Jump to content
  • Searches Community Forums, Blog and more

Search the Community

Showing results for tags 'ptsd'.



More search options

  • Search By Tags

    Type tags separated by commas.
  • Search By Author

Content Type


Forums

  • General VA Disability Compensation Benefits Claims Forums
    • VA Disability Compensation Benefits Claims Research Forum
    • RAMP Rapid Appeals Modernization Program
    • Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC
    • Veterans Compensation & Pension Exams
    • E-Benefits Questions
    • Vets.gov
    • PTSD Post Traumatic Stress Disorder Claims
    • Entitlement - Veterans Compensation Benefits Claims
    • Eligibility - Veterans Compensation Benefit Claims
    • CHAMPVA
    • TDIU Unemployability Claims
    • CUE Clear and Unmistakable Error
    • Success Stories
    • OEF/OIF Veterans
    • VA Caregiver Benefits for Post 9/11 Veterans
    • SMC Special Monthly Compensation
    • IMO Independent Medical Opinion
    • Veterans Benefits State & Federal
    • VA Medical Centers Navigating through it
    • Medication – Prescription Drugs-Health Issues
    • VA Training & Fast letters, Directives, Regulations, Other Guidance Documents
    • MEB/PEB Physical OR Medical Evaluation Forum
    • VA Regional Offices
    • VA Disability Claims Articles and VA News
  • VA Claims References
    • Title 38 / 38 CFR
    • 38 CFR 3 Adjudication
    • 38 CFR 4 Schedule for Rating Disabilities
  • Specialized Claims
    • TBI Traumatic Brain Injury
    • Mefloquine / Lariam
    • Gulf War Illness
    • Agent Orange
    • ALS - Amyotrophic Lateral Sclerosis
    • MST - Military Sexual Trauma
    • Radiation Exposure from Operation Tomodachi (Japan Earthquake Fukushima Nuclear Assistant)
    • Project SHAD/Project 112
    • Vocational Rehabilitation
    • VA Pensions
    • DIC
    • FTCA Federal Tort Claims Action
    • 1151 Claims
  • Veterans Helping Veterans Podcast
    • Veterans Helping Veterans VA Claims Podcast
  • Welcome Aboard
    • Help Files - How To Use The Forum
    • Introduce Yourself
    • Test Posting Messages Here
    • Roll Call
    • Technical Support For Forum
  • Extras
    • Hiring an Attorney Discussions on S. 3421
    • Social Security Disability Questions
    • VA Scandals
    • Discounts for Veterans
    • Federal Register Announcements
    • Active Duty MEB/PEB Physical OR Medical Evaluation Forum
  • Social Chat
  • Veterans Social Chat's Social
  • Veterans Social Chat's Topics
  • Hollie Greene's Multiple Sclerosis

Find results in...

Find results that contain...


Date Created

  • Start

    End


Last Updated

  • Start

    End


Filter by number of...

