ptsd 100% Schedular Ptsd No Longer Awarded?

[vasolas]

Please forgive my long-windedness but I'd really appreciate your advice, thoughts and opinions also I guess this is letting off steam for me.

I'm a Vietnam infantry vet and I served as a spotter on a sniper team. I've had about 16 years of intermittent private psychotherapy and continuous VA treatment since 2001. My ptsd claim included an '05 "PTSD Evaluation" from a private psychologist that I've seen weekly for almost 9 years. (it was very detailed but I'm only outlining here) It noted that I had chronic suicidal ideation, homocidal thoughts and that I was a risk to do harm to myself or others. It diagnosed ptsd chronic, severe and major depression, recurrent. It noted that I was medically retired due to ptsd and stated that, due to ptsd, I was totally and permanently disabled, unemployable and unlikely to improve. It assigned a GAF of 30. Also I had included supportive reports from a private social worker, psychiatrist, and former employer that documented my treatment for ptsd going back to 1990 as well as more recent progress notes from my VA hospital.

The VA C&P psychiatrist diagnosed chronic ptsd & major depression recurrent and severe. His report described me as a "hermit" who is "severely impaired socially and vocationally". He wrote that "It is unlikely that this man could ever function in any kind of work capacity at this time". He assigned a GAF of 35.

I'd expected to be awarded 100% schedular ptsd but in June 05 I received 70% and IU was deferred. I filed a NOD with a personal narrative that described how my symptoms had worsened and how they approximated the General Rating Formula for Mental Disorder's criteria for 100% schedular disability. Included was a copy of my recent SSD award due to ptsd, a progress note from a VA psychiatrist that stated that I was "considered totally and permanently disabled for gainful employment", 3 more progress notes all with GAF's of 30, plus other supportive documentation.

In late March 07 I received a SOC that continued my 70% and ignored most of my evidence that supported a grant of 100% schedular. It cited 9 pages of VA regs and 1 of reasons and bases. The R&B's described me as having mild to moderate daily dysphoria, moderate social anxiety symptoms (I've been a hermit for years inorder to cope with severe anxiety,depression and to avoid conflict with people), no violence toward people (my personal narrative described one of several such incidents in which I had crawled with loaded weapon to a car that had stopped at night in the boonies where I live - my VA psychiatrist hadn't quoted this incident directly in his report but had referred to it as an example of my "perpetual combat behaviors"). The SOC also stated that I denied suicidal or homocidal ideations (the preponderance of the many documents I'd sent noted chronic suicidal thoughts (w/o intent) and at least 2 of them reported homocidal thoughts). The SOC selectively plucked from the many documents I'd sent any positive reference to myself and ignored the statements that were supportive of a 100% schedular rating. For example, It used against me one sentence from a report that noted that I had helped to care for my terminally ill father but it made no reference to my occupational impairment, my consistenly low GAF scores and I was not offered another C&P.

I would greatly appreciate any advice, thoughts or opinions about my case and how I might best present my appeal for 100% schedular to the Board (my deadline is near). Perhaps I should be satisfied with 70% and the possibility of IU especially since so many deserving vets aren't even awarded that, and I know that it is now very difficult or perhaps impossible to be granted 100% schedular, but it is a matter of principal to me since I believe that my war-related mental disorder has rendered me 100% disabled.

Also is it possible/likely that VARO will deny me IU when I apply or order me to a C&P for IU? If it is awarded would it be retroactive to my original claim date-June 05?

Incidentally, I believe my claim for 100% schedular would have been granted 6-10 years ago despite the requirement of having psychotic symptoms per the General Rating Formula. I'm aware that VA has been criticised for spending so much and awarding so many 100% schedular awards in the past but I'm not aware of any published documents that have directed VA to limit granting such awards. Does anyone know of such directives or of any VA watchdog who has revealed them?

Does anyone know of anyone who has received 100% schedular ptsd in the past year and of the basis for that award?

Has the VA completely stopped awarding 100% schedular for ptsd?

[sixthscents]

I am 100%PTSD,as long as you can prove a stressor,ther Is no way,va can deny you PTSD,hospital records support a stressor.I WAS 6 months In hospital,for infection In ear,that went Into heart,under 3105a,hospital records will be accepted as proof to support clear unmistakable error,as well as In the line of duty,please read 3105a,you records might hold information,to support a clear unmistakable error,3105a,has several ,listed accepter as evidence to prove your claim

OK, I am getting sick of your prattle about this 3105a. 1st, Army and I were discussing the merits and differences in the VA's PTSD rating system. He has a valid point, and since I DONT suffer from PTSD I can and do see his point, and weigh it more than my own. For your information Army already HAS a stressor, or nexus. The guy has a purple heart.... while he and I disagree from time to time, he is a fine veteran, and FULLY capable of handling his claims just fine. He asks for help on certain issues, and offers advise on certain issues... but he doesnt need to prove a stressor, and I doubt his claim can go back 10 years based solely upon section 3105 (a) of CFR 38.

