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  1. Bare with me as I have done all this work myself, so if I don't have a specific answer or know an abbreviation. All I ask is you give me some time to look it up cause I am not well versed in VA lingo. I completed a Higher level review (This apparently means sometimes you get a more experienced person, I explained to her all the issues I have been having and she basically said, I will send this back down so they can fix it and she said she has everything she needs to increase my Bell's Palsy which was at 0% and she changed it to 10% She told me she would have to issue me a couple more exams. They are specifically for IBS and Mental Health. The exam package from QTC for the Psychology exam does not mention a specific condition. (This would be my third mental health exam) The initial application was in 2019 and included depression and anxiety. I submitted a 2900-0659 as my stressor. The second exam from qtc came back and said "PTSD with ADHD" so my claim for "PTSD" was denied. On the latest Denial letter, I have the following line items. Depression,anxiety and sleep problems (listed as one condition) Post traumatic stress disorder with attention-deficit hyperactivity disorder, predominantly inattentive type. (VA Doctor thinks I must have seen a child psychologist cause he said and I quote "That's the most insane diagnosis I've ever heard of) The QTC package for IBS is with a nurse practitioner at a clinic in town. So is the duty to assist for all of my conditions based on the fact that the previous examiners did not do there job?
  2. Anyone know of an individual whom I can speak to who can get more information about my claims? It’s being held up and no one knows why from the VA 1-800 number does anyone have an insider that can help? Thank You
  3. I have attached my denied claim for migraines. I have many docs I can attach. I.e buddy letter from my mother ( fractured skull prior to military), and also squad leader that mentions bad landing on military jump service connection ( knocked out). Military entrance exam showing fractured skull. VA NEUROLOGIST stating service connection. Sick call slip headaches. There is more but post. But I’ll start with the ones attached. I don’t understand the reasoning for denial . They have rated me earlier with SSD. Aalso they show a history of risk factors … and if you look at my disabilities the denied me hypertension , musculosketal pathology of the cervical spine and chronic opioid use (because of my service connection disabilities) … is that not oxymoron.. no pun intended. Did I make a mistake filing as a secondary to ptsd? I could have filed for a Tbi service aggravation.. but if they won’t service connect me for this than who knows. Any input would be great. I won’t post everything I have but this seems to warrant service connection if I did not redact anything please let me know.
  4. Hi, So what do you understand from this? photo in the Link - https://ibb.co/5Wm84vD I already got a diagnostic recently after the letter, So if I send the Diagnostic as a supplemental would they come back denying due to no nexus letter? Or is the nexus already covered? Also 3rd paragraph - the medical evidence support the conclusion that a persistent disability was not present. - would this be the next reason for a denial? how you overcome this? Around November 2007 I was in Afghanistan in the process of being medically transported to Germany and then WalterReed for another condition, I believe I left WalterReed around January or late December and that part of the favorable finding. When I complained of headaches. This last March 2021 I went to the VA Emergency Room due to strong headaches. I rarely go or complain I just pop some Tylenol or Ibuprofen and call it. Now I am taking Migraines medication Sumatriptan given to me by the VA. trying to get as much advise as I can before I send a supplemental claim. Thanks.
  5. I was wondering if anyone else has experienced this, but I have email chains with a veterans claim representative where they refused to SUBMIT my claim because they said it would not be something I could claim. I ended up submitting my claim myself, then submitting to higher level review and it looks like my claim is getting approved. If I had not been tenacious and listened to the VA rep that wouldn't even submit my claim, I'd be out thousands in backpay and a rating. Has anyone experienced having the VA refuse to file the claim? I started thinking about how many vets this could have happened to...shut down before they even submit!
  6. Hello, I got a denial for headaches and I'm not sure what it is saying. When I read it I think it's contradicting itself. Could someone please help me understand what it says? Also there are a lot of other times I reported headaches after service which are all in my VA medical records that they did not mention in denial so I'm thinking they didn't actually read my file? This is from the letter. Service connection for headache condition. Service connection may be granted for a disability which began in military service or was caused by some event or experience in service. (38 CFR 3.303) While your service treatment records reflect complaints, treatment, or a diagnosis similar to that claimed, the medical evidence supports the conclusion that a persistent disability was not present in service. (38 CFR 3.303) We did not find a link between your medical condition and military service. (38 CFR 3.303) The evidence does not show that your disease developed to a compensable degree within the specified time period after release from service to qualify for the presumption of service connection. (38 CFR 3.307, 38 CFR 3.309) Service connection for headache condition is denied since this condition neither occurred in nor was caused by service. (38 CFR 3.303, 38 CFR 3.304) Favorable findings identified in this decision: Service treatment record dated January 26, 2005 and July 25, 2007 shows headaches. Medical record dated January 13, 2020 from Canandaigua VA Medical Center shows headaches. You have sufficient service to meet the minimum requirements for presumptive service connection. The claimed disability is a chronic disease which may be presumptively linked to your military service.
  7. I submitted a claim for Sinusitis, OSA,, and Tinnitus. My claim was denied for all 3. The tinnitus they claim was neither occurred in nor was caused by service. My job on active duty exposed me to gun fire, explosions, tanks, and tracked vehicles. I submitted the Duty Noise Exposure Spreadsheet that displayed my AFSC was rated as highly likely to be exposed to loud noise. In the first Exam they claimed I said my hearing loss was from jets flying overhead. Never said that, so they scheduled a second exam. This one they acknowledged the correct job but I was still denied. The evidence listed on the second decision dd not include the MOS Noise exposure chart I included on the first claim. I never went to sick call for ringing ears because that is just silly (had I known then) and was not something you did. I have had quiet office jobs since separating from The Air Force. What am I missing? For the OSA claim, I submitted Lay statements from my current wife and my ex-wife as well as explained to the doctor my symptoms and that when I was on Active Duty i had no idea sleep apnea was a thing. I assumed I just snored and was tired because I was working hard. I had a sleep study this past year and was deemed to have severe OSA. In my claim I listed that I believed my osa was related to my cluster headache disability. They responded Cluster headaches do not cause OSA even if there are many people with cluster headaches and also OSA. I experienced a stuffy nose during my headaches on the left side. This was completely different from the closing of my airway when I would sleep. It was just worst if both occurred at the same time. They claimed I have other risk factors such as being male, obesity, and advancing age. Something I did not include in my claim was the fact that I was on the Fat Boy program at one point on Active Duty and my SMR made a reference to obesity. Would this help support my claim. Also in the second decision they said I was a 73 year old male and I am no where near 73 so they probably mixed my records with someone else. What can I do about this? And Sinusitis, I have a couple diagnosis in my SMR's specifically listing sinusitis. I have had sinus issues since I was on Active Duty. I use a Netti Pot and have been diagnosed post active duty with sinusitis. The DBQ from the QTC Medical Doc claims I have rebound sinusitis because I mentioned using Afrin. I have always been aware of the danger of over use and in my VA records I discussed this concern whenever the VA would prescribe a nasal spray. What am I missing and how can I get this corrected. The errors on the 2 decisions make it seem as if they are not very organized and I have to suffer from their disorganization. Are they supposed to review all of the evidence from the initial claim when you submit a supplemental, or should I have resubmitted all the documents from the initial claim. Are the documents that contain research that supports your claim supposed to be on the evidence list as well? They were not on there and if they did not give those documents equal consideration what is my recourse. Any assistance would be appreciated Thanks for listening.
