ptsd Private Psychologist Wins Over Va Ime Psychiatrist

[Josephine]

Citation Nr: 0614650

Decision Date: 05/18/06 Archive Date: 05/31/06

DOCKET NO. 96-02 947 ) DATE

)

)

On appeal from the

Department of Veterans Affairs Regional Office in Houston,

Texas

THE ISSUE

Entitlement to service connection for a psychiatric disorder.

WITNESS AT HEARINGS ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

Nancy Rippel, Counsel

INTRODUCTION

The veteran had active service from October 5, 1970 to

November 25, 1970.

This matter came before the Board of Veterans' Appeals (Board) on appeal from a rating decision rendered by the Houston, Texas, Regional Office (RO) of the Department of Veterans Affairs (VA), in August 1995, which found that new and material evidence had not been submitted to reopen a

claim of service connection for a nervous disorder. In July 1998, the Board found new and material evidence had been submitted to reopen the claim, and remanded the issue of service connection for a nervous disorder for additional development. That development has been accomplished, and the

case has been returned to the Board.

FINDING OF FACT

The competent evidence is at least in equipoise regarding whether a current psychiatric disorder, variously diagnosed, to include schizophrenia/schizoaffective disorder, is the result of a disease or injury incurred in service.

CONCLUSION OF LAW

The veteran is entitled to service connection for the psychiatric disorder variously diagnosed, to include

schizophrenia/schizoaffective disorder. 38 U.S.C.A. §§ 1110 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2005).

REASONS AND BASES FOR FINDING AND CONCLUSION

I. Duty to notify and assist

VA has a duty to notify claimants for VA benefits of information necessary to submit to complete and support a claim and to assist claimants in the development of evidence. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a)

(2005). As this claim is being decided favorably in full to the veteran, the Board need not discuss whether VA has satisfied its duties under the VCAA. Any defect in this regard would constitute harmless error. See 38 U.S.C.A. § 7261((2) (West 2002).

II. Service connection

The veteran urges that his current psychiatric disorder is related to service. He alleges that, during his short period of time in the marines, he was subjected to stress and abuse that triggered schizophrenia, first diagnosed in 1971, and his present psychiatric illness, including schizoaffective disorder. He has explained that he was the object of ridicule by his superiors and peers in the platoon because he

suffered from enuresis and nervousness. Those conditions are documented in the record. His treating psychiatric health care provider has opined, following a review of the record, that a current psychiatric condition is related to the short time in service. The Board notes that the veteran's first

hospitalization for schizophrenic type problems, in April 1971, reflects that his parents brought him in for treatment following a three to four month period of time in which he demonstrated depression and suicidal gestures.

The Board finds in the record sufficient evidence to put the claim into equipoise as to whether the current psychiatric disorder, schizoaffective disorder or schizophrenia, is related to service and thus, as set forth below, grants the claim.

Service connection means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated during service. 38 U.S.C.A. §§ 1110 (West 2002);

38 C.F.R. §§ 3.303(a), 3.304 (2005).

In order to prevail on the issue of service connection for any particular disability, there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and medical evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253

(1999); see also Pond v. West, 12 Vet App. 341, 346 (1999).

While service connection for certain chronic diseases, including psychoses, may be established in certain situations, based upon a legal "presumption" by showing that it manifested itself to a degree of 10 percent or more within one year from the date of separation from service, the veteran is not eligible for this presumption because he did not meet the 90 day minimum service requirement built into 38

U.S.C.A. § 1112 and 38 C.F.R. § 3.307. 38 U.S.C.A. §§ 1112, 1137 (West 2002); 38 C.F.R. §§ 3.307, 3.309 (2005).

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which

case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); VCAA. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin...such doubt will be resolved in favor of the claimant. 38 C.F.R. § 3.102 (2005).

The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the appellant. See Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v.Derwinski, 2 Vet. App. 614, 618 (1992; Hatlestad v.

Derwinski, 1 Vet. App. 164 (1991); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).

Service medical records show that the veteran was treated for bedwetting and nervousness on October 28, 1970. A urinalysis was within normal limits. He was begun in an 'Enuresis Program.' On November 20, 1970, the veteran was found physically qualified for separation. He reported no change

since an earlier examination. He was separated for "Unsuitability." There were no comments from the medical officer.