Joined

  • Start

    End


Group


AIM


MSN


Website URL


ICQ


Yahoo


Jabber


Skype


GooglePlus


Military Rank


Location


Interests


Service Connected Disability


Branch of Service


Residence


Hobby

Found 5,822 results

  1. How do I submit an article? Or get someone else to help research and flesh it out? Basic start: Berta, Bronco, and other primaries, if you are listening, get your crew to contact NIH and help do an article on this. (immunoexcitotoxicity) The primary source or beginning is a concussion, even mild ones. Could be from a fall as a toddler or at any time in your life. So, PTSD is simply a symptom of a Post-Concussion Syndrome. Started harping on the organicity of PTSD in 1987 along with the writing off simple PCS as adjustment disorders. Did a fast on the Mall in DC in 1995. Was visited by a group of neurologists led by an NIU neurologist, during the American Neurology Convention, who said NIH would look into it. If the military didn't pick up anything in those induction scores or if they accepted you for duty and subsequently, because of military exposure your condition is aggravated to the point of interfering with daily life including employability, the VA owes you compensation. That is the reason Yale has won the Discharge Review Case and is on the verge of winning a class action case on claims more than a year old. Between 1995 and 1998 the number of PCS studies in the NIH Library more than quadrupled. She, (the NIH neurologist) was good to her word. Must have said something at the convention to get it started. But look at the inertia of getting something done. 2008 an article in a newspaper cause Congress to finally recognize and compensate PCS calling it TBI. But PCS also happens in just exposure to a blast. Repeated outgoing heavy artillery brought a lot of vets into the PTSD groups I attended between 1984 and 1995. PTSD was the only peg they could hang their hat on. Even mild, moderate and severe TBI had found themselves in the "Adjustment Disorder" diagnosis and couldn't find any peg to hang a compensation claim on other than PTSD between 1980 and 2008. Before that they just had to accept adjustment disorder. There is no difference between being close to an improvised explosive and an incoming RPG (simply rockets in Vietnam) But the VA appears to be on the bend of recognizing only improvised explosives, not incoming heavy artillery or continuous exposure to outgoing from your enclosed turret on a ship or camouflaged field howitzer. Well, yes, PCS causes an adjustment disorder. But as long as you are treating it as a behavioral problem instead of an adjustment to an organic problem (immunoexcitotoxicity) the necessary adjustments won't be made to even have a semblance of a normal life. And an organic treatment has no chance of being appropriately directed. It is easy for physicians to see that diabetes is an organic problem that will never cure. It can only be maintained and controlled through continuing care. But they cannot recognize that with PCS or even that it is PCS they are dealing with. Cerebral malaria also brings on immunoexcitotoxicity with the exact same problems of PCS. But those victims from WWII, Korea, Vietnam, Somalia and the current wars are still "adjustment disorders" or hanging their hats on PTSD. The present pressure of having therapists put an "end date" on therapy simply doesn't recognize the problem. Some epileptic drugs help. But you won't be given them unless you get an EEG that shows something. For me the 2015 Rx for Keppra was life changing. At 74 I became more employable than I was at 34. All of my friends and family noticed a huge difference. And the VA doesn't want to confirm temporal lobe seizures (the center, I believe, for immunoexcitotoxicity) because it is a situation like diabetes, requiring continuing care and, often, ultimately compensation because of progression.
  2. I have been reading some of these blogs on MST and PTSD. I have a C & P exam on 8 July 2015. I have read some that are helpful and I am just a little nervous about this process. For one I am a Male and I disclosed it last year in July 2014. It was the hardest thing I have ever told anyone and was not completely comfortable telling my therapist either, but I had to do something because my mental state was deteriorating fast. I actually pushed the whole incedent out of my mind for along time telling myself it was no big deal. I could not tell anyone because I am a Guy this does not happen to men, so i silently suffered since 1995. I now have an exam. I have been diagnosed with PTSD due to MST and depression. I suffer from sleep distubances and night sweats. My wife tells me I scream in my sleep. I have gone to a couple MST groups and found them to be helpful. I still don't like to talk about it because I am supposed to be strong, but I have so much shame and guilt from it. I have constant anxiey and have panic attacks. I just worry about it and any guidence would be helpful.....
  3. Moderator, you might want to Pin this somewhere, as this seems to be a recurring trend. I have given out this information to others, but I will post it here so that others can find it rather than searching through the forum. First and foremost, claiming and getting sleep apnea secondary to PTSD or Mental disorder is not easy. I have personally seen more lost than won, however, it can be obtained and I myself have personally received it. If you had sleep apnea diagnosed while in active duty, it is usually a slam dunk........for the rest of those trying to get it, it could require a lot of work. I suggest trying to get it both direct and secondary service connected. It is easier to get sleep apnea as a direct service connection obviously, however, most Veterans do not get it diagnosed while in service. Best way to get that resolved is through buddy statements. I suggest getting 3-4 (I personally had 7-8) or more. Do not have them only say that they saw you snoring.......that is great and all, but that is not a symptom of sleep apnea.......it is incidental. They would need to say that they saw you gasping for air, choking, etc. Preferably roommates. If you were deployed, it would be easy to have many people saying that they saw/heard this as you would have more than likely been in an open bay setting at some point in time. You can also have your spouse write up a statement. This all needs to be during active duty periods of times and dates need to be included. M21-1 reference III.iii.2.E.2.b "Types of Evidence VA May Use To Supplement or as a Substitute for STRs" allows for buddy statements to act as STRs for medical evidence.........if they are certified "buddy" statements or affidavits.............having them written on VA Form 21-4138 solves this issue as it has the appropriate verbiage written near the bottom. Under M21-1 reference III.iii.1.B.7.a and 38 CFR 3.200, it meets the certification criteria..........problem solved. From my experience, getting all of the buddy statements needed can take longer than you originally anticipate....plan ahead. Now, for secondary criteria. Have you ever been diagnosed with alcohol abuse (it is frequently written as "ETOH")? If so, has it been attributed to your mental disorder or did it exist prior to that and is it considered willful? If you have been diagnosed with alcohol abuse, and it is attributable to your mental disorder, guess what, alcohol consumption is attributable to sleep apnea. would suggest that you start doing your own academic research. You might be able to locate peer-reviewed academic journal articles (those are the types of articles that you want to submit) through https://www.researchgate.net/. If not, another alternative is using a college database to search academic journals through. Ah, but you need to be a college student to use the database to search academic journals through. One might make an argument that you could register for classes at a local community college (you can even register online nowadays without even stepping foot on campus) and even register for "late start" classes, and have access to the aforementioned database immediately (hint hint, look in the academic journal Chest); one could easily find within a 60 minute search at least 5 appropriate and recent journal articles clearly establishing a link between specific mental disorders and sleep apnea; there is a clear link between PTSD, anxiety disorders, depression, and especially schizophrenia. One might make an argument that you could simply then disenroll from the classes that you enrolled in by the date specified in order to get a full refund, thereby being charged nothing. Save the academic journal articles as pdf files, and create a work cited page (bibliography) for them in APA format (google is your friend.) You now have a choice........... Submit your claim with the buddy statements, mental health notes from a private provider, and evidence that you have and go with either a VA exam or vendor exam (whichever is given) or you can get an IME and IMO from private providers. If go the latter route, I would schedule one with a sleep specialist, why, because sleep apnea is their specialty. Pulmonologists also fall within this scope as well, though I suspect that you will have better luck finding a sleep specialist believing there to be a link between mental disorders and sleep apnea. You will get a Sleep Apnea DBQ and an IMO. Make sure that you have your C - File first as an examiner is required to have access to it and state that they have seen it on the DBQ for it to acceptable proof to the VA. I would also get one from your psychologists/psychiatrist (Make sure that they are a psychiatrist or a psychologist.....if a psychologist, they need to be PsyD or Ph.D., or under the observation of a Ph.D.). Make sure before you solicit those medical opinions, that you acquire "buddy statements" from 3-4 (or even more) people with whom you served. Roommates would be best, or people who slept in close proximity to you.........again, this is only if you believe that sleep apnea developed while you were in Active Duty service. Make sure that they are written on VA Form 21-4138. Make sure they say that they witnessed clear symptoms of sleep apnea i.e. gasping for air, choking sounds, moments where they visibly or auditorily could determine that you ceased breathing etc. Remember, you will want the sleep specialist and the psych professional to have your academic journal articles and buddy statements. Once you have all of them, solicit your medical opinions from the two aforementioned providers. Ideally, you would love for the IMOs to say that they believe that you could be both direct service connected for sleep apnea or secondary due to mental disorder, possibly even say that the mental disorder and sleep apnea aggravate one another (which there is medical evidence to support.) If you opt to go the route of getting the private IMO and IME, you will obviously submit those with your claim, and all medical records from private providers pertinent to sleep apnea and your mental health treatment, buddy statements, academic journal articles, and a nicely written statement written by yourself on a VA Form 21-4138 talking about the issue at hand and summarizing everything concisely. Mention everything that you are providing that you wont to be considered for the claim, and when the issue first manifested.
