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Zero % After Dro Hearing For Ptsd


Johnny K.

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Dear Tbird,

This site is an unbelieveable blessing and, after more than two years of trying to prove service connection for my PTSD, I finally found the site a couple of months ago, after my Legion Rep told me about it.

I have been married twice, most recently for fourteen years. I am a Vietnam and Desert Storm non-combat veteran and worked as a Hospital Corpsman from 1973-1992 mostly with the Marine Corps as a Field Medical Service Technician as a platoon corpsman , and as an EMT/Paramedic at Camp Pendleton Naval Hospital emergency services, and in the refugee camp in 1975 where all of my documented stressors occurred, along with caring for the sick and wounded returning to Long Beach Naval Hospital during 1972.

Last week a DRO sent me a transcript of our meeting and changed me from a complete denial status of my service connection claim to zero %. I have been treated by private mental health professionals on an outpatient basis since 1981, and by VA doctors since 2005. The diagnoses have always included anxiety/panic disorder, major depression, etc. GAF 55.

My American Legion Rep is happy and says that, now that I have recieved service connection status, we can appeal again for a higher percentage of disability.

I currently work four hours a day, five days a week in a job which allows me to have minimal contact with the public, and that helps me avoid many of my stressors.

I drive to and from work, and drive at work and, because I am on medication continuously I have few road rage incidents. I have been on medication for many years for my symptoms and I recieve them from a VA psychiatrist.

The transcript from the DRO had several mistakes in it, and I would like to correct them. How do I do that?

Also, in order to get my rating increased do I need to get a statement of employability? And should I go to a civilian psychologist, or psychiatrist-- or the VA psychiatrist (who I do not completely trust). Who's opinion would carry the most weight with the people who make ratings decisions?

One of the great Hadit community members provided me with a list describing what each percentage increment for PTSD requires, and I believe I fall somewhere around 30-50 %.

Thanks for your great heart and the help of the whole Hadit community.

Doc John

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If I were you I would get an opinion from a private psychiatrist-

There is a specific criteria they should follow- see my topic "Getting an Independent Medical Opinion under the search feature.

They should also have the VA award letter and narrative that holds the Reasons and Bases for the low rating.And copies of any PTSD C & P exam results you have (they can be requested from the VAMC)

Any private doc has to make a strong nexus statement- such as "In my professional opinion the veteran's current disability is more than likely due to the veteran's exposure to......(stressful events, etc)in service."

Also he/she could throw in "there is no other known etiology but for the inservice (stressors ,events etc")to have caused this disability to the veteran.

A Psychiatrist would possibly give you the full gamit of psychological testing that would help them shape their opinion.

(Unless the VA did already?)

The VA gave the reasons for the "0" rating and this is what a good IMO has to combat with full medical rationale.

Edited by Berta
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Hi Berta,

So, I should go with a psychiatrist instead of a psychologist?

The psychiatrist at the VA only manages my meds. Will a private psychologist do a full work up?

The stress treatment group that I meet with has now been canceled 5 times in a row, and the head of the mental health department won't return my calls to complain. (Bay Pines in Florida)

Thanks for your input.

Doc John

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  • HadIt.com Elder

I know a few psychiatrists and psychologists in the Tampa Bay area. They helped out. I think I would see a psychiatrist because the VA gives them more regard for some reason.

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  • HadIt.com Elder

John I think it has to do with that little piece of paper that states a psychiatrist is also an MD where pyschologists are usually NOT MD's rofl could be the reason the VA gives shrinks more credence than pyschs :blink::unsure:

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JohnnyK,

I think your worst battle is over: It took you two years just to get SC but you did...and even 0% is good, too. Because PTSD usually only gets WORSE, not better...so NOW it's "just" a matter of getting your rating raised (as you know). But the SC was the hard part.

I believe the VA gives more weight to an MD or DO (psychiatrist's) medical opinion rather than to a Ph.D.'s (but these ALSO will help as supporting evidence to the main IMO)...so look for an MD/DO and one who (hopefully) specializes in dealing with combat vets/PTSD issues...a specialist in the field (PTSD) would have the most weight over a "general practice" shrink but they are RARE...but still, get what is available. Try to find a shrink who AT LEAST has dealt with vets before even if it's not his/her speciality.