Following service, the veteran was admitted to the Santa Rosa Medical Center with an admitting diagnosis of depressive reaction in April 1971. The discharge summary reflects that he had presented by his parents because he was feeling nervous and depressed, with some suicidal gestures,

particularly for the last three to four months. The veteran reported that he had felt that way since the seventh or eighth grade. The veteran reported no initiative, wanting to stay home and listen to music. He was irritable and withdrawn. He reported smoking pot on and off since the

ninth grade. The veteran was placed on multiple medications, including Librium, Quaalude, Thorazine, and Haldol, and also treated with electroshock therapy. The diagnosis was

schizophrenia, chronic undifferentiated type.

Thereafter, the record is replete with reference to ongoing mental health problems, including substance abuse (reported as in remission for many years), major depression, bipolar,

schizoaffective disorder, schizophrenia, post-traumatic stress disorder (PTSD), and others. He has been declared disabled due to the Social Security Administration since 1988 for recurrent major depression.

Two medical opinions have been added to the record in 2005. These address the likelihood of whether any of the current psychiatric diagnoses are related to service. One is an

independent medical opinion (IME) obtained by the Board, the other is an opinion in response to the IME, obtained by the veteran. The IME, dated in August 2005, was authored by psychiatrist Stanley P. Oakley, Jr., M.D., who reviewed the claims folder. Dr. Oakley opined that the veteran's current

psychiatric diagnoses include in pertinent part Axis I diagnoses of schizoaffective disorder, and mixed substance abuse, in remission, Axis IV diagnosis was chronic mental illness. Dr. Oakley opined that the mixed substance abuse may have pre-existed service but did not worsen or increase

in severity in service, and that the schizoaffective disorder did not arise until the hospitalization in April 1971. He opined that a psychiatric disorder is not related to the veteran's brief period of service.

In response to this opinion, the veteran submitted an updated statement from Sonja B. Montgomery, Ph.D., Mental Health Counselor and Intern Supervisor of the Heart Source Center for Counseling and Therapy, dated in December 2005. Ms. Montgomery provided a detailed statement of the veteran's

mental health condition in October 2005. She noted that she had been treating the veteran since August 2005. She explained that she had reviewed the veteran's private treatment records as well as his service medical records for this update. She noted his current diagnoses which in her

opinion included schizoaffective disorder, PTSD, generalized anxiety disorder, panic disorder with agoraphobia. Ms. Montgomery noted the veteran's service experience as reported by him, as well as the hospitalization in 1971. She noted the enuresis and nervousness were included in service medical

records. She explained that she agreed with the veteran's strongly held belief that his mental health was compromised in service. She felt that the experiences in boot camp triggered the current mental health problems and potentially triggered his schizophrenic symptoms and depression in 1971.

Thus, based upon her review of the service medical records, mental health records post service, clinical interviews and individual psychotherapy sessions, she opined it was at least

as likely as not that the current psychiatric disorder was related to service.

The veteran has had an ongoing diagnosis of schizoaffective disorder/schizophrenia since April 1971. He also had diagnoses of substance abuse, in remission, and other mental problems, in addition to his current and longstanding diagnosis of schizoaffective disorder at different times in

his health record.

It is significant to note that, in February 1998, the veteran offered testimony at a hearing held before the undersigned. The veteran testified that he was picked on and mistreated in

service. He started having problems such as inappropriate behavior and problems as a result of the abuse. He had trouble after service and although he had had some previous

problems, he felt these were mischaracterized and overblown in terms of significance. His real problems began in service.

In essence, Ms. Montgomery has opined that the veteran's manifestations of what was termed nervousness in 1970 were really the preliminary signs of the schizoaffective disorder

he has today and for which he was treated in April 1971. She offered detailed support for her theory, based on events in the veteran's record. She observed that the veteran had trouble with functioning since service. She noted that serious medications were administered in April 1971. The

Board finds it significant that the veteran was reportedly having problems for three to four months prior to that admission. This would put the veteran's symptoms at almost the same time as his discharge from service.

Thus, medical records both support and contradict the veteran's theory that his current psychiatric condition, variously but most repeatedly diagnosed as schizophrenia and schizoaffective disorder, are related to in service disease or injury. There is competent medical evidence of a current

disability. There is competent medical evidence relating the disability to service. This evidence is Ms. Montgomery's opinion. There is contradictory evidence in the form of the

2005 IME opinion.

The Board must assess the value of these two opinions. In doing so, the Board notes that an opinion by a medical professional is not conclusive, and is not entitled to absolute deference. The United States Court of Appeals for Veterans Claims (Court) has provided extensive guidance for

weighing medical evidence. A bare conclusion, even one reached by a medical professional, is not probative without a factual predicate in the record. Miller v. West, 11 Vet.