  4. I met with a VSO on Feb 8th 2019 and started my MST/PTSD claim. To be totally honest I am scared to death. The incidents happened during my Navy duty 88-89. I had hid it from everyone including my wife until this past December. I had went to a VSO to talk about other claims when it slipped out and I was offered help to form a claim. We filed an intent to claim in Dec 2018. She suggested I talk with my wife and make an appointment with my doctor. After sitting and having a very emotional talk with my wife and with her support I made an appointment with my personal doctor. I am very lucky to have a great doctor who sat with me and after many tears I was able to explain in detail what had happened. He diagnosed me with extreme anxiety mostly when dealing with other Males ( Authority Figures or when confronted), and PTSD/MST and prescribed an anxiety as needed. What we submitted: A two page statement from me ( Timeline form) A statement from my wife A statement from from my 20 yr old son detailing my issues with examples of my issues with male authority figures A Nexus statement from my Doctor saying he feels that my anxiety and PTSD is definitely caused by what happened while I served. The VSO said that it was the best written Nexus statement she has ever seen in her 10 years in doing Veteran claims. My Questions: After submitting a claim to the VSO how long before it shows up on ebenefits? Mine still shows as intent to file. The VSO says it has been submitted. What can I expect at my C & P exam? How can I prepare myself for the exam? This is what I dread/fear most. Is it ok if I post my journey? I also want to thank all the men and women who have submitted to the MST forum. I now know I am not alone. Being a male and reading that similar things has happened to other males and reading their journeys has prepared me to start my journey and start the healing process.
  5. I have my PTSD claim C&P scheduled for Thursday. The exam was set up by VES. The examiner is a PHd out of Las Vegas/Arizona/CA that does C&P exams. My question: Can my wife sit in the exam? She knew me before, during, and after the Army. We were married the last few years of service, and after my incidents.
  6. Greetings! I am a USMC Veteran, I have PTSD (working on getting mine service connected, but thats another issues). I was asked by a close friend of mine who served in the US Army to write a Buddy Letter for his pending PTSD claim. I'm gong to share what I have written so far, I would appreciate some feedback on any changes I need to make. My name is (withheld), and I've known the Veteran (withheld) listed above since the Summer of 1998. To say I just know him would be an insult to our bond, (withheld) is my brother, not by blood but by choice. We were forged in the same fires of hell. We met the Summer before High School and from that point on we went everywhere together, weekends and summers were spent together at each others parents home (along with our 2 other brothers - also Veterans). While we were in High School before we joined the Military (Him Army, me USMC) (withheld) was super outgoing. We would go to Tournaments for the various games we played that would range from small groups of 20 to large groups over over 200 in attendance, we would go to Movies, the Mall, the Beach, he never had issues with being in Crowded places. He always had the uncanny ability to just make every situation better and fun. He was always smiling, always enjoying himself, he never had trouble sleeping, he was an all American guy that everyone was proud to call their friend. After we enlisted and we both deployed out of country I noticed some major changes in his personality. He doesn't do well with crowded places, always has to sit with his back to a wall watching the entrances and exits, his ability to relax and just enjoy life has been stripped away from him. He doesn't sleep like he used to - nightmares, sleep disturbances, snoring, etc. He has control over his anger, but you can see it boiling inside of him. When we go places (withheld) has a happy face on, but you can see him always calculating the situation, sizing up the people around him for potential threats, and always being on guard - especially around new unknown people. Getting him to go out and do things isn't like it used to be, before it was "Hey lets go see a movie" we would get up and immediately leave to go see said movie, now its "hey lets go see a movie", and sometimes its a month before he has the energy to leave and be around people enough to see the movie His experiences overseas have altered his personality, his demeanor, and his life to a point that he is completely different person that is being forced to learn how to adjust in society without the help and support he truly needs. I hope this statement helps in you making the right decision to help (withheld) with his claim. Thank you, (Withheld) Any changes needed? is this sufficient?
  7. I am beyond frustrated right now!!!! My claim is now preparation for decision and my fear is that it will be denied and I will have to appeal. I filed for my non-service connected Fibro as caused or aggravated by the service connected IBS and/or service connected PTSD on an as likely as not basis. See my screen shot attached of my original claim in July 2018. I had my first C&P exam in September 2018 and it was negative based on the examiner stated there was no causation of my s/c PTSD to my Fibro. See the screen shot below. I will note that he did a separate C&P exam for Fibro and agreed I had Fibro. Never looked at aggravation and never looked at the possibility of IBS. I sent a statement in support of claim pointing this out to the rater. I get another C&P exam in December 2018 BUT by now I have THREE positive medical opinions from BOTH my RA and MH doctor. Both state my Fibro is aggravated by my PTSD and my MH doctor also states my Fibro is aggravated by my IBS. SEE ATTACHED 2 of the 3 letters. When I went to the second C&P exam, it was with the same doctor and he refused to look at the medical opinions. He also once again did not look at aggravation. Again a negative C&P exam. Then the rater asked for clarification/review of conflicting medical opinions. Here is what the rater asked, Per III.iv.3.D.3.a. and III.iv.3.D.3.d. We need clarification/review and reconciliation of conflicting evidence for claim for fibromyalgia secondary to SC PTSD. Negative MO received on 09/28/2018 (TAB A) stated that fibromyalgia was not secondary to PTSD. Received positive MO on 12/05/2018 (TAB B) relating fibromyalgia as secondary to SC PTSD and IBS. Negative MO received on 12/05/2018 (TAB D) stated that fibromyalgia was not secondary to IBS. Examination dated 12/05/2018 (TAB C) shows a diagnosis for fibromyalgia. Per reference please request clarification of conflicting MO for fibromyalgia as secondary to PTSD and IBS with rationale. This medical opinion was done last week w/o me present and once again the medical opinion was negative and doesn't address anything the rater asked. In fact, his statement is laughable. While he states he reviewed conflicting medical evidence, he sites PT notes and doesn't refute the positive medical opinions. Here is what it says: I HAVE REVIEWED THE CONFLICTING MEDICAL EVIDENCE AND AM PROVIDING THE FOLLOWING OPINION:All medical records were reviewed. Physical therapy note on 8/15/2018 by XXXXX documents diagnosis of fibromyalgia and PTSD. The exact cause of fibromyalgia isunknown but has associations with IBS, temporomandibular joint disorder, interstitial cystitis, vulvodynia, and tension headaches. Literature review reveals fibromyalgia along withits associated pain syndromes are clearly different and separable from depression and anxiety. The claimant's fibromyalgia is not secondary to the claimant's claimed PTSDcondition. The VA continues to miss the fact that I asked in my original claim either causation or aggravation. So on Monday, when I went to PFD, I sent the attached statement and uploaded in Ebenefits pointing out once again they are not looking at aggravation. My rep said if it comes back denied, which I am sure it will, we will file an NOD pointing out the fact that they are missing aggravation. MH positive opinion.pdf RA positive medical opinion.pdf
