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C&p Exam Scheldued For Next Week.. Help!

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101airborne

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I have a cp exam in 10 days, Im currently rated at 50% ptsd. My ptsd has become so severe that I'm not sure if I can make it through the exam saying all the things I should. I have absolutely no short term memory in which a neuro psycologist told me was due to severe ptsd and not brain trauma; this is what scares me when it comes to the questions he ask. I've been seeing a psychologist 1 a week for 8 months. I haven't worked since being fired in April for anger. The problem is my PTSD is so bad, I've thought about these events in Iraq everyday since 2003, I can't seem to extinguish whats real anymore and what I've made up. It is just like my mind is in a big fog and I've been on over 15 meds. I'm just trying to figure out how to tell some psycholoigist the same stuff in 1 hour that I've been telling my doctor for over 8 months. Any advice would be helpful. Thanks everyone. One day I'll be over all this and enjoy my life... hopefully

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  • HadIt.com Elder

First off....breathe! Relax buddy...you're in good hands here at hadit. If you look at THIS THREAD, I have put together a lot of info on MH claims. As far as not remembering things, you should gather your records from the previous 8 months (or more) and type up a timeline. Write a short paragraph about how you feel on your worst days, too. Then print two copies of this; one for the examiner, and one for yourself. Apologize up front for you memory being so poor, and explain that you may have to refer to your notes to give correct answers. Everything will be fine...don't stress out.

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I would make a list of all my pertinent information. Set the most important first, Diagnosis, test scores, Gaf etc. Take a copy with you and ask them if they have that in your c-file. It is all on evidence and you need to make sure the rater see your favorable evidence. The C&P examiner may not know about your doctor visits! Sure, he should. Make sure he does. You are allowed to talk! Be proactive, tell them just in case they don't know. Have hard copy if they ask you for proof. This is not about medical care, it is for collecting evidence. The rater sent you there for evidence of your medical condition. This is your chance to ADD to the medical evidence, they have to put down what you say, then it is part of the Evidence! As John99 said, surround & overwhelm them with evidence. From what you said, I think you have a very good chance. But you need to get that "read into the evidence" i e what you said here about how it effects you now, the over medications etc. I had to stop taking some of the PTSD medications. (holly-molly). :P You just have to figure out what works for you. You are close to a decision now. Good luck and welcome home soldier.If he ask you about the list, look at him like he is stupid. ;)

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  • HadIt.com Elder

Most PTSD C&P exams take about 15 minutes (my experience) they already know what they want to do when they schedule you if you have a solid history of treatment and lost your job because of PTSD related issues I expect you will either get 70% TDIU ot 100% straight up others here may have other experiences but I have had 2 mental health C&P exams one took 5 minutes and the other 10 minutes how extensive could they have possibly been? The fear leading up to the exam is always worse than the exam good luck

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  • HadIt.com Elder

When you go for the exam you want to represent yourself as you are on your worst day. This is not a job interview, so dress down to the occasion. When the doctor asks how you are doing tell him you are doing awful. Don't say one good thing about any part of your life. Remember, you were fine before Iraq and now your life sucks because of Iraq. I would not shave or brush my hair. I would not make eye contact. I would describe my symptoms in detail. I would tell the doctor my meds are not working if that is the case. Be truthful about homicidal or suicidal thoughts or plans. Make sure he knows you were fired because of your anger problems. If you have a private report from a doctor put it in the C&P doctor's hands. No matter what else happens be sure and show up for this exam, even if you have to stay up all night and drink ten cups of coffee. If you have a significant other get them to drive you to the exam. Maybe the doctor will let them come in with you. This C&P doctor only sees you for a few minutes so you want to make the most of it.

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Thanks for your help everyone. I couldn't go at this alone. I will start a list and try to gather as much evidence as I can. I definitely have fear about it because I don't know what to expect.

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  • HadIt.com Elder

Worksheet - REVIEW EXAMINATION FOR POST-TRAUMATIC STRESS DISORDER (PTSD)

Name: SSN:

Date of Exam: C-number:

Place of Exam:

A. Review of Medical Records

B. Medical History since last exam:

Comments on:

1. Hospitalizations and outpatient care from the time between last

rating examination to the present, UNLESS the purpose of this

examination is to ESTABLISH service connection, then the complete

medical history since discharge from military service is required.