App. 345, 348 (1998). A mere transcription of lay history, unenhanced by additional comment by the transcriber, does not become competent medical evidence merely because the

transcriber is a medical professional. LeShore v. Brown, 8 Vet. App. 406, 409 (1995). The probative value of a physician's statement is dependent, in part, upon the extent to which it reflects "clinical data or other rationale to support his opinion." Bloom v. West, 12 Vet. App. 185, 187

(1999); see also Black v. Brown, 5 Vet. App. 177, 180 (1995).

The Board has considered the veteran's statements made in written comments and personal sworn testimony to VA regarding the origin of his mental disorder, as well as those told to medical examiners by way of relating his own history. Lay evidence is competent if it is provided by a person who has knowledge of the facts or circumstances and conveys matters that can be observed and described by a layperson. 38 C.F.R § 3.159(a)(1) (2005). See also Espiritu v. Derwinski, 2 Vet.

App. 492, 494-95 (1992). In Washington v. Nicholson, 19 Vet. App. 362 (2005), the Court emphasized the difference between a veteran offering testimony about factual matters of first-

hand knowledge of in-service symptomatology and treatment, as opposed to testimony about a medical diagnosis or etiology. The Court instructed that the credibility of the veteran

affects the weight to be given to his testimony, in relation to other evidence of record. Id. at 7.

The veteran is competent to describe situations of perceived in-service ridicule and subsequent nervousness and bedwetting. Hearing transcript, (T.) pages 3-5. The Board recognizes that such reports are not contradicted by official records. Indeed, service medical records corroborate that he

was treated for bedwetting and placed in a special program for this problem. To this extent, the veteran is credible. Id.

The veteran testified that he did not have any psychiatric problems or treatment prior to service. T. 5. From approximately 1971, he has continued to require such treatment. Pivotally, of record are numerous affirmative conclusions, reached by medical and lay experts, that his current symptoms are due to and entirely consistent with the reasonably substantiated in-service incidents. These are

consistent with Ms. Montgomery's assessment.

Here, Ms. Montgomery cited to specific points in the veteran's history to support her conclusion that a current psychiatric disorder is causally related to service. The IME opinion, though probative, is not as thoroughly supported, in the Board's estimation. For instance, there was no explanation as to whether the nervous condition noted in service was an initial presentation of schizophrenia. That

is the crux of the veteran's argument. Also, there was no comment on the report in April 1971 that the veteran had been manifesting symptoms for three to four months. Ms. Montgomery's opinion is more probative than the IME because it is better supported as to these critical issues. See

Prejean v. West, 13 Vet. App. 444, 448-9 (2000) (Factors for assessing the probative value of a medical opinion are the physician's access to the claims file and the thoroughness

and detail of the opinion.).

Additionally, although the IME concluded that the veteran's psychiatric disorder first manifested in April 1971, he went on to state that it was at least as likely as not that the condition was not related to in service disease or injury. This statement is unclear and may actually be construed as an

opinion in favor of the claim when one considers that the April 1971 manifestations were reported to have been occurring for about four months.

The Board may adopt a particular medical expert's opinion for its reasons and bases where the expert has fairly considered the material evidence of record that appears to support a

claimant's position. See Wray v. Brown, 7 Vet. App. 488, 493 (1995). Thus, Ms. Montgomery's December 2005 opinion is accorded greater probative value. The Board notes that the

December 2005 opinion contains various psychiatric diagnoses under Axis I. However classified, this specialist has related the events in service, including enuresis and nervousness to the post-service psychiatric disabilities.

However, the Axis II diagnosis of borderline intellectual functioning and prior diagnoses of personality disorder are not disabilities for which service connection may be granted.

See 38 C.F.R. § 3.303© (2005) (Congenital or developmental defects, personality disorders and mental deficiency as such are not diseases or injuries within the meaning of applicable

legislation).

The Board must determine whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either case, or whether the preponderance of the evidence is against the claim, in which case the claim must be denied. See Gilbert v. Derwinski, 1 Vet. App. 49, 55

(1990). In this case, the actual probative medical evidence is both for and against the claim. Accordingly, service connection is thus warranted for a psychiatric disorder,

variously diagnosed. ORDER

Service connection for a psychiatric disorder, including

schizophrenia/schizoaffective disorder, is granted.