  8. I am concerned the "Diagnosis and Rationale" section are going to be the stumbling block for a DRO; in MY opinion, they are contradictory. The examiner wrote out a DBQ that I would have paid an independent examiner to write. The wording the examiner used could not have been any more favorable to my claim, at all! If I had chosen the words to use in my behalf, I would have fallen short of her submitted DBQ. However, the examiner left the diagnosis and rationale sections open to intrepretation. Does any one here on this forum have insight that will be helpful in explaining what I am seeing? Basically, am I looking at a blanket denial, or is there the possibility of a "reasonable doubt" situation? The following is a cut and paste from a C&P for mental health. I am not currently rated for any service-connected disability. I also have a current VHA psychiatrist diagnosis which matches the C&P examiner's diagnosis (Major Depressive Disorder). I read the request for the recent C&P, the rater did request two separate issues to be addressed: 1) Does the Veteran have a diagnosis of PTSD, Major Depressive Disorder, or other mental disorder that was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed stressors?2) Does the Veteran have a diagnosis of PTSD, Major Depressive Disorder, or other mental disorder that clearly and unmistakably existed prior to his military service, and that was at least as likely as not (50 percent or greater probability) aggravated beyond its natural progression by the claimed stressors?"Taken as a whole, in this examiner's opinion, the evidence available at this time is most supportive of a diagnosis of Major Depressive Disorder With Anxious Distress, and is insufficient to determine whether this condition was incurred during the Veteran's military service, or was aggravated by it. To make such a determination would require evidence regarding his pre-military history which has direct bearing on the question of the onset and etiology of his mental health difficulties, and which was not available to the present examiner." I claimed 3 stressors, applied for PTSD, or other MH diagnosis. The DBQ was well written, addressing each of the stressors. The examiners tied each of the stressors to DSM-V. Then, as part of her narrative, she included the following: "Consequently, for the purpose of the present examination, the claimed stressors are considered to be corroborated. For the purpose of this examination, the claimed stressors are also considered to be sufficient to cause PTSD as specified by DSM-5 diagnostic criteria, a clinical judgment which is inherently and unavoidably subjective to some extent."However, instead of a PTSD diagnosis, she chose "Major Depressive Disorder with Anxious Distress." Now, I am most concerned about her "Diagnosis and Rationale": She used the same wording to answer both of the rater's questions. "OPINION: It is this examiner's opinion that the Veteran DOES NOT have a diagnosis of PTSD, Major Depressive Disorder, or other mental disorder that was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed stressors. RATIONALE: The evidence available is insufficient to determine whether the Veteran's diagnosed mental disorder was incurred during his military service. To make such a determination would require evidence regarding his pre-military history which has direct bearing on the question of the onset and etiology of his mental health difficulties, and which was not available to the present examiner."
  9. Hello fellow veterans! My question is this. My psychologist at a VA facility told me he does "not provide letters with regard to unemployability." Not that he opined negatively, but that he simply doesn't do it! Now PTSD programs (Cinncinnati) in their brochure say they will not provide any letters with regard to VA benefits. I have now moved to Vietnam in order to be able to live (got my ticket right before my decision that gave me 70% arghhh!) so any ideas what I can do now? I have a truly horrible work history but mostly I would quit because the stress would be too much. This was before I had any benefits to lean on, I simply lost everything and became homeless. Any help is appreciated. Thanks.
  10. Hello Everyone, First of all I would like to thank EVERYONE who has taken the time to respond to my numerous questions in the past. I have had nothing but very informative and caring responses from the users on this board, and your comments have always helped me work through whatever issue it is I was dealing with at the time. Having said that I have a new question that I would like to present to the Hadit community. I am currently rated as 100% P&T for Major Depressive Disorder w/Anxiety Attacks AND PTSD, as well as SMC for other disabilities totaling approximately 60% (Sleep Apnea @ 50%, Tinnitus @ 10%, other disabilities at approx 10%). I was initially granted an award of 10% back in 1999 when I initially separated from the USMC, and I was attending Nursing School through the Vocational Rehabilitation program from around 2002-2004 when I had to drop out due to medical reasons. Shortly thereafter (approx 2005) my rating was increased to 100% P&T for PTSD and SMC was added for the additional 50%+. I did not return to my Nursing School due to the fact that I could not continue my clinical rotations while on narcotic pain meds that I am still taking today due to degenerative disc disease in my spine. I would like to add that the increase in my disability in 2005 was back dated to 1999, as it was found that these conditions existed during my time in service. I spoke with my VA Therapist about a year ago who stated that although I would never be able to work full-time ever again due to the severity of my PTSD, they did believe that I would at some point be able to pursue part-time employment at some point in the future. After much prayer and personal introspection I have realized that I believe I could pursue a career as a Patisserie/Bakery Chef decorating cakes out of my home on a part-time basis. Working out of my own home would allow me to pursue some type of gainful employment while working in an environment that would allow me to avoid the stressors and situations that aggravate/cause my PTSD and anxiety attacks. While it would be impossible to explain the nature of my disabilities, and how they keep me from being able to pursue gainful employment suffice it to say that I am unable to manage interpersonal and professional relationships with people in a working environment, and being around crowds causes severe panic attacks/feelings of being suffocated and my life being in danger. The ONLY way I can work would be in a situation where there are NOT a lot of people and I am NOT under direct supervision from an individual, AND I have a place that I can retreat to when things begin to get crazy. This is why working from home is such an ideal situation. Believe it or not, my Vocational Rehabilitation counselor was actually open to the idea of pursuing my education for the purpose of opening my own home based cake decorating business given the uniqueness of my disabilities, providing I could get signed off by my VA doctors stating that they feel I could handle the stressors of such a situation. OK...HERE IS MY QUESTION..Am I putting my 100% P&T at risk by applying for Voc Rehab? Can they take away my rating just for applying for Voc Rehab? Can I work part-time from my house and still maintain my 100% P&T rating? What are your recommendations regarding this whole situation? Once again, I thank you for your time and I realize that there are endless possibilities and answers to this question. Please answer the question to the best of your ability, and feel free to email me or ask me here should you require any further information. Sincerely Yours, Jeff Crockett
  11. I would like to thank you all for the information that helped me gather my information in my other question. Took most of the year, but finally filed PTSD due to personal trauma, early Jan 2019. Intent to file was running out. I did file some secondary conditions as well. I have just been called by VES to have my C&P PTSD exam in March. A question and answer exam I was told, 30-45 min. Glad I have researched similar exams here. Berta, Andy, Buck, Geekysquid, Thanks for the help and guidance. Was able to a buddy statement, CID records, VET center records from before I was discharged and current, and other current discipline records from work. Good statements from my wife and I as well.
  12. I recently did a new C&P for PTSD when I filed for I.U. He neglected to mark a lot of my symptoms. I am currently rated at 50% PTSD, was wondering if you think this keeps me a the same or warrants an increase. He did forget to mark my suicidal ideations and a few other symptoms though so I am worried I won't be rated correctly. 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 ICD Code: F43.10 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD ICD Code: F43.10 Mental Disorder Diagnosis #2: Panic Disorder ICD Code: F41.0 Mental Disorder Diagnosis #3: Major Depressive Disorder, Recurrent ICD Code: F33.1 Mental Disorder Diagnosis #4: No Axis II disorder 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? [ ] Yes [X] No [ ] Not applicable (N/A) If no, provide reason that it is not possible to differentiate what portion of each symptom is attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses: The PTSD is currently the more severe and responsible for the veteran's current level of impairment; the clinical depression and the Panic Disorder are certainly significant, however. The depression and Panic Disorder are seen as more likely than not caused by the chronic PTSD symptoms. It is difficult to ferret out the contribution of the three disorders due to the overlap of symptoms and variability of degree; at times any of the three disorders may be the more severe, but the PTSD is responsible for the current level of impairment. c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] 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? [ ] Yes [X] No [ ] No other mental disorder has been diagnosed If no, provide reason that it is not possible to differentiate what portion of the indicated level of occupational and social impairment is attributable to each diagnosis: The PTSD is currently the more severe and responsible for the veteran's current level of impairment; the clinical depression and the Panic Disorder are certainly significant, however. The depression and Panic Disorder are seen as more likely than not caused by the chronic PTSD symptoms. It is difficult to ferret out the contribution of the three disorders due to the overlap of symptoms and variability of degree; at times any of the three disorders may be the more severe, but the PTSD is responsible for the current level of impairment. c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence Review ------------------ Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS 2. Recent History (since prior exam) ------------------------------------ a. Relevant Social/Marital/Family history: Veteran received his previous PTSD C&P on Mar 2016. At that time he was living in an aparments. He still lives in but has moved to a different aprtment. He lives with a roommate. He is not in a relationship. The veteran is not employed. His typical day consists of going to school, "I have classes five days a week but "I only go two days a week because of panic attacks. When I'm home I sometimes lay in bed and cry or think about everything." He noted he does not sleep much at all. He said he only gets out for school; is roommate will cook and get most of the groceries. b. Relevant Occupational and Educational history: The veteran has not worked since he was discharged from the Air Force in 2016. He has applied for jobs and tried to do a work study but quit because of panic attacks; at times he will scream and hit his back pack. He started there in August and is taking 12 units. He is schedule to attend classes five days a week but rarely makes all five days. "I'm close to failing a couple of classes for attendance. c. Relevant Mental Health history, to include prescribed medications and family mental health: The veteran is current being followed by a staff psychologist every two weeks; he has being seeing her since August. He is also followed by a staff psychiatrist who prescribes: prazosin and Celexa. He has taken other medications. He said they help only a little bit. d. Relevant Legal and Behavioral history: Denied by the veteran. He did say he got into an altercation about two weeks ago at the gym when he through a dumbbell at the floor; he was kicked out. e. Relevant Substance abuse history: The veteran has not drank alcohol for over one years; he denied ever abusing it. He does not use illegal substances. 