tdiu May 8, 2008 Rating

[Josephine]

I am in the process of writing a NOD for these low-ball

ratings,

If you have the time to give me just a tad of assistance.

I am going to start by typing out the Rating of May 8, 2008.

I definitely will not send all this back to them, but did this for

your benefit. Sometimes it is difficult to read from a scan.

Service Connection for Chronic Anxiety with depression.

Service connection for chronic anxiety with depression has been

established as directly related to military service.

On March 4, 2008, The Board of Veterans Appeals granted service

connection for an acquired psychiatric disorder to include chronic

anxiety and depression. A detailed explanation of how they came to

that decision. You originally filed for service connection for an

anxiety disorder in an application received on February 8, 1992.

Service connection was denied on the basis of your service treatment

records not showing any treatment for non-congenital psychiatric

disorders. Because there was a failure to retrieve mental heath

records and not stored with service treatment records, we are able to

go back to that date even though that decision was finalized with no

further action until 2002.

An evaluation of 10 percent is assigned from February 6, 1992.

An evaluation of 10 percent is assigned if there is evidence

of an emotional tension or anxiety productive of mild social and

industrial impairment.

At that time, you had been married for over 20 years. You get along

well with your spouse and two children, and had a number of friends.

By your own account, you had quit working in a public place in 1983

in favor of working from home. A treatment record of Dr. Pxxx dated

August 31, 1983, noted you worked at a high stress job at English

Mxxxx. However, there is no indication that you were having trouble

handling that stress, several personal events occurred over the

years, causing acute increase in anxiety.

Dr. Payxx treatment record states: I was working at a high stress

job and under a great deal of stress and strain. Activity level low

and is working at home.

I was not given a C&P examiation in 1992 to see

what my true medical condition was for the VA standards.

A higher evaluation of 30 percent is not warranted unless there is

definite impairment in the ability to establish or maintain effective

and wholesome relationships with people, the psychoneurotic symptoms

result in such reduction in initiative, flexibility, efficiency, and

reliability levels as to produce definite industrial impairment. The

evidence on file does not show the aforesaid symptoms.

There would not be a note in my medical records of

1992 as to what was going on in my life considering occupational and

social employment.

Effective November 7, 1996, The Secretary of the Department of

Veterans Affairs amended the Schedule for Rating Disabilities for

mental disorders to better conform to the Diagnostic and Statistical

Manual for Mental Disorders. Volume IV (DSM- IV),

Which is used for most mental health practitioners.

However, your symptoms closely mirrored those listed at the 10

percent level which is occupational and social impairment due to mild

and transient symptoms which decrease work efficiency only during

times of significant stress. The symptoms had not elevated enough to

warrant a 30 percent evaluation, which includes occasional decrease

in efficiency and intermittent period of inability to perform

occupational duties due to symptoms such as suspiciousness and mild

memory loss.

Under the amended rating schedule, an evaluation of 50 percent is

assigned for occupational and social impairment with reduced

reliability and productivity due to such symptoms as flattened

effect, circumstantial, circumlocutory speech, panic attacks more

than once a week; difficulty in understanding complex commands,

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

highly learned material, forgetting to complete task) impaired

judgment, impaired abstract thinking; disturbances of mood;

difficulty in establishing and maintaining effective work and social

relationships.

In a medical report dated August 7, 1997, Dr. Pxxx noted you had

an exacerbation in your anxiety disorder, resulting in him labeling

you with Severe Anxiety Disorder.

In a statement by Dr. Pxxxx dated May 27, 1998, Dr Pxxx noted your

symptoms had been ongoing in all factors of your life since the

exacerbation nine months earlier.

Additional information regarding your mental disorder is not

available until 2004.