  8. Hello everyone and thank you for accepting me in to the forum. Last year I filed a new claim for Generalized Anxiety Disorder and Major Depression. For the past 3 years, I have been seeing a civilian psychiatrist for my anxiety and depression. She had already diagnosed me with GAD and Major Depression, and I have been on anti-anxiety medications, antidepressants, and sleep medication. I was on differing types of the same medications since coming out of the service, but it wasn't until about 3 years ago, that I admitted to myself that I needed mental help, and that is when I started seeing my civilian psychiatrist, and that is when I first heard of GAD and Major Depression, when she said she had diagnosed me with them. It was at her suggestion, that I file a claim with the VA for GAD and Major Depression. She said she very much felt like my conditions were associated with my time in the service. When it was finally time to have my C&P exam, I was interviewed by a VA psychologist. I told her about my civilian psychiatrist, and her diagnosis for me, and the medications she had me on. I also talked to her about my time in the service, me being overseas in the Gulf War, and me being in a humanitarian mission in Ecuador. I told her about my friend who was with me during basic training. And how he was shot and killed right in front of me, in a horrible accident, during one of our live ammunition training exercises. I told her how all this had affected me from those moments on, all the way until now. At the end of our meeting, she told me that she felt like my condition was more PTSD, rather than Generalized Anxiety Disorder and Major Depression. At the time I didn't think anything of what she said; that is until I was sent my denial letter. In my denial, it stated that my 2 claims for GAD and Major Depression, was changed to GAD (to include PTSD) and Major Depression (to include PTSD). So the VA psychiatrist did what she said she would. She essentially changed what I had claimed, and added (to include PTSD) on each of my 2 claims. So, for the basis of PTSD, there has to be a proven stressor. The VA used what I had talked to the psychiatrist about the death of my friend during boot camp, as my stressor. The VA said they searched records during the time I was at boot camp, and found no incidents related to what I was saying. So, because the VA psychiatrist took it upon herself, to change my claimed conditions from GAD and Major Depression, to GAD (to include PTSD) and Major Depression (to include PTSD), now it was up to me to prove a stressor, because with claims associated with PTSD, you must prove your stressor. I knew from talking to other Army buddies of mine, how difficult it could be sometimes to find old records of deaths. The death of my friend during boot camp happened in 1962 at Ft. Jackson, SC. My civilian psychiatrist never suggested to me that I had PTSD. She always said it was Generalized Anxiety Disorder and Major Depression. If I had wanted to file a claim for PTSD, I would have done so. But I knew how difficult it would be for the VA to search for and find any record of the death of my friend at boot camp. So I filed GAD and Major Depression, because I was told those claims did not require a specific stressor (exact time, place, person, etc). I was told that GAD and Major Depression, could be claims based on your entire military career, with everything you've done and everything you've experienced, all amounting to intense anxiety and depression. So that is why I claimed GAD and Major Depression, over that of PTSD. But because the VA psychiatrist took it upon herself to change my 2 claimed conditions, and added the words (to include PTSD) to each of my claimed conditions, it was not just GAD and Major Depression any longer; it includes PTSD, which requires a specific and provable stressor. I had a stressor, and very specific one - the death of my friend during live ammunition exercises during our time at Ft. Jackson, SC boot camp in the summer of 1962. But the VA said neither they nor the JSRRC could find any record of that taking place. If my 2 claims had remained what they were suppose to be, simply GAD and simply Major Depression, I do not think I would have been denied. But because the VA psychiatrist added PTSD to each of my conditions, the VA asked for my stressor, the VA and JSRRC said they could find no record of my stressor, so my claims were denied. I believe I would have been approved if not for the VA psychiatrist adding PTSD to my 2 claimed conditions. So with all that said (and I apologize for the length of it), is there any hope for me, if I appeal my denial? And do any of you know how I would go about appealing it? Would I simply say to the VA that I disagree with the VA psychiatrist adding PTSD to my 2 claims, when I never claimed PTSD myself?; that that was her decision entirely. I have had a VA Disability Representative for the past couple of years, but he was utterly useless. He never answered my calls or emails. He basically never helped me at all. I did most all myself over eBenefits. But now, since I've had this recent denial, I have considered hiring a VA Disability Law Firm to take my case. I've spoken with 2 so far. They both told me I had a very strong case and that I could win. But they also said they couldn't take my case because of their huge client load. I think it was simply that they could probably win my case, but there wouldn't have been much in the line of backpay, so they wouldn't have gotten much compensation for their work for me. So I guess I will continue searching for other VA Disability Lawyers, or I may have to appeal my denied claim myself over eBenefits. Could any of you, please help me with this? I have read many questions on here regarding GAD and Major Depression, but I haven't come across one yet, where they filed a claim for GAD and Major Depression, and then the VA psychiatrist during the C&P exam, decided to change the claim (to include PTSD), thereby changing the criteria for acceptance, by now making me prove a specific stressor, instead of it she had just left my 2 claimed conditions alone, without including PTSD to them, then no specific stressor was required - it would simply go by your overall experiences while in service. I am a 20 year Veteran by the way, with most of my time served in the National Guard. But I was activated numerous times during my 20 years, including during the Gulf War. It isn't my fault that the death of my friend during boot camp, isn't something the VA or JSRRC can locate in records. If the VA psychiatrist had just left my 2 claimed conditions alone, instead of tacking on (to include PTSD), then the VA wouldn't have even had to search for a specific incident, they would have just based my conditions on my overall military experiences. Thank you for any help, assistance, or advice you might be able to give. Donald
  9. Hi all! Just found this site and from the looks of it there are more answers here than with the VA or with my VSO, so here goes. Several months ago I filed for asbestos exposure issues arising from Naval Service (old snipe on an older no longer existing aircraft carrier). Everything I've read and printed out for future use, notes that evidence of asbestos exposure typically doesn't rear it's ugly head for 30- 50 years. Which it has in my case. Lung fibrosis, calcified and non-calcified pleural plaques and a small lung (possibly benign) lung nodule all revealed initially poorly via an x-ray and later better identified by a CT scan. All on my dime. I thought I'd just have to grin and bear it until a Vet informed me about it being related to my naval background so I filed with the VA using a VSO. (I should point out that as of yet I do not have lung cancer, mesothelioma or asbestosis.) Two things. I get my response from the VA and they tell me that because I didn't file within one year of discharge (1968) I couldn't file for prostate cancer, which I have been operated on for this year, and still have some residuals that I'll probably have for the rest of my life. Then, they inform me they want a C&P exam, by a contractor, performed regarding my "pleural plaques." (Pleural plaques are evidence of asbestos exposure causing the moderate lung fibrosis and the lung nodule. The only concentrated asbestos exposure I had was during my Naval enlistment.) So, I went in to the C&P with print-outs noting asbestos exposure has a long latency period, how it can cause pleural and calcified and non-calcified pleural plaques, as well as a copy of my CT scan. The doctor could have cared less. He actually pushed away the paperwork I had brought with me. He never took vitals. Nothing. I was there to get a chest x-ray (not worth a crap compared to a CT scan) and to take a pulmonary function test. He opted not to do the x-ray when he glanced at my CT scan report, that he had previously pushed away, spoke out loud more to himself than me, stating, "I can use this." And, pretty much dismissed me, stating as he walked out the door that his report would be done in two or three days. Oh, and the chest x-ray was never done. The "nurse" then did my PFT exam. I either flunked it or failed it so miserably, she gave up after administering the test five (not three) times in about as many minutes. Simply put, I ran out of air, I guess, faster than she thought I should. Every time I took the test I happened to cough into the tube as I ran out of air. Twice. She said the machine read that I was coughing not exhaling. I told her that I was out of air by that time and of course I was coughing. So then, she let me hold the machine, I took a deep breathe, exhaled and as I started to cough pushed the machine away from me so I didn't cough (heaven forbid) into the tube. I did that three times and by then I was about to pass out. She ultimately left the room and came back in a few minutes later letting me know I could go. As to the prostate cancer, I have found several internet articles from medical sites that link asbestos exposure and prostate cancer and have proffered them with my Request for Reconsideration. Assuming this request takes months for yet another denial, does the time it take for their reconsideration adversely impact the year I have to file either a NOD or an appeal? Any like cases or suggestions out there?
