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Found 5,467 results

  1. From S to R2?

    I was most recently diagnosed with a seizure disorder and was referred to University of Pittsburgh for a case study along with the Mayo Clinic. Here is his letter Attention Mayo Clinic/University of Pittsburg concussion Center ; As noted in Mr. Frei’s history, he underwent severe trauma while active duty military. He has since been retired from the military with posttraumatic stress disorder and traumatic brain injury which is not fully been compensated yet. Traumatic brain injury is definitely a component. I have been his primary care physician for approximately the last year as he has started with the VA in Wilmington, Delaware. After his military career. He was a helicopter pilot in the military, then a aircraft mechanic at Philadelphia international Airport. However, his memory was so impaired and headaches as well as circadian rhythm disturbance due to his union schedule. He lost his job at Philadelphia and was until recently working on helicopters down in Maryland. Once they found out memory issues. They terminated his employment. Most importantly patient has the chronic symptoms of PTSD associated with anxiety as well as some slight physical residual symptoms from the motor vehicle. He suffered while active duty. On several occasions approximately 2 times per year. He has had sudden episodes of loss of consciousness where he is found on the ground and after just a minute or so is conscious. He has never swallowed his tongue. He has never been foaming at his mouth. He has never had loss of urine. MRI shows consistency with TBI. There is no evidence of significant seizure workup as well as etiology and combination to create one full situation of posttraumatic stress disorder associated with seizure disorder associated with traumatic brain injury. At this point, I believe Jamie Frey would be most benefited by a a full team approach medical evaluation by the Mayo Clinic for University of Pittsburg concussion Center as the current system of addressing one issue at a time at different facilities is not coming up with an answer and this is a 31-year-old white male in very good physical condition with physical injuries and former military service. If accepted to the program. I suspect we will have a good chance of having her in the Veterans Administration cover costs, but cannot guarantee. Until that is actually submitted If the hospital turns it down he said it a good chance it will be approved couldn't I use this as a way to get SMC-R2? This makes my life a living hell with the timing my wife's pregnant, has lymphoma during pregnancy doctor thinks. Son has a minor birth defect my daughter has a heart defect. Worrying about my own health issues is trivial in my eyes. Dealing with 2 black outs a year and headaches with short term memory problems seem minor to my pregnant wife. Life's full of curveballs
  2. IU and SSDI

    I was just rated 70% for PTSD bringing my total disability to 90%. I have worked very part-time as a bus driver but have been let go due to the meds I'm on and my PTSD. I am planning on applying for IU and SSDI. Is there one I should be applying for first or can they be applied for at the same time? Any thoughts and comments are very much appreciated!
  3. I'm new here and am re-posting under this topic as it may be a more appropriate forum. First off, let me say this site has been extremely helpful to me in developing my brother's VA claim. He's a former Marine - served in Vietnam 1969-70 and was WIA by tripping a grenade booby trap - Purple Heart. He was unemployed for approximately 4 years of the first 8 years he was back. Then in the 8th year, he attempted suicide, taken away in a straight jacket, hospitalized and diagnosed with Schizophrenia, Paranoid Type. In the 5 years that followed, he underwent long-term mental health therapy, was incarcerated for hitting a police officer with his truck (charged with intent to maim/kill), received a Felony conviction, put on Probation, and lost his license. There were many other bizarre behaviors too numerous to list here. My father filed a VA claim for his "nervous condition" in 1982 - The VA denied it saying "evidence did not establish service connection for PTSD - and disorder not shown by the evidence of record - your nervous condition not shown to have been incurred in service." With my parents now gone, my husband (retired USA LTC) and I now financially support my brother, who lives below the US Census Poverty level. His only income is SS retirement. He's on food stamps. This prompted me to re-file his claim. They came back with "disabilities claimed" of PTSD - reopen; Non-service connected Pension - new; Schizophrenia, residual type, competent; Scars - increase; Compentency - new; and Special Monthly Pension - new. My biggest obstacle has been gathering medical evidence for this claim. I was only able to submit the written diagnosis from his hospital for schizophrenia in 1978 (quite detailed though citing suicide attempt, paranoia, second coming of Christ hallucinations and all that); emergency center invoice from the local County Community Mental Health center in 1982, a physician's report of medical status (schizophrenia-form episode with depressive symptoms) in 1983. I also submitted relevant documents including the Probation Officer's consult with his mental health therapist agreeing his behavior arose from Vietnam combat experience, a Circuit Court judge probation condition that he undergo a year of mental health treatment, and a DMV suspension letter indicating license would only be reinstated on the condition that he file a psychiatric evaluation annually. I've reached out to the hospital, the mental health center, even the County Court reporter to get further documentation. All records have been destroyed in accordance with the state record destruction policy because it's been so long. The VA has now come back asking for "medical evidence of his permanent inability to obtain/maintain gainful employment". They didn't ask for a medical exam, they didn't offer a medical exam or Field Examination. They made no reference to PTSD or Schizophrenia. (Are they planning to deny it outright or are they perhaps accepting it based on his booby trap trauma??) There is no other medical documentary evidence to be had! I am creating a time line of sorts for them - showing his below poverty earnings and unemployment correlating to the times he was hospitalized and undergoing mental health therapy. DOES HADIT or ANY VET out there have any other suggestions for me as to how to tackle this lack of evidence in my response to the VA? Please come back to me --- they are asking for my response back within 3 weeks. Would greatly appreciate any comments.
  4. Good morning, I filed a Fully Developed Claim on May 16th for Sleep Apnea secondary to PTSD.I included a DBQ from my Civilian Primary Care MD, a Sleep Study,a letter from my MD that the CPAP was medical necessary and an Independent Medical Opinion, claimed just moved to Prep to Decision . . I hope I did everything correct? Any thoughts on if I missed anything.I will let everyone know how it goes
  5. Anybody have any idea or know anything about the part of the PTSD criterion relating to derealization and or dissociation? I experienced them both during my multiple MST events...still do.