____________________________________________

M. SABULSKY

Veterans Law Judge, Board of Veterans' Appeals

Department of Veterans Affairs

[free_spirit_etc]

Josephine,

I don't know all the particulars of your case - but based on what I know - I would think you have a pretty strong case - at least as far as the BVA would be concerned. Especially since you have a C&P exam that is in your favor.

If you have been treated for nervousness and anxiety for that many years - yet your treating doctor - even if not a psychiatrist - didn't see any indications of personality disorder -- and the FIRST C&P was in your favor - it just seems completely odd that they would send you for a SECOND C&P that magically discovers that you have been suffering from an undiagnosed personality disorder all these years.

When they had the evidence to grant SC - even from their own doctor -- you wonder what would compel them to keep digging for evidence that you have a personality disorder (besides all the retro).

And WHERE did they get the information they came up wit to use against you? (The kicking walls, cutting, etc.)

Can I ask - Does your relative that works for the VA think you have a personality disorder? Do you think SHE is having something to do with this claim?

(i.e. looking at your FIRST C&P and deciding to tip the RO off that SHE doesn't think it is right - so THEY have to send you to someone who basis THEIR opinion on HER opinion?)

Just wondered.

It just does not make sense that you gave them YOUR evidence...THEIR doctor who examined you gave you a favorable report -- and then the case went all to heck with strange meetings with more than one doctor interviewing you at the same time -- who suddenly have access to all this private information --etc..etc..etc..

I hate to say it - but I would wonder if your relative not only did not help you - but totally set you up.

Free

When I located this case, I wanted to post it, so that no one will walk in my shoes.

There are people out there that never post, but may be in the same situation that I am in.

On one hand I have a PHD Psychologist who used his profession with the upmost of integrity who gave me a C&P with complete rationale as to why he gave me a " More Likely than Not" decision.

I have a Board Certified Internist that has treated me for 30 years, a Board Certified Psychiatrist before him and a General Practioner, graduated from Harvard Medical School before him, making this a total of 43 years of treatment for Nervousness, Anxiety, Depression and Headaches.

My Military doctor Dr. C. who treated me in service with Librium and Cafergot, which were not for headaches only, as stated by the two psychiatrist. In his written letter of May 12, 2004, he states that the cafergot was for a headache and the Librium was for Anxiety and to the best of his memory, he probably referred me to the two military Psychiatrist for same.

On the other hand I have two VA psychiatrist who resorted to slander to arrive at their decision and just how clear is their decision?

In contrast to Dr. P.'s opinion, and that of a VA psychologist in an October 2004 report, a board of two VA staff psychiatrists found that the veteran's symptoms were primarily consistent with a personality disorder and that it did not appear she developed a chronic psychiatric disability while on active duty.

I don't think that my doctor , Dr. P, would get by with the word " Appear". Dr. P used the wording "Origin"

Josephine

[free_spirit_etc]

Good point.

I will have to admit - when I started reading it- and saw the length of service -and the pre-existing psych stuff - I was surprised by the decision.

However, though schizophrenia/schizoaffective disorder has a genetic base - it also usually requires SOMETHING to set it off. In this case, the VA ruled that it is at least as likely as not that the boot camp experience was that something.

That is common with many psych disorders - you can have the predisposition for it - but it doesn't develop because nothing brings it out. Or you can experience the horrors of hell (with no predisposition) and not end up with a psych disorder.

But just because you had the predisposition - or just because something would have occured to set it off anyway -- if it is at least as likely as not (benefit of the doubt to the vet) that what occured in the service IS what set it off - it would be Service Connected.

That would actually be no different than to say that someone had a weak lower back that went out when lifting something in the service that never improved -- that the service CAUSED the degree of disability. Rather than to say that -oh..well - it would have ended up going out someday anyway --when they lifted something somewhere else.

I think mental disorders are subjected to a lot of discrimination in that respect. It has been our culture to blame people for their mental disorders...adn see them as a sign of weakness.

"Well that shouldn't have bothered them - it wasn't that bad -- it wouldn't bother a "normal" person ---yadaydayada.."

But again -- some people can lift heavy objects and never have a back problem. Another person can lift something a fraction of the weight and mess up their back forever.

They used to actually fight a lot of worker's comp claims with the "their back was bad -they had poor posture -- it would have went out anyway."