And if you DO get an outside medical opinion, be sure to print-out and take with you -- for his/her reading pleasure and enlightenment, and in order to write an IMO in VA-Speak that will be acceptable -- the appropriate PTSD C&P Exam guideline. Preferably, get the guideline to the doctor BEFORE seeing you so the doctor has time to read through it so he/she can ask the appropriate "VA format" questions, etc....be sure the doctor understands the VA is pretty demanding in what it wants to be sure the guideline is covered. And don't forget that the all-important "rationale" for his/her opinion must be indluded.

Good luck,

-- John D.

Hi Berta,

So, I should go with a psychiatrist instead of a psychologist?

The psychiatrist at the VA only manages my meds. Will a private psychologist do a full work up?

The stress treatment group that I meet with has now been canceled 5 times in a row, and the head of the mental health department won't return my calls to complain. (Bay Pines in Florida)

Thanks for your input.

Doc John

Edited by cloudcroft
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True. But remember, shrinks first and foremost are medical doctors rather than academics, and shrinks go through a LONG period of medical training (internship/residency), way more in time and type of training than a Ph.D. does.

I would use Ph.D. opinions is a supporting role to my main MD/DO IMO(s). So the main goal would be seeking out an MD/DO for at least ONE IMO, if not more than one....unless I couldn't get an IMO that is FAVORABLE to my claim then I would think I just didn't have a case of enough merit to continue with it.

-- John D.

John I think it has to do with that little piece of paper that states a psychiatrist is also an MD where pyschologists are usually NOT MD's rofl could be the reason the VA gives shrinks more credence than pyschs :blink::unsure:
Edited by cloudcroft
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I know a few psychiatrists and psychologists in the Tampa Bay area. They helped out. I think I would see a psychiatrist because the VA gives them more regard for some reason.

Thanks, John,

Do they specialize in PTSD?

Send me some names by email.

Doc John

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True. But remember, shrinks first and foremost are medical doctors rather than academics, and shrinks go through a LONG period of medical training (internship/residency), way more in time and type of training than a Ph.D. does.

I would use Ph.D. opinions is a supporting role to my main MD/DO IMO(s). So the main goal would be seeking out an MD/DO for at least ONE IMO, if not more than one....unless I couldn't get an IMO that is FAVORABLE to my claim then I would think I just didn't have a case of enough merit to continue with it.

-- John D.

Dear Cloudcroft,

I think you are right about the M.D./D.O. opinion being necessary. In my C-File I have three opinions from psychologists and one from a VA Psych,M.D. all stating I have PTSD and major depression with panic/anxiety which began during my first tour of active duty at the end of the Vietnam war.

When I finished with the DRO she looked at me and my wife and said "good job".

And then came the transcript, and my Rep telling me zero percent. I am not angry but I am determined to get the rating that is correct for my SC.

Thanks for the good advice,

Doc John

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JohnnyK,

You're welcome.

1. As for the rater giving you 0%, sometimes it's just the particular ratings officer you got...a different rater may have given you something different.

2. At least your foot is in the door getting the 0%...at this point, that's the victory. Now, you continue the struggle...as lots of us have.

3. Remember, most of the time a VA doctor's opinion is given more weight than a civilian doctor's opinion (IMO)...that's just how it is. But don't let that stop you. Even a VA doctor at some point down the road may agree with you or, you can get a civilian doctor who is helpful.

Now you must prepare yourself (and family) for the 3-5 year process this may take (this includes the time it took to get this far, from the date of filing your claim to the rendering of the 0% decision). If it takes less time then good for you, but don't count on it. If you aren't mentally/emotionally prepared for the long-haul, you won't make it, and like most vets, will give up.

-- John D.