  6. My heart goes out to all of my fellow survivors of MST ... For me, I have found I can no longer suppress and manage the daily physical and emotional affects of the sexual assault that took place on December 25, 1985 while serving on active duty. In effort to find some help, relief and hopefully someday healing I am starting the uphill journey to deal with this and try to share some of the highlights of my battle. I will be the first to admit I have no idea what I am doing and can only hope that God the father.... will guide my feet day by day. First step locating documentation of the event. A few weeks ago I was able to locate the police dept. and requested a copy of the report. I received a copy of the 15 page report this past week and it makes me emotionally and physically sick just to look at the envelope it's in. I also tried to locate medical records over the years from prior mental health therapists and physicians that would have documented my history as it related to these events, but the practices were closed or my records were no longer available due to time. April I called the VA to inquire about mental health services for MST and hesitated to start the process because the MST would not be marked in my record for all my providers to see. This was a big hurdle mentally as I have always hid this event at all costs from my providers. I am sure this did not help my physicians treat me and fully understand my ongoing medical problems especially those in which are usually brought on by some big life event which I always adamantly denied when asked. May 2nd 2017, I submitted a "intent to file". May 4th 2017, I went to a VSO rep?? to asked questions about the process to file a claim related to MST. The rep was belittling, insulting, hurtful, rude and I walked out of that office with no more information and the psychological affects were pretty devastating. At the encouragement from my daughter to go straight to the patient advocate office and file a complaint....I did just that. I found myself have a total mental breakdown just trying to give the details of what just went down and was thankfully met with support and many reassurances that I would have a team of people helping moving forward and that person would be brought in...dealt with and re-trained. I will spare you all the details. My next step is hearing from the mental health dept. to set up an appt. to do some type of baseline evaluation of my symptoms etc. as it related to MST... I guess to get an official diagnosis on record and to get me the specific therapy I need started. I will likely opt for tele-therapy once I have a few sessions onsite at the VA. That's it for now
  7. Hello all. I had a c&p exam for my ptsd/mst claim on 1/19/17 at the VA Outpatient center in Fort Worth and just got the results back today. I was quite shocked by the notes. I feel that the c&p psychologist did not review the merits of my case properly and just opined hat I was exaggerating my symptoms based on a 15 question "MENT" test which consisted of me differentiating between happy, angry and sad faces. She also asked me to remember 5 items after 5 minutes (which she gave me the answer after I couldn't remember 2 of them). She asked me nothing about my symptoms or about the events of the trauma. She picked what parts of my VA medical records she included in the report (i.e., sleep disturbance). I feel like I have been shafted. She is basically refuting the diagnosis given by my TWO VA psychiatrists, VA psychologist and my VA social worker. I waited over 25 years to file my sexual assault claim due to me being extremely embarrassed and unable to bring myself to talk about the events that occurred while I served as a submariner in the Navy. The assault happened in 1988; back before don't ask, don't tell. Needless to say I was traumatized and afraid of being kicked out. Nonetheless, I was medically discharged a year later due to asthma brought on by anxiety and panic attacks while onboard my duty station. So, now I am at the point where I am finally seeking help and I spend 20 minutes with a c&p psychologist who seems to be indifferent about my condition. I almost feel like I should have just retreat back to my home in silence instead of being treated like a liar!!! What can I do about this? Here is my c&p exam: LOCAL TITLE: COMP & PEN MENTAL HEALTH/PSYCHOLOGY EXAM STANDARD TITLE: PSYCHOLOGY C & P EXAMINATION CONSULT DATE OF NOTE: JAN 19, 2017@09:30 ENTRY DATE: JAN 19, 2017@11:27:37 AUTHOR: EXP COSIGNER: URGENCY: STATUS: COMPLETED Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran: SECTION I: 1. Diagnostic Summary Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [ ] Yes [X] No 2. Current Diagnoses a. Mental Disorder Diagnosis #1: No Diagnosis Comments, if any: Psychological Testing A test of response bias specifically related to PTSD symptoms was administered to the veteran during this examination to assess the credibility of his self-report. The name of this measure is withheld in this report in order to protect the integrity of the test. This test was specifically standardized on a sample of veterans applying for financial remuneration for a claim of disability resulting from PTSD. The veteran's score on this test was significantly above the established cutoff, indicating that his performance was not consistent with persons diagnosed with PTSD but was consistent with the test performances of disability claimants simulating symptoms of PTSD. As such, there is reason to suspect symptom exaggeration and a response style indicative of attempts to portray himself as worse off than he actually may be with regard to PTSD symptoms. Based on the Veteran's scores, additional testing was performed to further evaluate the possibility of overreporting or exaggeration of mental health symptoms. A second test of response bias was given that was specifically designed to assess the credibility of reported psychopathology symptoms of response bias related to mental illness. Each item on this test was designed to evaluate constructs and behaviors useful in identifying overreporting. This test was developed and validated using both simulation and known-groups designs to identify individuals attempting to overreport symptoms of mental illness. In addition, the validity of this exam has been generalized across various racial/ethnic groups, genders and settings. The Veteran's total score on this measure was above the cutoff, indicating that his responses were not consistent with persons diagnosed with any mental illness. In addition, the Veteran's scores on this interview indicate that his behavior was inconsistent with his reported symptoms and he endorsed very extreme and uncommon symptoms, symptom combinations that are both unlikely and inconsistent with common mood and psychotic disorders, and he had a tendency to endorse severe and unusual psychotic symptoms. He also endorsed an unusual course of illness that is inconsistent with the course of most psychiatric disorders recognized in clinical practice. It is possible that the veteran suffers from a mental illness. However, I am ethically unable to provide a diagnosis at this time given the veteran's response pattern of overreporting on three objective, reliable and valid psychological tests. Providing a diagnosis would require this examiner to resort to mere speculation and would violate the American Psychological Association's (APA) Ethical Principles of Psychologists and Code of Conduct. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Deferred to a physician 3. 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 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] No mental disorder diagnosis 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 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): Family - Veteran was raised in a "normal" environment by his mother. "I wasn't that close to my father." Veteran has two brothers and two sisters. Veteran's mother was a kindergarten teacher and his father was a "mobile home constructor". Veteran denied any childhood medical/mental health problems. Veteran denied a family history of mental illness. Marital - Veteran has never been married. His last relationship ended around October of 2016 due to his "agitation." "She wanted to talk about stuff and I didn't want to discuss issues with her." Veteran has three sons (ages 16, 20 and 22). "My oldest two sons I don't really talk to since they're gone-one is overseas and the other I think moved up North. I call them every now and then and try to reach them but I hardly get in contact with them. I have a close relationship with my youngest son. He keeps me going." Social - "I had a lot of friends growing up but over the years they sort of fell to the wayside. I had friends going into the military and in boot camp but after sub school I stayed to myself. I had some associates but I didn't want to make any friends after sub school. Currently I have a few associates but I wouldn't call them friends." Prior to the military, the veteran enjoyed running track, playing football, singing in the choir and being in the art club ("I was the cartoonist for the school paper."), science and chess club. "During the military I didn't have any activities other than working on my rating. After I got out I got into oil painting, swimming, cycling and home renovation. I can no longer cycle or swim because of my back and respiratory issues. I haven't attended church in three years and my mother is now a pastor." b. Relevant Occupational and Educational history (pre-military, military, and post-military): Educational - Veteran earned a Bachelor's Degree in Electrical Engineering in 1995 and a Master's Degree in Biomed Engineering in 2009. Veteran informed that he was a good student and denied a history of suspensions, expulsions or learning problems. Occupational - Veteran's job history prior to the military includes custodian and lawn care (self-employed). Veteran serve in the Navy from July 13, 1987- May 16,1989. Veteran was a college student from 1990-1997 and 2004-2009. Since being discharged from the military the veteran has worked as an RF engineer/consultant (1997-2004: "I got into an argument with my supervisor because he always wanted to include me on projects he was working on and I thought that was inappropriate. I thought he had an interest in me even though he didn't say it outright. He wanted to go out and do stuff outside of work hours."); and bioengineer/prosthetic designer for the Department of Commerce (2010-March of 2016: "I got in several arguments because of space and eventually withdrew and stopped producing. I had to share a small space with a