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  1. I separated from active duty service in the Air Force with in 2010 and had undiagnosed non-combat military connected PTSD with alcohol use in remission (According to my VA disability paperwork which puts me at 50% for ptsd.) This was granted the beginning of last year. I recently put in to have my discharge upgraded to honorable from general and have yet to hear back from them. (E-benefits say maybe I'll hear about it early February 2018.) There were a few selfmedicated incidents with alcohol that happened while I was active duty that resulted in going into a civilian rehabilitation facility, a perscription to an antidepressant, and a lot of suicidal ideation I recently admitted in my paperwork to the review board that I was afraid to admit to my command because they would do things like write someone up for a sunburn (destruction of government property), or purposefully keep spouses apart by writing one up for something they didn't do and keep them from going during their significant others' PCS (because someone else did it to them for five years and "they turned out fine"(There was no way to prove otherwise.)). I was recently reading about medical retirement from the military. It's a little confusing. I was wondering if there was a way to submit for reconsideration and medically retire from the military after separation?
  2. 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.
  3. I was given a medical discharge for depression from the service about 20 years ago and have a 20 year history of ongoing mental health treatment. I finally decided to file for VA benefits (I've always worked) and had my C&P exam a couple weeks ago and wondered if this was a normal experience. The exam lasted almost three hours and I had to take a long test of a couple hundred questions. The doctor (psychologist) was very nice and he seemed interested in my case but asked a lot of questions about my childhood. My case involved childhood MST and repressed memories of it until a flashback while I was on active duty brought everything out. I was tossed in the hospital and given a medical discharge for depression, existing prior to entry, service aggravated condition per the medical board. I'm a bit worried the doctors focus on my childhood means he was trying to say I was depressed prior to the service which isn't the case. With the repressed memory of the rape I had a pretty normal growing up experience after the event and had friends and a stable family. He seemed to be trying to get me to say my current problems with trusting people were related to what happened then. Obviously they are but I was concerned he spent hardly any time on the in-service stressor that led to the flashback or the fact I've been pretty miserable since then. I had a friend tell me not to worry that it's normal and he may be trying to figure out what percentage of my disability was existing prior to entry versus how much was service aggravated. I've got the service connection thing taken care of with the "service aggravated" note on the medical board and my private psychiatrist wrote a nexus letter and completed a DBQ stating my conditions are related to my service. I'm thinking I have enough medical evidence to show it but I'm concerned about the C&P examiners report. Do you think I need to worry about this? (I have anxiety issues too). Is a three hour exam normal? Do you think the examiner was just being detailed and it'll be OK? He said it would be a couple weeks to view his report and I'm still waiting but I'm a nervous wreck. JW in MN
  4. Good Day All Just a question: I am presently rated at 80%, and was recently by my outside PSYCH doctor with Depression Disorder and Anxiety Disorder and was wondering how this would affect my overall 80% disability rating?
  5. I didn't go through what most of you real military went through. But, I am going through alot physically now at the age of 32. I been out of the military since Aug of 2014. I only did about 3 years before getting medically separated. I just filed my first claim increase for both knees, major depression, both wrist, headaches, lower back, and left foot for several conditions. Im sooo nervous. Im soooo paranoid. I keep thinking that everything and anything will be used against me. There are days where I can't leave bed...I feel like that will be used against me. "Ohhhh...so you just want to get a check? We're taking away your benifts." There are days where I refuse to let my depression and accompanying ailments beat me and I try to work somehow to ease the financial burden on my wife. "Oh....you're working...let me take away your benifits. Im not looking for a free ride. Im just trying to be wise. I hear the stories from many veterans about how bad their condition gets in 10 years. Then they are left high and dry and can't work, and can't improve themselves, and people end up leaving their life cause of the burden. I have a Va rep filing for an increase in my conditions. My C&P is not dated yet...but Im sooo anxious and paranoid thinking that everything will be used against me to take the little I do make a month to contribute towards my wife paying bills. Please share some, or direct me to some experiences of people filing their first claim increase stories...and leading to c&p . Please help me understand this process better. My va rep says I have a shot at 100 percent. Im so worried. I have red and met people who have been screwed. I can't take yet another thing going bad. I think i'll kill myself if it does.
  6. First of all wanted to start this out by saying thank you to all the members on this site. I have been doing all my own research and very often arrived here. Today I decided it might be better to get direct contact instead of lurking in the shadows. The short version is that I have not been able to find work after separating, I'm currently on unemployment to keep myself out of debt while I figure this all out. I was in school for a few months and while I was struggling a bit I did my best to push through which was kind of working out for awhile. Eventually I started getting to the point where I could only manage to push myself to get to class and landed right back in bed afterwards. This effect snowballed and now I have just been medically withdrawn from university after missing 2 weeks of class. Those two weeks I could not get out of bed almost the entire time, I have been taking my meds and everything but sometimes depression just decides its going to mess your life up and you don't have the will or energy strong enough to overcome and keep going. But back to the point, the VA awarded me 30% for depression, anxiety and insomnia combined into one rating. Trying to figure out how I am going to get by and what I can do to survive brought me to the vets group on campus where one of the other guys after hearing what was going on suggested trying to get my rating increased and possibly seeing if I am eligible for individual unemployability. After reading how the VA scores depression I believe I might be in the 70% range but I'm not sure how to go about this. I've got the NOD paperwork but didn't want to fire off half cocked. I look to you all for some help with this as time and again I've seen this community help each other navigate the labyrinth that is the VA. My question here is multifaceted, which I will break down for easier reading and responding. 1. When filing a NOD should I go for DRO or traditional? 2. What evidence should I include with this to increase the likelihood of conveying my situation properly? 3. Should I talk to my doctor about trying to raise my percentage or keep the two separate? 4. Should I focus on the depression or give information on insomnia and anxiety as well/ would they all go together? 5. Lastly What sort of timeframe should I expect, I've seen people saying a few months and others waiting years later. Thank you all for any help you can provide and if you need any more information or clarification I will gladly supply it. (There are other things in my disability claim but they are much minor to the mental health issues and I believe the ratings I received for the others were fair or fair enough.)
  7. I have 4 months left into the navy . I've been seeing a psychologist at Behavior Health for the passed 3 years for adhd , social anxiety , and what I thought until now ... depression . I've been diagnosed as having MMD like 2 years ago but it isn't current but every other time I have a appointment I told to fill out that questionnaire that shows I wasn't doing well mentally . Apparently my doc didn't feel the need to order any meds for depression so I trusted his judgement even though I expressed verbally and on the questionnaires I wasn't good to go . Now doing some research of want I can claim , I see the depression symptoms for 50% and they line up perfectly for what i'm going through for the past 3 years . I guess what i'm trying to ask is Do I have to be prescribe medication for depression to claim any benefit from it ? And what can I do to lock in my depression claim from here ?
  8. Hello All, Put in 1 claim for anxiety and depression and 1 for ptsd(noncombat). Had QTC exam today.. Doctor said I have signs of ptsd but dont meet full criteria for it. Definitely have anxiety and depression. But he couldnt say if my issues are more of the ptsd or the depression, but I needed to continue counseling. So is this good or bad?