But at least they are moving more to the "law suit" standard of You take someone AS THEY ARE. If picking up a cotton ball makes their back go out -- and you handed them the cotton ball - guess what...

Free

Interesting what this claim shows me that evidence and even testimony confirmed by competent credential professional will win a claim that looked like it was dead in the water.

Good find and the BVA rational is important.

[Josephine]

Free,

If you read the first C&P examination, it is obvious that this doctor was set up by the VA and this would be where my niece is Supervisor of the DRO's.

DIAGNOSIS: anxiety disorder, not otherwise specified, with depression.

SUMMARY AND CONCULSION: this veteran clearly has a very long history of anxiety with depression, and currently during this examination, warrants such a diagnosis due to the above- mentioned symptoms. It appears that her diagnosis is not what is in question, according to the examination request.

The main question appears to be “ Does the veteran have a chronic acquired psychiatric disorder which began in service?” Based on the evidence to be discussed next, this examiner’s opinion is that it is as least as likely as not that the veteran’s anxiety and depression was caused by a result of her military service.

The evidence reviewed in this case was the entire Claims file, though, in particular, there are records indicating that she was diagnosed with anxiety and prescribed Librium in 1967, whereas the examination request initially stated that her psychiatric treatment dated from 1979, according to the form.

In addition, the veteran reports no medication treatment prior to that in 1965 when evaluated, due to her pregnancy, which is plausible. Given the closeness of her treatment to her military service (compared to 1978), this makes it more likely than not she had been having problems in 1964, as well.

The veteran’s friend from the navy was in with her also provided a letter describing how the veteran was anxious and on medication for” nerves” while in the service. The veteran who wrote the letter, Jxxx also describes some of the abusive and stressful conditions that they endured, which could certainly contribute to such anxiety states.

In addition, the veteran’s current fear of heights and water could also certainly be tied to such experiences. Of course, it is recognized that such experiences are not proven, though this veteran’s friend does corroborate them.

In addition, the veteran had two psychiatric referrals within a short period of time in March 1964. Given this fact, it makes it more likely than not that she had some kind of psychiatric difficulty while in the service, and she was judged to be unsuitable for service. It is unclear why, despite the veteran’s report of telling of her stressors, that they were not documented. The veteran also has indicated no childhood psychiatric difficulties again making the beginning of her troubles dating to service more likely.

C. M. PhD Clinical Psychologist

Free,

If you read you can see that the VA ask him to evaluate me from 1979 forward, but he upset the Apple Cart and went all the way back to when my problems began.

It was not in the plan for him to evaluate me from 1964 to date. He was to get rid of me and it back fired on the VA.

When this C&P came through, my niece hurried up and signed off my claim, and it was sent to another Regional office for them to Rate Only.

The second office set up that Stupid C&P. Someone wants rid of me badly. I think it is because of the " New and Material Evidence" of those " Psychiatric records" which has opened all of my claims back to 1978.

Free,

My niece only says that everyone has personality traits and that I definitely do not have a Personality Disorder.

If only she could write a letter for me.

She will be up the 17th for my Birthday. She always stops by and I am sure that she will this year also.

She came up to see my new home last month and brought a picnic with her.

I can't see her doing anything of this nature.

She knows that as long as she can remember that I have always been nervous. A lot of it has been listening to her mother talk.

My sister, her mother died in 2003 and this has been very upsetting to her. I promished my sister that I would never drop this claim and I will not.

It doesn't seem possible that the ones that could write a letter for me are gone. I lost my mother one year after I started this claim and then my sister.

I only have my husband and daughters and my Dr. P to dispute those stupid lies.

I do have 3 letters by my Pastor, one of my life before being in service and two after my return from service and his counseling me for 13 years. This is his Philosophy on life.

" I believe a person's future is more important than ones past and must be considered above the present, for without a future the past and the present become unimportant".

When my niece comes up, this time I am going to hand her that C&P and tell her to read it.

I will let you know how she acts.

Thanks to all,

Josephine

Edited August 9, 2007 by Josephine

[john999]

Josephine

I think the VA just does not want to pay you. They found a way to wriggle out of it for now, but keep fighting. With these guys it is not about right or wrong just money.

[Josephine]

John,

I think that there is definitely a huge Big Fat Rat in my claim and I will keep fighting them until I locate it.

Thanks,

Josephine

[free_spirit_etc]

Yep. That is a pretty supportive opinion. I like how he points out that the records show you were in treatment LONG before the VA indicated you were.