coworker and he was constantly rolling back in his chair asking me questions and tapping me on the shoulder so it finally came to a head."). Occupational problems reported include poor social interaction ("Shouting at people and avoiding contact with guys in the office. I worked better with females."), difficulty concentrating ("Because I was focused on not being in a vulnerable position. I missed deadlines or didn't finish tasks because I couldn't focus. I asked to have my own office but you can't have one as a junior engineer."), difficulty following instructions ("If men tried to get close to me because it reminded me of sub school and the threat of not being advanced or promoted."), forgetfulness, and increased absenteeism ("In 2015 I couldn't deal with the office so I started working from home but my supervisor didn't want me to sever myself from the office totally. I had anxiety about going back and sharing an office with another male. I felt better working by myself because I was more productive."). In regards to reprimands, the veteran informed that he was written up for poor work performance, absenteeism, being AWOL and conflicts with his officemate. "The conflicts with my officemate led to me being fired." Veteran informed that he has applied for one job since being fired. When asked if he was a productive and reliable employee he stated, "As long as I was alone and no one was being touchy with me." Veteran denied the following occupational problems: assignment of different duties and tardiness An October 5, 2016 MH OUTPT NOTE states, "He is unemployed and uses income from renting rooms to pay living expenses." An October 5, 2016 MH Attending note states, "Lost his last job as a biomedical engineer in March 2016 after "tussling" with an older man in his office who would repeatedly come up behind him and touch/pat his shoulders which reminded him of his Navy experience...Owns home and rents out rooms for income." c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): Mental Health Veteran began mental health treatment at the North Texas VA in August of 2016 and is compliant with his medication regimen of risperidone, prazosin and sertraline despite feeling "groggy and spaced-out." Veteran denied a history of psychiatric hospitalizations. An October 12, 2016 SLEEP TELEPHONE NOTE states, "I called the patient and explained their sleep test results in detail. I explained him that the study did not show significant sleep apnea despite his sleeping on his back. He is unable to sleep on his side due to his shoulder problems...Encouraged the patient to lose weight." A November 2, 2016 MH PTSD INDIVIDUAL NOTE states, "Veteran believes that gay men are going to hurt him. He also informed worker that he has experienced a lot of fear and worry this Halloween with people who are transgender, to the point that he is not sleeping for fear they will break into his home. Veteran is worried that he may have to "barricade" his home with bars on the windows." A November 3, 2016 MH Attending Note states, "Updates that since last appt, his GF ended their relationship, "she said I was over agitated." Last week, he describes an incident at a restaurant when a transgendered person was standing by him, he turned and saw the person, got so upset that he ran out of the restaurant and vomited. Since last week has felt progressively worse. "It's harder to tell which people to stay aware from.. it's a whole new ballgame with transgendered [people]...I don't know who my enemy is." He states he needs to set a perimeter on his house, put bars on his windows/doors, and update his security alarm. Reports poor sleep, gets out of bed 3-4x/night to check doors/windows and frequency of NMs has increased. Appetite is low. Feels that he cannot focus, "I'm constantly thinking how to avoid these people." Reports hearing male voices talking outside of his windows so he fears they will break in (reason for "setting perimeter"). When he is in public he has thoughts of "I need to get them before they get me" when he passes male strangers. Has not had any violence but does say he has had verbal arguments (told someone in the Wal-Mart line to back up and they argued with him, for example)...+ MST in Navy- unwanted taunts, suggestive remarks and genital contact and kissing from supervisor." A December 5, 2016 MH ATTENDING NOTE states, "Updates writer that he has spent ~$3000 since last visit adding bars to the outside of his first floor home window and installing a security system with cameras. Reports he still plans to add more cameras to monitor his roof because "maybe someday deterred by the barricade downstairs might want to get in up there." Reports vague AH of hearing footsteps on his second floor when he is down on the first floor. Denies hearing voices from upstairs or outside his window like he endorsed last visit. Reports nighttime is the hardest for him because "that's when they are outside...the enemy, the transsexuals." Denies actually seeing anyone outside of his house at night. Reports he is comfortable with certain people coming up to his house, like the mailman, but states he is not comfortable when strangers come up. States he is not aggressive but tells them to go away. Does not take his gun with him to the front door. States he now feels better with his house more protected. Is able to watch movies and enjoy them during the day. His security system is on his phone app and he checks it every 3 hours. At night he "secures the perimeter" every 2 hours, has an alarm set." d. Relevant Legal and Behavioral history (pre-military, military, and post-military): Behavioral - "In 2005 I grabbed a guy that was dressed like a female. We were meeting for a date but his profile said he was a female. Two months ago a person behind me in line was transgender. I pushed him to the side and ran outside." Legal - Veteran denied a history of legal problems. e. Relevant Substance abuse history (pre-military, military, and post-military): Substance Abuse - Veteran denied a history of substance abuse. f. Other, if any: No response provided. 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: MST February-April of 1988: CPRS states, "A male teacher began touching him during class and stepped over lines trying to get too close that made him feel very uncomfortable. Veteran says there was never genital contact because there was touching and kissing on the part of the instructor." Veteran's stressor statement states, "One trainer would come up behind me and massage my shoulders. He also grabbed my waist and pressed himself against me. I could feel his erect penis against my buttocks. He also made sexual innuendos and jokes. He also asked me if my nipples were hard because I was glad to see him. He then said, 'I bet you have a nice sized tool'. He then touched my left nipple and kissed my neck. When I confronted him he stated that if I didn't cooperate, I may not pass through with my classmates. He then grabbed my crotch and said, 'Pass or no pass. You make the determination.' My relationship with my long time high school sweetheart ended that summer (June of 1988) because I withdrew fro the relationship and was too ashamed to confide in her." Please note that this last statement is in contrast to the statement provided by his former girlfriend who stated that the veteran "mentioned that a sexual assault happened to him during training that changed him and that he needed time to work through it." 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 Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. Veteran's treatment records, buddy statement and stressor statement were reviewed. However, there are no markers in the veteran's STRs or personnel records which the VBA has confirmed. 4. PTSD Diagnostic Criteria No response provided. 5. Symptoms No response provided. 6. Behavioral Observations MENTAL STATUS EXAM - Appearance, Behavior, and Speech Veteran's appearance and dress were appropriate for the exam. His speech was normal in rate and tone. Veteran's response to the evaluation was guarded but engaged. Rapport was easily established with the Veteran who put forth a conscientious effort to answer all questions to the best of his ability. Thought Process - There was no evidence of loose associations, flight of ideas, circumstantial, or tangential thought process. Veteran completed similarities and interpreted proverbs accurately. Thought Content - Veteran denied having any obsessions or suicidal/homicidal ideations. However, delusions regarding the security of his home and transgenders were reported. "Transgenders are trying to get back at me because I grabbed the transgender that I was supposed to go on a date with. His profile said he was female. I have to hone in and decipher whether someone is male or female because my initial problems came with my sexual assault in training so I've distanced myself from males who are the enemy. The transgender caught me off guard and now they're trying to trick me. It's a whole new ball game." Perceptual Abnormalities - "I keep hearing my instructors voice in my head. Especially if I get around someone who has to make choices that involve me. I keep hearing 'pass or no pass' which is what he said to me. I hear a human voice outside my windows. When I go look there's nothing there so I don't know if they've run away or what. That's why I put up security cameras." Mood and Affect - Veteran's mood was "indifferent" and his affect was flat. Sensorium and Cognition - Sensorium was clear. Veteran was oriented to time, place and person. Immediate memory was good as he was able to repeat five of seven numbers forward and six of seven numbers in backwards sequence. Recent memory was fair as he recalled two of three items after five minutes. Remote memory was fair as he recalled the names of the last three presidents, the name of his high school, his youngest son's birthday, and his first job. Veteran was unable to recall the name of his elementary or junior high school nor his siblings or two oldest sons birthdays. In regards to concentration, Veteran spelled world forward and backwards and completed simple mathematics, serials 3's, and serial 7's. His intelligence appeared to be average. Judgment and Insight - Veteran's insight is good as he understands the outcome of his behavior and the choices he makes. His judgment is impaired but he informed that he would return a library book to the library if found, pull over for the police, and return a wallet he found to the owner. 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 Financial: "My brother pays any bills that I can't pay online." NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.
