diabetes Angry And Confused

[Jerry_O]

THIS IS NOT A FORMAL NOTICE OF DISAGREEMENT.

I am very confused about the recent rating results of my claim. Would you please explain some areas for me? My PTSD remained at 30% (the same since 1991 even though I have been recalled twice since that time).

PTSD: Progress Note by An Le, Psy.D. Psychologist, Signed: 06/13/2007

Axis I: PTSD with secondary Major Depression

Axis II: None identified

Axis III: Diabetes, broken knuckle, Depression, PTSD, Pulmonary, Cardiac, Cataracts, HTN, Neuropathy, and ED

Axis IV: Strained relationship with oldest son who was drug and financial problems; inadequate social support; health problems, recently moved and trying to sell old home.

Axis V: Current GAF – 50-55 due to PTSD (periods of suicidal ideation or thoughts of death, depressed, isolated, flat affect, occasional panic attack, has only one friend but rarely interacts with him, difficulty concentrating, difficulty sleeping w/o medication, anxiety).

Capacity: Veteran has the capacity to manage his financial affairs.

General Rating Formula for Mental Disorders:

Occupational and social impairment, with 70

deficiencies in most areas, such as work, family relations, judgment, thinking, or mood, due

to such symptoms as: suicidal ideation; or irrelevant; near-continuous panic or

depression affecting the ability to function independently, appropriately and effectively;

impaired impulse control (such as unprovoked irritability with periods of violence); spatial

disorientation; difficulty in adapting to stressful

circumstances (including work or a work-like

setting); inability to establish and maintain

effective relationships........................... ALL NOTED BY DR. LE.

Occupational and social impairment with reduced 50

reliability and productivity due to such symptoms

as: flattened affect; circumstantial,

circumlocutory, panic attacks more than once a week; difficulty in

understanding complex commands; impairment of

short- and long-term memory (e.g., retention of

only highly learned material, forgetting to

complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and

mood; difficulty in establishing and maintaining

effective work and social relationships........... ALL NOTED BY DR. LE.

It appears to me that the Psychologist stated I had met the criteria for 70% if not 50%.

Please note – and this is not a hateful remark – the Psychologist was Vietnamese. I had a very difficult time being in the room with her as I was on edge and didn’t want to come across as a weak American. I did not tell her about my personal hygiene or finances. My wife does all the finances and my personal hygiene is lacking. I don’t think the Regional Office takes into consideration that a person of the nationally where a traumatic event took place would cause additional anguish to a personal interview. I don’t believe our returning soldiers with mental disorders would want to be interviewed with an Arabic speaking person. Just my thoughts.

Also, I was wandering why my Major Depression was not considered. Or why wasn’t my PTSD associated either with my heart attack while on active duty or Diabetes.

Please note in Ms. An Le’s summary she wrote: From 2004 to 2006, he worked at an EDUCATION CENTER where his job required him to visit mortuary, read synopsis of every death from OIF/OEF and select out articles from those synopses. During this time, his drinking and depression had increased.

I can assure you that this was not done at a civilian EDUCATION CENTER! This was done at the DEPARTMENT OF THE ARMY HEADQUARTERS, Hoffman Building II, Alexander, VA while on my second tour as a volunteer. I provided my DD 214. To me it seems fundamental that the claim would be for active army trauma. I worked at the Education Center when I was recalled.

I would like to draw your attention to Ms. Le’s PSYCHOSOCIAL ADJUSTMENT SINCE THE LAST EXAMINATION. JOBS. SOCIAL. MEDICAL PROBLEMS. IMPULSE CONTROL. SUMMARY STATEMENT OF CURRENT PSYCHOSOCIAL FUNCTIONAL STATUS. MEMORY IMPAIRMENT. PANIC ATTACKS. ASSESSMENT OF POST-TRAUMATIC STRESS DISORDER.

ALSO – My first PTSD examination was in 1991 in Boise, ID. Additionally I was seeking a claim in Agent Orange at that time since I was having patches of white skin appearing all over my body. I was told in 1991 that I was not in an area where AO was sprayed later this turned out to be untruthful.

I was told that my claim for asbestos was denied. I never filed a claim pertaining to asbestos.

Did anyone read the letter on my behalf from Mr. Bob Waechter, MA., MPA Team Leader, Vet Center, Kansas City, MO 301 E. Armour Blvd, Suite 305 Kansas City, MO 64111. Telephone (816) 753-8166 Fax (816) 753-2328.

He wrote and I quote: Jerry Osborne has been seen in Individual and Group psychotherapy at the Kansas City Vet Center since September 7, 2006. He presented with symptoms consistent with a diagnosis of Post-Traumatic Stress Disorder, Chronic and Severe. The letter Mr. Waechter is quite long. I asked C&P if that letter was attached and they assured me that it was.

My other doctor at VA KC MO is Dr. Elizabeth Yaffee. She is the chief Psychologist for OIF/OEF vets. She has me on several medicines from PTSD and Major Depression. Also, she is considering having me undergo Electroconvulsive therapy (ECT): Treating severe depression.

Was she contacted? He telephone number at KC VA Medical Center is (816) 861-4700 Ext 56664 – Her secretary’s is Ext 56625. Her GAF rating for me was 45.

Very Respectfully:

Jerry

THIS IS NOT A FORMAL NOTICE OF DISAGREEMENT

[Jerry_O]

Berta - I have not received any "formal" letter or allied papers. I was told to call a lady named Darlene at my RO - St. Louis. She said my CAD is being deferred for additional paper work and my PTSD increase was denied. When I first was awarded PTSD my GAF was 50 in 1992. At my recent C&P it was 50. Just a reminder on my history. I had a heart attack while on active duty and had a heart attack and triple bypass within a year of discharge and return to retirement status.