2. Frequency, severity and duration of psychiatric symptoms.

3. Length of remissions from psychiatric symptoms, to include capacity

for adjustment during periods of remissions.

4. Treatments including statement on effectiveness and side effects

experienced.

5. SUBJECTIVE COMPLAINTS: Describe fully.

C. Psychosocial Adjustment since the last exam

1. legal history (DWIs, arrests, time spent in jail)

2. educational accomplishment

3. extent of time lost from work over the past 12 month period and social

impairment. If employed, identify current occupation and length of time

at this job.

If unemployed, note in COMPLAINTS whether veteran contends it is due to

the effects of a mental disorder. Further indicate following DIAGNOSIS

what factors, and objective findings support or rebut that contention.

4. marital and family relationships ( including quality of relationships with

spouse and children)

5. degree and quality of social relationships

6. activities and leisure pursuits

7. problematic substance abuse

8. significant medical disorders (resulting pain or disability; current

medications)

9. history of violence/assaultiveness

10. history of suicide attempts

11. summary statement of current psychosocial functional status (performance

in employment or schooling, routine responsibilities of self care,

family role functioning, physical health, social/interpersonal

relationship, recreation/leisure pursuits)

D. Mental Status Examination

Conduct a BRIEF mental status examination aimed at screening for DSM-IV

mental disorders. Describe and fully explain the existence, frequency and

extent of the following signs and symptoms, or any others present, and

relate how they interfere with employment and social functioning:

1. Impairment of thought process or communication.

2. Delusions, hallucinations and their persistence.

3. Eye Contact, interaction in session, and inappropriate behavior cited

with examples.

4. Suicidal or homicidal thoughts, ideations or plans or intent.

5. Ability to maintain minimal personal hygiene and other basic activities

of daily living.

6. Orientation to person, place, and time.

7. Memory loss, or impairment (both short and long-term).

8. Obsessive or ritualistic behavior which interferes with routine activities

and describe any found.

9. Rate and flow of speech and note any irrelevant, illogical, or obscure

speech patterns and whether constant or intermittent.

10. Panic attacks noting the severity, duration, frequency, and effect on

independent functioning and whether clinically observed or good evidence

of prior clinical or equivalent observation is shown.

11. Depression, depressed mood or anxiety.

12. Impaired impulse control and its effect on motivation or mood.

13. Sleep impairment and describe extent it interferes with daytime activities

14. Other disorders or symptoms and the extent they interfere with activities,

particularly:

a. mood disorders (especially major depression and dysthymia)

b. substance use disorders (especially alcohol use disorders)

c. anxiety disorders (especially panic disorder, obsessive-compulsive

disorder, generalized anxiety disorder)

d. somatoform disorders

e. personality disorders (especially antisocial personality disorder

and borderline personality disorder)

E. Assessment of PTSD

1. state whether or not the veteran meets the DSM-IV stressor criterion

2. identify behavioral, cognitive, social, affective, or somatic symptoms

veteran attributes to PTSD

3. describe specific PTSD symptoms present (symptoms of trauma

re-experiencing, avoidance/numbing, heightened physiological arousal,

and associated features [e.g., disillusionment and demoralization])

4. specify typical frequency, and severity of symptoms

F. Psychometric Testing Results

1. provide psychological testing if deemed necessary.

2. provide specific evaluation information required by the rating board or

on a BVA Remand.

3. comment on validity of psychological test results

4. provide scores for PTSD psychometric assessments administered

5. state whether PTSD psychometric measures are consistent or inconsistent

with a diagnosis of PTSD, based on normative data and established

"cutting scores" (cutting scores that are consistent with or supportive

of a PTSD diagnosis are as follows: PCL - not less than 50;

Mississippi Scale - not less than 107; MMPI PTSD subscale a score

greater than 28; MMPI code type: 2-8 or 2-7-8)

6. state degree of severity of PTSD symptoms based on psychometric data

(mild, moderate, or severe)

7. describe findings from psychological tests measuring other than

PTSD (MMPI, etc.)

G. Diagnosis:

1. The Diagnosis must conform to DSM-IV and be supported by the findings

on the examination report.