  10. my husband was 70% PTSD with GAF score of 50% Viet Nam Vet.. He was killed by the VA 41/2 years ago, and so I receive Pension on those grounds. But before "They killed him" we had 3 claims pending: Agent orange : (needed to prove in contiguous waters) They are denying AO because he was on a ship and a "Secret Mission" so very hard to get verification. (waiting on C-Files). Aid and Attendance : ( I took care of him for several years) A&A : Outright denial.. He was on oxygen, 80 pills a day and 5 shots a day.. I also have recorded (from another non VA hospital.. he could not take care of any daily activities. So why the denial.. We were denied twice before he died. TDIU : back pay since (at least) PTSD rating. Beyond, because of Gross negligence on the part of the VA (Not including conceeding his death) which has all been very well documented. WHAT I NEED TO DO NOW IS!! figure out how to remove an old Social Security claim. (back trouble, of which he was receiving care for at the Va) but it should not "Supersede" his claim for TDIU.. (of which we had not been receiving any monies for, for a very long time. I don't know how to move forward. How would I get it removed or make the VA not use the SSI to deny his Unemployability claim??? I don't think going to SS office would be beneficial because it has been a "Mute" point with them for a long time.. So I am assuming it would lie somewhere within the VA system. BUT WHERE?? WHO?? and HOW??
  11. If a c and p examiner checked the box stating it was an in-person exam, and it was not. Is this good enough for appeal for remand or reversal?
  12. Does this sound or look right to anyone? Denied TDIU... ========================================================================= Date/Time: 20 Jun 2017 @ 0800 Note Title: C&P MENTAL DISORDER Location: Chalmers P Wylie VA Outpatnt Signed By: HOULE,ALLISON C Co-signed By: HOULE,ALLISON C Date/Time Signed: 20 Jun 2017 @ 1641 ------------------------------------------------------------------------- LOCAL TITLE: C&P MENTAL DISORDER STANDARD TITLE: MENTAL HEALTH C & P EXAMINATION CONSULT DATE OF NOTE: JUN 20, 2017@08:00 ENTRY DATE: JUN 20, 2017@16:41:06 AUTHOR: HOULE,ALLISON C EXP COSIGNER: URGENCY: STATUS: COMPLETED *** C&P MENTAL DISORDER Has ADDENDA *** Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire Name of patient/Veteran: xxxxxxx 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 been diagnosed with PTSD? [X] Yes [ ] No 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder ICD Code: F43.10 Mental Disorder Diagnosis #2: Opioid Use Disorder, Severe, In early remission, on maintenance therapy ICD Code: F11.20 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A) If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: The veteran's symptoms are primarily related to his PTSD since he has not used substances in more than six months. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [X] Yes [ ] No [ ] No other mental disorder has been diagnosed If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: The veteran's impairment is related to his PTSD. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] 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 Evidence Comments: The veteran's electronic medical records (CPRS & VistAWeb) and military records (VBMS) were reviewed. The veteran was referred for a compensation and pension examination. The veteran was informed verbally of the nature and purpose of the examination and confidentiality limits. He appeared to have a basic understanding of the purpose of the examination and confidentiality limits. He was provided with a chance to ask questions about the evaluation procedures. All questions were answered to reasonable satisfaction or referred to other resources. He was informed that this examiner is not his treating clinician or the legal determiner of compensation or pension benefits. Instead, he was informed that this examiner is an independent provider of clinical information and expertise to assist those who review and make legal compensation and pension claim decisions and would not be participating in her healthcare. He was given information about the Veteran's 24-hour Crisis Line. The veteran indicated understanding of these terms and explicitly and freely consented to the evaluation. The judgments of symptoms and opinions in this evaluation report are offered to a reasonable degree of psychological certainty and are only based upon the information available at the time of the evaluation. This report was dictated using Dragon Naturally Speaking dictation software. The report has been proofread; however, there still may be some typographical errors due to the nature of the dictation software. The veteran began participating in recovery services at the VA in May 2017. His last group note was dated 5/31/17. A note dated 2/26/17, by Dr. Laurie Berger, indicates that the veteran began therapy at the Vet Center in October 2016. He attends therapy on a weekly basis. He attended six sessions with Dr. Berger when this note was written. The veteran was initially evaluated for a C&P exam by Dr. Janine Schroeder on 3/22/17. 2. Recent History (since prior exam) ------------------------------------ a. Relevant Social/Marital/Family history: The veteran was born and raised in xxxx. He was raised by his mother and father until they divorced when he was 7 years old. The veteran then lived with his mother until he was 14 years old. The veteran's mother remarried when he was 11 years old and he reported that he did not get along well with his stepfather. He went to live with his father at 14 years of age due to being disrespectful towards his stepfather. The veteran has one older sister and one younger brother. The veteran's father did not remarry, but he was in a relationship with the same woman for 20 years. He reported physical abuse by his father throughout his adolescent years. He recalled one incident where he got a black eye after his father hit him. He denied any Child Protective Services involvement. The veteran describes his father as emotionally absent. His father died in 2007 from a heart attack. The veteran is a 36-year-old, divorced male. He was married in 2001 for five years and divorced in 2006. The veteran reported that they divorced due to his drug use. They have a 1X-year-old daughter together. His ex-wife and daughter live in xxxxx. He maintained some contact with his daughter, but has not seen her in several years. The veteran reported that he was involved in a relationship for a few years following his divorce. They are no longer in a relationship, but are close friends. The veteran reported that he has spends time with three friends from high school. The veteran stated that he enjoys gardening. b. Relevant Occupational and Educational history: The veteran reported that he did not enjoy school and did not want to do the work. He frequently skipped school to go skating. He stated that he would "have a few beers and smoked pot" when he skipped school. He reported being suspended several times for truancy, fighting, and disrespect towards teachers. He was never held back a grade. He was expelled his junior year of high school due to nonattendance. He earned his GED in 1997. The veteran worked for his father from 1997 until 1999 doing ironwork. The veteran enlisted in the Navy in October 1999. He reported several disciplinary issues while in the service related to going AWOL, being late, and underage drinking. He reported that the sexual assault occurred in the summer of 2001. The veteran received a general under honorable conditions discharge in September 2001 for misconduct. The veteran worked in Virginia Beach beginning in September 2001 doing ironwork. He worked at a company for one year and was fired due to not showing up for work and using alcohol and drugs. He then worked for Roofing Services Incorporated from September 2002 until August 2003. The veteran then earned his tanker men certification, z card, and AB certification to work on tugboats. He worked on boats from September 2003 until March 2005. At that time his wife left him and he moved back to Ohio to be closer to his family. The veteran continued working on boats in Ohio until the summer of 2005 when he got fired. The veteran was incarcerated from 2006 until 2016. After his release from prison, he worked with friends doing landscaping and painting. He began working at ABS Money Systems in January 2017, a company that his mother owns. The veteran reported that he was working 30-40 hours per week for the first two months. He stated that his hours have declined significantly since March and he is currently working 5-6 hours per week. He stated that his work has declined due to his mental health symptoms. However, according to the initial C & P exam, "he is unable to do a lot for her because she works serving ATM machines in banks and with his record he isn't allowed to work in banks." He also reported that his employment since the military has been "short-lived due to his drug and alcohol use." c. Relevant Mental Health history, to include prescribed medications and family mental health: The veteran reported that he was diagnosed with ADHD during childhood and received treatment. The veteran reported a suicide attempt in 2001 after he was discharged from the military. He began attending treatment at the Vet Center in October 2016. He reported that he attends individual therapy twice per week with Dr. Berger. The veteran described his mood as "anxious, paranoid, and depressed." He stated that he feels as though he "can't get a break." He reported having passive thoughts of suicide, but stated that he does not have a plan or intention to kill himself. He stated "I couldn't do that to my family." He stated that he has had difficulty dealing with his emotions since he is no longer using substances and does not have an escape. He stated "I don't have the coping skills." He described having difficulty sleeping and stated that he does not sleep every night. He stated that he is not feel safe in his bed. d. Relevant Legal and Behavioral history: The veteran reported that he had several misdemeanor offenses as a juvenile, including truancy, driving without a license, and theft. He reported that he was arrested for selling drugs at 18 years of age and was placed on probation for one year. According to the previous exam, he was arrested numerous times from June 1998 to September 1999. The veteran was convicted of armed robbery for robbing three pharmacies with a weapon. He served a 10-year prison sentence beginning in October 2006 and was released in September 2016. He is currently on parole for five years. e. Relevant Substance abuse history: The veteran reported that he first drank alcohol at 10 years of age. He began regularly drinking alcohol during high school. He began smoking marijuana at 15 years of age on the weekends. He also experimented with mushrooms and pain/anxiety medication that he took from his father. The veteran's alcohol use increased significantly while in the military. He denied using any drugs while in the service. After his discharge from the service, he continued using alcohol and marijuana. In 2002, he began using narcotic pain medication. He also began using heroin and reported that he eventually used heroin intravenously. The veteran reported using substances throughout his time in prison. He reported that he has been clean from drugs and alcohol since October 2016. He has maintained sobriety using Suboxone. He currently attends AA meetings approximately once per week. He attends substance abuse groups at the VA twice per month. f. Other, if any: No response provided. 3. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors). 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 #6 - "Other symptoms". Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violence, in one or more of the following ways: [X] Directly experiencing the traumatic event(s) Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion 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). Criterion 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, 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). [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] The duration of the symptoms described above in Criteria B, C, and D are more than 1 month. Criterion G: [X] The PTSD 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] Chronic sleep impairment [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships 5. Behavioral observations -------------------------- The veteran arrived 10 minutes late for his appointment and was pleasant upon meeting. The veteran was oriented to person, place, situation, and time. His grooming and hygiene were adequate. He made appropriate eye contact and presented with a depressed mood with a congruent affect. His speech was within normal limits for tone, volume, and rate. His thoughts were logical, linear, and goal-directed. He did not evidence any psychotic symptoms, including responding to auditory or visual hallucinations and delusional beliefs. On a brief mental status exam he was able to freely recall two of three words presented after a brief delay. He was able to recall six digits forward and three digits backward. He was able to complete a serial seven subtraction task with no errors to seven places. He was able to spell the word WORLD forwards and backwards. He was able to complete a two-digit addition and subtraction tasks. He was able to compare an apple and banana and was able to reason abstractly when comparing a poem and a statue. His response to the proverb "don't cry over spilled milk" was good. He was not able to provide a response to the proverb "people in glass houses should not throw stones." 6. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 7. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 8. Remarks, (including any testing results) if any: --------------------------------------------------- The veteran was administered a psychological measurement that is useful for interpreting the veracity of other data provided by an examinee during a psychological or neuropsychological examination. This assessment can assist in evaluating and making a clinical opinion regarding the veracity of an examinee's purported symptoms. Research has determined that this tool is a useful instrument to administer in order to screen for possible feigning of PTSD symptoms. The following results should be interpreted in light of the fact that the measurement that was chosen is a screening tool and not designed as a definitive measure of whether or not an individual is feigning mental illness. The Veteran's total score was not elevated beyond the cut-off score. Therefore, his PTSD symptoms are considered to be credible. The veteran was administered the Minnesota Multiphasic Personality Instrument-2-Restructred Form (MMPI-2-RF), which is a self-report psychological assessment used to identify a variety of psychological syndromes. The veteran was provided a quiet, private room to complete the testing. It appears the veteran understood the items and responded to the items in a consistent manner. The veteran over-reported psychological dysfunction, which is evidenced by a considerably larger than average number of infrequent responses. The veteran also possibly overreported symptoms associated with non-credible memory complaints. Although there is evidence of over reporting of symptoms, the profile is considered valid and will be interpreted. Overall, the veteran endorsed considerable emotional distress that is likely perceived as a crisis. The veteran reported feeling sad and dissatisfied with his currently circumstances. He reported a lack of positive emotional experiences, a lack of energy, and a lack of interest in activities. He also reported experiencing various negative emotional experiences including anxiety, anger, and fear. The veteran also reported a significant history of antisocial behavior. This behavior includes involvement with the criminal justice system, difficulty with authority figures, conflictual interpersonal relationships, impulsivity, juvenile delinquency, and substance abuse. The veteran also endorsed various unusual thought and perceptual processes. The veteran endorsed a diffuse pattern of cognitive difficulties including memory complaints. He also reported past suicidal ideation and feelings of helplessness. The veteran endorsed feelings of anxiety, being anger prone, and experiencing multiple fears that restrict his activity inside and outside of the home. He also reported being unassertive and shy. The veteran endorsed not enjoying social events and avoiding social situations. He also reported disliking being around people. On a scale of personality pathology, the veteran endorsed being self-critical and guilt-prone. He also endorsed being pessimistic and feeling depressed. The veteran is currently diagnosed with Posttraumatic Stress Disorder and Opioid Use Disorder, Severe, In early remission, on maintenance therapy. The veteran currently lives alone and is not involved in a romantic relationship. He maintains phone contact with his daughter. He has a close relationship with his mother, sister, and two friends. He is currently working for his mother's company. He reported experiencing symptoms of PTSD. He is attempting to cope with his emotions without the use of drugs. The veteran has been employed numerous times and has been fired for tardiness or alcohol and drug use. He is currently working 5-6 hours per week for his mother's company. According to the previous C&P exam, he is not able to work many hours due to not being permitted to work inside of a bank due to his felony record. The veteran reported that he was "working" during his 10 years in prison selling drugs. He denied having any difficulties while in prison. The veteran is capable of following instructions and performing simple tasks. He is able to concentrate on a simple task and respond appropriately to coworkers and supervisors. /es/ ALLISON C HOULE, PHD C&P Psychologist Signed: 06/20/2017 16:41 06/20/2017 ADDENDUM STATUS: COMPLETED The veteran presented for his appointment. The report from the C&P Exam was completed in Capri by Allison Houle, PhD; procedure code 99456 and 96101. /es/ ALLISON C HOULE, PHD C&P Psychologist Signed: 06/20/2017 16:42
  13. How do i proceed with this claim I filed in Nov 2016 which has been denied without a C&P exam or any communication from the VA. I currently have a VSO but they are completely useless so that is not an option, (when I informed my VSO that i intended to file this claim he said to me you are already rated 70 percent so why rock the boat?). Denial Letter 4-29-17.pdf
  14. Hi all, I am new here and wanted specific advice on my condition although I have read lots of other forums. This grammar will not be right, I'm sick, I'm tired, and I just want to get through this crap. I submitted a claim recently and it got denied. PTSD, partially due to MST, partially due to harassment and belittlement. I went into the service with no 'noted' conditions, although I am finding out through years of ongoing therapy i was abused as a child. Mind you, there were no "noted" abnormalities upon entry. I did say several times that at 9 i tried to hang myself...whicih i found out recently is a true memory. The denial was because the guy who did the report contradicted himself several times throughout the report and said I didn't have PTSD but I did and it was due to childhood trauma and that the PTSD I got in service was proven by XYZ that occurred in service, ultimate position,..denial. I do have a diagnoses of PTSD, I have gone through bouts of homelessness, unstable relationships, substance abuse (which I am afraid to report for fear of blame being put on use of acid and alcohol and marijuana), severe pain to include Degenerative disc disease (where my separation comes from, medically separated, honorable) IBS -almost died because I was so sick a couple of years ago and had dropped 60 lbs out of nowhere and the diagnoses was 'marijuana abuse'. severe weight gain in service, pregnancy scares, stds, body augmentation requests, sporatic marriage and divorce to a man i knew a number of weeks, poor evals and often reprimanded, the list goes on... i was called the barracks whore, i feel so much guilt and shame about it, i feel like the females were put in service so the males wouldn't terrorize the females. we were told we would be broken down to be built back up but the second half didn't happen. the only time i felt any worth was when i was sleeping with someone and 99% of the time i was so wasted i had no clue what was happening. i have put together spcific citations from the VA website of similar instances but I am going to be as thorough with this rebuttal as possible because this is stupid to have to go through again. I recently had my first baby with a husband who feels he got the short end of the stick in a wife and cps is involved because i am terrified i will hurt my 5 month old because of my anger outbursts. i cannot be alone with him. i am doing a voluntary thing with cps so i can get the healing and help i need so i can be a good mother to our son. So, what all should I include in my rebuttal?