  8. I just submitted my first claim for PTSD from MST. When I was overseas, I was on guard duty was an infantryman. When in a guard tower, he exposed his penis and started playing with it. He was looking at me and wanted to me "help" him out. We were locked and loaded so I was fearful on what this man was going to do next. I just froze. I told his SGT and he was detained and sent back to garrison. The rules changed and I was looked at a different way since the incident. There was no touching but this incident has impacted my life and my sense of security. I'm fearful of everything and what's worse is that it's now effecting my children and my marriage and that's why I'm now filing. I haven't talked about it openly with my friends and now I'm expected to talk about it with a stranger for my c&p appointments? Any advice on what to expect and how long the whole process take.
  9. Hi, This afternoon I have my C&P exam for PTSD secondary to MST, with a contracted provider. I found out Friday evening after work. Fed Ex had delivered the paperwork earlier, but I didn't get a chance to see it until I got home from work. To say that I am nervous would be the understatement of the year. I am desperately trying to hold myself together. My digestive system is all out of whack. I did spend an hour on the phone last night with a wonderful person from a non VSO group. She is a Marine and has trauma history, so that made the connection pretty easy. She gave me a lot of good tips, if I could only remember them when it's crunch time. One of my biggest fears is that this will be just like my previous mental health C&P...where that examiner, a VA employee, when straight for the jugular and ignored my heaps of physical evidence. I don't know why I am even doing this. I fully expect to get more of the same....nothing. If I do get granted SC, the shock of that may well kill me...because that goes against the grain of what the VA has given me over the years....tons of grief and denials. Anyway, just wanted to write this down as some kind of therapy... No body has to read it, or respond. I'm not here anyway.........
  10. All, I competed my C & P exam for TDIU claim for PTSD and Lumbar DDD. I am uploading the notes from my C & P exam for PTSD. The examiner stated I do not know why you are here because your last C & P was in March. If anyone has experience with interpreting the notes I would appreciate your help. I did delete her extensive notes about what I said about my family and events.... My previous C & P exam was 70% for PTSD and total rating of 90% 40 lumbar ddd and radiculopathy, 10% for each knee, 10% for tinnitus. Also I was just diagnosed with Moderate to severe Sleep apnea.... but I have not filed for disability. I would have to get a nexus letter from doc stating secondary to PTSD. If I am denied TDIU I will start that process.... I would like any advice on the results below and also what should I do with sleep apnea claim... I also have High BP... not sure if I should submit Sleep apnea claim and try to go for SC 100% Thanks in advance for your "time and your help" Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No SECTION I: ------------- 1. Diagnostic Summary ------------------------------ Does the Veteran now have or has he/she ever had a diagnosis of PTSD? [X] Yes [ ] No 2. Current Diagnoses ------------------------------ If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder ICD Code: F43.10 Mental Disorder Diagnosis #2: Major Depressive Disorder ICD Code: F33.9 b. Medical problems relevant to the understanding or management of the mental health disorder(s): Physical health problems that he described as affecting his day-to-day functioning or requiring the use of daily medication or medical devices include back pain and sleep apnea. Just got a CPAP yesterday. Please see his medical records for additional information about his physical health conditions. 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 and discuss whether there is any clinical association between these diagnoses: These conditions can co-occur, and there is some overlap in their symptoms and associated features, which precludes attribution of certain specific difficulties to JOHN DOECONFIDENTIAL Page 22 of 68 one condition or another without resorting to speculation. Consequently, these conditions cannot be fully differentiated from each other. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed Comments: Not applicable. d. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [ ] Yes [ ] No [X] Not applicable (N/A) 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 deficiencies in most areas, such as work, school, family relations, judgment, thinking, and/or mood 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 [ ] Not applicable (N/A) 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: As these conditions cannot be fully differentiated from each other, their associated functional impairments cannot be differentiated without resorting to speculation. 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 and Virtual VA) [X] CPRS [X] Other (please identify other evidence reviewed): VistaWeb or JLV JOHN DOECONFIDENTIAL Page 23 of 68 2. History ------------------------------ Relevant Family and Social History: Relevant Mental Health History: EVALUATION AND TREATMENT HISTORY EMOTIONAL AND BEHAVIORAL PROBLEMS: SUICIDAL OR SELF-INJURIOUS IDEATION OR BEHAVIOR: Other Relevant History: None reported. 3. 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 Criterion 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 Criterion 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) JOHN DOECONFIDENTIAL Page 26 of 68 sexual violence, in one or more of the following ways: [X] Witnessing, in person, the traumatic event(s) as they occurred to others [X] Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic events(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related. 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] 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] 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 the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). JOHN DOECONFIDENTIAL Page 27 of 68 [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. 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] Hypervigilance. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] Duration of the symptoms described above in Criteria B, C, D, and E is more than 1 month. Criterion G: [X] The symptoms described above cause 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. 4. Symptoms --------------------------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks more than once a week [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] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships CONFIDENTIAL Page 28 of 68 [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting 5. Behavioral Observations --------------------------- The Veteran arrived on time for the appointment. His appearance was unremarkable, and his grooming and hygiene were appropriate. He was alert and oriented to person, place, time, and situation. The nature and purpose of the evaluation, the examiner's role in the disability claims adjudication process, and the limits of confidentiality were discussed with him. He verbalized understanding and consented to participate. He engaged well with the examiner, and his responses to inquiries were appropriate in content and level of detail. While no formal evaluation of his mental status was conducted, his cognitive functioning appeared to be adequately intact for the purpose of the present interview. His thoughts were logical, coherent, and goal-directed. His speech was clear and intelligible, and of normal rate, volume, and prosody. There was no evidence of significant expressive or receptive language impairments. There was no overt evidence of perceptual disturbances, delusional beliefs, or perseverative thoughts. His attention, concentration, and motor activity were unremarkable. His mood and affect were appropriate in nature, range, and intensity to the situation and to the topic of conversation. He was tearful throughout much of the interview. He denied current suicidal or homicidal ideation, intent, or plan. He appeared to be a reliable historian and credible informant, and there were no overt indications of malingering or of symptom overreporting or underreporting. 