2. If there are multiple mental disorders, delineate to the extent possible

the symptoms associated with each and a discussion of relationship.

3. Evaluation is based on the effects of the signs and symptoms on

occupational and social functioning.

NOTE: VA is prohibited by statute, 38 U.S.C. 1110, from paying compensation

for a disability that is a result of the veteran's own ALCOHOL OR DRUG ABUSE.

However, when a veteran's alcohol or drug abuse disability is secondary to

or is caused or aggravated by a primary service-connected disorder, the

veteran may be entitled to compensation. See Allen v. Principi, 237 F.3d

1368, 1381 (Fed. Cir. 2001). Therefore, it is important to determine the

relationship, if any, between a service-connected disorder and a disability

resulting from the veteran's alcohol or drug abuse. Unless alcohol or drug

abuse is secondary to or is caused or aggravated by another mental disorder,

you should separate, to the extent possible, the effects of the alcohol or

drug abuse from the effects of the other mental disorder(s). If it is not

possible to separate the effects in such cases, please explain why.

H. Diagnostic Status

Axis I disorders

Axis II disorders

Axis III disorders

Axis IV (psychosocial and environmental problems)

Axis V (GAF score - current)

I. Global Assessment of Functioning (GAF):

NOTE: The complete multi-axial format as specified by DSM-IV may be required

by BVA REMAND or specifically requested by the rating specialist. If so,

include the GAF score and note whether it refers to current functioning.

A BVA REMAND may also request, in addition to an overall GAF score,

that a separate GAF score be provided for each mental disorder present when

there are multiple Axis I or Axis II diagnoses and not all are service-

connected. If separate GAF scores can be given, an explanation and

discussion of the rationale is needed. If it is not possible, an explanation

as to why not is needed. (See the above note pertaining to alcohol or drug

abuse.)

J. Capacity to Manage Financial Affairs

Mental competency, for VA benefits purposes, refers only to the ability of the veteran to manage VA benefit payments in his or her own best interest, and not to any other subject. Mental incompetency, for VA benefits purposes, means that the veteran, because of injury or disease, is not capable of managing benefit payments in his or her best interest. In order to assist raters in making a legal determination as to competency, please address the following:

What is the impact of injury or disease on the veteran's ability to manage his or her financial affairs, including consideration of such things as knowing the amount of his or her VA benefit payment, knowing the amounts and types of bills owed monthly, and handling the payment prudently? Does the veteran handle the money and pay the bills himself or herself?

Based on your examination, do you believe that the veteran is capable of managing his or her financial affairs? Please provide examples to support your conclusion.

If you believe a Social Work Service assessment is needed before you can give your opinion on the veteran's ability to manage his or her financial affairs, please explain why.

K. Other Opinion:

Furnish any other specific opinion requested by the rating board or BVA remand (i.e., furnish the complete rationale and citation of medical texts or treatise supporting opinion, if medical literature review was undertaken). If the requested opinion is medically not ascertainable on exam or testing please state WHY. If the requested opinion can not be expressed without resorting to speculation or making improbable assumptions say so, and explain why. If the opinion asks "... is it at least as likely as not..", fully explain the clinical findings and rationale for the opinion.

L. Integrated Summary and Conclusions

1. Describe changes in PSYCHOSOCIAL FUNCTIONAL STATUS and QUALITY of LIFE

since the last exam (performance in employment or schooling, routine

responsibilities of self care, family role functioning, physical health,

social/interpersonal relationships, recreation/leisure pursuits)

2. Describe linkage between PTSD symptoms and aforementioned changes in

impairment in functional status and quality of life.

Particularly in cases where a veteran is unemployed, specific details

about the effects of PTSD and its symptoms on employment are especially important.

3. If possible, describe extent to which disorders other than PTSD

(e.g., substance use disorders) are independently responsible for

impairment in psychosocial adjustment and quality of life. If this is not

possible, explain why (e.g., substance use had onset after PTSD

and clearly is a means of coping with PTSD symptoms).

4. If possible, state prognosis for improvement of psychiatric condition

and impairments in functional status.

5. Comment on whether veteran is capable of managing his or her financial affairs.

Signature: Date:

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