Edited by cloudcroft
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  • HadIt.com Elder

Johnny, as far as VA docs go, I have a shrink that I didn't think much of either, but he writes excellent notes from the clinic vists. I at one time wanted to switch from him to the PTSD team, after being messed up by the PTSD team on the admissionto the inpatient program (they rejected me on the basis I was to sick to be in the hospital)so I asked the shrink if he would continue to see me (my wife suggested I keep him, due to his notes. In the long run it was one if NOT the most impiortant decision I ever made, my 100% came from his notes and his letters supporting my claim for the 100%. Sometime the people you expect to help you the least help you the most

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Johnny, as far as VA docs go, I have a shrink that I didn't think much of either, but he writes excellent notes from the clinic vists. I at one time wanted to switch from him to the PTSD team, after being messed up by the PTSD team on the admissionto the inpatient program (they rejected me on the basis I was to sick to be in the hospital)so I asked the shrink if he would continue to see me (my wife suggested I keep him, due to his notes. In the long run it was one if NOT the most impiortant decision I ever made, my 100% came from his notes and his letters supporting my claim for the 100%. Sometime the people you expect to help you the least help you the most

Hey Testvet,

Here is what Berta said on the topic earlier, I really appreciate her, too:

date='Jul 29 2007,

I am astonished that the VA has not awarded you yet with the evidence you mentioned.

Do they have all of that evidence?

Did they ever refer to it yet in any Statement of the Case?

Have they attempted to rebutt those IMos with any VAola quackola medical opinions?

I would certainly bring all of the above opinions to the DRO hearing and make sure they are fully considered-

and are made part of the record----

My Rep at a DRO hearing- claimed he highlighted my IMOs -but the DRO record shows this never happened and that VA did not even have any IMos from me.

I hope the AL will sure show up for the hearing.

When the VA has enough medical evidence to make an award -they should award-

they should NOT do any doctor shopping to try to find a VA opinion against your claim.

When MY rep called me before the DRO conference (it wasnt really a hearing)

he said he was sure he would walk in with my IMos and walk out with an award.

I dont know what he walked in with- my IMOs disappeared from that point for over 2 years-in spite of being re-sent by me many times-and he never gave them to the DRO.

I will look for the regs and post them here-

that show that VA -with enough medical information to award (regardless of where it comes from-claimant or VA )is supposed to award.

You have a preponderance of evidence -

actually it is really too late for VA to doc shop-

I sure hope the AL knows the regs in and out on this one.

Berta

I saw the VA psychiatrist yesterday for my quarterly eval. He was not even aware of my claim, although I assumed he was. You know what they say about "assume".

I was not aware that the claims people do not talk to the medical people so yesterday I had him enter information about my claim into my VA medical record. He really only seems interested in controling my meds- not in counseling or therapy.

I have decided to stay with him and also get an IMO letter stating my employability and other conditions of my disability. But I guess I need a Psychiatrist who specializes in PTSD, what do you all think?

The DRO 's transcript did not mention that I have to be on meds all the time so I will get a statement from the doc to that effect.

John D. (cloudcroft who is very sharp, too) states that the VA psych's opinions are given more weight than a civilian doctor's. But I have two VA psychiatrists so far: one VA psychiatrist for my C&P (who said I have SC major depression but not PTSD) and another on a regular basis for treatment. Plus I have four psychologist opinions ( two from VA and two civilian) stating I have service connected PTSD already recorded in my C-file and the VA medical records.

I will not give up even though the battle just makes my symptoms worse.

Thanks for the encouragement! Got to go .

Doc Johnny K.

Edited by Johnny K.
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sounds like the DRO was playing the numbers game. if the issue in front of him is "entitlement to service connection for ptsd" then he can award service connection and pull the issue off appeal as a "complete grant of benefits." he did that by granting you what you asked for, and assigning a zero percent evaluation. he gets the credit for disposing of a case, and his pending appeals numbers go down by one.

now you have a new claim for "evaluation of service connected posttraumatic stress disorder" which is not on appeal. since you have a diagnosed mental disorder and take medication, an evaluation of 10 percent is inevitable. but higher evaluations may depend on complex issues specific to your claim. do you have co-existing mental disorders, one of which is not service connected? such a scenario is suggested by the DRO's assignment of a 0 percent, and can be problematic for getting a higher evaluation.

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Johnny K.,

Yes, if you can find a civilian (non-VA) shrink who specializes in PTSD that would be great. Better yet is one Board Certified for PTSD and on top of that, best of all would be one who has worked with combat vets and is VA-experienced. Because PTSD can have other non-military service causes, if your PTSD is from combat service, you'd want a shrink who has dealt with that environment and also knows how to write up IMOs according to VA guidelines.