  9. I noticed that the VA didn't award me anything for my anxiety. I was diagnosed with PTSD, depression, anxiety and MDD all at the same time. I looked through my records and see where it's all listed. It has been less than a year since I received my award. Can anyone tell me how to go about getting my anxiety added into my disabilities. Do I file an appeal or..........
  10. so my claim was submitted on 12/12/2016. I submitted for bipolar/depression (reopen) and tinnitus (new). I sent it in as an FDC with all my evidence. I checked ebenefits on 12/21/2016 and the status is already showing preparation for decision. Is this normal? I haven't even gone to a c&p exam, I haven't recieved any correspondences or anything. For the bipolar depression it is a reopen because when i first filed in 2011, I missed my appointment. After I missed my appointment, the VA sent me papers (back in 2011) saying that they see that i was treated for depression during active duty. but since i failed to show up to the appointment, it was denied. So now i've sent a ton of new evidence that supports my claim and they've reopened the case. But does the speed with which this is progressing means that i am being denied? As noted below, ebennies is showing that the va rep has already made a decision, in less than two weeks. With no exams or anything... What does this mean... Is this normal? have i been denied? Is there a phone number i can call?? im freaking out. Here's what ebenefits show: Estimated Completion: 01/24/2017 - 03/04/2017 STATUS: Preparation For Decision The Veterans Service Representative has recommended a decision, and is preparing required documents detailing that decision. If more evidence is required, the claim will be sent back in the process for more information or evidence
  11. I have asked a lot of questions and i continue to ask alot of questions to learn even more. I think this may be my final question before i file. So i am currently service connected at 80% 60% asthma 30% allergic rhinitus 10% carpal tunnel 10% cystic acne (due to jet fumes) Now here's my question. Back in 2009 i began seeing a shrink for depression. ive been on pills and have gone to a counselor very often ever since. It is believed that my depression came from the 3 plane crashes that i witnessed. And another 1 that i didnt witness, but i was apart of the HR (human remains) team that shipped the 6 recovered bodies home. It is also believed that my depression has come as a result of the severe asthma and allergy pains. Recent my therapist marked me down as bipolar I, fyi. My question is, do you think i would have a better chance claiming bipolar/depression as secondary to the asthma and allergies. Or should i just say that ive been depressed from the plane crashes and hr missions. Or should i just claim depression as its own issue. please help. Thanks.
  12. Hello all. I am looking for some thoughts on how much of an impact a VA psychiatrist note in my record. I am filing for aggravation of mental conditions the pre-existed prior to service. I had a special waiver signed prior to joining where the military doctor granted me permission to enter because I had been taking lithium trials. The psychiatrist note from 2016 therapy session that states "In brief, -------- has contended with depression, anxiety, and anger as far back as teenage years. There were aggravating circumstances during his time in the Army (1988-96), though he was not in combat, and for quite a period of time alcohol misuse exacerbated his symptoms, but he says today he's been sober since 2011, when he went through treatment in the VA hospital. He doesn't attend AA; he just knows he's better off not drinking. -------- has contended with hostility and paranoid perceptions and ideation for many years. When it's been bad he'll use Abilify to counteract those symptoms. I have been seeing the VA doctors for mental health problems since 2009 and have an extensive history in my VA records of meds and groups etc. Do I have a nexus? I have been appealing this for years. Happy to provide more info if needed. Thank you
  13. back in 2011 I filed for a plethora of disabilities that i received during my time in the air force as a load master. I was given an 80% rating. One of the claims was for depression an ptsd. However, I missed that c&p appt (i forget everything) and i obviously was not given a rating. However, I was sent a letter that says: "You were denied service connection for depression/anxiety/stress because you did not report for the scheduled exam in order to determine if the current disability began on active duty and to obtain sufficient information for evaluation of the disability. Although there is a record of treatment in service for anxiety/depression/stress, no permanent residual or chronic subject to service connection is shown by the service medical records or demonstrated by evidence following the service." Now this was sent to me in 2011. Since then ive received a ton of treatment but ive also have had some unfortunate events happen as a result of the depression, anxiety, anger etc (jail, a stint at the mental health clinic, even a broken hand twice on two separate occasions on 2 separate faces, and few more incidents. i am working so hard on controlling my frustrations with the world and i am taking my meds and getting counseling - i hate living like this because i physically cant control it. And i was never like that prior to 06' my join date). so my question is what exactly does that quote from the va mean? does it mean that they recognize i was treated for depression during active duty but due to me missing the appointment, they need more information? And if i were to file a claim for depression and ptsd - and i were to receive the 80% I need in order to be rated 100%, how would the back pay work? Would the date go bak to my initial 2011 date? Or would they back pay me from the current date of filing? Sorry for the long post - thanks for the help. Also am i correct in saying that they would only be paying the difference between the 80% pay and the 100% pay right??
  14. Hi, sorry if my message seems like a downer but my depression and anxiety is bad right now and i have questions that have me in panic mode. So im currently at 80% 60% for severe allergies rhinitis/sinusitis I developed and the rest split between asthma and cystic acne. here's my deal. i witnessed a b2 bomber crash (its only happened twice so you can probably guess my base). When i say i witnessed it i mean i was actually out working on the flightline during the crash. And i dont know why or how but iv been screwed up every since then. ive been off and on antidepressants, im afraid to be in front of windows, ive gotten in trouble for violence, and more. But it gets worse, the pain from the allrgies and asthma is sickening - literally. i can't sleep longer than 4 hours, headaches, constant shortness of breath, no energy, EVER, dont want to leave the house and so much more. All of that caused my depression to go overdrive - i have no friends, my family cut me off. havent been able to hold a job in over 3 years. I seriously thought about suicide and cant say the idea is fleeting at this point. It was so bad that i was forced to stay in the mental health clinic for 4 days. a few weeks ago I need help - do you think i would be able to file a claim for major depression, ptsd, headaches, and chronic fatigue syndrome, and do you think it would possibly help me get to 100% - as that would improve my life so much right now. Im capable of working,i want to work, ive tried to work. but the jobs im skilled in i cant work because of the asthma and sensitive allergies/sinuses.. The hospital says the headaches are probably caused from the sinus infections i keep having, as i type im on antibiotics for a sinus infection, the mri shows that my right sinus cavity is extremely inflammed and filled with "stuff" as the dr. put it.. I caught strep throat 5 times last year. Thank you - and sorry for the sad posts - im just not feeling to well right now.
  15. I tore both of my shoulders had surgery that is S/C already. At the time of me filing for VA claim I had no idea about secondary conditions (just learning bout it). Both Shoulders I have these Symptoms experience: Chronic PainPain Pain Diisorder (believe if I push or grab stuff) Cause Depression Cant Sleep (get well since suregery over 2 years ago) What is the best way to file the secondary injuries? Can I file for each shoulder all those symptoms I experience? Basically trying to understand the best way to file this so I dont get screwed by the VA.
