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Found 5,829 results

  1. Hello everyone and thank you for accepting me in to the forum. Last year I filed a new claim for Generalized Anxiety Disorder and Major Depression. For the past 3 years, I have been seeing a civilian psychiatrist for my anxiety and depression. She had already diagnosed me with GAD and Major Depression, and I have been on anti-anxiety medications, antidepressants, and sleep medication. I was on differing types of the same medications since coming out of the service, but it wasn't until about 3 years ago, that I admitted to myself that I needed mental help, and that is when I started seeing my civilian psychiatrist, and that is when I first heard of GAD and Major Depression, when she said she had diagnosed me with them. It was at her suggestion, that I file a claim with the VA for GAD and Major Depression. She said she very much felt like my conditions were associated with my time in the service. When it was finally time to have my C&P exam, I was interviewed by a VA psychologist. I told her about my civilian psychiatrist, and her diagnosis for me, and the medications she had me on. I also talked to her about my time in the service, me being overseas in the Gulf War, and me being in a humanitarian mission in Ecuador. I told her about my friend who was with me during basic training. And how he was shot and killed right in front of me, in a horrible accident, during one of our live ammunition training exercises. I told her how all this had affected me from those moments on, all the way until now. At the end of our meeting, she told me that she felt like my condition was more PTSD, rather than Generalized Anxiety Disorder and Major Depression. At the time I didn't think anything of what she said; that is until I was sent my denial letter. In my denial, it stated that my 2 claims for GAD and Major Depression, was changed to GAD (to include PTSD) and Major Depression (to include PTSD). So the VA psychiatrist did what she said she would. She essentially changed what I had claimed, and added (to include PTSD) on each of my 2 claims. So, for the basis of PTSD, there has to be a proven stressor. The VA used what I had talked to the psychiatrist about the death of my friend during boot camp, as my stressor. The VA said they searched records during the time I was at boot camp, and found no incidents related to what I was saying. So, because the VA psychiatrist took it upon herself, to change my claimed conditions from GAD and Major Depression, to GAD (to include PTSD) and Major Depression (to include PTSD), now it was up to me to prove a stressor, because with claims associated with PTSD, you must prove your stressor. I knew from talking to other Army buddies of mine, how difficult it could be sometimes to find old records of deaths. The death of my friend during boot camp happened in 1962 at Ft. Jackson, SC. My civilian psychiatrist never suggested to me that I had PTSD. She always said it was Generalized Anxiety Disorder and Major Depression. If I had wanted to file a claim for PTSD, I would have done so. But I knew how difficult it would be for the VA to search for and find any record of the death of my friend at boot camp. So I filed GAD and Major Depression, because I was told those claims did not require a specific stressor (exact time, place, person, etc). I was told that GAD and Major Depression, could be claims based on your entire military career, with everything you've done and everything you've experienced, all amounting to intense anxiety and depression. So that is why I claimed GAD and Major Depression, over that of PTSD. But because the VA psychiatrist took it upon herself to change my 2 claimed conditions, and added the words (to include PTSD) to each of my claimed conditions, it was not just GAD and Major Depression any longer; it includes PTSD, which requires a specific and provable stressor. I had a stressor, and very specific one - the death of my friend during live ammunition exercises during our time at Ft. Jackson, SC boot camp in the summer of 1962. But the VA said neither they nor the JSRRC could find any record of that taking place. If my 2 claims had remained what they were suppose to be, simply GAD and simply Major Depression, I do not think I would have been denied. But because the VA psychiatrist added PTSD to each of my conditions, the VA asked for my stressor, the VA and JSRRC said they could find no record of my stressor, so my claims were denied. I believe I would have been approved if not for the VA psychiatrist adding PTSD to my 2 claimed conditions. So with all that said (and I apologize for the length of it), is there any hope for me, if I appeal my denial? And do any of you know how I would go about appealing it? Would I simply say to the VA that I disagree with the VA psychiatrist adding PTSD to my 2 claims, when I never claimed PTSD myself?; that that was her decision entirely. I have had a VA Disability Representative for the past couple of years, but he was utterly useless. He never answered my calls or emails. He basically never helped me at all. I did most all myself over eBenefits. But now, since I've had this recent denial, I have considered hiring a VA Disability Law Firm to take my case. I've spoken with 2 so far. They both told me I had a very strong case and that I could win. But they also said they couldn't take my case because of their huge client load. I think it was simply that they could probably win my case, but there wouldn't have been much in the line of backpay, so they wouldn't have gotten much compensation for their work for me. So I guess I will continue searching for other VA Disability Lawyers, or I may have to appeal my denied claim myself over eBenefits. Could any of you, please help me with this? I have read many questions on here regarding GAD and Major Depression, but I haven't come across one yet, where they filed a claim for GAD and Major Depression, and then the VA psychiatrist during the C&P exam, decided to change the claim (to include PTSD), thereby changing the criteria for acceptance, by now making me prove a specific stressor, instead of it she had just left my 2 claimed conditions alone, without including PTSD to them, then no specific stressor was required - it would simply go by your overall experiences while in service. I am a 20 year Veteran by the way, with most of my time served in the National Guard. But I was activated numerous times during my 20 years, including during the Gulf War. It isn't my fault that the death of my friend during boot camp, isn't something the VA or JSRRC can locate in records. If the VA psychiatrist had just left my 2 claimed conditions alone, instead of tacking on (to include PTSD), then the VA wouldn't have even had to search for a specific incident, they would have just based my conditions on my overall military experiences. Thank you for any help, assistance, or advice you might be able to give. Donald
  2. Curious what to do with this piece of information. I was going through my c&p's and the one I had in Aug 2018 that bumped me to 100% has this line in it. "He reports breathing difficulties, diagnosed - Obstructive Sleep Apnea. " I was using my CPAP when my original C&P in 2013 was done. My record has all sorts of references to it, including the VA issuing me on and way. I have the Sleep Study results in my hands. So what paths are open to me? in the 2013 standards being issued a CPAP w/ an SC (PTSD) related condition should have given me a 50% rating. Today's standards say I need the medical opinion to state' "he will die without it" or other such magic word nonsense. what is my most likely path to getting it rated and possibly retro pay?