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 symptom s 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] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] 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] Panic attacks more than once a week [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] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Neglect of personal appearance and hygiene 5. Behavioral observations -------------------------- No unusual behaviors observed. 6. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [X] Yes [ ] No If yes, describe: The veteran reports having suicidal thoughts 3-4 times a week but doesn't dwell on them. He said he would never attempt suicided because of his kids. 7. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 8. Remarks, (including any testing results) if any: --------------------------------------------------- No remarks provided.
  13. Looking for some guidance. I served on active duty in the Navy from 87-90 overseas on a ship. My original plans when I enrolled was to do 20 years, Back in Dec of 2018 I met with and amazing Veterans Service Officer about a tinnitus claim which was approved. While there she had handed me a bunch papers about claims and one was on PTSD and MST. She was copying and I was reading the PTSD-MST document and it triggered a bunch of emotions where I started shacking and tearing up. The VSO walked in and noticed my state and asked me if I was ok. I tried to answer her but, couldn't she went and got a male VSO and a male nurse to come in. Once the nurse helped calmed me down the male VSO noticed the document I was reading and we talked for awhile about it and I briefly explained a little. He recommend that I file a DBA for PTSD-MST and recommended the following. I document everything I can remember about the events is causing my stressors: I wrote an eight page document in details about the events. Talk to my wife about what happened and have her write a document on what she sees and how it effects our relationship: After having an very hard emotional talk with her, she wrote a two page document. My 20 year old son also wrote a two page document on things he as seen, even though he only knows a little about what happened. Talk to my doctor about what happened: Made an appointment and discussed detail what happened and he diagnosed me with severe PTSD and anxiety placed on Xanax as needed. He wrote a Nexus letter and has sent it into the VA for me Now I explain a little about what when on when arriving on ship I was assigned to a steam generator room and assigned watch with two other sailors one was a 2nd Class Petty officer and the other a 3rd class. At the time we were doing 12 hour watches 12 on 12 off. The first few watches went well. We were getting ready to pull into Subic Bay Philippines for a few days before heading back to Japan. They both stated " We want you to come out and drink with us and then we can tag team a few girls". Now a little history alcoholism runs in my family and I don'y shy away from drinking I just know my limits. When we arrived in port I hung out with a few of my buddies instead. When we headed back to sea things went down hill. On my first watch back with them they yelled to me to come to the watch booth which was big enough for 2 chairs and a small table/chair between them the whole booth was maybe 4 feet by 6 feet with a center door and windows. When I went in I noticed they both had towels over their laps which wasn't unusual do to it being over 100 degrees in there. I was told to sit down and did then one of them stated we figured out why you didn't go out with use you must be gay and not like girls. I didn't get a chance to answer when they ripped the towels off and exposed themselves to me. I tried to leave but they held the door laughing. I was finally let out and was very shaken up. This happened many time the next few day the both continually exposed themselves to me. I would ask them to stop and would be ignored. I went to my Chief Petty officer and told him what was going and and got this remark back " Why you trying to get them in trouble they are just playing with you". I went to back to my watch and was cornered by them and verbally threatened to keep my mouth shut. With out going in two many details things escalated to the point where I wold come done to watch and they would be masturbating in the open I'd try to move away and they would chase me around. One time I was working in the bilge( bottom area of ship lots of stinky water and valves) under the floor of our work space crawling around attempting to fix a valve when I felt what I thought was water coming down on me upon looking up realized they were urinating on me. A lot more worse things happened. I was very depressed and felt helpless. I tho ought about suicide many time and even cut my wrist once when things were at its worst. Got scared and told everyone I fell and sliced it still have the scar. Other than my failed attempt to tell my Chief about it I never told a soul about it. I ask myself why didn't I fight back? Lets put it this way at the time I weighed about 125 lbs soaking wet and about 5'7". They both were about 170-180 and were both over 6 feet. I was working in a space alone with them at anytime they could injury me say I got hurt working it was my word against the 2 of them. Why has it taking so long for me to open up about this? I always thought that Sexual trauma only happened to woman. I was scared and embarrassed to admit he happened to me. How has this affected me. I have nightmares weekly. I have flashbacks. Something will trigger memories and I'll have panic attacks. I have intimacy issues. I have ED issues that started at an early age. I have issues in places where there may be Male Public Nudity ( Locker rooms, even public restrooms I'll use a stall ) Just because it triggers flashback of them and what they did. I have issues with Male authority figures. I have the tendency to back down from and conflicts even though and right. Fear retaliation And the big one still fear retaliation from them. Still fear after almost 30 years that exposing them and what happened they will find away to get me. Thank you to everyone who reads this. Now my questions: Is there anything else I should include to help my case? I'm aware that after my meeting with the VSO they will set me up with a DBA with someone from the VA. What can I expect from that meeting and how should I prepare for it? What about secondary PTSD symptoms what applies? After meeting with my personal doctor he actually interned at the VA center I going to. He suggested apply for ratings secondary to the PTSD rating for the following. Erectile dysfunction, hypertension. Do you feel that these are ok? Are there others that I should consider or be aware of?
  14. Hello All, Ive been coming to this site on and off for a couple of years, but this is my first post. Lot of knowledgeable and great people here. Thank you to all the old timers and those with experience for everything you contribute here. You do a lot for people, even though it may not be evident. Im a 36 year old 100 P&T VA for combat related PTSD, TBI and other service connected issues. Former active duty 11B B4, fought with the 101st in OIF. Left active in 2009 as I was having issues. No one was helping me, didnt understand what was wrong with me, and of course the culture of "if youre not bleeding or missing a limb, dont go to sick call", ect. So I left, joined the reserves where Ive been ever since. That door is about to close as well, as I just cant do it anymore. I did my best to try and still contribute to my nation, feel some sense of worth and continue to serve, but my issues are too great and I have to step away. Even though the Army has changed a lot, I still feel a great sense of loss of over this. But, I have a family now and must do what is best for them. That alone is difficult for me. Those of you who have the same issues as me may understand, PTSD and TBI are what I call a "perfect storm of bull____". Our hardware and software are both busted and feed off each other in ways that I myself cannot even begin to describe. Damn near ruined my life and just trying to get through the average day takes everything Ive got. I used to be a mostly-normal, fun-loving, smart and well-adjusted guy and I was good at my job. Anyway, this ain't a therapy session, but Im sure a lot of you can understand where Im coming from. My latest battle is with SSDI. Denied. Appeal denied. Now Im onto the hearing phase. Hearing is set for April 5th. I have a lawyer firm I sort of just picked out of a hat. They arent even in my locale, Im in the Northwest, they are Philadelphia or something. They are supposed to be representing me. I have a hearing in April and I havent even talked to a real lawyer yet. Im worried and scared about this whole process. It has made me extremely anxious, among other things. Its causing a lot of extra stress. Im trying to find answers on how to maximize my chances of success. What Ive gleaned so far is of course, get all VA records. I still attend treatment every month (i would go more but Its a 4 hour round trip just to see them every month). Im sure its going to be harder to get SSDI because of my age too. Not to mention, the VA does not seem the best at keeping records. Most all of my treatment has been with the standard-issue social worker therapist type and of course, the docs/nurses who prescribe me my meds. My head is swimming. I am having a hard time making sense of all this. Im scared and I could really use some guidance. I dont trust these lawyer people to do their best for me. Im hoping there is not something critical I am missing. Im not good at describing my symptoms, reflecting on my life.... let alone in court in front of a judge. Sorry such a long post, sort of hard to collect my thoughts. Thanks for any input and advice.