  16. Camp Lejeune Horror Story

    Sort of Long I joined the United States Marine Corps Reserve in July of 1986, and received an honorable discharge in July of 1994. For approximately 45 days in early October of 1986 until late November of 1986, I was stationed at Camp Lejeune, NC with the Warehouse Unit (3051) for training (ACDUTRA). Several years after my separation from service in approximately 1993, I really began to experience the effects of consuming the contaminated water at Camp Lejeune. My mood changed drastically and I began to have major panic attacks. At one point in 1995 I was even taken by ambulance to the hospital for shortness of breath and the fear that I was having a massive heart attack. During this same year, I was formally diagnosed with suffering from Bipolar Disorder and Manic Depression. The strange thing about it is that I have never suffered from any psychological issues prior to my service at Camp Lejeune and do not have a family history of any psychiatric disorders. Over the next nineteen years, I took medication and occasional psychotherapy for my psychiatric condition. In spite of this my condition never really improved to the point that I felt normal. Since approximately 1992, I have had literally dozens of jobs. This is true, because my psychiatric condition makes it nearly impossible to hold down a job for any considerable amount of time. I have real trouble concentrating and focusing on things for long periods of time. Due to my educational background, I have been afforded some really good and high paying jobs like the Social Security Administration and school teaching. However, because of my lack of ability to focus, I am unable to sustain meaningful employment for more than a few months at a time. The stress of the workload and my inability to handle authority make it very difficult to remain on any job for very long; as a result, I ultimately quit. I reason that I can do better working alone and for myself and that I’ll earn a lot more working for myself, but that never seems to manifest either. I would say that most of my family members and close friends believe that there is seriously something wrong with me. I have been out of work for a year and a half and drive for Uber from time to time to earn money for gas and auto insurance. I prefer to spend most of my time alone and have pretty much cut off all contact with friends. I no longer have good health insurance like I did when I was married. Since it is difficult for me to maintain employment, I don’t have regular insurance coverage. As a result, I have not the taken much needed psychiatric medication for approximately four years. Consequently, my alcohol consumption has increased greatly and I weigh more than I ever have in my life. In my heart of hearts, I truly believe that my condition is the direct result of my exposure to the contaminated water that I consumed while at Camp Lejeune, NC. According to the EPA, the levels of PCE, TCE and other chemicals at Camp Lejeune were at least 1000 times higher than normal. Apparently the Marine Corps was aware of this situation and did nothing to correct it. Hundreds of thousands of Marines and their families have been victimized by this situation. In 2012, President Obama signed into law the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 (P.L. 112-154), which guarantees those veterans who served at Camp Lejeune from 1953 to 1987 for a minimum of 30 days and suffer from any of fifteen identified conditions, free treatment through the VA. I content that I suffer from Neurobehavioral Effects, which is one of the identified conditions. Depression falls within the realm of Neurobehavioral Effects. Perhaps there is a “light at the end of this long tunnel,” because, a Veterans Law Judge, in his appeal letter stated that my service record confirms that I was stationed at Camp Lejeune for training, which falls within the range of subjects identified as potentially exposed to VOCs during my service and that my VA treatment record shows that I have a history of depression and that I have received treatment from the VA for such. Aside from this I also show a history of being treated for years by outside psychiatrist. As a result, I will be afforded the elusive P&C examination as part of my case; I am finally going to receive the due process that I deserve. I keep getting denied! What would you do?
  17. Please, welcome new VET2VET podcast episode: https://youtu.be/9paX1-FyCaI Today we’re talking about SERVICE CONNECTION. When we talk about service-connecting a medical condition, disease, injury or illness to military service, we are talking about proving the relationship between the two. 1) Direct Service Connection 2) Service Connection by Aggravation 3) Presumptive Service Connection 4) Secondary Service Connection 5) Service Connection due to Injury Caused by Treatment in the VA Healthcare System 6) Special Service Connection Rules for Post-Traumatic Stress Disorder ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  18. Please, welcome new VET2VET podcast episode: https://youtu.be/waV5t0HPtbM Today we are joined by Thomas Wendel, DAV National area supervisor for West Cost Region. Thomas E. Wendel served in the U. S. Marine Corps from 1983 until 1997. Since 1999, Tom has worked assisting veterans in processing various entitlement claims on the local, state and federal levels; first in Clare County as a county service officer and then when he came to work for the Disabled American Veterans in 2000. In 2008 he was promoted to the position of supervisor of the DAV Service Office in Detroit and later he was promoted to the position of supervisor of the DAV National area for West Cost Region. DAV is America’s largest, most effective veterans service organizations dedicated to the needs of those injured, ill or wounded in service. We have more than 1,300 Chapters in communities nationwide to help make sure veterans from all generations and their families get the benefits and support they deserve. Today, nearly 1.3 million veterans belong to DAV, and we encourage you to add your voice to the cause. Our programs and free services help all veterans get the health, disability and financial benefits they earned. Take advantage of our benefits claims assistance, medical transportation and employment resources. Your local DAV Chapter is a great way to connect with fellow veterans in your area. ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/VETOVET2 ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/VETOVET2 ▶ youtube.com/c/VETOVET2 ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  19. Please, welcome new VET2VET podcast episode: https://youtu.be/sTH3p-WwXn0 The way VA defines The word "permanent" slightly differently. For that matter, the word total doesn't mean total when discussing a disability. These are just terms to VA. There really isn't a protected rating. Any rating can be modified by VA at any time, depending on the circumstances. How do you know if your benefit is P & T? What is IU? What is substantially gainful employment? Are there any other eligibility requirements? How is the way VA decides total disability different from other agencies? TDIU awards may be permanent or they may be temporary. If I get a 100% rating, should I continue fighting the VA for benefits? SMC compensation Can you think of any other scenarios were a Veteran might want to keep filing to VA after they reach a 100% rating? ★ JOIN US IN OUR COMMITMENT TO YOU AND OUR FELLOW VETERANS ★ ▶ facebook.com/veterantoveteran/ ▶ itunes.apple.com/us/podcast/vet2vet/id1077206523?mt=2 ▶ twitter.com/veterantovetera/lists/vet2vet ▶ youtube.com/channel/UCebXFpogeJ9r4EqRyxHriYQ ▶ plus.google.com/u/0/+VETOVET2 ▶ goo.gl/app/playmusic?ibi=com.google.PlayMusic&isi=691797987&ius=googleplaymusic&link=https://play.google.com/music/m/Iiqawbuzg7eviiyqm6xz7kju62m?t%3DVET2VET ▶ feeds.soundcloud.com/users/soundcloud:users:198832065/sounds.rss ▶ soundcloud.com/vet2vet ▶ stitcher.com/s?fid=80842&refid=stpr ★ LIMITED LIABILITY CLAUSE ★ THE INFORMATION AVAILABLE THROUGH THE VET2VET MAY INCLUDE INACCURACIES OR ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. VET2VET MAY MAKE IMPROVEMENTS AND/OR CHANGES OF THE CONTENT AT ANY TIME. ADVICE RECEIVED VIA VET2VET SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION. IF YOU ARE DISSATISFIED WITH ANY PORTION OF VET2VET, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE CONSULTING VET2VET.