  3. Hi, I have been rated at 30% for PTSD since 2005 (60% total). In 2015 I lost my job and after a year social security found me eligible for social security disability benefits based on PTSD. I have not worked since. In 2018 I filed a claim for increases on several things but not for PTSD. At the same time, I was trying to get the VA to add depressive order to my list of service-connected items as I had the diagnosis for it. The VA then re-evaluated me for PTSD and said I was still at 30% and denied all my increases. I had never told the VA or the rater about social security finding me disabled due to PTSD. I appealed the VA decisions regarding the increases they denied me and now the VA is requesting my social security disability findings so, I went ahead and sent them in through ebenifits. The VA sent me a letter stating that " we completed your request for a higher level review, and discovered an error in our duty to assist in gathering evidence in support of your claim". What are the chances that the VA will raise my PTSD to 100% upon finding out that I cannot and have not been able to work because of the problems I have from PTSD . Also, is the VA supposed to address these kinds of issues if the find them? thanks for any thoughts. I never wanted to mess with my PTSD rating for fear of the VA screwing up as usual and that is why I never asked for an increase or told them about the social security disability based on PTSD.
  4. I first found this forum after I started my claim Aug 7, 2018. This was 10 years after my discharge. I had done everything I could to stay away from the military after my experience and had never even been to the VA before this year. I prepared my claim myself and was concerned I would be denied. I posted my c and p exam results here October 31, 2018 and members commented on their thoughts of success or failure, and said I would get about 50%. I then took my exam results to the Veteran rep here at my local unemployment office who told me ultimately I would be denied and should appoint a representative and prepare for appeal. I choose the DAV and left with my spirits a little crushed, but after reading people stories here I knew I had to remain hopeful. Nov. 29, 2018 I received an email from the DAV with the Decision that had been made even before I could see it. The email stated I had been service-connected at 70% PTSD permanent, also approved for TDIU and Dependent Education, but Ebenefits still said pending approval. So again I came to the forums for assistance and posted a copy of the email. I was met with congratulatory responses and assurance that the email was legit. @GeekySquid then messaged me a ton of information about benefits that were now available to me. It was from that information I was able to start the process of getting my life back on track. Im currently working with VR&E also known as Voc Rehab, to go back to school. Geeky told me they would give me hard time but to be persistent and it paid off my counselor has approved my long term goal of a Masters Degree. I can not put in words how thankful I am for this forum and its Members.
  5. I was never diagnosed in service with OSA. I weigh 220 and I am 6' tall. I am rated at 70% for PTSD and the meds I take add to the OSA. I had my personal Dr. and the Psychiatrist I see both write letters to support that the meds I take add to and cause the OSA. My Dr filled out the DBQ and sent it in as well. I had a failed sleep study results sent in with my claim. I also have documentation I sent it that back up the fact that OSA is tied to PTSD and is aggravated by PTSD. Then sleeping with the prescribed CPAP machine adds to the PTSD. Just curious if anyone has ever won this claim? I am going to appeal but wanted to get any advise here first if someone has any to share.. not sure if there is anyone who has gone this route before and won? thanks!
  6. 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.
  7. I have been learning a lot on the hadit forums over the past few months. I have learned quite a bit and I wish I would have found this site 10 years ago. I filed a claim about a week ago and I just realized that I made an error on the date of my stressor statement. I always remember the date I started my shift which was 17 January 1991 so that is the date I put down. I just realized that the stressful event happened later on in my shift and the date was actually 18 January 1991. Is there a way to correct this date before my claim moves farther through the process by submitting another statement with the correction?
  8. This is interesting about the LIMBIC Part of the Brain check this out! Sleep Apnea/OSA http://www.answersforsleep.com/neurological-disorders/the-ptsd-and-sleep-apnea-connection/ ................Buck
  9. 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.....
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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?
  15. 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
  16. 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."
  17. 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.
  18. 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
  19. 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.
  20. 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.
  21. 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?
  22. 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.
  23. 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.
  24. 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.
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