  15. This is EXTREMELY humiliating but I don't know where else to go for anonymous help. Please be gentle, I'm not proud of my past. I had posted in the PTSD forum, but I can be more specific here since my issues stem from MST. I have some issues from my childhood, I do have a psych history including suicide attempt at age 9 (which I didn't even remember until after I was at my first duty station), verbally and possibly physically abusive step fathers (5 total), my mother walked out several times when I was a child and told my dad she didn't want me and wouldn't call me for months, my step-brother sexually abused me when we were around 7 years old, I was in a rehab center for teens for cutting myself when I was 12...I lost my virginity to alcohol induced rape at 17 and joined the marines about a year and a half later to make something of myself. I was involved in a party after boot camp when I was in my MOS school and a group of army guys passed myself and my drunk friend around at a party and had their way with us. I started having a lot of problems after that and became a heavy alcohol user and extremely promiscuous the next 4 years of my enlistment. Most of my encounters happened when I was too drunk to remember or even walk for that matter. I had been diagnosed with Borderline Personality Disorder about 4 months into my first duty station and I never reported to my psych doctors that I was drinking like I was...most of the time I denied I drank at all. I told them about what happened as a child but would never bring up things that were happening in service out of humiliation, guilt, pain, fear that it would get back to my command and I would be reprimanded or mocked or looked down on more than I already was. I was the 'barracks whore'. I was hospitalized several times in service and often had counseling from my command, got very overweight, caught chlamydia once and begged for hysterectomy and tubal procedures which were all denied. I had a restraining order from my gysgt for homicidal thoughts towards him and got married to a man i knew for a month to get off base. After I got a medical separation for my back I ended up homeless in Denver, on acid (which I won't tell my councilors now in fear that it will hinder me getting compensation for the PTSD from MST), divorced and remarried, hospitalized a few more times, and now I am involved with CPS because we just had our first child and I am scared to be alone with him because I get so angry. I am petrified of being around men, my sex life with my husband doesn't exist, my emotional problems cause a huge disconnect in our marriage that we are fighting to keep... My C&P exam states that I have BPD not PTSD and that what I said at the exam (which wasn't much at all) was inconsistent with what was reported over the years. I feel like the 'doctor' conducting the exam did the 'Develop to Deny' trick, he was contradictory in his report, made some false statements, and denied me. I told him about the first incident in MOS school, but apparently that wasn't enough for him to think that I was affected at all. I have around 10 buddy statements ranging from family and friends that knew me prior to service to buddies that I actually served with that were BRUTALLY honest in their reports. My therapist says I definitely have PTSD, but she can't differentiate what is from childhood and what is from MST. I don't know what to do, I'm afraid anything I say will be misconstrued and that I'm ever going to get my PTSD rating. Also, for the test portion my report says, "MMPI2RF-Invalid profile (F z=1.53, Fp z=2.15, Dsrf z=1.94); clinical scales cannot be interpreted." --what the heck do those codes mean?
  16. Guest


    I received a determination letter stating that my husband's stomach issues and liver tenderness would not have been a symptom of HCV noting that these started prior to Viet Nam, where he was wounded. He totally messed up the dates. Injury occurred 05/70 symptoms started 07/70 - shown in his medical records. One medical examiner stated that his medical records did not show he received a transfusion. That's because there are no records from his time in the hospital in Saigon. Maybe I should restate that-those records were requested beginning 1999, again 2001 by my husband and by me in 2016. None were ever produced. Would either of these qualify for cue? The VA made their decision, denial of course, after I had requested his c-file and again, the medical records from the dates he was in the hospital. I requested and extension, 30 days after I receive the info. Wouldn't they have to honor that request? Thanks Pat
  17. Good day to you all, I have a few questions concerning the appeal process as it concerns the decision, BVA, RO, and claim date that hopefully you all can chime in to help clarify. 1. When the BVA letter indicates a "complete grant" for sought benefits, does that mean award the maximum rating allowed? or just award and process? 2. Story Line - In my case, the BVA stated in my letter a few remands (for nasal related issues) and a "complete grant" for sleep apnea (Received the letter 5 days ago). The letter indicated my claim was through a credible lay statement (which described my condition while in service), DBQ from the sleep specialist (who indicated my symptoms started while in service from a nasal injury), and a sleep apnea study performed by VA post service in 2009. The letter indicated consistency of my condition. My claim for sleep apnea was entered in 2013. My question is in regards to the effective date. 2a. What is meant by the date entitlement arose? The va.gov website states "an effective date for service-connection for a disability that is directly linked to an injury or disease that was incurred or aggravated by military service is the date VA receives a claim or the date entitlement arose, whichever is later".. 2b. What is meant by whichever is later? For instance, if these two dates (2/4/2016 for the date Va receives the claim and 1/5/2014 for the date entitlement arose) are in question, which is meant by later... the 2016 date or the 2014 date? 3. If the lay is credible and is indicating the time the condition was first noticed, and the medical evidence through the years also backs up my claim as credible without being a secondary condition, is it possible for the entitlement date to be initialized by back to my date of separation? or would it be the date of the 2009 exam? or would it be when the claim was entered in 2013. 4. Do remands put you in a bad situation or is it for our advantage? As of now I am in Preparation for Decision for the granted condition and the remanded appeals are currently in the works which date back to 2008. I am just trying to get an idea of what to expect prior to a decision. Thank you for your responses in advance.