  20. I am 40 percent service connected for Spondy 20% knees 10% patellofemoral.. I am also being treated for Anxiety, Depression, insomnia, fatigue at the VA. I have been diagnosed with Generalized anxiety disorder, and Major Depressive disorder (mod) In my records it references that this is because of my Chronic pain.. I also have a Note/letter from my VA MD that says my "Anxiety/Depression is "most likely" caused by my Chronic pain syndrome from my Service connected disabilities" is this sufficient to get these rated? Any help would be appreciated. Thank you
  21. Just had my C&P last week. And, I've been trying to figure out if I will get the compensation benefits and at what percentage?..I was hoping some of my service family could help me with..Appreciate any input you guys or girls can give me. Thanks!! Initial Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire * Internal VA or DoD Use Only * Name of patient/Veteran: Taylor, David G. 0507 SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [X] Yes [ ] No ICD code: 309.89 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: Other Trauma- and Stressor- Related Disorder ICD code: F43.8 Comments, if any: This is the DSM-5 diagnosis which applies when symptoms characteristic of a trauma- and stressor-related disorder cause clinically significant distress or impairment, but do not meet the full criteria for any other specific disorders within this category. In Mr. Taylor's case, criteria are met for categories A. (stressor), B. (intrusive symptoms), and C. (avoidance symptoms), but not catagories D. (Negative alterations in cognition and mood) and E. (Marked alterations in arousal and reactivity). Mental Disorder Diagnosis #2: Unspecified Depressive Disorder ICD code: F32.9 b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 3. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A) If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: Mr. Taylor's Other Specified Trauma- and Stressor- Related Disorder includes situational symptoms which are activated by situations like thunderstorms. These symptoms are reported to include intrusive thoughts/fears/memories and accompanying states of anxiety. Mr. Taylor makes efforts to avoid encountering triggering stimuli. The Unspecified Depressive Disorder includes symptoms of sad and depressed moods, decreased energy and motivation, interpersonal withdrawal, feelings of hopelessness, and anxious distress. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [X] No [ ] Not shown in records reviewed 4. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [X] Yes [ ] No [ ] No other mental disorder has been diagnosed If yes, list which portion of the indicated level of occupational and social impairment is attributable to each diagnosis: The symptoms related to Mr. Taylor's Other Specified Trauma- and Stressor- Related Disorder are situationally circumscribed and seem to be mild or transient in nature. Symptoms of the Unspecified Depressive Disorder are more pervasive, resulting in occasionally diminished social and occupational functioning. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ In order to provide an accurate medical opinion, the Veteran's claims folder must be reviewed. a. Medical record review: ------------------------- Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes [ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes [X] No If yes, list any records that were reviewed but were not included in the Veteran's VA claims file: If no, check all records reviewed: [X] Military service treatment records [X] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [X] Department of Defense Form 214 Separation Documents [X] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [ ] Other: b. Was pertinent information from collateral sources reviewed? [ ] Yes [X] No 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Mr. Taylor was born and raised in Buffalo, NY. Family consisted of his mother and a brother five years older. Mr. Taylor's father was not involved in his upbringing. Growing up, "We weren't rich... single mom... towards (my) teenaged years she got addicted to some things... got pretty bad... brother was older, so I was kind of there by myself a lot." "I had a godfather that kind of watched me when my mom was working... He was there, which is more than what I could say about my dad..." Father had 15 children- "You can see why he wasn't around... came around to high school graduation... boot camp graduation... I forgave him... just the type of person he is... I have all these other siblings... call me when they need some money... Only time I talk to them is when I go visit... got a little sister who will call me once in a blue moon..." Relationship with his brother- "We're working on it... He was a little abusive... beating me up... one time I had to come at him with a knife... I was always doing the chores... wasn't really the best brother to have... Think he was probably a littl e jealous... He always had problems in school... I was kind of the smart one... He apologized to me... We're working on it..." First marriage- 1995-1997. From that relationship, "I had a daughter and a son (both are currently in Buffalo), same mom..." "My daughter, she's 20... pregnant now... with a man that's older than I am... I think it's because I wasn't there... looking for a father figure (Mr. Taylor is visibly, audibly sad, no longer making eye contact)... My daughter, that's awreck... She's staying over there with the guy... He's trying to control her... I talked to her about stuff, but kind of late, like 16, 17... Her mom and her got into it and her mom said she had to go... but too young to go... I just want to be there for her when she needs someone... If I was there, it could have been a little different..." "My son, I'm still working on him... I think he's a little mad... thinks I abandoned him... wasn't my choice... couldn't financially help him... I flew him down a couple summers ago... apologized to him for not being there... told him my thoughts... I got to be honest with myself, I could have done more for him..." "I was married (second) for about seven, eight years... two kids in that marriage... I was unfaithful, but she kind of forgave me... but I think that was more a way to get out.. I don't think I was really.. I get in so many situations I'm not comfortable... I'm not maybe the marriage type... getting married for no reason... I just left..." Current marriage of three years- "Terrible... I don't know if it's me... reason I'm here is maybe 50%... I think I moved too fast once again... When I left my first marriage, I was supposed to work on myself... I think it was more just having somebody there... She's kind of verbally abusive, and I think I allow it because... I can take a lot..." "I don't want to be a third time loser... but I think I need to be by myself... same thing over and over..." "She (current wife) thinks I'm just around now because it's comfortable... If I could afford to move, I'd have been gone... That's true... I bit off more than I could chew.... worst thing that could have happened to me... wrong relationship for me... I need to go, but I don't know how..." "My second kids... When they come over my house... feeling guilty because I left them... If I was there, they'd be living a little bit better... a little bit of order... I try to make sure when they come and see me that everything is good... got clothes... do things with them..." His current wife gets mad because they don't have more responsibilities when they visit. Friends- "I have friends... wife kind of chased them off... Now I'm embarrassed to even go... They know... certain changes... She throws temper tantrums... doesn't really have no respect for nobody..." b. Relevant Occupational and Educational history (pre-military, military, and post-military): School- "Very well... honor roll... played basketball." Pre-service work at McDonald's. Marine Corps- 1995-1999- Administrative Clerk- No deployments. Honorable discharge. "The reason why I got in... I had a daughter on the way when I was in high school... early entry program... didn't work out so well... She (wife) broke up... She was gonna go to school and come back... didn't hear from her for a while... back with her old boyfriend... caused my issues in the service... I told my commanding officer I needed to go home... try to save my marriage... I came back and they shipped me to another office... Headquarters Battalion... They were more focused on the job than some young guy focused on trying to save his marriage..." After the Marines, "A lot of call-center the first couple years... kind of moved down here because there wasn't a lot of good jobs where I'm from... I got laid off about a year ago... help desk... Carolinas' Associated General Contractors... about seven or eight years..." Currently, "I'm working at Lending Tree in Ballantyne now... going good... I'm always able to separate (work life)... from my personal life..." c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): Mr. Taylor says he took anger management classes during the service, following an altercation with his wife. No indication of any other mental health problems observed in STR, nor in military separation exam- June 8, 1999. Denies any mental health services before or after the military. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): During the service, "I got some anger management classes... Me and my ex-wife had got into it.. she kind of hit me first.. reactionary thing... I hit her back... I did get arrested for that think with my first wife... got restrictions for a week or two... money taken away..." Other disciplinary action, "Here and there... I'm not good at relationships I don't think... kind of got in trouble sleeping around with a... married woman... some other rules things... over-sleeping because I was drunk maybe a couple times..." Thinks he had two or three Article 15s. "I did get caught shop-lifting... When I was young... didn't have money to buy things... (in the service) video game card... got like 30 days restriction... like $400 in pay... maybe why I never got promoted beyond E-3... Most of the things happened during the first two years... kind of settled down after that." e. Relevant Substance abuse history (pre-military, military, and post-military): Alcohol- "Usually I'm just a social drinker... lately... kind of depressed... things ain't working out like they should have... expected more of myself... I might make two or three (drinks), maybe three, four times a week..." Sometimes more. No history of alcohol treatment. No history of illicit substances. f. Other, if any: Sleep- "I guess it depends... lately either I can sleep good, real deep... or I have... since I applied for this... sleep more off and on because I'm thinking about it... some periods I might have like restless leg syndrome... wife tells me... in and out of it..." "I try to work out now... try to help me sleep a little better... This bad relationship I'm in though, don't help me with my sleep..." Mr. Taylor says he gets "a good five" hours of sleep, "Then I toss and turn... had a surgery on my thumb... bulging disc in my neck... muscle relaxers... help me go to sleep..." Depression- "I've been depressed for a while... kind of live with it... I do have thoughts of maybe, you know..." Denies suicidal intent or plan. Wouldn't act on it because of his children. "I think I'm just hard on myself... The women, I don't really have emotional attachment with... my kids, I love my kids... feel like I've failed them... guilt... probably don't do what I need to do to handle it right..." Talks about his son acting out, being disrespectful to his mother, with Mr. Taylor feeling guilty/responsible for it. "If I was there, I know that wouldn't be going on." "My confidence in myself... kind of mumbling... I lost it somehow... It's embarrassing... Everything pretty much... I think my mom had more hope for me... kind of let myself and my kids down... especially my older kids..." Anger, "I can keep it in check, cause if I don't keep it in check, I don't know where it will go... That's the reason I don't discipline my kids... one time I did it... ended up (going too hard)... that's why I don't..." Anxiety, "I think I'm... I can tell by how my nails look, how I'm doing lately... I swear it has something to do with losing my hair... I kind of go in kind of a shell too... There's kind of a compulsive thing I do... I always got a remote in my hand... constantly going back and forth (does some numerical patterns with buttons/symmetry). "If it's raining... lightning... If I see that (memory of reported stressor)... even in the car... Even though when the lightning struck, we weren't near a tree... lightning hit the ground... I always had a wariness of... lightning... staying where I'm at, or make sure if I'm getting anywhere, I don't see no puddles of water... or passing by trees or metal... I know it happens... I was right there... I'm staying there until it at least slows down..." "Ever since I started coming here, I keep replaying it in my mind... wonder if it has anything to do with what's going on..." 3. Stressors ------------ Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military): a. Stressor #1: "What they said and what happened are two different things... storms... rifle range... lightning hit the surrounding tree line... I'm like... 'That's real close... don't know why we were still there.'... As we were leaving... two formations... guys (other group) right behind me... I was in the back of mine... Drill sergeant was like, 'Cover your rifles with your ponchos.'... We were doing that... All the sudden... blue light... no sound... feel this heat on the back of my neck... several of us got down... As I turn around... see several guys down on the ground... Drill instructor is running up... eyes out of his head... 'Everybody get up to the... shelter!'... This one guy... just down... all this happened in probably no more than ten seconds... That heat... and you could smell it, like electrical burn... 'til I hear the boom, then I recognized what it was... My ears was ringing... One of the guys... He had died... hit him first, and came out and hit the people closest to him... We was in boot camp... didn't tell us anything... We went to his funeral... after that, we didn't do but ten or fifteen percent of the stuff... because it was raining a lot... lightning... We didn't do it after that... He could have been alive if we'd have left ten minutes earlier..." Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No If no, explain: Mr. Taylor was witness to another man being killed by a lightning strike during training. Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No 4. PTSD Diagnostic Criteria --------------------------- Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criteria A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violation, in one or more of the following ways: [X] Witnessing, in person, the traumatic event(s) as they occurred to others Criterion B: Presence of (one or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: No response provided. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: No response provided. Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Chronic sleep impairment 6. Behavioral Observations -------------------------- Mr. Taylor arrived about 15 minutes early for his appointment. He was neatly and casually dressed. No abnormalities of gate or posture were noted. He was cooperative with the interview process and made good eye contact. Mr. Taylor was fully oriented. Speech was clear and coherent, quiet at times. Mood was somewhat depressed. Affective expression was mild, congruent, sad at times. Thought process was logical and goal-directed. Thought content was relevant and with adequate detail. Gross concentration and memory were adequate. Insight and judgment are in tact. There was no evidence of perceptual disturbance. There was no evidence of thought disorder or hallucinations. Mr. Taylor relates that he has thought about suicide, but denies any intent or plan. Homicidal ideation is denied. 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, (including any testing results) if any -------------------------------------------------- Prior to beginning the interview, the undersigned examiner informed the veteran of the purpose of the evaluation, the role of the undersigned examiner, and the limits of confidentiality. The veteran indicated understanding of the aforementioned information. Per VA Memorandum titled Information Bulletin: Implementation Guidance for the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) use in Compensation and Pension Examinations, dated December 16, 2013, this examination was conducted using DSM-5 criteria. Of note, the DSM-5 no longer requires computation of a GAF score. Per 2507: "Please indicate in exam report the stressor(s) claimed by the veteran upon which a diagnosis of PTSD is based. **If a diagnosis other than PTSD is rendered, please state if that psychiatric condition is at least as likely as not (50 percent or greater probability) linked to the conceded stressor." Examiner's Response: Mr. Taylor does not meet DSM-5 criteria for a diagnosis of PTSD. However, he does currently meet criteria for Other Specified Trauma- and Stressor- Related Disorder. This includes situational symptoms including intrusive thoughts/fears/memories of the stressor event, with accompanying states of anxiety, which are triggered by situations like thunderstorms. Mr. Taylor makes efforts to avoid encountering triggering events. The Unspecified Depressive Disorder includes symptoms of sad and depressed moods, decreased energy and motivation, interpersonal withdrawal, feelings of hopelessness, and anxious distress. The symptoms related to Mr. Taylor's Other Specified Trauma- and Stressor- Related Disorder are situationally circumscribed and seem to be mild or transient in nature. Symptoms of the Unspecified Depressive Disorder are more pervasive, resulting in occasionally diminished social and occupational functioning. It is at least as likely as not (50 percent or greater probability) that Mr. Taylor's currently diagnosed Other Specified Trauma- and Stressor- Related Disorder is due to his having been witness to the lightning strike killing a fellow Marine during training. The reported stressor is sufficient for the potential development of a trauma- or stressor-related disorder. The symptoms of intrusive thoughts/fears/memories of the stressor, accompanying states of anxiety, and efforts to avoid triggers to memory of the stressor are meaningfully related to the stressor itself. It is less likely as not (less than 50 percent probability) that Mr. Taylor's currently diagnosed Unspecified Depressive Disorder is due to the lightning strike killing a fellow Marine during training. Mr. Taylor's problems with depression seem more likely due to historical and current difficulties with significant other relationships, difficulties and regret in his relationships with his children, and perhaps aspects of adverse circumstances during childhood.