So did they ever give you a reason as to WHY -with several medical opinions already in your favor - they sent you to another doctor.

It would seem like they would have to give a reason as to why they considered the medical opinions you had inadequate before they sent you for ANOTHER one.

In fact, THIS one says that your DIAGNOSIS wasn't in question. So - again - you have been treated for YEARS for anxiety and depression. The VA C&P examiner even states your disgnosis is NOT in question - the only question is did you aquire it in service, or as the result of service.

Then you get sent to another exam with a WITNESS in the room that suddenly decides that you have a DIFFERENT diagnosis - one that magically would make you ineligible for benefits.

Geez.......

Anyway -- didn't the second C&P kind of suggest that you already had personality disorder in the service? That you displayed symptoms in the service -- but that they were from a personality disorder?

Free

Free,

If you read the first C&P examination, it is obvious that this doctor was set up by the VA and this would be where my niece is Supervisor of the DRO's.

DIAGNOSIS: anxiety disorder, not otherwise specified, with depression.

SUMMARY AND CONCULSION: this veteran clearly has a very long history of anxiety with depression, and currently during this examination, warrants such a diagnosis due to the above- mentioned symptoms. It appears that her diagnosis is not what is in question, according to the examination request.

The main question appears to be “ Does the veteran have a chronic acquired psychiatric disorder which began in service?” Based on the evidence to be discussed next, this examiner’s opinion is that it is as least as likely as not that the veteran’s anxiety and depression was caused by a result of her military service.

The evidence reviewed in this case was the entire Claims file, though, in particular, there are records indicating that she was diagnosed with anxiety and prescribed Librium in 1967, whereas the examination request initially stated that her psychiatric treatment dated from 1979, according to the form.

In addition, the veteran reports no medication treatment prior to that in 1965 when evaluated, due to her pregnancy, which is plausible. Given the closeness of her treatment to her military service (compared to 1978), this makes it more likely than not she had been having problems in 1964, as well.

The veteran’s friend from the navy was in with her also provided a letter describing how the veteran was anxious and on medication for” nerves” while in the service. The veteran who wrote the letter, Jxxx also describes some of the abusive and stressful conditions that they endured, which could certainly contribute to such anxiety states.

In addition, the veteran’s current fear of heights and water could also certainly be tied to such experiences. Of course, it is recognized that such experiences are not proven, though this veteran’s friend does corroborate them.

In addition, the veteran had two psychiatric referrals within a short period of time in March 1964. Given this fact, it makes it more likely than not that she had some kind of psychiatric difficulty while in the service, and she was judged to be unsuitable for service. It is unclear why, despite the veteran’s report of telling of her stressors, that they were not documented. The veteran also has indicated no childhood psychiatric difficulties again making the beginning of her troubles dating to service more likely.

C. M. PhD Clinical Psychologist

Free,

If you read you can see that the VA ask him to evaluate me from 1979 forward, but he upset the Apple Cart and went all the way back to when my problems began.

It was not in the plan for him to evaluate me from 1964 to date. He was to get rid of me and it back fired on the VA.

When this C&P came through, my niece hurried up and signed off my claim, and it was sent to another Regional office for them to Rate Only.

The second office set up that Stupid C&P. Someone wants rid of me badly. I think it is because of the " New and Material Evidence" of those " Psychiatric records" which has opened all of my claims back to 1978.

Free,

My niece only says that everyone has personality traits and that I definitely do not have a Personality Disorder.

If only she could write a letter for me.

She will be up the 17th for my Birthday. She always stops by and I am sure that she will this year also.

She came up to see my new home last month and brought a picnic with her.

I can't see her doing anything of this nature.

She knows that as long as she can remember that I have always been nervous. A lot of it has been listening to her mother talk.

My sister, her mother died in 2003 and this has been very upsetting to her. I promished my sister that I would never drop this claim and I will not.

It doesn't seem possible that the ones that could write a letter for me are gone. I lost my mother one year after I started this claim and then my sister.

I only have my husband and daughters and my Dr. P to dispute those stupid lies.

I do have 3 letters by my Pastor, one of my life before being in service and two after my return from service and his counseling me for 13 years. This is his Philosophy on life.

" I believe a person's future is more important than ones past and must be considered above the present, for without a future the past and the present become unimportant".

When my niece comes up, this time I am going to hand her that C&P and tell her to read it.

I will let you know how she acts.

Thanks to all,

Josephine