6. Other Symptoms --------------------------- Does the Veteran have any other symptoms attributable to PTSD and other mental disorders that are not listed above? [X] Yes [ ] No If yes, describe: [X] Irritable or angry mood [X] Loss of interest or pleasure in activities [X] Appetite disturbance [X] Weight disturbance [X] Fatigue or loss of energy [X] Difficulty thinking, concentrating, or making decisions [X] Feelings of worthlessness or guilt CONFIDENTIAL Page 29 of 68 [X] Emotional numbing and detachment 7. Competency --------------------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No If no, explain: Not applicable. 8. Remarks, (including any testing results) if any: -------------------------------------------------- JOHN DOE: is a 45-year-old male who was in the Army, and who had a deployment to Iraq in xxxxxxx. He has a service connection for PTSD, with a current rating of 70%. This examination was focused on his functioning since the previous examination on 3/15/2017, although information regarding prior history was reviewed and obtained where relevant to the issues in question. Please see the report of the previous examination for relevant prior history. The present examination was based on a face-to-face interview with the Veteran and review of records as indicated above. Except where otherwise indicated, historical information presented above is taken from the interview. Results of the examination indicate that the Veteran's difficulties are consistent with current diagnostic criteria for PTSD. They also indicate that he experiences symptoms supporting a diagnosis of Major Depressive Disorder (MDD) at this time. These are considered to be separate, comorbid conditions which share some symptoms and a common etiology. Due to the overlap in symptoms and associated features of these disorders, it can at times be difficult to determine--and clinicians may reasonably differ regarding--whether the clinical picture might be better accounted for by a single diagnosis or by multiple diagnoses. Results of the examination indicate that as a result of his mental health conditions, he is experiencing significant impairments in a number of domains, including occupational functioning. As he is no longer working, his occupational functioning is inferred from his past work history, from his current social functioning, and from the nature and severity of his current symptomatology. He has not held paid employment since February 2016, when he lost his job due to irritability and angry outbursts. He indicated a previous history of work-related difficulties due to anxiety and panic. Taken together with fatigue, problems with attention and concentration, forgetfulness, intrusive thoughts, hypervigilance, discomfort in interpersonal interactions, and a propensity for social withdrawal and avoidance as a means of coping with stress, these difficulties would significantly limit his ability to secure and maintain gainful employment. He would likely experience challenges in adjusting successfully to a work environment due to difficulty establishing and maintaining effective work relationships, as well as to reduced reliability, productivity, efficiency, accuracy, and timeliness in JOHN DOECONFIDENTIAL Page 30 of 68 attending work and fulfilling job responsibilities. ***This DBQ was completed solely for the purpose of a disability evaluation, and does not represent the results of a comprehensive clinical or forensic evaluation of this Veteran. It represents the information and impressions which could be gathered and reported within the constraints of the time allotted for interview, review of records, and documentation, and within the constraints of this mandated format. DBQs are completed in highly specialized ways that conform to the requirements of the disability claims adjudication and appeals processes. Some items may be left blank or diagnoses may be omitted where the symptoms or disorders might actually be present but, for example, cannot be attributed to a specific cause or etiology, cannot be attributed to the specific condition for which the C&P examination was requested, or cannot be linked to the Veteran's military service on the basis of evidence that conforms to the required standards. The conclusions and opinions documented on this form were based upon the information available to the examiner at the time the evaluation was completed, and may differ from those of professionals who have evaluated the Veteran in a clinical setting and/or from the findings of any previous C&P examinations. New or additional information might result in changes to the examiner's interpretations, conclusions, or opinions as documented on this form.*** NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application.
  11. Thank god for this community. I thought my military service was ancient history (NAVY 88-93), but it turns out I have lived longer than my capacity to continue running. May I ask for help here in navigating this? I've filed my claim and am on stabilizing medication, but I feel an almost adversarial relationship with the VA and my family is in crisis. Squatting in a falling apart rv on a now estranged friend's property. We have just received a VASH/HUD section 8 voucher and are hopefully getting into a place with plumbing in a few weeks, but our financial crisis will not be helped by our inexperience and naive handling of this claim, not to mention my current level of incapacity which is complete. About 7 years ago my life started to unravel. I was having difficulty with my job as a plant manager for a large bottled water company. I was missing easy things, forgetting important and essential deadlines and I was becoming less and less able to focus. I was prescribed adderal and that helped for a time, but by 2009 I had to resign. That began a downward slide into homelessness for me, my wife and 2 small kids as my capability was eaten away and replaced with panic, sudden bursts of anger and frustration and implacable feelings of it all ending very soon. I've become almost completely isolated and have been unable to support my family at all for 22 months now. I was hospitalized in december (st joes in tacoma) for 5 days due to suicidal thoughts and a comprehensive nervous breakdown. It was from here that I was able to see the events without conditioned filters and my wife (the absolute most patient woman in the world) helped me file a claim with the va. I've been diagnosed by a psychiatrist in Arizona, the staff at St Joe's and by the VA as having PTSD/MDD and am on a lot of stabilizing medication. During my active service while deployed to Diego Garcia in support of the gulf war effort I was told during a routine physical that I had blood in my urine. My flight surgeon was concerned because she did not have the necessary equipment on hand to rule out bladder cancer. The decision was made to take me off of flight status and medivac me to Japan for more detailed diagnostic testing. I was in Japan about a week and had several examinations that ruled out bladder cancer. During one exam, conducted alone and in an unprofessional manner by a naval officer I was sexually assaulted and it left me in a great deal of physical pain, feeling violated and deeply ashamed. When we were alone in the exam room, the doctor nodded at my wedding ring and asked if there was any ‘other’ reason that could be causing this