I was told perhaps my PTSD was not increased because I'm still working. But wouldn't they make a comment to that?

I will let you know what the official letter states. Thank you for your concern.

Jerry

[free_spirit_etc]

Oh yeah.. I remember you were pretty well counting on getting 100%. Gosh! It would seem like you would get an increase on the heart - needing the surgery and all.

I wondered about the NOD because I had read once somewhere that you can only file one offcial NOD -- so I wondered if you were having your say - and getting it on the record....but waiting to submit your formal NOD.

I thought it was a great idea.

I read where they often do "top sheeting" - where they just skim over a report or two - and take their info from there. I am sure that is what they did on my husband's cancer claim. Everything is straight off the Doctor's opinion (NOT a C&P because he didn't SEE him) --

You were good at pointing out things they didn't consider right on the report though.

You know what would be great -- if to work for the VA you had to take a reading test - and be able to read technical stuff and report it back accurately before you could get a job. -- since how they read affects people and all.

Of course, this isn't unique to the VA -- have had the same problems with about anyone who is "giving out" money. They have an uncanny ability to read something and notice everything BUT the main point.

Free

Free - Because I'm upset and tired! My wife will have her breast removed in a few weeks, I had open heart surgery plus triple bypass 7 weeks ago, and I'm at the end of my rope. I just returned to retirement status from a volunteer tour of two years with mortuary and casualty affairs. I had to write synopis of death, view, and retrive personal effects.

I noted Not a Notic Of Disagreement because at the time I didn't know exactly what I was writing - I was raging.

[Berta]

"You know what would be great -- if to work for the VA you had to take a reading test - and be able to read technical stuff and report it back accurately before you could get a job. -- since how they read affects people and all."

I love this comment and it was point of a complaint I filed with the IG about my RO in Jan 2006.

It seems that the VA got a copy of the complaint and this was when they took steps- against all established VA case law- to send my AO death claim to the BVA.

The claim still lacked proper and legal VCAA letter and my medical evidence still had not been addressed.

I got it back from the BVA in weeks.

Would the VA retaliate against a claimant who writes to the IG?

Seems to me they did in my case-

I had to attempt Saturday to find a local librarian with a Bachelors Degree to proctor my LOA exam for my graduation.

Much to my surprise most of the librarians in this rural community dont have BAs.They are exempt due to the locale.

But I got into a discussion with one of them as to how many young people only seem to use the library these days to play vidoes games on the PCs.

Reading abilities seem to have been forsaken for the entertainment value that computers can provide.

I have three local young kids who call me often to see if I need work done on the farm-

none of them graduated and none if them can read well.

Young people today are doomed to poverty without at least a High School diploma and some proficient reading and writing skills.

One even brought over a job application asking me what it said.

Years ago I filed an Administrative review at VA Central Office.

Neil Richland- attorney for VACO -called me up and said they hardly ever see anything like this and what was it I expected VA to do regarding the AR-he had not read it all yet.

I briefly explained my claims (subsequently awarded) and how the RO was ignoring my medical evidence and continually losing the good atuff.

My Administratiove Review to VACO was-in essense, an attempt to find someone at the VA who knew how to read.

Well he bust out laughing- and long story- but those claims were awarded-because the VA in DC employs literate attorneys.

RO employees told the Inspector General in a 2005 anonymous (I think) survey that they simply cannot take the time to read all claims thoroughly.

So this means they dont need to take a crash course in Reading 101 or VA access to Reading for Dummies- it means the Backlog has GOT to be reduced.

[betrayed]

I believe that if you want them to read what you write do it on a statement in support of claim form. I have had the same problems as you and wondered if they read what I write. I know that every statement in support has been read because the info in them has been included in their rating decisions.

[Pete53]

I did this and it worked. I numbered all the evidence pages and than on a Separate Piece of paper I bulleted short statements and referred to highlighted evidence and page number

Example: Hospitalized for 1 week for panic attacks p.4 yellow highlighted.

If you do something like that it is hard for them not to read it.

[tssnave]

Free - I totally agree with your comments about reading comprehension at the VA. The C&P doc in my case wrote I was "100% Total Occupational and Social Impaired due to inability to maintain work due to sc bipolar disorder", got a good handle on my symptoms, and under the "Problems with Activities of Daily Living" question wrote "Yes" (and then "moderate" next to all 4 categories), GAF 49, and yet I was rated 50% because it "doesn't impact your ability to function independently". Yea, right. That's why I can't drive, go shopping, be in crowds, etc. I think the DRO forgot to read the entire C&P exam as well as the part of the M21-1MR that says a rater can't substitue their own opinion for well documented medical opinion. If I can ever get and stay in the murky middle of bipolar where I'm not a screaming maniac or suicidaly depressed long enough I'm going to finish my NOD. The whole VA process boggles my mind.

Pete - thanks for the pg number and highlighting tip. I always number/date my pages so they go as a packet. Because of the top sheeting issue someone else mentioned (which I've read about on other vet boards as well) I'm going to do a cover sheet with my NOD and after reading your comment I think I'll use 3 highlighters (increased rating, UI, Perm/Total). Maybe it'll do some good and help compensate for the fact that they have a difficult time reading what's in the record.

Jerry O - hang in there and keep us posted on your family's progress.

TS Snave