So... hush! Unless you have something real to offer.

[LBM56]

I have been reading this posting with great interest. I have been rated within the last 2 weeks at 100% with severe post traumatic stress disorder due to combat exposure and stressful incidents in Vietnam. My C & P also states my symptoms are directly linked to anger issues, isolation, and nightmares, which effect my employment, social and family life to a significant degree. The xaminer gave me a GAF score of 35, which by he way was the 2nd score of 35 I have received over a 18 month period. After all of this and after 3 years of intense treatment my rateing is not considered permanent and I am up for a future examination in 3 years. PTSD is horrible and effects everyone. My wife probably could get a low GAF score yet the only benifit denied my without the Total and Pernanent statue are the benifits for her.

The VA does give 100% when warranted. They just don't reconize the suffering of the families.

[Jay Johnson]

Army,

The VA cannot rate each individual mood disorder. By CFR 38 it would be pyramiding, so they can rate you for PTSD, and take into consideration the other diagnosis while making the rating but thats it. PTSD is classed as an anxiety disorder - but I'm no shrink so who knows. The VA is SUPPOSED to consider the highest rated disorder, and thats what they actually compensate you for.

Further - They have stereotyped and lumped combat mental problems into PTSD

Well, it is Post Traumatic Stress Syndrome..... combat mental problems are obviously traumatic, and post apllies, so what would you have them do? Honestly, its a rational system if used correctly. I am not stating that it is or is not used correctly, but how it is laid out makes perfect sense. In fact, I can think of no other way to do it.

I am not trying to score points here off of you but I dont understand what you would prefer happen. The pyramiding rule applies to all injuries, not just mental, s its not unfair in that aspect. So, help me out here I dont understand.

This is incorrect and I would ask you to talk to ANY civilian psychiatrist on this topic to get their opinion. This is more evidence that the VA is hoping that the average veteran doesn't understand how psychiatry works.

There's a few things one needs to understand about basic psychology before making these types of statements:

1) Problems like major depression and PTSD are NOT related; they're not even under the same category of diagnosis. The categories are as follows:

A) Anxiety disorders - GAD, panic disorder, phobias, agoraphobia, OCD, PTSD, etc.

Mood disorders - Major depression, bipolar, etc.

C) Schizophrenia - Although categorized separately, many issues with hallucinations fall into this category.

D) Dissociative disorders - DID

E) Personality disorders - APD, BPD, etc.

F) Other - Substance abuse and disorders not covered by the aforementioned.

2) Just because PTSD falls under the "anxiety" category doesn't mean that you cannot have another anxiety issue separate from PTSD. Many individuals with PTSD suffer from OCD, which is not linked to any type of stressor, but seems to manifest itself when the brain is damaged in some way from some other psychological problem...they are NOT linked.

The VA's standard on this are completely insane and extremely bias. To say that a veteran with PTSD shouldn't have their major depression evaluated is nonsense....those two problems are completely opposite of one-another in how they work inside of our brains. The chemical process that causes anxiety (which *IS* PTSD) has nothing to do with the process by which hallucinations occur (dopamine issues).

This would be like the VA saying to a veteran, "well you're rated for arthritis in your shoulder, so we can't give you arthritis in your knee, because you already have a diagnosis of arthritis".....that would cause a big issue if done that way I'm sure.

It is flat wrong for the VA to require "total occupational AND total social impairment" to award 100% for PTSD alone....many 100% vet who are physically disabled have neither total social impairment, nor total occupational impairment. This is a blatant double standard as is trying to lump completely separate medical conditions into one all-encompassing super condition, to which no other medical professional on earth would agree with outside of the VA.

P.S. - Major depression (mood disorder) is an issue dealing with serotonin in the brain (and other neurotransmitters). PTSD, an anxiety disorder, is treated with gamma-aminobutyric acid (GABA) increasing drugs such as xanax, valium, etc.....these lower the crisis responses in the brain (fight or flight) which are linked to anxiety/panic attacks. The ONLY difference between PTSD and generalized anxiety disorder (GAD) is that PTSD has a specific stressor and/or trigger...they are both merely anxiety disorders that the VA has twisted into some sort of super-disorder which simply does NOT exist.

Edited May 16, 2007 by Jay Johnson

[Pete53]

Interesting but from personal experience I can say that Panic Disorder led to Major Depression.

[Jay Johnson]

It probably did; just as a broken (or missing) arm, foot, etc. can lead to arthritis later in life. PTSD may prep your brain for other afflictions, but that's doesn't mean they are the same disorders. People with physical disorders get secondary diagnosis and compensation all the time, so why don't PTSD vets?

[john999]

What I see from the VA is a totally subjective system for rating mental disorders. On any given day a vet could get a rating of 10% to 100%. You see some resident for 10 minutes and he hangs a diagnosis on you and bangs out a C&P report.