A higher evaluation of 70 percent is not warranted unless there are

deficiencies in most areas, such as work, school, family relations,

judgment, thinking or mood, due to such symptoms as: suicidal

ideation, obsessional rituals, which interfere with routine

activities; speech intermittently illogical, obscure, or irrelevant;

near- continuous panic or depression effecting the ability to

function independently, appropriately and effectively;

Impaired impulse control ( such as unprovoked irritability with

periods of violence ) ; Spatial disorientation;

neglect of personal appearance in hygiene;

difficulty in adapting To stressful circumstances

including work or a work like setting); inability to establish

And maintain effective relationships.

Although your impulse control has been impaired,

It was not continuous. Your personal hygiene was still intact,

as well as your spatial orientation.

According to a VA examination dated October 18, 2004, you were

staying active with friends and family. Panic attacks occurred only

once per week.

In a VA examination dated April 12, 2005 your spouse announced a more

frequent pattern of impaired impulse control, including fits of anger

during which you kicked holes in a walls and broke furniture.

You reported crying spells and sleeping problems.

You admitted to decreased concentration.

The examiner noted you were appropriately dressed but appeared

disheveled.

Although your speech flowed normally, your mood was anxious with a

constricted effect. You denied suicidal and homicidal intentions.

During a January 15, 2008, Independent Evaluation by Dr. Crowley,

you were cooperative and well orientated. No abnormities of thought

processes were present. Again, your fears of driving and of heights

were noted. You also stressed that you constantly dream of stairs

Leading to a pool. The dreams were noted as night terrors,

which are far worse than nightmares.

This result in six hours of sleep, but you noted it does not harm you.

During this exam however, the examiner noted your hands being wet

This symptom had been occurring for over 30 years, but at this stage,

your hands became wetter as you talked.

A higher evaluation of 100 percent is not warranted unless there is

total occupational and social impairment due to such symptoms as: a

gross impairment in thought processes or communication; persistent

delusions or hallucinations; grossly inappropriate behavior.;

Persistent danger of hurting self or others; intermittent inability

to perform activities of daily living

( including maintenance of minimal hygiene );

disorientation to time or place;

Memory loss for names of close relatives, own occupation, or own

name. There had been no indications of hallucinations or dangerous

behavior toward self or other people.

You have kept up your personal hygiene and noted no memory loss

period. There has also been no mention of complete and total

occupational and social impairment.

This is taking from my the September 23, 2008 Rating.

Entitlement to Individual Unemployability

Entitlement to individual unemployability is granted because the claimant is unable to secure and follow a substantially gainful

occupation as a result of service connected disability.

Social Security Administration income statements show that you

have not worked since 1983. Your VA examination, dated August 22, 2008

showed that you had been unable to work due to your severe anxiety.

The examiner noted that you would not be employable due to your panic

attacks, anxiety, and interactions with customers and co-workers

in a working environment.

Based upon the opinion of the examiner, entitlement to individual

unempoyability is granted effective April 12, 2005 to August 20, 2008,

the date of your increase to 100 percent.

In the August 22, 2008 is this examiner stating that

I was not able to work in the public sector in 1983 as well?

Thanks,

Betty

Edited September 28, 2008 by Josephine

[Berta]

"In the August 22, 2008 is this examiner stating that

I was not able to work in the public sector in 1983 as well?"

I am not sure Betty - have to think about what you mean here-BUT

"In a medical report dated August 7, 1997, Dr. Pxxx noted you had

an exacerbation in your anxiety disorder, resulting in him labeling

you with Severe Anxiety Disorder."

Was this a VA doc or a private doc- I forget-and wouldn't this show as Severe anxiety- a higher rating then they gave you?

Did they ever mention your SSA records in detail?

What I mean is what percentage of the SSA award is for anxiety?

There is a vet here who I suggested to that he use the rating SSA gave him for his SC shoulder (the SSA had other NSC percents too)

as evidence of how much ,per the SSA, his SC shoulder was disabling him because the VA lowballed him at 10%.

I dont know if this tactic will work but why not-

My husband got SSA solely for a CVA then on reconsideration it was a better EED and SSA totally for PTSD.

So I dont really know how SSA handles percentages when they award on more than one disability- others here sure would know-

I agree that you should definitely try for a better EED.