problem. I said ‘No’. He pressed authoritatively, “You need to be honest with me, I’m your doctor, are you telling me that you have not fooled around on your wife on deployment?” I was concerned that there was evidence of something bad like HIV that needed my honesty to secure needed treatment and the truth was that I had cheated on my wife with a girl in my squadron. And though I was reasonably sure that the protection we had used and the time that had elapsed since our triste was enough to ensure that I was safe from such things, the doctor’s demand for complete honesty and the fact that I felt reasonably safe sharing the truth (he’s my doctor after all) had me answer his question in the affirmative with the explanation of why I didn’t think it material given the explanation of time and protection cited above. The doctor’s demeanor visibly changed. Like a mask had come off. He looked very disappointed, on the verge of open anger. His face grew red and his breathing changed, like he was trying to control his temper. “Now I’m going to need you to turn around and drop your drawers.” As a Naval air crewman, I’ve had over a half dozen prostate exams. Only one of them could be defined as digital sodomy. He held me forcefully and told me to, “BE QUIET” when I cried out from the shock and intense pain, begging him to stop or at least tell me what the hell he was doing. It felt like he was trying to force his entire hand inside of me in a procedure that lasted at least a full minute in which the doctor exerted a tremendous amount of effort, nearly lifting my feet from the ground several times. I started crying as he finished. He released my shoulder and told me to “HOLD STILL OR WE’RE GOING TO DO IT AGAIN” and he squeezed my prostate producing a burning and painful discharge of fluid from the tip of my penis that he collected on a glass slide. He removed his hand from me and said, “Get your clothes on and next time, keep your dick in your pants.” He did not answer me when I asked what he had done. The exam left me in a great deal of pain, feeling ashamed, punished and deeply violated. This proved to be a very destabilizing experience as I slowly began to realize through intense and intrusive flashbacks, that this was not the first time I had experienced this combination of emotions at the hands of an angry male authority figure. I began to withdraw from friends, I took myself off flight status, I was no longer able to shoot my bow, something that had always been effortless before. But now I was starting to unravel, unable to face the shame of the reality of what the doctor had done and the overlap it had with the, until now, completely repressed memory of being handcuffed and violently raped by my best friend’s uncle at the age of 7. By the time I was discharged from the service, I was suffering greatly. It was as though a plug had been pulled and I couldn’t stop the flow of effluent that was leaking out. And I couldn’t get away from it either. I desperately needed help. But I was terrified, confused, intensely embarrassed and depressed. Within a few months of discharge my increasingly impulsive and erratic behavior led to me causing a vehicle accident while street racing my car (something I had never done prior to the assault, but was now doing compulsively) that killed two elderly women returning home from church on a Sunday morning. My wife, pregnant at the time, lost the baby shortly thereafter and our relationship imploded. That KO'd me for a while. I shunned treatment, counseling anything associated or linked to the accident. My shame over having killed two people by my irresponsibility became a massive boulder that sealed everything associated with that event off like a tomb. I did not want to be seen as a victim myself and set out to become something. I worked my way up in a company willing to take a chance on a felon and went from a $10/hour night loader to the Plant manager and near 6 figures in 10 years without a degree. I started racing ATV's (I'd never ridden a motorcycle before) and in 4 years had climbed into the top 10 as a national pro. But my life chaos was increasing exponentially as was my self destructive behavior. after 13 years I again divorced. This coincided with resigning my position at the water company and and marrying my 3rd wife. From there we had our first child while we blew through my retirement trying to figure out what in the hell we were supposed to do. We moved in with friends and I got a job doing driveways for $12/hour. My degrading social skills put huge strains on the friendship status of the family that was good enough to help us. We ended up living in a small camper for 5 months with no plumbing. I called my old boss who now lived in Georgia and was running a consulting firm to the energy sector and asked for a job. This guy thought I walked on water at my last place of employment. We moved in late 2012 across the country. It was an unmitigated disaster. I lasted 18 months before I had to resign. the physical manifestations, panic attacks, loss of focus, inability to follow direction, intense and growing phobia for talking on the phone (it was phone sales job) and an increasing tendency to freeze in stressful situations. (on the phone or in person) just really weird long silence from me. We moved to Arizona to live with our in laws. My wife flew ahead and I met up with my father in law, who was only 6 years older than me in NM. 15 minutes after meeting up, he, died of a massive heart attack in front of me on the side of the road, I had to call my wife and tell her dad had died. the two years spent living in phoenix with a wrecked mother in law going through menopause and losing her mind over her grief now had me and my incapacity to focus her pain on. I started smoking pot heavily (I had not had a substance abuse issue prior to this) and my capability continued to recede. I was working in a tiny post office in a rural town for 4 hours a day. My beard hair fell out and my panic attacks were happening 3 - 12 times a day and everyone felt like the heart attack I saw my father in law have. My Daughter was born in August of 2015 The relationship with my mother in law deteriorated until she sold her house and bought us this little rv we are in now, early in 2016 I went to the doctor in phoenix for the first time in April of last year where he diagnosed me with PTSD and we picked up and moved back home here to washington to flee the intense stress from living in a dirt parking lot in July in Phoenix in an rv, not to mention the now open hostility directed toward me from my in laws who weren't buying any of it. By some miracle my wife was able to locate my Pink medical folder and it has the doctor's name in there and the dates, though he doesnt mention in the chart notes the procedure in question, at least from what I can tell. This guy was a ltcdr in the NAVY, I'm fairly confident I am not the only person he taught this lesson to. So now we are in process. My wife has done all the filing to date and has been as thorough as possible, but there is a lot of water left to cross and Im not entirely sure of the strength of our case and I dont want to learn on my own experience the lessons of those who have successfully navigated this. Any help is greatly appreciated.
  12. What weight would a private psychologist have on my claim for PTSD. The VA keeps ducking saying it was due to childhood trauma. I am trying to get them to admit it exasperated any preexisting condition. I had a Top Secret Clearance from 92 to 96 and would (back n those days) NEVER received it with any hint of mental issues. I feel if I can get a professional to say this into my medical record I might have a fighting chance. I have been denied twice I think. Link for so many of us it has been a long journey... Thoughts? Also does anyone know of a Veteran friendly Private Psychologist in South West Florida?