  22. I am presently service connected for Tinnitus 10 % ; Bilateral Hearing Loss 80 % and TDIU 100 % P&T. Without going into a lot of discussion this was attained from 2001 through 2013. I am considering filing a claim for Heart Disease, Sleep Apnea, Hypertension, and Depression/PTSD. I feel if any of these claims prevail it will have to be secondary to my service connected hearing loss and loss of employment. I will try to explain this without having to write a book someone can give me some advice. My service connection disability had never been a factor for me until I was 48 years old and after working twenty two years in my chosen profession in law enforcement. I had never filed a claim for hearing loss mainly because my VA service rep twenty something years earlier told me they probably wouldn't be able to find my medical records and I wouldn't prevail. In 1992 at age 48 my agency demoted me, cut my salary, loss of other benefits and threaten to fire me due to my loss of hearing. I had just started wearing hearing aids so it made the hearing disability obvious. After this happened I became depressed, angry and still depressed to this day. I was ordered to see different psychologist and had to undergo weekly visits for six months. In addition I began to have hypertension problems, chest pain and marital problems. Priver or to the action related to my hearing I had never been treated for any of these problems and no hospitalization of any kind since I was very young. Before all of this I still was walking several miles a day and in excellent health. I ended up having to file suit to get my benefits back and prevailed in that regard. I have taken medicine for depression since 1992 and finally took an early retirement in November 2000 and moved back to my home state. I retired with two stents in my heart, high blood pressure, depression and frequent angina. I took a part time job as a US Marshal working in a federal court in my home state. Six months into the job I was medically terminated due to my hearing loss. In 2001 I filed my first VA claim for hearing loss. I was granted service connection with increases up until 2013 when I was granted TDIU. I had tried two different times for TDIU prior to 2013 and was denied. My depression is documented by VA medical records. Since 2001 VA has diagnosed seep apnea and issued me CPAP. I take VA prescribed meds for depression. In addition I have 15 stents in my heart, two heart attacks and quadruple by pass surgery after having a heart attack at VA medical facility in 2004. Sorry this is so long but is there anything secondary or otherwise I can hang my hat on in this information. I know I am blessed to have the TDIU but feel my heart condition and depression are both related in the chain of events over the years. I know I am not likely to die from hearing impairment but surely the heart disease will prevail.
  23. Here are the results from my C&P exam for depression, let me know what ya'll think, and what my possible rating might be. Thanks These are blue button download notes, so not in exactly easy to read format. Print Done T========================== Date/Time: 03 Nov 2015 @ 0800 Note Title: COMPENSATION & PENSION NOTE Location: Lebanon VA Medical Center Signed By: VONRAGO,LAWRENCE L Co-signed By: VONRAGO,LAWRENCE L Date/Time Signed: 03 Nov 2015 @ 1032 ------------------------------------------------------------------------- LOCAL TITLE: COMPENSATION & PENSION NOTE STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: NOV 03, 2015@08:00 ENTRY DATE: NOV 03, 2015@10:32:49 AUTHOR: VONRAGO,LAWRENCE L EXP COSIGNER: URGENCY: STATUS: COMPLETED Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire Name of patient/Veteran SECTION I: ---------- 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes[ ] No If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Major Depression, chronic Comments, if any: Patient reports that he has been depressed throughout his military career and never felt depressed prior to joining the military. After leaving the military, he remained with chronic clinical depression which is never resolved. He never received day treatment until recently. Mental Disorder Diagnosis #2: history of alcohol use disorder in partial remission versus full remission b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): No response provided. 2. Differentiation of symptoms ------------------------------ a. Does the Veteran have more than one mental disorder diagnosed? [ ] Yes[X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes[X] No[ ] Not shown in records reviewed 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication b. For the indicated level of occupational and social impairment, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by each mental disorder? [ ] Yes[ ] No[X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes[ ] No[X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence review ------------------ a. Medical record review: Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed? [X] Yes[ ] No Was the Veteran's VA claims file (hard copy paper C-file) reviewed? [ ] Yes[X] No If no, check all records reviewed: [ ] Military service treatment records [ ] Military service personnel records [ ] Military enlistment examination [ ] Military separation examination [ ] Military post-deployment questionnaire [ ] Department of Defense Form 214 Separation Documents [ ] Veterans Health Administration medical records (VA treatment records) [ ] Civilian medical records [ ] Interviews with collateral witnesses (family and others who have known the Veteran before and after military service) [ ] No records were reviewed [X] Other: cprs and vbms were reviewed. b. Was pertinent information from collateral sources reviewed? [X] Yes[ ] No If yes, describe: cprs and vbms were reviewed. 2. History ---------- a. Relevant Social/Marital/Family history (pre-military, military, and post-military): Re: Section 2.0, please refer to section 6.0 below b. Relevant Occupational and Educational history (pre-military, military, and post-military): No response provided. c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-military): No response provided. d. Relevant Legal and Behavioral history (pre-military, military, and post-military): No response provided. e. Relevant Substance abuse history (pre-military, military, and post-military): No response provided. f. Other, if any: No response provided. 3. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Chronic sleep impairment [X] Disturbances of motivation and mood 4. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to mental disorders that are not listed above? [ ] Yes[X] No 5. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes[ ] No 6. Remarks (including any testing results), if any: --------------------------------------------------- Please note the following regarding Compensation and Pension exam documentation: 1. The examiner is a poor typist and no longer has access to a transcriptionist for dictating reports; however, parts of the report will be automatically typed via transcription software or dragon software. This dragon software is prone to error, therefore there may be typos in the body of the report. Important documentation considered vital, such as diagnosis and recommendations, will be proofread before submitting. 2. In order to maximize face-to-face time with the veteran the following measures will be taken: 1.) with regards to the grammar, syntax, structure, etcetera in this report, only the assessment, diagnostic formulations, and conclusion of the report will be thoroughly proofread. The non-essential parts of the report will NOT be thoroughly edited and WILL contain typographical and organizational errors (the body of the report may not be well-written, 2.) select parts of the exam may be dictated in the spoken language of the veteran or will be paraphrased; when the author types in the first person, assume the sentence is likely a quotation. When deemed essential to understanding the context of a statement, quotations will be included in the report. 3. An ACE examination was not completed today. The veteran was present for this examination. Acronyms used in report: hx =history abuse x 3 = physical/sexual/verbal abuse pt = patient asap = as soon as possible sx = sympto m bc = because fx = function d/a or D&A = drug and alcohol fxing (functioning) s/p = status post si/hi = suicide homicide cfs = pt is able to contract for his/her safety CIP/cip = crisis intervention protoco mh = mental health hs = high school or at bedtime avh = auditory visual hallucination c/o = complains of FH = family history c/w = consistent with Rx = medication rship relationship dx = diagnosis nm= nightmares N= no Y= yes s = without c = with re: = regarding XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX IDENTIFYING DATA: . He presents today for a compensation and pension exam. He offers no cc. He provides a document in support of his argument that his chronic depression is caused by his chronic pain which is caused by a leg injury he had during the military. PAST PSYCHIATRIC HX: 1. Inpatient psychiatric treatment? none 2. Counseling hx? + 3. Psychiatric Rx Tx? no 4. Family psych. Hx? none known 5. Legal Hx? non 6. Drug Abuse Hx? 7. Alcohol abuse/dependence? He abused alcohol most of his military career per patient. I "think I started drinking regularly for sleep?He then reported excessive drinking throughout the military and he had one article 15 for etoh abuse. He has not been drunk since 22 years old. He continues to use etoh as a "sleep aid". I only drink 2 beers nightly. Denies cage and problematic drinking patterns. 