  18. Dear Veterans, I just received another denial letter from the VA for my Left Knee and Sleep Apnea service connection. I'm currently working with a VA Claims Specialist in Long Island, New York to help me with the claims process. He has told me we will have to file a Notice of Disagreement / De Novo Review for the Left Knee and Sleep Apnea. He also advised me this process could take up to 1-2 years. This is unfortunate and I want to make sure the VA has everything they need to give me the proper decision. I've attached pictures of my original claims from July 2013, and the decisions I've received for Sleep Apnea and my Left Knee condition in May 2016. I originally submitted my Left Knee claim right before I got out in July 2013 and I was denied. I dislocated my Left Knee cap in 2012 while in service. Since 2013 my knee has gotten worse, I've attended many months of physical therapy and I recently had surgery in March 2016. My knee is now worse after the surgery, I'm unable to run and I'm still in physical therapy. All of this is coming out of pocket because the wait times were too long for physical therapy at the VA Hospital, and I didn't trust the VA with surgery. I was unable to submit the surgery to the VA because I received surgery after I submitted. I've submitted two (2) lay statements, a physical therapy report, and VA examination which was requested by the VA. The VA examination explained that I couldn't stand up for more then 15 mins without pain and that my knee would lock up making it difficult to walk. I was diagnosed with Sleep Apnea in October 2013, just 3 months after I got out in July 2013. I submitted the claim a few months after because I wasn't sure about the claims process. I've submitted two (2) lay statements from Marines I deployed, lived and served with. I also have the doctors report from the VA hospital sleep study. With all this evidence I was still denied the claim. When I spoke to the VA rep on the phone they told me they didn't have my lay statements, however, the VA Claims Specialist I'm working with said this wouldn't matter because I was diagnosed within a year of discharge. I'm currently 50% with Anxiety and Depression and I have a special purpose claim for Erectile Dysfunction. Furthermore, the Left Knee claim is coming up as (New) on eBenefits even though I originally submitted in July 2013. Once I receive a decision will they back date the claim to July 2013 or from when the new claim was submitted? I appreciate all the help and suggestions you can offer. Semper Fi
  19. Hello, I have been on SSDI for the last 3.5 years and got the long form in the mail last night. Obviously, I am very concerned that my SSDI benefits may be stopped. A bit about me. I am a veteran with a 50% rating for issues that are not mental health related but I do have open appeals for depression and anxiety with the VA that have been remanded from the BVA to my local office about 2 weeks ago after being on appeal since 2009. I was awarded a 10% increase in this remand for a physical issue and received back pay for it. The other mental health issues( depression and anxiety) are still on remandI was awarded SSDI for a combination of mental health and physical disabilities. I have been diagnosed by the VA since 2010 with depression not otherwise specified, Paranoid personality disorder, alcoholism in remission, anxiety and history of other psychotic disorder all this was pulled from the ebenefits website blue button thing.I take Zoloft and Buspar daily and Abilify sometimes and am mostly in compliance with the meds. It has stated in my medical records that I have been non compliant before and then things get worse and I report it to my doctors and I get back on the meds but if I have to give it a percentage I would say I am 80-90% compliant and take the meds. I have seen my treatment team at least every 2 months since 2010 and the team includes a pyschchiatrist and a physcologist although the pscycholgist recently left the VA a few months ago but I was transferred to another pscychologist on the same team.I have included a (scrubbed of personal data) one of my latest session notes from the new psychologistI see from just a few months agoLongstanding Hx of psych sxs , including depression and paranoid personality traits. Some interpersonal difficiulties and problems managing anger. Chronic, fleeting violent thoughts (baseline), but has not acted on them in a long time, stated that he is in control of his behavior. Had SI in the past, stated that he might get to that point again at some time in the future, but denied any current SI. No job. Protective factors: Social support (living with his wife, her daughter, and his son from a prior relationship, mentioned his wife to be supportive). Future-orientation . Interested in MH treatment. Pt denied any current suicidal ideation. Some positive coping skills. Pt seems committed to his son, stated that he is very protective of him. Stated that he is in control of his behavior. Offered to review MH Safety Plan, but pt declined, stated that he has the plan at home, agreed to adhere to it should he start feeling worse. Assessment: Pt is currently considered to be at lower risk for suicide given the above-mentioned factors.Pt denied any homicidal ideation, has chronic, fleeting violent thoughts, but is clearly aware of them, does not have plan or intent to hurt any specific person, has not acted on them in a long time, stated that he is in control of his behavior, agreed that this would go against his value of being a good father. Patient Education: Readiness to learn: Attended session, Appeared to listen attentively, Asked questions, Responded to other's questions Content: Behavioral strategies for managing depression and impulses. Patient Understanding: Verbalized comprehension of material, Asked questions for clarification, Demonstrated application of contentA - Active Problems Treated This Encounter: Paranoid Personality D/O (per chart). Unspecified Depressive D/O (double depression). Alcohol use d/o (dependence), in remissionMental Status: Grooming: Good Motor: tense Mood: mildly irritable and guarded Affect: Appropriate to content; limited range Speech: Overall Normal Thought Content: Normal Thought Processes: Overall Logical Suicidality: Absent Homicidality : Absent Hallucinations: Absent Delusions: Absent Oriented: Fully Oriented Judgement: Fair Insight: FairProgress Toward Goals: At the start of today's session, pt confirmed full Social Security number and DOB, and I discussed my scope of practice, documentation practices, confidentiality constraints, and mandatory reporting requirements. Pt orally consented to participate in psychotherapy sessions.Discussed pt's goals for treatment. He described his MH tx hx , described how he is dealing with violent thoughts. Agreed that those thoughts are not problematic as long as he is able to control his behavior, and he stated that he is able to do that. Explored what startegies help him with that, and he agreed that remembering his value of being a good father is helpful, and also thinking about possible consequences should he ever act out those thoughts. He also mentioned that not having to work has reduced his stress, which has also been helpful in controlling his behaviors. Briefly touched upon the concept of values (things that are meaningful to him) and Encouraged him to think about other aspects that might give his life more purpose and meaning. Pt did not mention any significant sxs of depression, but it seems that these issues at times contribute to pt feeling frutsrated and depressed. He also mentioned occasional urges to drink, but knows that the consequences would not be good, has overall been in control of this. Pt also mentioned some discord with his wife's grown-up daughter, wants to bring his wife for a collateral session next time.Reviewed MH crisis phone numbers and offered pt card with them, but he declined, stated that he has those numbers. P - 1. Ind. psychotherapy with this writer, once or twice/month (offered earlier session, but pt wanted to return in about a month) 2. Continue psych med mgmt with DR. Soo. 3. Consider supportive groups (if pt interested)This one here is my lastest one from my phvstiatrist that perscribes me pills at the VA IDENTIFICATION: ****is a 48-year old, married (and previously divorced), male Army veteran with a history of depressive symptoms, cluster B personality traits, paranoid ideation (of overvalued rather than delusional intensity), and recurrent problems with irritability and anger management. He was last seen by me on 10/23/15 and returns today for a 30-minute follow-up appointment. For further details related t the patient's present illness and other aspects of his history, please refer to the C&P exam note from 2/4/10, Dr. ###'s notes from 5/19/10 to 7/14/10, Dr. Erickson's note from 7/26/10, Dr. $$$'s therapy notes from 6/28/10 to 10/12/11, Dr. ###'s therapy notes, and my initial note from 9/2/10.CURRENT PSYCH MEDS:Zoloft 200 mg po qday (pt has been taking it on most days) Buspar 30 mg po bid (pt currently takes 40 mg a day)Abilify 30 mg po qday (pt is no longer taking the medication) PSYCHIATRIC MEDICATION HISTORY: Has been on Paxil "on and off" for several years but did not find it helpful. Dr. $$$ therefore switched him to Celexa on 5/19/10. Pt also tried Seroquel very briefly, in July 2010, but did not like its effects (felt "goofy" on the medication). The record also alludes to past trials of lithium. On 1/11/11, I started him on Abilify, to augment his antidepressant medication (which at that time was Celexa) and address intrusive, possibly obsessive thoughts. The medication seemed to help initially, but he decided to discontinue it because he did not think it was beneficial Because of sexual side effects, he called in on 3/30/11 with a request to D/C the Celexa, which I agreed to substitute with Wellbutrin. He eventually decompensated and stopped taking the