  13. I received my C&P over the weekend. My exam was nearly three hours and I think the report is accurate and fair and represents how things are. I was as honest as I could be with the examiner and despite being nervous to the point of an anxiety attack about it the day before calmed down a bit and was OK during the visit. The doctor did a good job asking questions and made me feel at ease which is saying something. The report ended up being 18 pages which surprised me. I had PMd the results to a handful of people here on HADIT and a couple recommended I post it for more input. I was hesitant to do so but decided my desire for more information is more important than my paranoia of posting it. I'd really like to get the opinions of some senior HADIT posters like Berta and others. I'm thinking this is a good C&P for my claim but would like a more seasoned opinion than my own completely inexperienced one. I've posted the opinion and rationale below. . Thank you. JW. ___________________________________ 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 [X] Mild memory loss, such as forgetting names, directions or recent events [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Suicidal ideation REQUESTED OPINION: Based on information from the clinical interview, review of records (C-file and VA medical records), and psychological assessment measures, It is my opinion that the veteran meets DSM-5 diagnostic criteria for (1) Post-Traumatic Stress Disorder (PTSD) due to childhood sexual trauma with delayed onset, and (2) Major Depressive Disorder (MDD), Recurrent, with Mood-Congruent Psychotic Features secondary to PTSD. While his PTSD and MDD were less likely than not to have been caused by an in-service stressor, both conditions were more likely than not incurred in service (i.e., delayed onset with clinically significant symptom presentation beginning while on active duty). PSYCHOLOGICAL ASSESSMENT / OBJECTIVE TESTING: Objective psychological assessment measures administered: -- Personality Assessment Inventory (PAI): valid profile without any evidence to suggest inattention, inconsistency, or negative/positive impression management; primary code type - DEP/ARD (97T/85T) * Summary/interpretation of results: Briefly, the veteran's responses on the PAI were suggestive of significant tension, unhappiness, and pessimism, with various stressors (past and/or present) contributing to low mood and self-esteem. Individuals with similar profiles often see themselves as ineffectual and powerless to change the direction of their lives and feel uncertain about goals, priorities, and what the future may hold. In addition to depression, the veteran endorsed significant distress on measures of suicidal thoughts, traumatic stress, and social discomfort or detachment. His profile was most consistent with major depression, and while some traumatic stress concerns were indicated, he did not endorse the full range of concerns typically seen among individuals with PTSD. RATIONALE FOR OPINION: 1. The veteran's symptoms meet DSM-5 diagnostic criteria for PTSD due to childhood sexual trauma. The veteran's history of childhood sexual abuse is well-documented across multiple sources and during the current evaluation, he endorsed the full range of trauma-related symptoms meeting criteria for a diagnosis of PTSD. He was first diagnosed with PTSD while on active duty in xxxx by a DOD psychiatrist and mental health records (private and VA) dating back to xxxx also show that multiple mental Health providers have diagnosed and treated PTSD. Although the veteran experienced some symptoms immediately following the assault (bed wetting, night terrors), these symptoms largely resolved by the time he was in middle school due to reported "traumatic amnesia." His only residual symptoms throughout the remainder of middle school and high school were associated with a chronic mistrust of others and related social detachment. His enlistment exam was silent for any relevant concerns, as were STRs from the time of his enlistment in xxxx until the first disclosure of the assault and associated symptoms in xxxx and xxxx. Thus, there is no evidence to suggest that the veteran was experiencing clinically significant symptoms of PTSD prior to his enlistment and thus the question of aggravation is moot. Records clearly document onset of symptoms while the veteran was on active duty and indicate chronic trauma-related symptoms and impairments since then. 2. The veteran's current mental health symptoms also meet DSM-5 diagnostic criteria for Major Depressive Disorder (MDD), Recurrent, with Mood-Congruent Psychotic Features, secondary to underlying PTSD. His current depressive symptoms are a continuation of those first diagnosed in service as Dysthymic Disorder, and the veteran has been treated for MDD by multiple mental health providers (private and VA) since at least xxxx. As indicated above (Rationale #1), there is no evidence to suggest Clinically significant symptoms of depression prior to military service, and he was first diagnosed with a depressive disorder while psychiatrically hospitalized in service (xxxx). Subsequent records indicate chronic problems with depression since his discharge from active duty. 3. The veteran's history is suggestive of some underlying Personality features which are likely contributing to some of his on-going concerns (e.g., schizoid and avoidant features). Although he was diagnosed with a personality disorder in service, there is insufficient evidence to warrant a personality disorder diagnosis at present, as some of his on-going symptoms can be attributed to underlying PTSD (e.g., mistrust of others, social/interpersonal detachment, avoidance of intimate relationships). 4. The veteran showed no signs of significant exaggeration/feigning or minimization of mental health symptoms on objective testing, during the interview, or when comparing his self-report to the evidence in the record. As such, information from this evaluation is believed to be an accurate reflection of the veteran's current mental health concerns and relevant background.
  14. I went online to EBenefits this morning to see if nothing changed after my C&P last month. It said claim closed and Decision letter sent. After checking around I found a 70% rating for PTSD and MDD and a 3/15/17 effective date which was when I filed my claim. I hadn't set up banking info yet so I did that. Some questions: 1. Will they mail a retro pay check since I didn't have banking set earlier? 2. I know I need to wait for the letter but is EBenefits usually accurate with the rating? 3. Is there a certain day of the month VA sends payments (Like social security is always at the start of the month) or is it the claim date each month? 4. Where can I find information on how my VA class will change? I was class 8 before (big copays). 5. I have a very good private therapist I'm paying for myself. Now that I'll have a rating will the VA pay for him or do they only cover their own therapists? Thanks for the help! JW
  15. After failing a sleep private study and required to sleep with a CPAP machine and meds, my private psychiatrist wrote me a NEXUS letter linking the sleep apnea as secondary to the PTSD. Also I had my Dr fill out a DBQ also linking them together. I have been waiting on them to send me info on when to go to a C&P exam but nothing yet. So I called my Veterans Services Rep and they looked it up and said they see where the information has been sent out for a medical opinion. any idea if this means NO C&P or if they are looking info to see if they will even schedule one? thanks!
  16. 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.
  17. I am rated at 30% for PTSD and I have other things pending but after returning as a door gunner in Desert Storm, I started having severe headaches and TMJ. Both have been diagnosed and DBQ done by my medical Dr stating more likely than not related to the PTSD. I have an upcoming C&P exam with QTC for my diagnosed Bruxism, related to PTSD. I have broken several teeth from grinding at night and just broke another crown that they will see on Monday when I go in. Anyone else ever dealt with this or have any advice? I sleep with a mouth guard but I am on my 3rd one right now after chewing threw the first two. I also have been diagnosed with Sleep Apnea and sleep with a prescribed CPAP machine.. Any advise is appreciated. Semper Fi!