  15. I hope you can help me; not sure what I should do. I was rated Service Connected Disable for PTSD on August 21, 2012 @ 70%. I didn't expect this at all. If anything, I thought I would get a low rating for my physical aliments............(neck, back head shoulder). When I applied in 11/2011, I had been out of work for 3 yrs and was totally distraught,confused and disoriented. Needless to say, I finally got a job in 02/12 and it is no where near what I use to do or the money I use to make. I'd like to know what your advice would be for this: I see where I do have serious social and economic problems and believe I am totally diasable & want to ask for 100% PTSD, Permanent and Total. I'm still on this job that wrecks my nerves, can't stop the obsessive thoughts and wants to hurt people because I don't work well with people at all. I took this week off because I couldn't pull up the gumption to go back in there after the week, mentally. What should I do; appeal my rating 1st and then apply for TDIU while working or do I go ahead and let the job go in order to apply for TDUI and then appeal the VA's decision? Thanks in advance.
  16. Hello everyone I am new to the site. And I recent submit a the dbq for an increase for my PTSD and I trying to understand it but im just not getting it. So I figured would ask you all. Below is what the examiner put in the record. Review Post Traumatic Stress Disorder (PTSD) Disability Benefits Questionnaire Name of patient/Veteran: ========= Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No SECTION I: ---------- 1. Diagnostic Summary --------------------- Does the Veteran now have or has he/she ever been diagnosed with PTSD? [X] Yes [ ] No ICD Code: F43.1 2. Current Diagnoses -------------------- a. Mental Disorder Diagnosis #1: PTSD ICD Code: F43.1 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? [ ] Yes [X] No c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] 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? [ ] Yes [ ] No [X] No other mental disorder has been diagnosed c. If a diagnosis of TBI exists, is it possible to differentiate what portion of the occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] No diagnosis of TBI SECTION II: ----------- Clinical Findings: ------------------ 1. Evidence Review ------------------ Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS Evidence Comments: MENTAL HEALTH OUTPATIENT FOLLOW UP NOTE [excerpts] DATE OF NOTE: MAR 05, 2018 AUTHOR: ========,NP NURSE PRACTITIONER CHIEF COMPLAINT: "same old same old" INTERVAL HISTORY: Veteran is here for 6 week follow up for PTSD, Alcohol Use Disorder, unspecified, episodic. At last appointment, low dose venlafaxine was added, aripiprazole, prazosin, and melatonin were continued. He reports symptoms are about the same. His wife is pregnant with twins, so he is trying to minimize arguments at home. He worries he will not be able to connect with the babies, because he struggled so much with his daughter and points to her persistence as the reason they are close now. He see no change in sleep, remains irritable, and more hypervigilant due To recent car break ins on his street. He has cut down on drinking, and denies any binges since last appointment. He continues to have fleeting SI, but denies intent. He often has thoughts of hurting others, but strongly denies acting on the thoughts. No recent hallucinations. He does talk to himself when he is trying to work something out, but denies hearing voices other than his own. It can be embarrassing as coworkers and wife have caught him. ASSESSMENT AND TREATMENT PLAN GOALS: DSM 5 Diagnostic Impression PTSD Alcohol Use Disorder, Unspecified, episodic Goals: 1. Decrease irritability and anger- does not interfere with home or work life more than one time per month, ongoing, improving 2. Improve feeling of connection with others- enjoying and developing relationships, ongoing, no change 3. Decrease avoidance of social situations/crowds- can tolerate Wal Mart, enjoy outings with family, ongoing, no change 4. Improve sleep- no difficulty falling asleep, sleep 6 to 8 hours nightly, ongoing, worsening PLAN AND PROGRESS TOWARDS TREATMENT PLAN GOALS: reviewed records and discussed options - increasing venlafaxine to 75 mg - continuing aripiprazole, prazosin, and melatonin - suggested individual supportive counseling at the Vet Center after Dr. Bhatia leaves. - monitoring labs at next appointment - Will continue to follow closely. RTC 6 weeks/PRN 2. Recent History (since prior exam) ------------------------------------ a. Relevant Social/Marital/Family history: Last C&P PTSD DBQ May 2016 Lives in Moncks Corner, SC with wife of 9 years and daughter age 4. Daily routine: Lay down for bed 2100. Will fall asleep 2300. Wake frequently. "I have to do certain things to calm down. I need my gun next to me. I have to check the house make sure its locked. Make sure the alarm is on. If I hear something, it wakes me right up and I have to check it out." +Nightmares, night sweats. "Sometimes I'm swinging and yelling and talking in my sleep, so my wife leaves for a different room. I wake up and she's not there and it freaks me out." Prescribed melatonin for sleep, prazosin for nightmares. Abilify for PTSD. Diagnosed sleep apnea by sleep study in 2013, prescribed CPAP and is compliant. Relationship with wife: "We almost got divorced a few times. She didn't understand what was going on. She started reading up on it. The whole reason I went to mental health was because of her." Relationship with daughter: "She is scared of me. She has seen me Snap a few times. She is on guard. She doesn't know if I'm going to be up or down. She is my heart. She is the only thing that makes me feel normal." Will watch cartoons and read books together. Hobbies: play basketball, go to gym "but now I just sit in the House watch TV or just in the room." Likes anime. Support: father "he's been with me through everything." And is Veteran too, wife "but there is a wall there where I don't open up." b. Relevant Occupational and Educational history: Working for passport services for 3 years. "Its rough at times. There's a lot of people in there. They had to move my seat because I'm too jumpy. They moved it so I'm not around a lot of people. It is hard to focus. I have to use sticky notes. They have been pretty supportive. I've had good supervisors." Was counselled about days missing for work; "I had a blow up at my co-workers so they spoke to me about that." Miss 2-3 days per month. "When I get to work, I drive around the Building and if I see something I don't like, I just go home." Military history: E4, MP, Separated 2014, Honorable, Served about 6 years. c. Relevant Mental Health history, to include prescribed medications and family mental health: Mental health treatment with prescriber and therapist. No history of hospitalizations. Was in group therapy "but I didn't like it." d. Relevant Legal and Behavioral history: "When I was in Japan I got us into trouble because of my alcohol abuse. I got into a car accident and hit 3 cars." Was sent to ADAP for anger and PTSD. A month ago got into a physical altercation with sister's boyfriend "I laid hands on him. So then I went to a hotel room and stayed there and then I went on a drink binge." e. Relevant Substance abuse history: Alcohol - "I abused it really bad. My PCM said it was affecting My liver." Was drinking4-5 25 oz beers, drink a bottle of liquor over The weekend. Now will drink 1-2 beers. Tobacco - 2-3/day Denies other substances. f. Other, if any: Current reported symptoms: Anger: "I black out and become very violent. I knock TVs off walls. My wife was ready to leave me." Triggers: "foggy day and rain." "Ignorant and stupid people." Social avoidance. "If a car is behind me too long, I start to think he is following me. There is a particular truck that I know and he gets too close to me. I got sick of it and one day I followed him home. I didn't do anything, but I blacked out mad. I knew I needed help." Flashbacks - "I was shopping with my wife, and this guy had a turban on his head and I thought I was back there. Its constant, its all the time." Hygiene - "My wife got on my because I went a week without washing And I didn't even realize it." Suicide - "I thought about driving into traffic at the light. One Time I sped up and got on railroad tracks when a train was coming. I thought, what am I doing? I went into store parking lot." Reports this occurred 2 weeks ago. "I keep a picture of my daughter in the car to keep me from [doing it]." 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) [X] Witnessing, in person, the traumatic event(s) as they occurred to others Criterion B: Presence of (one or more) of the following intrusion Symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred: [X] Recurrent, involuntary, and intrusive distressing Memories of the traumatic event(s). [X] Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). [X] Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings). [X] Intense or prolonged psychological distress at exposure To internal or external cues that symbolize or resemble an aspect of the traumatic event(s). [X] Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). Criterion C: Persistent avoidance of stimuli associated with the Traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following: [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. [X] Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). [X] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.) Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. [X] Reckless or self-destructive behavior. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Criterion F: [X] 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] Mild memory loss, such as forgetting names, directions or recent events [X] Flattened affect [X] Impaired judgment [X] Disturbances of motivation and mood [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Suicidal ideation [X] Impaired impulse control, such as unprovoked irritability with periods of violence [X] Neglect of personal appearance and hygiene 5. Behavioral observations -------------------------- Veteran was open and forthright with no evidence of exaggeration or feigning symptoms. Affect blunted. Minimal eye contact. Speech regular rate, tone, volume. Thought process linear, logical, goal directed. Thought content absent for delusions, hallucinations, paranoia or HI. Endorses SI with no active plan, but drove car onto train tracks last week. Discussed safety, crisis line, Veteran has MHC appointment next week. Veteran reports safety to return home today. 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: --------------------------------------------------- PCL-5 score 72, indicating probable diagnosis of PTSD. Veteran continues to meet criteria for PTSD. He reports social withdrawal, sleep problems, memory problems, irritability, anger that is both verbal and physical, suicidal thoughts. He has work accommodations because of his PTSD symptoms. He misses several days of work a month because of his symptoms.
  17. First, What Cannot be CUE? The Code of Federal Regulations provides that the following situations do not constitute CUE: (d) (1) Changed diagnosis. A new medical diagnosis that ‘corrects’ an earlier diagnosis considered in a Board decision. (2) Duty to assist. The Secretary's failure to fulfill the duty to assist. (3) Evaluation of evidence. A disagreement as to how the facts were weighed or evaluated. (e) Change in interpretation. Clear and unmistakable error does not include the otherwise correct application of a statute or regulation where, subsequent to the Board decision challenged, there has been a change in the interpretation of the statute or regulation. 38 CFR 20.1403 (d)(3) above is most interesting. As long as the VA relied on some negative evidence that was in the record, even the most dubious and slimmest of evidence, a veteran cannot argue that the analysis was flawed. It doesn’t matter if the evidence on the veteran’s side amounted to a mountain and the negative evidence on the other side amounted to a mole hill, so long as the VA relied on the negative evidence to reach its finding of fact adverse to the veteran, it cannot be challenged as CUE. The CAVC put it this way: “when there is evidence that is both pro and con on the issue it is impossible for the appellant to succeed in showing that ‘the result would have been manifestly different.’” Simmons v. West, 13 Vet.App. 501 (2000). If you find yourself in this situation, the best route is to reopen the claim with new and material evidence that specifically rebuts the VA’s previous rationale for denying the claim. What IS CUE? Analyzing a BVA Decision for the following types of substantive errors: BVA findings of material fact that are "clearly erroneous": Whether constitutional provisions, VA statutes, regulations, or M21-1 provisions were violated or misapplied Failure to comply with a BVA or CAVC remand order Failure to reopen a claim supported by new and material evidence Failure to consider a claim or legal theory reasonably raised by the record Failure of BVA to State its Reasons or Bases for its Findings of Fact and Conclusions of Law BVA Findings on Medical or Vocational Issues of Fact Unsupported by Competent Evidence in the Record The BVA's Failure to Explain Why It Rejected Positive Evidence Supporting the Claim Some Examples of CUE Failure to Fully & Sympathetically Develop Claim Even though the failure of the VA to fulfill its duty to assist a veteran is not grounds for a CUE claim, the courts have allowed CUE claims based on the VA’s failure to “fully and sympathetically develop a veteran’s claim to its optimum.” Moody v. Principi, 360 F.3d 1306, 1310 (Fed. Cir. 2004). This means that the VA must “give a sympathetic reading to the veteran’s filings by ‘determining all potential claims raised by the evidence, applying all relevant laws and regulations.’” Moody 360 F.3d at 1310. Therefore, if there was evidence when the previous decision was made that the veteran was eligible for compensation for a claim not raised by the veteran, and the VA did not adjudicate that claim, this constitutes CUE. For example, if a veteran applies for benefits for back problems relating to an incident while serving in Vietnam and subsequent VA medical exams reveal the veteran has Hodgkin’s disease, the VA has a duty to adjudicate a claim for Hodgkin’s disease on the veteran’s behalf (Hodgkin’s disease is a presumptive service-connected condition for veterans who served in Vietnam). Failure of the VA to adjudicate a claim for Hodgkin’s disease would be CUE and the effective date for the Hodgkin’s claim will date back to the date of the back injury claim. 38 CFR 3.156© Using Newly Added Service Records You can use 38 CFR 3.156© to get an earlier effective date “if the VA receives or associates with the claims file relevant official service department records that existed and had not been associated with the claims file when VA first decided the claim.” So, if after reviewing your C-file you find official service records that were added to your file after the denial, and these documents would have manifestly changed the decision, you can argue for CUE based on 38 CFR 3.156©. An example would be a previous denied claim for PTSD because of lack of a stressor in service. If an official service document is added to your file after this denial that clearly shows the veteran suffered a stressor in service, the veteran can use 38 CFR 3.156© to get an earlier effective date equal to the date he originally filed the claim for PTSD (assuming you have the proper nexus and medical opinion). Thanks to Katrina Eagle, and John Forristal
  18. Hi there! Long time member here but been MIA for awhile. Life has been busy and I have been dealing with health issues. Long story short, I went through a battery of tests to find out what is wrong with me. I did an ANA-TITER test, and it was positive for an auto immune disease. Was referred to the RA doctor for further testing to see if I had lupus. The RA doctor did blood tests and determined I don't have lupus. We did additionally physical exam at the VA back in May and he determined I had Fibromyalgia and diagnosed me with it. We discussed that my Fibromyalgia co-exists with PTSD/MST and IBS. We also discussed that Fibromyalgia can be secondary to my already service-connected PTSD/MST or even maybe my IBS. I discussed this with my representative and we decided to file a claim for Fibromyalgia (non-service connected disability) to an already service-connected disability. Either PTSD/MST or IBS and we asked that they evaluate either causation or aggravation. We filed in July and I had my C&P exam in September. The examiner was asked by the rater to give his medical opinion as to the Fibro being secondary to my PTSD/MST. The rater did not ask if it was possible to be secondary to my IBS like we requested. The examiner did a C&P DBQ for Fibro and that was positive. I do have Fibro, that isn't the issue. The medical opinion is what was disturbing. I was with the examiner for less than 5 minutes. He stated he physically examined me when he did not and he seemed very unknowledgeable about Fibro/PTSD-MST/IBS as co-existing and determining either causation or aggravation. Of course the medical opinion stated, "less likely than not". I was floored, so I went to work for my claim. I contacted my RA doctor and we talked with my representative on the phone as well. By the end of the call he was confident enough to link my PTSD/MST as aggravation to my Fibromyalgia. He wrote a one/two paragraph letter on my behalf. We sent that to the rater. Then I spoke to my MH provider last week and she too wrote me a very good NEXUS letter. That was sent to the rater yesterday. Both my doctor's are at the VA and both stepped out on a limb for me. I am hoping their medical opinions outweigh the negative C&P medical opinion. I am attaching the C&P exams (redacted), the two medical opinions (redacted) - I am hoping I am successful because this will make me 100% scheduler. I am currently 94% overall rated. C&P _Redacted.pdf nexus 2_Redacted.pdf redacted.pdf redacted2.pdf
  19. Hi, I have recently started the claims process with the VA (I filed an informal claim on 04-Sept-2013 I see a private therapist and have a current diagnosis of PTSD, Bipolar II, poly substance abuse. My therapist agrees with me that my disorders are SC I've taken the initiative already to get copies of my DD214 as well as my private medical records. Currently I'm trying to track down my records from when I was placed on a 72 hr hold in a psych ward in 2000. My prescribing Psychologist, who puts in time at the practice I go to, is also a VA doc. I guess my question is this. If my therapist tells me that they have diagnosed me with the above disorders does that mean that my Psychologist (the VA doc) had to have signed off on the diagnosis and if so does this mean that I should have an easier time with the VA? I'm also concerned that I may have to track down treatment records from the Army (I assume those would be in my DD214?) Where would I look for any SMR's that I may need? I also wonder if maybe I should try and track down any relevant records from my old Unit to show things such as an Article 15 and any evaluations done that would show the onset of my conditions. Also if anybody could advise me of what else I should be doing at this early stage to present an effective claim please feel free to advise me. Thank you in advance for any and all help Jason