medication. Following his admission to 1K in Aug 2011, he was not restarted on Wellbutrin but was prescribed Zoloft, which was continued when he was discharged to St. Cloud RRTP. Buspar was also added during his stay at St. Cloud, for anxiety. Abilify- started on in Aug 2012, as he was experiencing intrusive/obsessive paranoid thoughts that were worsening his anxiety and irritability. The medication helped. When he went off it months later, he had a resurgence of paranoia (believed that members of Hells Angels, with whom he had never encountered, were trying to harm him). He resumed the medication but stopped it again in mid-2013. This time, he did not experience a return of the aforementioned thoughts and elected to stay off it. I discontinued the medication on 8/30/13. As he began experiencing obsessive and intrusive suicidal ideation (with no clear trigger), I restarted him on the medication in mid-July 2014.Prazosin- started on 10/3/14, to address nightmares. Pt eventually stopped taking it as his dream subsided.INTERVAL HISTORY:Although he looks mildly anxious and pensive (per his baseline), **** has been feeling "pretty decent" overall. He is concerned, however, about two "attacks of paranoia" that he experienced recently, in the presence of his wife. Apparently, while lining up at Walmart, an African-American man, with a "teardrop" tatoo over his eye came up behind him. His proximity made **** extremely uncomfortable, so he moved away, at which point the other person moved closer. He subsequently moved to a different aisle and noticed that man peering at him, which evoked a lot of fear. %%%% thought that this individual was planning to kill him and initially considered confronting him aggressively. Instead, he called Dr. %%% and talked through the situation. He left the store without incident. Later, he had a terrifying moment at another store when a "Mexican" man, who looked like a "gang member", entered the same aisle as him. He again needed to restrain himself from attacking but, in the end, refrained form any provocative action. He now recognizes that his fears were exaggerated and that what he interpreted to be threatening actions may have actually been benign.He wonders why he would have such a reaction in the first place. Possibly, the ethnicity of the individuals involved may have been a trigger, especially when coupled with his chronic distrust and anxiety. To some degree, his wariness is not completely inappropriate, as many reasonable people might feel temporarily uncomfortable in the situations he described. However, the degree of fear he experienced and the assumptions to which he leapt require some modulation. I affirm that, ultimately, he was able to manage his fears appropriately. Since these incidents, he has begun taking a higher dose of Buspar (40 mg po qday instead of 30 mg po qday ). It is too soon to tell if this has had any effect. I note that, should he continue to experience such "paranoia" on a consistent basis, he could consider restarting Abilify ( twhich is still on his prescription list, even though he has not taken it for many months). He acknowledges this possibility.He is otherwise doing relatively well. He and his wife are still adjusting to the presence of his son, ###, but the transition is going a bit better than he expected (although some tensions between his wife and his son are present). MSE: Pt describes mood as "pretty decent" but affect remains pensive. At one point, he expresses irritation at a misunderstanding on my part. Thought process generally logical. No delusional thoughs noted. No hallucinations. Insight and judgment seem adequate at this time for maintaining safety.IMPRESSION: Other than for two recent episodes of anxiety and acute suspiciousness towards strangers, pt has been doing relatively well. He was able to handle the aformentioned situations appropriately and without resorting to violence. He is also adjusting to the presence of his son, ###. He has not had suicidal or homicidal thoughts and feels well supported by his wife.DSM-5 DIAGNOSES:Persistent depressive disorderETOH use disorder, in remission History of other psychotic disorderOther specified personality disorder (paranoid traits) PLAN:1) Continue Zoloft 200 mg po qday , Buspar 30 mg po bid, and Abilify 30 mg po qday . Pt not currently taking Abilify and is taking a smaller dose of Buspar. Will not change his existing prescriptions, so that he can return to his original regimen should anxiety worsen and paranoia return.2) He will continue to see Dr. ### for therapy.3) He can resume AA meetings as needed.4) He will return for follow-up in 2 months. We discussed my upcoming depature from the VA. While he is naturally quite concerned about this development, he seems to accept it overall. We spend some time processing some of his fears regarding the transition. Am I in danger of losing SSDI? Would you need more information to give me an idea? Anyone else been in this position?
  20. I'm asking this question to see if anybody else has ever run into this, and this question is pertaining to only one of the conditions I was found unfit for. I was medically discharged out of the Army National Guard through the IDES system. The MEB determined that my degenerative disc disease, "was not incurred while entitled to base pay", did not "exist prior to service" but was "permanently aggravated by service". In the MEB Board summary "this condition could be a result of military duty during deployment, with permanent injury occurring while not on duty status". I should also note that I had been seen while in AIT for back pain due to sit-ups, and also was seen by an army doctor due to back pain upon return from deployment. (all documented in the records). As is the process with the IDES system, my MEB paperwork was sent to the VA for a rating. The VA's determination was: "2 . Service connection for lumbar spine degenerative disc disease (claimed as back) is denied. NIS; STR; NONEX 1. The veteran reported injuring his back in 2009 or 2010 at the beach and there is no evidence of a Nexus to active duty service. Therefore, SC is denied." "Your service treatment records did not contain complaints, treatments or, diagnoses for this condition." BUT for the purpose of the PEB: "For PEB purposes only-the evaluation for lumbar spine degenerative disc disease is 20% disabling based on ROM. This makes the combined evaluation for PEB referred conditions of 40% disabling (20% for right ankle and 20% for lumbar spine=40%)" Now here is where it gets odd, when I received my PEB documents there was not one mention of the degenerative disc disease. It was as if it magically disappeared after the VA disagreed with the MEB determination. Other conditions that were found "fit" for duty were even included in the PEB but anything relating to my back was not mentioned. My questions are: Has anybody else had the VA disagree with the MEB determination without providing any sound medically analysis to over ride their decision? I thought that Horn v. Shinseki, 25 Vet.App. 231, 235 (2012) determined “VA may not rest on the notion that the record contains insufficient evidence of aggravation,” and the Secretary’s failure “to produce clear and unmistakable evidence of lack of aggravation” entitles a claimant to a finding of in-service aggravation of the preexisting condition).” Has anybody else successfully appealed a VA decision similar to this one? and if so what was the approach you took when appealing the decision?
  21. I first enrolled on the Agent Orange Registry in about 2008. No real reason then, except others said it was a good idea to get on the list. I was in-country in Vietnam from 1968-69. In 2012, I saw that Ischemic Heart Disease was added as a covered Agent Orange disease as of September, 2010. I had a heart attack in 2006. So, I applied and got a 60% rating and was paid retro to September 2010. That 2-year lump sum deposit was sweet! In 2013, I applied for PTSD and was denied because of a doctor filling out his report wrong. I appealed and was granted 50% only 6 weeks later! Now, my rating increased to 80%. In December, 2014 I applied for a rating because the VA said I was a diabetic and put me on an RX. They rated me 20% for that, but not enough to change the 80% rating I already had. In February 2015, I asked to have the PTSD rating increased and that I had left my job 2 months earlier because of the PTSD. In April 2015, they increased my PTSD to 70%, for a new rating of 90% overall. However, they also put the added benefit of Unemployability on the claim, which boosted the claim way up there. With a spouse, I went from getting $1688 to $3415 per month! They now put me at 100% Total and Permanent disability! When that rating came in, I immediately went to my Motor Vehicle Dept and got a Disabled Veteran plate for my car. Cost: only $4.50/yr! Then to the county appraiser's office here in florida to file for my exemption. At 100% total and permanent, they waive 100% of your property taxes on your home! ($3600/yr savings!) If you are under 65, which I wasn't, you can also apply for a waiver of your monthly premium for some types of Servicemen's Group Life you may have. Also, but not the least, I went to a somewhat (75 mi. away) local Naval base and applied for a ID card that gives me 100% privileges at any commissary or exchange anywhere in the world, at any military base. I went to an Air Force one yesterday! I can even book a campsite or room at any base that offers it. Disney, Universal, etc are on the discount list too! The gist of all this, it's that you can do it yourself! Everything you need is available online .Sign up for Ebenefits online today! If you feel you need assistance, see your local VFW, American Legion, of VA Officer. Most states also have service officers that are paid by the state itself. They are usually disabled vets themselves and are there to be on your side. Stay away from the attorneys! They are in it for the money only!