Edited September 28, 2008 by Berta

[Josephine]

Berta,

I never had enough credits to file for Social Security.

In a medical report dated August 7, 1997, Dr. Pxxx noted you had

an exacerbation in your anxiety disorder, resulting in him labeling

you with Severe Anxiety Disorder."

This came from my private doctor of 30 years. Not Military.

I am trying see how the VA came up with the 10% after 28

years of treatment at that time.

They have my post medical records from 1965 to date.

Had the VA give me a C&P in 1992, when I first filed, but here

we go, they are taking the responsibility of not acquiring my military

mental records, thus denying me, but my condition was worse

in the earlier years, than the years they gave me the higher rating.

I will have to type what Dr. Mxxx actually said in his C&P and not

the words of the rater.

Thanks,

Betty

Edited September 28, 2008 by Josephine

[Berta]

I apologise Josephine- you told us that many times before-

then again a person without enough SSA credits certainly has not had any long work history-and this is often only due to disability itself-

"In a medical report dated August 7, 1997, Dr. Pxxx noted you had

an exacerbation in your anxiety disorder, resulting in him labeling

you with Severe Anxiety Disorder."

This came from my private doctor of 30 years. Not Military.

I am trying see how the VA came up with the 10% after 28

years of treatment at that time."

This is the issue to focus on in the NOD-I agree with you.

[jbasser]

At that time, you had been married for over 20 years. You get along

well with your spouse and two children, and had a number of friends.

By your own account, you had quit working in a public place in 1983

in favor of working from home. A treatment record of Dr. Pxxx dated

August 31, 1983, noted you worked at a high stress job at English

Mxxxx. However, there is no indication that you were having trouble

handling that stress, several personal events occurred over the

years, causing acute increase in anxiety.

Dr. Payxx treatment record states: I was working at a high stress

job and under a great deal of stress and strain. Activity level low

and is working at home.

Betty, I believe the VA is hung up on one statement. Working at home.

Were you holding down a job at home back then. I believe the Doc meant Housework.

You can question that and have the Doc clarify it in your NOD with a statement from him.

I believe that is the only thing that you need to succeed.

John

Edited September 29, 2008 by jbasser

[Wings]

At that time, you had been married for over 20 years. You get along

well with your spouse and two children, and had a number of friends.

By your own account, you had quit working in a public place in 1983

in favor of working from home. A treatment record of Dr. Pxxx dated

August 31, 1983, noted you worked at a high stress job at English

Mxxxx. However, there is no indication that you were having trouble

handling that stress, several personal events occurred over the

years, causing acute increase in anxiety.

Dr. Payxx treatment record states: I was working at a high stress

job and under a great deal of stress and strain. Activity level low

and is working at home.

Betty, I believe the VA is hung up on one statement. Working at home.

Were you holding down a job at home back then. I believe the Doc meant Housework.

You can question that and have the Doc clarify it in your NOD with a statement from him.

I believe that is the only thing that you need to succeed.

John

I agree with John B. I think he's spot on!! ~Wings

[Josephine]

At that time, you had been married for over 20 years. You get along

well with your spouse and two children, and had a number of friends.

By your own account, you had quit working in a public place in 1983

in favor of working from home. A treatment record of Dr. Pxxx dated

August 31, 1983, noted you worked at a high stress job at English

Mxxxx. However, there is no indication that you were having trouble

handling that stress, several personal events occurred over the

years, causing acute increase in anxiety.

Dr. Payxx treatment record states: I was working at a high stress

job and under a great deal of stress and strain. Activity level low

and is working at home.

Betty, I believe the VA is hung up on one statement. Working at home.

Were you holding down a job at home back then. I believe the Doc meant Housework.

You can question that and have the Doc clarify it in your NOD with a statement from him.

I believe that is the only thing that you need to succeed.

John

I agree with John B. I think he's spot on!! ~Wings

Thanks so much, I will get that letter the 13th of October.

Betty