  20. C&P Exam PTSD:MST Eating Disorder.pdf ^^^^^^Well the attached report indicates to me a 10% PTSD rating. I am currently 30% and I do not understand how this happened but I might be in for a reduction. I thought the exam went well. I had a PTSD and Eating Disorder C&P. Regarding the occupational/social impairment she checked the one that resembles 10% and for "b" she marks YES and goes on to say my trauma impacts my occupational/social impairment. Look at the symptoms she notes: Anxiety; Panic Attacks more than once a week; Chronic sleep impairment; difficulty in establishing and maintaining effective work and social relationships She even stated in the exam that I was BDD (Body Dysmorphic Disorder) but her reports indicates while I have BDD characteristics I don't warrant the BDD rating. She states for the VA established diagnosis of SPECIFIED TRAUMA AND STRESSOR RELATED DISORDER, there is NO CHANGE in the diagnosis. At this time the claimant's condition is active. Does this Exam mean I am going to be reduced or would I fall under the below??? 3.344 Stabilization of disability evaluations. (a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind. (b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, §3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made. (c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.
  21. Can MDMA "cure" PTSD? https://www.independent.co.uk/news/health/mdma-ecstasy-mdma-post-traumatic-stress-disorder-veterans-a8332561.html https://www.ncbi.nlm.nih.gov/pubmed/16499508
  22. I am just wondering to what extent does the VA's Duty to Infer reach? I keep seeing it mentioned but I am not finding any particular bounding rules or interpretations, so any links or opinions would be great. Take for example a post I read this morning. OP was initially rated as 70% PTSD and was not/had not been working. Said it was in his file. Asked if VA should have inferred IU. So what has to be in their file to trigger the Duty to Infer? Is simply stating they are unemployed enough to trigger the question? is a mention in their intake memo enough? from their Primary Care doc? Psychiatrist? does a discussion with the 1-800 number trigger this duty? What if they are homeless or near to becoming homeless is that enough? Do they have to have an extensive statement saying they have not worked in two decades (or whatever) and don't think they ever will again? Would the duty to infer by itself require the VA rating decision to mention IU or send the IU form with an explanation? For example my latest rating decision for SMC K include a statement that I might have a claim for Voiding Dysfunction and tells me to file a "new" claim if I want to explore being rated for it. To my mind this is a Duty to Infer action on the part of the Rater; taking that back to the 70% PTSD example should there also have been a statement inferring possible IU and the forms needed to process such a claim? What about something like sleep apnea? I know the rules have changed on needing a statement that CPAP is "Medically necessary" but what if under the old rules a sleep study is done, a cpap issued and following that a C&P finds the veteran to be Service Connected for PTSD and has Chronic Sleep issues? Should the rater 'infer' that C&P is in order, or does the veteran have to intuitively know (yeah right) that SA is a ratable condition and then has then file a new claim? what about under the new rules? how would a new veteran know that their sleep apnea might be a ratable condition if service connected? doesn't the VA have an obligation to tell us if some condition is potentially a ratable condition or secondary to a rated condition? I cannot imagine it was the intention of Congress for Veterans to have to know things and rules they could not possibly be aware of before they file claims, particularly veterans new to the VA process. In that light it makes zero sense that legal requirements such as a Duty to Infer would/could be narrowly interpreted. Any links, discussions, BVA or CAVC results, etc would be appreciated.
  23. So, i submitted a claim for "PTSD secondary to sleep apnea". I had no evidence of sleep apnea in the service, except for a few buddy statements. I submitted a package from Dr. David Anaise for the nexus....Had my C&P Exam... the dr (who i would love to share the name of cause shes seriously did not know what the hell she was talking about) kept telling me that "Sleep apnea cannot be secondary to ptsd because it does not cause it", i told her "it aggravates it"... i asked "Why would it be an option for me to choose "sleep apnea secondary to ptsd if it doesnt exist? why would the va even give that option to us".. she said "I dont know". I had all the studies printed out to give to her (as well as submitted in the claim by dr. anaise and myself).. she didnt even read it.. Just kept telling me that ptsd does not cause sleep apnea. I was going back and forth telling her "You dont think that my ptsd aggravates my sleep apnea?" "She says i dont know if it does or not"...... She then said she will grant me "Sleep Apnea" but not secondary to ptsd.. i was like i am not putting in for just "sleep apnea" i am putting it into connection with ptsd. She had no idea wtf she was talking about and had no general understand. I uploaded a statement after the C&P Exam stating all my points. I even showed her a BVA decsion showing that veterans have been service connected for it in the past even (i know) that all claims are individual... she wouldnt have any of it. Just kept denying me and saying not worry as i will get service connected anyway.... Well few monthes go by and i got service connected for it. Amazing... that was like 6 monthes ago.... Fast foward to today and i go through my blue button on myhealthyvet and i saw that that doctor DENIED me and said "b. The condition claimed is less likely than not (less than 50% probability) proximately due to or the result of the Veteran's service connected condition. c. Rationale: Obstructive sleep apnea is caused by narrowing of the upper airway leading to obstruction while sleeping. This needs to occur on average a minimum of 5 times per hour to have a diangosis of ostructive sleep apnea. There is currently not enough medical evidence to show that PTSD causes obstructive sleep apnea." also she stated:"I reviewed his medical chart, VBMS records, letters from an outside physician and studies he presented. total time spent 1 hour. After extensive discussion, Veteran did not agree with my medical opinion"Has anyone ever heard of being granted service connection for something that the C&P doc denied you for? i did not appeal or do anything, i was simply granted.... I would really like this doctor to see that she got rejected as bask in all my glory. She was something else... Good luck to all and if you have questions please feel free to ask me.... attached is a letter i submitted after my claim disagree with the c and p doc... stating shes an idiot in kinder words
  24. Does the Veteran have a diagnosis of PTSD DSM-5 criteria on today's eval? [X] Yes [ ] No 2. Current Diagnoses,1PTSD 2Panic Disorder 3Agorophobia 4Major Depressive Disorder b. Medical diagnoses relevant. obstructive sleep apnea, fibromyalgia, hypothyroidism. 3. Differential a. Does the Veteran have more than one mental disorder diagnosed? [X] Yes [ ] No 4. Occupational and social impairment [X] Occupational and social impairment with reduced reliability and productivity b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [ ] Yes [X] No [ ] Not Applicable (N/A) Vet has multiple co-morbid psych dx and therefore cannot differentiate level of impairment due to each mental disorder due to overlap in symptoms. Does stressor meet Criterion diagnosis of PTSD)? [X] Yes [ ] No Is the stressor related to the Veteran's fear of hostile military terrorist activity? [X] Yes [ ] No Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No Criterion A: Exposure to [X] Directly experiencing the traumatic event(s) Criterion B: Presence of [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). [X] Recurrent distressing dreams [X] Dissociative reactions [X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic [X] Marked physiological reactions to internal or externalcues that symbolize or resemble an aspect of the traumatic Criterion Persistent avoidance of [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated traumatic event(s). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, Criterion Negative alterations [X] Persistent and exaggerated negative beliefs or expectations about oneself, others [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event that lead the individual to blameherself others. [X] Persistent negative emotional state [X] Markedly diminished interest or participation in significant activities. [X] FeelingsofdetachmentEstrangement [X] Persistent inability positive emotions Criterion E: Marked alterations arousal [X] Irritable behavior angry outbursts [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance Criterion F: [X] Duration disturbis more than month. Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important Criterion H: [X] The disturbance is not attributable to the physiologicaleffects of a substance Criterion I: Which stressor contributed to the Veteran's PTSD diagnosis?: X] Stressor #1 5. Symptoms [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Panic attacks more than once aweek [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recentevents [X] Flattened affect [X] Impaired judgment [X] Disturbances of motivation a [X] Difficulty in establishing and maintaining effective work and social [X] Difficulty in adapting to stressful circumstances,including worklike setting [X] Obsessional ritualsInterfereActivities [X] Neglect personalAppearance hygiene DSM 5 Diagnosis:PTSD-Panic d/o with agoraphobia-Generalized Anxiety D/o Vet meets the DSM-5 diagnostic criteria for PTSD as level of severity - severe. Relationship of mental disorders to each other Vet's MDD, recurrent,moderate is secondary to her PTSD.HerPanicDisorder, Agorophobia and FSAD are also secondary to her PTSD. It is my medical opinion that vet's MST stressor is as least as likely as not suppported by and consistent with the in service marker evidence. Her agorophobia preclude her from functioning satisfactorily in work environments.
×
×
  • Create New...

Important Information

{terms] and Guidelines