The more suited a shrink is (due to his/her specialization) for whatever your mental disability is -- not just PTSD - AND who has worked with vets before, the better, and the harder it is for the VA to dismiss it.

I mean seeing a shrink specializing in children/adolescents, family issues or phobias, for example, isn't really going to be that helpful even though he/she may be a very good shrink; same for a shrink who knows nothing about vets or the VA...unless that's all you can find in your town. Also, keep in mind that some shrinks will not even do IMOs, others will, while even others will do IMOs, too, but will want to see you for a while (x-number of sessions) before they write one up. Ask the shrink about this ahead of time.

And an IMO could be expensive: A local shrink here requires a $2000 retainer before he will even see you...he said, "This in case I have to go to Washington and testify before the BVA or CVA" (but I don't see why he can't wait to BE SURE he will have to go before asking for the 2 grand, and besides, requesting the shrink's presence is unlikely anyway). And the famous Dr. Bash is several grand (but I don't know if he does mental issues, let alone PTSD). Otherwise, consider about $300 for the IMO sesson itself plus the actual write-up/report.

Unfortunately, a shrink like this -- PTSD specialist/board certified for PTSD/VA-experienced -- probably will be VERY hard to fund in small or medium-sized towns/cities...even in larger cities it may be tough. I expect that in a few years there will be more shrinks specializing in PTSD and vet-experienced due to the increasing number of vets coming back from Iraq. But that doesn't help us NOW. The lack of VA-experienced shrinks is probably the same as the lack of VA-experienced lawyers.

VA shrinks are the best way to go if you can find one who is vet-friendly and sympathetic to PTSD issues. Get one who isn't vet-friendly and you're probably in trouble.

Good luck,

-- John D.

Edited by cloudcroft
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  • HadIt.com Elder

Doc. As I read your post and the replies here, you seem to be on track to correct your PTSD rating. Thanks to experienced Hadit family and years of effort, my disability rating issues are truing up.

My 2 questions.

First, do you have a copy of your C-file and have you read it? When I first requested and recieved my C-file, I only got the "medical" office visit notes. I learned here that I didnt get the entire thing, so I re-requested a copy of my "entire" Cfile, wow, it had so much more data, like V.A. specific disability diagnosis statements, C&P exam results, claim notes, claim letters and proof submitted. Once I submitted a claim using the wrong diagnosis, that was before I had my Cfile copy. Afterwards, my VSO and I had correct info. There were some things in my C-file that I was surprised at, telephone record notes that I had reqeusted this or that (a few untrue statements too that upset me too!) All in all, a very important, interesting and eye opening read.

Second, Do you know you can update your listing here with your hard earned disability rating? See "my controls" at the top of the page, smile. cg

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Doc John, don’t give up, almost 5 years ago when a vet wanted to help me with a claim for PTSD I told him, “Your crazy as hell, I don’t have PTSD” A shrink the VA sent me to said, “the service was more likely then not the cause of my problems” (Not the exact words.) I am now waiting for the formal notice of my new rating of 70% MDD and 100% TDIU. Of course the waiting will probably kill me. So just keep working, it will come. AND there is a lot of great help here. bill

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  • HadIt.com Elder

Johnny, controlling my meds is all my shrink does to, he's the only MH type I see, but his comments about my symptoms, the GAFs he's given me for the past 4 years all showed the extreme effect PTSD has on my life, he has given me scores from 30-45 for 4 years now and 2 letters in 2004 and 2005 that plainly stated that "he felt that my SC PTSD was totally and permanently disabling, and that due to the fact that I have been affected by symptoms of PTSD for over 30 years he doubted I would ever get better" the first time they gave me 50% the second time after I wrote Darth Vader (Dick Cheney) in Dec 2005 the VARO awarded me the 100% I think just to get me to quit writing the WH. LOL

He also made some comments about my having Obsessive Compulsive Disorder OCD, and was to fixated on the fact that the Army turned me over to some damn Nazi doctors the OSS/CIA brought to the US after WW2 who worked at Edgewood Arsenal doing human experiments on soldiers, and I was test subject 6778A out of 7120 men used. Gee I wonder why he thinks I would be obsessing about something like that? :blink::unsure:

Edited by Testvet
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If I were you I would get an opinion from a private psychiatrist-

There is a specific criteria they should follow- see my topic "Getting an Independent Medical Opinion under the search feature.