8. Behavioral Hx? neg 9. SI/HI Hx? He tried to cut himself in the military. He talked to a chaplain, but had no mh treatment otherwise. He has suffered from chronic suicidal. SUICIDE HX: The veteran presents a chronic history of suicidal ideation. He indicates that in the context of his pain primarily, and his resultant depression, he was on the verge of cutting his wrist in order to end his life. Just when he was about to do this, someone intervened. He has not subsequent had suicide attempts, but he reports that he has suffered from chronic, intermittent, suicidal ideation, which she reports waxes and wanes. He reports that this seems to present with stress but can occur out of the blue. He has been able to contract for his own safety with his current counselor and he denies any current intent, plans, wishes, or goals to harm himself. He expressed an excellent understanding of crisis intervention protocol (cip) and expressed a good understanding of how to initiate cip if need be. The patient is able to contract for safety and will not act on any SI/HI if it subsequently presents. If the patient exhibits warning signs/symptoms of worsening MH problems, e.g. becomes increasingly depressed or anxious etcetera, the veteran promises to notify the treatment team. The patient reports he is safe and does not need to be in the hospital and indicates that this is been going on for years. The patient appears reliable at this time regarding the above and seems aware of which symptoms warrant contacting the treatment team so that the risk of si/hi is minimized. The patient is seen as lower risk for acting out, but in the context of this being so chronic, one would be advised to monitor this for worsening. In the context of the obtained clinical history and the mental status examination, there are no significant signs of acuity today that would suggest or indicate that the veteran is in imminent risk for acting out regarding si/hi. On exit interview, the veteran did not appear to be in any acute distress nor was suicidal/homicidal issues deemed to have been provoked. The veteran denied any acute SI/HI symptoms at the conclusion of the evaluation. Re: guns/weapons, the veteran was counseled to avoid any access to firearms and other dangerous weapons/devices, etc., due to the increased risks associated with access. PAST MEDICAL HISTORY: see chart/records CURRENT STRESSORS: "dealing with the VA". He had a couple claims denied. They were mostly resolved. " Life in general". CURRENT FUNCTIONING: 1. INTERPERSONAL- FRIENDS, FAMILY: Per patient, he has less than adequate relationships in general, which he believes is related to his depression. He says that he has no true friends. He admits to having acquaintances. 2. WORK HX : good relationships at work. Good work hx. he has never been officially fired. 3. TYPICAL DAY : I don't do anything for fun. I go home, I work a 10 hour shift. When I am off I sit around. I like doing yardwork. He report watching TV. He and his wife are financially struggling so they don't go out to eat much. He reports no friendships. He had no true friendships in childhood either. "I was a military brat". I don't do social events. He has only recently started counseling despite the fact that he has been depressed most of his life. He has a 9 yo and a 14 yo. He will do activities with his children. His relationship with his wife is , well, it is not great but not horrible either. He variably indicated that he argues a lot with her. Counseling records seem to describe the relationship as being strained MATERIALS REVIEWED? VBMS was reviewed. CPRS was reviewed. The veteran was examined. The computer records were reviewed. Military Hx: no combat hx. Served in the military x 6 yrs. HPI : The veteran self-reports that he was a fairly normal kid. He indicates that he never had any kinds of mental health problems whatsoever. He was easy-going. He does not recall having any problems sleeping or being a nervous anxious person etc. He seems to have excellent mental health per the patient. Once he got into the military and injured his leg, everything seemed to go downhill. He indicates that he injured his leg and needed to wear a brace for about 8 days. He indicates that ever since that time he developed problems sleeping which she then self-medicated with alcohol. Because he self-medicated with alcohol to sleep this then caused his alcohol problem. Although he never sought any treatment for his depression, he believes the depression directly resulted from his leg pain and his insomnia, the latter of which caused was the cause of his alcohol problems. He does not take personal responsibility for his alcohol problems, indicating it was a result of his insomnia. He indicated that he wore a leg brace for 8 days and then was sent back to active duty. He reports that he has suffered from a lifetime of pain which is caused his problems. He indicates his pain ranges and now he has pain in the number of different places. He indicates his pain average to be falling in the range of 6 through 8. The veteran currently reports feeling depressed and indicates that he has been depressed throughout his military career and throughout his life. Although he feels strongly that his leg pain caused his depression, he does admit with questioning that there were other stressors. One of the stressors he indicated was the fact that there was stress in the military. He was in the Marines I believe and indicated that they had strict standards. At one point he was afraid that he was going to have to buy new uniforms because of something a commander said to him.. He reports that would take a full paycheck. He believes this was the trigger when he was going to commit suicide by cutting his wrists. With further questioning, he did admit that he had a girlfriend who developed cancer. Psych clear what happened but her family lied to him and told him that she died. He subsequent found out that that was alive. Regarding the patient's depression, he feels depressed, chronically, and admits to neuro vegetative symptoms of depression such as feeling angry and irritable frequently, having trouble concentrating and focusing, having no desire to do things at times. He indicates it's hard for him to enjoy things. He has trouble sleeping at night which he relates is secondary to his mind racing. He does not endorse bipolar problems. He does not endorse psychotic problems. He does not endorse drug problems. He does indicate that he has had alcohol abuse problems, but he self-reports now that all he drinks are to light beers per night, no more low less. He reports that he had been clearly abusing alcohol in the military and in fact received an article 15 for alcohol related charges. He described out of control drinking, drinking most days of the week and really feeling out of control. He was able to stop this when he left the military at some point and currently has maintained a pattern of only 2 drinks per night to, per patient, help him fall sleep. He denies any abuse. He denies people being concerned about his drinking patterns, or other him symptoms suggestive of alcohol problems. No history of panic. He does describe feeling stressed and anxious but does not feel he is a worrier. He does not endorse social phobias or any other type of OCD/anxious based disorder. No other comorbidities were noted. There is no history of significant trauma. Regarding the patient's history of insonmina he does suffer from chronic depression which most often is connected with sle with sleep problems. The veteran does not recall having any sleep problems whatsoever as a child or adolescent. His sleep problems began when he joined the military, as did his clinical depression. He has been diagnosed with sleep apnea, and vividly recalls being a heavy snorer when he was in the military. He does not recall having any problems with being us nor prior to joining the military. I don't see any clear military connection for sleep apnea although he reports that his sleep apnea may have started in the military as well. Since there was heavy drinking during this