointment with a new psychiatrist for July 19th. I noticed on my appointments page that is emailed to me by the VA that it had been canceled and not new appointment was scheduled. I called the MH clinic last Monday to inquire about it and was told someone would call me back. Thursday, still no phone call from the clinic and I called the patient advocate because not only was my appointment canceled by the pharmacist had entered a new mh diagnosis and I noticed some notes from my phone call in Jan. that were not true. The patient advocate told me someone would be calling me to schedule me and appointment and the other issues would be looked into. I have yet to receive a phone call to schedule me for a new psychiatrist appointment and I don't even know what to do anymore honestly. I never had this problem for over 10 years. I am TDIU P and T. I am rated for mh and I can't get an appointment. I also have agoraphobia which makes it nearly impossible to just go and sit at the mh clinic all day hoping someone doesn't show for an appointment. What should I do now?

Are there any other Veterans on here that were at the Pentagon 9/11-9/30 for search and rescue/recovery? I was denied PTSD in 2005 (VA said it wasn't service connected), I appealed it, but never received a letter that the appeal was denied, at that point I said f-it and gave up on the VA. I created an ebenefits account recently (December 2015) and it says that appeal decision (denied) was made in March 2006. I am still having issues. I am reopening the claim for PTSD. I have the VA ROI from 2005 that shows all the VA Psychologist and LCSW notes on file chronic PTSD and GAF:40. I was going to that VA clinic 2004-2006. went back in 2009 to get prescription for nightmares and flashbacks. shit is still not going away.

So I am trying to understand my whole MH rating. I just looked at my award letter from November 2014 and I was awarded 30% for "other specified trauma and stressor". What diagnostic code is that??? What is other specified trauma and stressor??? What is the diagnostic code for this? 11/2014- On the award letter where it details the disability It stated chronic sleep impairment; anxiety; depressed mood; and the occupational/social impairment verbiage that warrants the 30%. 11/2014- On the award letter I was also awarded anorexia nervosa (diagnostic 9520) 0% which is a totally separate disability and rating. I see a therapist weekly for both my eating disorder and MH issues through Tri-West. FAST FORWARD to 2/4/16- I went for my C&P exam for MH increase and eating disorder increase. While in the exam, the examiner was thorough and she actually started to realize I was not correctly diagnosed for my eating disorder. She told me that I should be bulimia with purging (laxatives) which should be diagnostic code 9521. That I agree with because for decades I have abused laxatives to purge. The examiner said she was going to have the anorexia nervosa diagnose changed to bulimia. Now keep in mind an eating disorder is separate disability from the typical MH disability ratings. Its rather tough to even get S/C for it at 0% let alone get anything higher than 0% unless you have at least two weeks of incapacitating episodes. Moving on to my area of confusion and hope that someone can help me.....While in the C&P exam and as we were talking she told me that I suffer from BDD (Body Dysmorphic Disorder). I looked this up and it falls under diagnostic code 9421 Somatization disorder. Is this a separate rating from the occupational/social impairment rating of 9440? Isn't there only ONE main MH rating and then you can have other sub-ratings? Is the Occupational/Social diagnostic code 9440 the MAIN MH diagnostic code? Is this what determines your MH rating or can you have other diagnostic codes with this code and then have them all together???? How do they rate you when you have all the different MH diagnostic codes? I guess where I am confused is the rating codes. Is the MH rating based on the MAJOR MH disability and then lump the other disability ratings under the main MH disability? If I am diagnosed with several MH ratings along with BDD under 9421 would I still be rated under the 9420 occupational/social impairment? Did I just confuse you??? I am so confused LOL Can anyone help me understand this???? PLEASE SEE ATTACHED MY C&P EXAM FROM 2014 FOR EATING DISORDER AND PTSD....THIS IS WHAT I GOT THE 30% FOR PTSD AND 0% FOR EATING DISORDER....C&P for Eating Disorder & PTSD-Redacted.pdf

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

A few years ago my PTSD was so intense I attempted suicide twice. First by drug overdose and then two months later by slicing my wrists. "Stupid on my part"! My two questions are; 1. Has anyone ever heard of a way to have the scars corrected so they don't look so bad? 2. Since I did slice my wrist during a PTSD panic attack would they be eligible for compensation secondary to a service connected condition? Would really be interested in a way to correct the scars if anyone knows of a way.

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 % ?

Okay so I am still awaiting the "official" BBE to come but I do have a coordinator I have been in contact with for several months and she is at the RO office. She and I were chatting today and she "unofficially" told me my breakdown and one of them is 30% for Other Specified Trauma/Stressor......WHAT IS THAT? I had a MH claim in for Anxiety/Sleeping - Eating Disorder and then I added PTSD/MST a few months ago. The original claim is from May 2013. In addition I was 0% S/C for my Eating Disorder Anorexia Nervosa which is great b/c I can get the treatment now and the VA will out source me to a treatment facility. But I am baffled at the Other Specified Trauma/Stressor....Anyone heard of this????