  22. I received a letter stating that I have not filed a substantive appeal in a timely fashion. Which is completely untrue. I had 60 days from July 1st (since my SOC) to send my form 9,(VA actually never sent my SOC until AUG. 12, I only found out of the status change due to my e-benefits status)I still sent a form 9 even though the VA never even sent my SOC to me. I send my first attempt to address given in my Statement of case to VA Regional Office of Appeals located in Winston Salem,NC 27120-1309. Sent Certified mail dated July 7/28/2014. Which I paid for fast delivery. I called with follow up and I have recored all follows ups with VA reps. I was told to wait that it would take 3-6 weeks to update. I called again 9/23/2014 was told to wait and also wait for an appeals agent to call me in 7-10 days. Agent called me and said that my form was forwarded to a "scanning office" it should be updated soon and to give it another 3-6 weeks. Called VA 12/3/2014 was told Appeals would call me back in 7-10 days. No call back. Called and was told to wait another 7-10 days for appeals to call me. I got a call back 1/6/15 I was told to resend the form to WINSTON SALEM I sent it Certified mail with fast delivery again. 1/20/2015 A VA rep advised me that my VA regional office has changed for the first time that my VA office changed from Winston Sale to Los Angeles and my case has been improperly handled, then gave me the Evidence intake center address in Janesville WI. Where I re-sent My form 9, 1/20/2015. I've done nothing but try to get this form to the VA since July 28th,2014, 28 days in to my 60 day time span which I only found out from calling the VA since my SOC was not properly sent. I Disagree With the decision to not take any further action to send my case to BVA. Due to all the statements above, the Form 9 was sent out in a timely matter with directions given from all VA reps and my SOC.
  23. Here is a brief summery of my last yeah and a half trying to get my appeals to go through. 09/11/2012 Local VA Office Decision RO 06/24/2013 Notice of Disagreement (NOD) RO 08/12/2013 Appeal Pending RO 07/01/2014 Statement of the Case (SOC) RO 09/01/2014 Decision & Claims File Dispatch BVA Which is they closed out my case 9/1/2014 saying they never got my Form 9 .......which I have sent many many times...... So I received a letter stating that I have not filed a substantive appeal in a timely fashion on 1/26/2015 . Which is completely untrue. I had 60 days from July 1st (since my SOC) to send my form 9,(VA actually never sent my SOC until AUG. 12, I only found out of the status change due to my e-benefits status)I still sent a form 9 even though the VA never even sent my SOC to me. I send my first attempt to address given in my Statement of case to VA Regional Office of Appeals located in Winston Salem,NC 27120-1309. Sent Certified mail dated July 7/28/2014. Which I paid for fast delivery. I called with follow up and I have recored all follows ups with VA reps. I was told to wait that it would take 3-6 weeks to update. I called again 9/23/2014 was told to wait and also wait for an appeals agent to call me in 7-10 days. Agent called me and said that my form was forwarded to a "scanning office" it should be updated soon and to give it another 3-6 weeks. Called VA 12/3/2014 was told Appeals would call me back in 7-10 days. No call back. Called and was told to wait another 7-10 days for appeals to call me. I got a call back 1/6/15 I was told to resend the form to WINSTON SALEM I sent it Certified mail with fast delivery again. 1/20/2015 A VA rep advised me that my VA regional office has changed for the first time that my VA office changed from Winston Sale to Los Angeles and my case has been improperly handled, then gave me the Evidence intake center address in Janesville WI. Where I re-sent My form 9, 1/20/2015.I've done nothing but try to get this form to the VA since July 28th,2014, 28 days in to my 60 day time span which I only found out from calling the VA since my SOC was not properly sent. I Disagree With the decision to not take any further action to send my case to BVA. Due to all the statements above, the Form 9 was sent out in a timely matter with directions given from all VA reps and my SOC. I asked to Please re-open my appeal and send it to BVA. I also contacted my Congress Man out here in CA. I have many other factors to my appeals and mistreatment and threats from my VA Doctor in Landstul Hosbital when I was seperating in 2011 ... if I discolsed any mental health issues and lack of care from the Military doctors. So for my denials to my orginal claims I went and got diagnoses from civilian physiatrists, therapists and physical therapists right when I seperated the AF in 2012. any advice ? They closed out all my appeals due to this awaiting response from my NOD for the close out to my appeal. of my
  24. My situation: I am an expat living in Europe that is taking a much-needed pause from work after being in Afghanistan the last 3 years straight. I anticipate taking the next year off from work. I recently separated from my employer on 30 Sep 2013. I currently have no medical insurance coverage from a private company. Paying for my health care out-of-pocket is feasible. I am 90% disabled, and expect that soon will be 100% disabled once my claim finalizes (December or January). I would rather not spend money on costly COBRA or anything else if I am in the situation I am in. I am currently looking for insurance that will cover me if something terribly catastrophic would happen (hit by a car, etc). My concern: CIGNA (and other big insurance companies do this too, I am sure) just sent me a ”certificate of group health plan coverage” indicating I was covered through 30 Sep 2013 that is seemingly useful to gain coverage for pre-exisiting conditions when getting a new policy **IF** I get insurance within 63 days of the policy expiring (approximately 02 Dec 2013 in my case). I want to make sure I do not screw myself by not taking action now, but do not want to buy insurance I do not need, or will be too much of a hassle to use. My question: Does being a disabled veteran exempt me from this ”lapse in coverage” stuff, at least for service-connected conditions that might not be covered in the future? And what about being outside the United States? If I am enrolled for VA healthcare, am I good to go? THANKS! ro → en the
  25. Howdy to All, It's been a while since I've posted here. I've been busy with helping the wife take care of our baby girl we had this past March, and with also assembly my own NOD before the deadline next year. I have been lurking and reading though, and appreciate all of the input and advice. I have an interesting one, and I'm not sure what to do to help. I have a friend that lives down the road from my home. He is 87 years old, and a World War II Navy Veteran. He has never been on any VA disability, nor received any benefits to my knowledge. He has hearing aids from pretty major hearing loss, and is trying to get the VA to help him on the cost of the hearing aids, and perhaps his eyewear (glasses). He only makes less than $1,300.00 a month in Social Security/retirement. Apparently, he had somebody help him complete paperwork at the VA clinic in Beaumont, Texas and was "placed" in Priority Group 8g due this household income exceeding the VA's established financial thresholds. He provided me a copy of his denial of services letter, and was hoping that I might be able to help. I don't know that he has used any Veterans service organization yet. Does anybody have any ideas of where I can send him, or what I can do to help him get things moving? I would think that a WWII Veteran would be able to get rated for a service connection, and provided for pretty quickly. Any help would be greatly appreciated. Mark
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