time period and again there is no documentation, I do not believe there is any grounds to suggest that his current sleep apnea is military related. Sleep apnea could itself be one of the many risk factors for development of depression. PERSONAL HX: CHILDHOOD, SCHOOL, PARENTS The veteran reports having an unremarkable (history seems to fall WNL) childhood hx. 1. Hx of abuse x 3 : n 2. Hx of MH problems : n 3. D/A hx : n 4. Academic hx: n MSE: unremarkable. No si/hi/avh/del. 1. Is the examiner concerned with imminent si/hi ? N 2. Is the examiner concerned re: avh/del/psychomotor agitation/mania/mixed/manic sx's? N 3. On exit assessment, are there any imminent concerns noticed that need acutely addressed? N 4. Re: safety issues, is the examiner sufficiently concerned re: reliability of the candidates hx? N General Overview re: Compensation and Pension exam-- In this checkbox formulated template report, although a veteran may endorse experiencing certain symptoms, one may not see a symptom checked off on the provided diagnostic checkbox list of symptoms. Any symptom reported by the veteran but not checked off on the checkbox list indicates that the symptom(s) is not deemed to be clinically significant. This means that the symptom(s) reported has not been determined to represent psychopathology (an aberrant symptom(s)) but rather, the symptom is deemed to fall within the normal limits of human experience). The examiner's role in this process is to determine which symptoms represent abnormal or pathologic mental health states vs. those symptoms that fall within the normal limits of human experience. The presence of psychological symptoms can be considered "normal" depending on various factors. For example, it is not necessarily pathologic (a mental illness) for one to feel sad, angry, anxious, depressed, etc. Experiencing such symptoms does not mean that one is suffering from a clinical depression or has mental illness ( e.g. psychopathologic depression). It is within the range of normal human experience to feel "emotional", sad, angry, or even anguished at times when thinking of friends, fellow soldiers, or innocent victims that have been injured or killed; merely experiencing such an emotion does not constitute psychopathology. In some individuals, feeling intermittently emotional about past traumatic experiences can fall well within normal limits, even if symptoms surface on and off for many years. Feeling strong emotions at times does not necessarily mean that you are mentally ill (experience psychopathology). Discussion: The veteran feels strongly that his clinical depression which has been present throughout most of his adult life has been caused by a leg injury that he had in the military. He did not seek out any help for his depression in the military because he was ashamed. When he left the military, even though he continued to be remain moderately to severely depressed dailiy, he never sought any form of treatment and has no documentation of clinical depression. He only recently started clinical treatment. Findings: The veteran describes chronic depressed mood, with no history of meaningful clinical improvement and certainly no remission. He reports feeling depressed daily, and ranks his depression as being moderate (7 on a scale of 1-10 for depression). He describes neurovegetative symptoms of depression including problems with chronic suicidal ideations. Typically, depression is considered to be multifactorial. There can be genetic influence often times but not always. Clinical depression is very common in general oftentimes there are multifactorial elements, which play a role in so far as etiology. In this veteran, there is no documentation supporting that he suffered from depression while he was in the military. He indicates that he was so severely depressed that he had been seconds away from attempting suicide but never sought any treatment throughout. He did indicate that he talked to religious counselor once I believe. There is no evidence of any specific cause of his depression which hes has felt throughout his adult life. There are multiple clinical factors that are believed to be prominent triggers for depression such as of low self-esteem, unfulfilling relationships, chronic use of alcohol, which we know now is a risk factor for depression. Although the veteran believes his pain has specifically caused his clinical depression, however depression is most often determined to be multifactorial. In the examiner's opinion, there is insufficient evidence to suggest that in this particular case his clinical depression is solely secondary to his leg pain. That is, the examiner believes that there is a greater chance than not that other factors played substantial roles in his chronic clinical depression and in the absence of clinical evidence i.e. documentation, to suggest otherwise, there is not sufficient evidence to support his own belief that his pain is ultimately the sole cause of his chronic depression. By his history and per records there've been multiple stressors throughout his life that could play a significant etiologic role. With regards to there being a military stressor large enough to provoke clinical depression while in the military, it is unlikely that a minor injury (an injury that required a leg brace for 8 days and then back to duty) would be sufficient grounds to cause clinical depression, particularly since there were numerous stressors including relationship issues and legal problems. xx /es/ LAWRENCE L VONRAGO M.D./STAFF PSYCHIATRIST Signed: 11/03/2015 10:32 -------------------------------------------------------------------------
  24. Hey everybody, just a quick update on me. On Friday I had a joint C&P exam for my R ankle and hips for secondary claims. Ankle was found Dorsiflexion of 0-5 and Plantar flexion of 0-40 Hips were found flexion: 0-40 extension: 0-20 Abduction: 0-20 Adduction 0-20 Rotation, external 0-20 and internal 0-20. Examiner opined that the ankle was at least as likely as not caused by already SC L ankle, but the hips were found less likely as not caused by current SCDs. X-rays of hips showed nothing. Ok, now hear this...he suggested/advised that I call my PCP and request for an MRI for my hips for further evaluation and treatment. Is this his way of saying that my pain and reduced ROM are for real and should be further investegated that I may then be SCd? He also said in his opinion it seems more likely that the soft tissue of the pelvis/hip region is inflammed which is causing my pain and reduced ROM. And that I may need to see a Rheumatologist for treatment. Not sure what that is implying, but I have heard of rhuematoid arthritis, is this what he may be hinting at? Ok PTII, today I had a C&P for depression secondary to chronic pain... One of my worst ever exams!!! When he was done(VA phyc) I felt that I shouldn't have even filed that claim. He was very nice and polite, but every twist and turn he kept trying to lead me outside of my AD time and the years since. He kept asking about before I went in the Marines. I kept redirecting by saying these things and symptoms all started after my enlistment began. He kept repeating the same questions over and over, waiting for me to slip up. I knew what he was doing, and yet still felt like I was the one in the wrong. Then he went on some spiel about how 30% of the general population is depressed and most of them don't have suicide ideations and such. And that most of us are biologically predisposed to things like depression. He wanted me to try to explain why I think I don't have any friends, even though I had told him that my state of mind keeps me from doing that. I went into detail about my chronic sleep impairment and drinking, and he made it sound like it's the normal thing no big deal. I told him that I did not grow up with these things in my life or family. And that they all began to manifest after I was in the Marines. I told him that on my 5th day of boot camp, when I fell down the stairs, is the initiation point. Then he said he will have re-review my record to see if he really could find some way to SC this. Funny, it was supposed to be for secondary to chronic pain. He asked about current SCDs and I told him what they were and the ratings, several of which are listed as pain conditions. Is this normal? Or am I looking at a long road of NODs and BVA land??? I sure hope all that was just his way of trying to trip me up into screwing myself by saying the wrong thing. I did have a written statement covering things I wanted to make sure were covered, and I told him that a copy of same will be submitted into evidence for my claim, to ensure nothing from it gets left out. He made a funny face at that, but said it was a good idea to be prepared like that. Anyway, thanks for letting me ramble on. Andyman
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