1. Diagnostic Summary Does the Veteran have a diagnosis of PTSD that conforms to DSM-IV criteria based on today's evaluation? YES 2. Current Diagnoses a. Diagnosis #1: PTSD Axis I Diagnosis #2: Alcohol Dependence in remission Axis I b. Axis III - medical diagnoses (to include TBI): Chronic pain, diabetes, hyperlipidemia, hypothyroidism, GERD, HTN, sleep apnea c. Axis IV - Psychosocial and Environmental Problems (describe, if any): Unemployment, recent death of dog d. Axis V - Current global assessment of functioning (GAF) score: 50 3. Differentiation of symptoms a. Does the Veteran have more than one mental disorder diagnosed? YES b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? YES If yes, list which symptoms are attributable to each diagnosis: The Veteran no longer drinks alcohol. 4. Occupational and Social Impairment a. <X> Occupational and social impairment with reduced reliability and productivity SECTION II: CLINICAL FINDINGS: 1. Evidence Review a. <X> Claims Folder (C-file) <X> YES <X> Other, please describe: Interview, CPRS and Vistaweb review b. Was pertinent information from collateral sources reviewed? NO 2. History a. Relevant Social/Marital/Family history (pre-military, military, and post-military): The Veteran reported a generally normal childhood and socialization although he had few friends growing up. He was married once for 6 years and had one daughter, but divorced after his wife cheated. He was married a second time for 4 years, but divorced after his wife cheated. He has been married for the past 3 years which is doing well. He spends his days shopping, cooking, watching TV, doing yardwork, going to church, and sometimes fishing. b. Relevant Occupational and Educational history (pre-military, military, and post-military): The Veteran completed the 12th grade. He completed 1.5 years of college with a 3.5 GPA in construction management, but left school when he was unemployed and unable to afford it. The Veteran worked in construction management at 2 different positions for 7 years total, leaving them for better positions, but at his 3rd position which he held for 4-5 years he was laid off as part of a downsizing maneuver. The Veteran did well and was being groomed for a VP position, but did have an argument with a client which he believes may have impacted the decision to let him go. He has been unable to find work and began collecting SSDI for PTSD in 2009. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): The Veteran first began psychiatric care in 2005 and psychotherapy last year. He currently attends group therapy and medications include prazosin and sertraline. He did participate in marital counseling during his second marriage. Family mental health history is positive for suicide and addiction. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): One suspension in school for fighting. One Article 15 in 1996 for having a foreign national in his barracks. e. Relevant Substance abuse history (pre-military, military, and post military): The Veteran does not smoke. He did smoke marijuana regularly from 2000-05. The Veteran began drinking heavily following Desert Storm until 2009 and would drink 24 beers or more until passing out. 3. Stressors a. Stressor #1: On 2/25/91 the Veteran was on guard duty at Khobar, Saudi Arabia when a SCUD landed and killed 28 soldiers and injured 250 others. The Veteran was later required to remove his protective mask to assess the possibility of chemical agents. Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? YES Is the stressor related to the Veteran's fear of hostile military or terrorist activity? YES 4. PTSD Diagnostic Criteria a. Criterion A: <X> The Veteran experienced, witnessed, or was confronted with an event that involved actual or threateded death or serious injury, or a threat to the physical integrity of self or others. <X> The Veteran's response involved intense fear, helplessness or horror. Criterion B: <X> Recurrent and distressing recollections of the event, including images, thoughts, or perceptions <X> Recurrent distressing dreams of the event Criterion C: <X> Efforts to avoid thoughts, feelings or conversations associated with the trauma <X> Efforts to avoid activities, places or people that arouse recollections of the trauma <X> Markedly diminished interest or participation in significant activities <X> Feeling of detachment or estrangement from others <X> Restricted range of affect (e.g., unable to have loving feelings) Criterion D: <X> Difficulty falling or staying asleep <X> Irritability or outbursts of anger <X> Difficulty concentrating <X> Hypervigilance Criterion E: <X> The duration fo the symptoms described above in Criteria B, C, and D is more than 1 month Criterion F: <X> The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning b. Which stressor(s) contributed to the Veterans PTSD diagnosis?: <X> Stressor #1 5. Symptoms <X> Anxiety <X> Chronic sleep impairment <X> Difficulty in establishing and maintaining effective work and social relationships <X> Difficulty in adapting to stressful circumstances, including work or a worklike setting 6. Other symptoms: NO 7. Competency Is Veteran capable of managing his or her financial affairs? YES 8. Remarks, if any The Veteran reported symptoms consistent with a diagnosis of PTSD. He reported a stressor wich would meet diagnostic Criterion A for PTSD and is consistent with the kinds of duties expected of a service member at that time and in those circumstances. There are no pre- or post-military traumas which would account for his symptoms and his entrance physicals on 5/31/88 and 7/7/88 do not show any indications of prior psychiatric history or treatment. It is at least as likely as not that the Veteran has PTSD that was caused by or resulted from military service. The Veteran reported only mild anergia and amotivation as current symptoms of depression. He did report prior depressive episodes beginning after service in Desert Storm, but these are more likely than not manifestations of PTSD rather than a separate medical entity. After the interview, the psychologist shook my had, thanked me for my service, and said "enjoy your retirement" Thoughts? Thanks in Advance!