  18. Success at the BCNR

    Hello Hadit members, it has been a while since I posted. I believe that my last post was regarding an Earlier Effective Date NOD that I filed in 2015. I received the SOC last year, submitted my Form 9 this year, returned it and am now waiting to be certified to the BVA. A little background: https://community.hadit.com/topic/63190-70-service-connected/#gsc.tab=0 https://community.hadit.com/topic/63830-what-evidence-is-needed-for-an-eed/?tab=comments#comment-386303&gsc.tab=0 I sent a letter requesting a discharge upgrade in 2015 at the same time that I submitted the NOD. However, I did not file the proper form and never got a response. This year, due to another process that is going on, my General Under Honorable - Personality Disorder discharge came up again. At that moment, I realized that although its seems that I have not been affected by the stigma attached to that reason, when it comes to official business, it does harm veterans. The same day that I submitted the Form 9 for my appeal, I took the initiative to make copies and submit almost identical paperwork to the Board of Naval Corrections to have my discharge upgraded. On June 11th, “in the interest of justice” a decision was made and I am now an honorably discharged veteran (characterization). The narrative is being changed to Secretarial Authority and the reinlistment code was changed to RE-1J (Eligible to reenlist but elected to separate). I did not receive the letter because it was sent to my old address, but after many calls, bad numbers and full mailboxes a wonderful lady took the time to speak to me and personally forwarded me the information last week. I just want to say that I have spent countless hours online here at Hadit and other sites, reading BVA cases, reading WARMS, 38CFR’s, speaking to other veterans and watching Chris Attig and other videos on YouTube to get a good understanding of how the various processes work. I have decided that if I win this EED appeal then I will believe that I am able to help other veterans with their claims. I have done my share of sharing websites, videos and posting information on social media but I do not have the confidence to help on a larger scale. I am afraid that I will mess something up. Will I ever be a VSO? Probably not but at least I will be able to guide someone in the right direction. I just wanted to write this to encourage others to never give up and keep fighting for what’s right. I know that we all have had struggles with the VA but do not give up. It took me over 21 years to get service connected and over 26 years to get up the nerve to apply for the upgrade. Please please do not give up. I have been a member of Hadit for almost 10 years and although I do not post much I am always on or sending others this way for help. Love and hugs, txcooper aka 1994 and counting
  19. Mailed off my PTSD secondary to MST on Monday. I don't know where to go from here. My life is falling apart around me. My marriage is on the rocks, my work is suffering. I've been in therapy at my VAMC for 2 years now. I don't know if I will survive. I got a letter that the VA wants to reduce my back...I can't deal with that, and this...and I'm at my breaking point. On January 23rd my life changed forever. I had sexual assault reporting and prevention training at work a few days earlier, which triggered my memories. They had been blocked. I had always thought what happened was consensual gay sexual activity...at least that's what that predator had told me he would say if I talked. And that he would kill me and hide my body in the woods. I have been having memories drown me ever since that time....I have 37!!!!!!!!!!!!!!!! years of sexual, child sexual assault, physical assault, domestic violence abuse.....how the crap am I even still alive??????? I know I can't talk about anything that didn't happen during my service years. So that limits me to 4 sexual assaults, 2 by females and 2 by same male predator. The last was a drunk female Sailor while I was on deployment. She tackled me then began assaulting me. She was drunk off her butt, and I was automatically the perpatrator...sober male Marine, versus a drunk female Sailor...who do you think is guilty??? I can't comprehend...37 years of garbage history in the last 10 weeks....I am utterly worthless
  20. Good Evening Everyone! Okay I have a few questions regarding my Disability claim as well as my husband. First let me start off by listing all my service connected disabilities: 1.) PTSD-100% 2.) 60% Asthma 3.) 50% Migraines 4.) 50% Endometrosis with IBS 5.) 10% Eczema 6.) 10% Rt. Knee 7.) 10% Left Knee 8.) 0% scar left breast 9.) 0% hernia 10.) 0% rt breast scar I'm currently rated 100% SMC S and I'm paid at the housebound rate. I'm a little confused. Another veteran told me I should be rated L or L1/2 because I was getting paid the housebound rate prior to Migraines and Asthma being increased from 10% to now 50% and 60%. Is this true? I read on one forum (can't remember where) that I should receive the letter S and 3 K's which ultimately equals L. Just confused. Also, my husband was medically retired due to Lupus. He's currently rated at 100% for Lupus and 100% for Depression. I recently applied for Aid & Attendance because with two kids and my own disabilities (no family within 2 1/2) its extremely hard. When he has flares he can't do anything. He has flares anywhere from 2 to 3 times a month lasting anywhere from5 to 7 days. His civilian dr filled out the Aid & Attendance form and explained how bad he needed this benefit. Well of course the VA denied it. They stated Aid & Attendance is for someone in regular need of assistance. They also stated since he can walk with a cane 25 ft he doesn't need it as well. I'm really at the end of my rope with the VA. To add insult to injury, when I filed a claim for his kidenys (he has stage 3 kidney failure) they said that falls under Lupus. I understand if I opened a claim regarding back, joint or neck pain, but Kidney failure! We have a two young kids and we will make due, but I can't make it to my MST meetings unless I have someone here with my husband. Sorry, folks I had to vent. Please help
  21. My apologies in advance if this question has been asked before. I searched the site and could not find the answer. I am 80% but rated at 100% IU. 70% PTSD and 30%Recurrent Shingles I want to try working again as I have difficulty maintaining employment due to my PTSD. My Psychologist and Psychiatrist also suggested that I try working again as well as it may improve my mental health and assist in me overcoming anxiety and social phobias. I've lost 5 jobs in the last 11 years due to exacerbation of my symptoms. I will be requesting an ADA accommodation due to my PTSD. (I have been applying for a position at the local VA hospital. ) I am a Registered Nurse and I usually make a descent hourly wage. Does an accommodation under the ADA qualify as employment in a protected environment?
  22. I was awarded 70% PTSD, 10% Tinnitus, and P&T Unemployability June 2013. A couple days ago I get a VA Form 21-4140 (Employment Questionaire ) from the RO. I did do some part time work last year which amounted to around $4000.00 total. I did this to help supplement my disability income so as to help pay the debtors . I did the work on the up and up and claimed the income on the IRS grab ("Render unto Caesar.......), so as not to get in any trouble with them. Do I have anything to worry about? My wife says I should just quit locating and doing odd jobs. I don't want to jeopardy losing the benefit as it does help me to keep the wolves at bay. Anxiously awaiting your advise. Ralph
  23. I was diagnosed at 70% for "Adjustment disorder with depressed mood and insomnia". My doctors have told me that i have PTSD, so I'm filing a new claim with VA. Can I be back paid to when I was diagnosed with the above disability, since I've really had PTSD this whole time?
  24. Hi everyone! Hope all is well. I just wanted to stop in and say hello. I haven't been on here since late last year. Life is going good. As most know my story and it was a doozy, I finally got everything I deserved! Overall 90% and I couldn't be happier. It took a lot of hard work and sleepless nights and a lot of C&P exams and fighting the VA but I prevailed. I was thankful for this sight b/c without it I would have never met a great guy that helped me with the final phase of my rating. I am now just waiting on an EED for my contentions but I am really not really worried about it and if it happens great and if not, I am good. Don't give up EVER!
  25. Hello everyone, I served in OIF at the onset of the war from 3/2003 - 4/2004 as a front line medic.I also did a tour in 2008. I am currently 70% PTSD/Major Depression, 20% Cervical Radiculopathy and receiving 100% IU P & T as of 5/2013 but have been receiving 100% IU for my PTSD since 2/2010 . I also receive 80% CRSC for both of those conditions since 2013. I was denied service connection for asthma/COPD and Sleep Apnea. Since 2013 new information, and I assume evidence, has come out to establish burn pits as a cause for COPD and that sleep apnea can be a secondary condition to PTSD. My question is 1. Should I attempt to get these two conditions service connected with the goal of a 100% scheduler rating rather than IU or will that most likely adversely effect what I have now? 2. Is sleep apnea secondary to PTSD and COPD linked to burn pits, combat related? So I can keep my CRSC or possibly get it increased?
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