They should also have the VA award letter and narrative that holds the Reasons and Bases for the low rating.And copies of any PTSD C & P exam results you have (they can be requested from the VAMC)

Any private doc has to make a strong nexus statement- such as "In my professional opinion the veteran's current disability is more than likely due to the veteran's exposure to......(stressful events, etc)in service."

Also he/she could throw in "there is no other known etiology but for the inservice (stressors ,events etc")to have caused this disability to the veteran.

A Psychiatrist would possibly give you the full gamit of psychological testing that would help them shape their opinion.

(Unless the VA did already?)

The VA gave the reasons for the "0" rating and this is what a good IMO has to combat with full medical rationale.

Hi Berta,

I saw a Fee For Service psychiatrist for my C&P exam. It was at 11:30 A.M. and he must have been hungry. He did a very brief and incomplete exam, not even mentioning hyper-vigilance, insomnia, etc.

When he asked his first question it was about when I was first seen for my symptoms, and I said 1981. Then he asked what the psych's initial diagnosis was and I said

" dysthymia (major depression)" and before I could say "but, he later changed his diagnosis to PTSD", the quack had moved on to the next question. Because of this poor exam (which did concede SC major depression but failed to service connect me for PTSD, I asked to see the DRO.

After she read all of my IMO opinions, she put me at 0% for PTSD and now I am adding the Major Depressive disorder and TMJ to my ammended claim.

The VSO sent me the DRO's transcript, but I have not received the actual opinion letter yet. The DRO meeting was only on Sept 12, so it should come soon.

Oh, and now I have found out the VARO at Bay Pines has hired the quack (Dr. Mack) as

a staff psychiatrist- no longer fee for service. My Vet Center counselor says that this guy has not diagnosed PTSD in any claimants and five of her clients have documented PTSD diagnoses from IMO's which have been ignored by him. Maybe that is how he got the staff position? B)

Thanks Doc Johnny K.

Edited by Johnny K.
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  • HadIt.com Elder

JohnnyK. nice a Vet Center counselor is helping you. I hope all goes well and future interactions with your VA docs in the future are professional (client/doctor). Some doctor/patient relationships just dont work; had one myself, am adjusting some "odd" statements in my CFile thanks to them. Now, got a great VA doc and I wouldnt trade for anything (well nearly!) Again, good luck, expect good things and think about an official greivance if its really needed.cg

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sounds like the DRO was playing the numbers game. if the issue in front of him is "entitlement to service connection for ptsd" then he can award service connection and pull the issue off appeal as a "complete grant of benefits." he did that by granting you what you asked for, and assigning a zero percent evaluation. he gets the credit for disposing of a case, and his pending appeals numbers go down by one.

now you have a new claim for "evaluation of service connected posttraumatic stress disorder" which is not on appeal. since you have a diagnosed mental disorder and take medication, an evaluation of 10 percent is inevitable. but higher evaluations may depend on complex issues specific to your claim. do you have co-existing mental disorders, one of which is not service connected? such a scenario is suggested by the DRO's assignment of a 0 percent, and can be problematic for getting a higher evaluation.

Wow... I knew that they played the numbers game, I had been told about it before, but having it confirmed by another ex-rater is scary. Do they do this often? I mean honestly, how often do you think this occurs? Maybe you cant answer this because it's too involved but I think it is pertinent to the question at hand, and other claims as well. I have seen claims where this is what I thought happened, or something similar... so I'd like to know an estimate if possible. Sorry if it puts you on the spot. Don't answer if your not comfortable in doing so.

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Thanks Entropent,

I filed for PTSD in 2000, got denied and failed to appeal because of cancer surgery, and chemo/radiation.

I filed a new claim for PTSD IN 2005, and now, since this DRO decision, I am adding Major Depressive Disorder, which the C&P psych conceded as service connected.

I just keep punching the clock and filing appeals.

They can play the numbers game all they want- I will not give up until I get what they owe me. Or die.

Doc John

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