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Qtc Evaluation And Rating


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Question

Hello Veterans,

I have been viewing your site for several months and have found it informative. I am currently 50% service connected for bipolar disorder. I recently filed a claim for an increase for/due to anxiety (for all the things that fall under that diagnoses - OCD, Paranoia, etc). Because it is a psychological disorder, it is being rated as "Bipolar (anxiety)". Because of my OCD I tend to stay on top of things. My evaluation was just submitted from QTC to the VA and my veteran representative was able to pull up the summary in his system. Although the VA has not made a decision yet because the report was just submitted, I am ferious and paranoid that the decision may not go in my favor due to substanial inaccuracies.

I have a difficult time maintaining employment due to my disability. I can list all my credentials to justify my qualifications and intelligence, but the point is that I can not maintain stable employment and too much stress can get me into trouble. I have worked inconsistently since I left the military at a young age (honorably). Now my disability has gotten worst since my self-medicating has stopped because I have lost the indifference that came with the self medicating. I take my prescribed medications, but even that is difficult at times because I feel too tried and withdrawn to do much of anything. On the flip side, my actions can be risky in behavior.

Now the point of this post is to find out if people with experience can offer me advice, or allay my fears that all my hard work with this va claim for an increase will not be in vain do to a horrible evaluator at the QTC clinic in San Antonio. He was a older examiner who hardly took any notes, used no tape recorder as a reminder, and admitted he hadn't read my va package when I questioned him after he would spend much of the exmination time asking me questions that are clearly addressed in my paperwork. To make a long story short, despite not being rated yet, I am extermely disappointed in what my examination summary says. Although it is not final, I find it a complete insult to get so much of my exam wrong and state that I made statements which I had not.

For example, in my medical records it is noted that I use to self-medicate(which I did for many years upon my release from the military). Yet, the doctor states that I stated I have had no problems with alcohol or drugs. I even admit past use (and current use, when it was current), it's in my record. I even told this examiner, but he stated otherwise. He got my relationships with family members completely wrong, historical information about my past wrong, even the location (state) of family wrong. He states I stated my mother takes insulin which I never said (she has no reason to take insulin - it was my great grandmother who had diabetes, and I helped to take care of before she died). He got my college graduation time wrong stating I graduated with my bachelor's degree after I got out the military when it was prior to getting out of the military. He states the wrong major for a master degree I was working on while in the military, and confuses it with the degree I wanted to get through voc rehab but was refused due to my low GAF score of 40.

I am insulted that he states I said things that were not said and is clearly different from what I have stated to past doctors, my va file which he had access to but obviously didn't read (my va rep thinks he cut and pasted information from my original rating from 1 year ago), and my own memory which he viewed as "reliable". I was completely honest and did not try to appear worst than I really am, but I do believe I am much worst than what he stated. But to have such a poor evalutation performed and not to really acknowledge how severe my employability is is so discouraging.

I am currently in voc rehab but I am not sure if maintaining a full-time job long term will be possible for me, but I am trying. I am currently unable to work as much (when I am able to work) due to school, so an increase in va benefits is necessary for me. I went through a lot of crap while in the military and I have tried my best to get the negative throughts out of my mind, but can't. I am proud to be a veteran. I truly hope that the raters will be able to see through obvious inconsistencies with his GAF score (which is the same as the original claim), his evaluations that doesn't make me seem as bad as I truly am on the inside and in the privacy of my own home, and the wrong information about my personal/family life and background, work history, educational background, and substance abuse issues that is so wrong but may not be a big deciding factor. He did write that I am currently not working.

Specific questions:

1. Are the raters though and will really look over my records, witness statements, personal statement, and treatment diagnosis and overlook the examiner's poor summary of me?

2. Can this examiner be fired for not doing a properly evaluation and stating I said things that I hadn't?

3. Is the fact that my memory is good for the most part going to affect my rating if I have bipolar and anxiety issue. I know that memory is a key factor on the rating decision, but sometimes I forget things and sometimes I don't. But these are not my true issue. My mood (depression) and irritability (anxiety and anger) is something that effects my employment. My medication often makes me feel more depressed and tired because my brain slows down and I feel too relaxed, sad?

4. Is it possible for the raters to lower my 50% rating with a GAF of 40 both times, even though my original claim the examiner noticed my issues and even recorded our conversation, and this claim the examiner didn't get anything right except that I was arrested for the first time (after my original examination) for a criminal charge (the case was dismissed), and this was the first time I contemplated suicide (although I may have contemplated this prior to the arrest, my thoughts weren't as serious as when I was looking at prison time). The charge had to do with assult.

Please don't get me wrong. I am a very kind, loving, and responsible person. I try my best to be the best person I can be. I just need more help from the va so that perhaps I can live a happier and less stressful life.

I really appreciate responses. I would prefer information from people that has had experience with rating claims and has an idea of how the rating board will interpret this information submitted. Does it matter that I am a female and servered in the Persian Gulf.

Thanks

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  • HadIt.com Elder

With a "consistent" GAF of 40, it is my opinion (please refer to Standard Rule #1 concerning "opinions") that a GAF of 40 will NOT get a 50% disability rating lowered, and, with suicidial ideations and a GAF of 40.......quite possibly a 70% rating.

Having said that, I find that I need to stress that I don't know WTF I'm talking about.

I have never known, nor will I ever know.

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  • HadIt.com Elder
Welcome to Hadit!

Some of the things that you mentioned in the beginning of your post will matter (self-medicating), and some will not (who actually took the insulin).

Specific questions:

1. Are the raters though and will really look over my records, witness statements, personal statement, and treatment diagnosis and overlook the examiner's poor summary of me?

They are supposed to be, but a lot of times they are not. They have to get through something like 10 claims per day, so you can see where some claims (re: most) just get a glance. I see that you are in San Antonio, and I believe you go through the Waco VARO. If that is the case, I have heard nothing but good things about them from other vets when I lived in Austin.

2. Can this examiner be fired for not doing a properly evaluation and stating I said things that I hadn't?

If this was a VA employee, they could possibly be reprimanded. You could still talk to the patient advocate, or your VSO, but it likely wouldn't get you anywhere. Besides that, looking like you're on top of things doesn't bode well for a MH claim. Your best bet at this point would be to get a good IMO from a board cerified psyhciatrist. If you can't find one, a board certified psychologist could suffice.

3. Is the fact that my memory is good for the most part going to affect my rating if I have bipolar and anxiety issue. I know that memory is a key factor on the rating decision, but sometimes I forget things and sometimes I don't. But these are not my true issue. My mood (depression) and irritability (anxiety and anger) is something that effects my employment. My medication often makes me feel more depressed and tired because my brain slows down and I feel too relaxed, sad?

Memory plays a factor in the rating criteria, but there are plenty of other criteria as well. It can be used against you, though. You need to find out what the C&P doc had to say about your memory and ability to concentrate.

4. Is it possible for the raters to lower my 50% rating with a GAF of 40 both times, even though my original claim the examiner noticed my issues and even recorded our conversation, and this claim the examiner didn't get anything right except that I was arrested for the first time (after my original examination) for a criminal charge (the case was dismissed), and this was the first time I contemplated suicide (although I may have contemplated this prior to the arrest, my thoughts weren't as serious as when I was looking at prison time). The charge had to do with assult.

If your rating has been in effect for five years or more, it will take more than one C&P to reduce that rating. The Global Assesment of Functioning score is only one piece of the total picture, and it is a snapshot of that current moment in your life. It is usually not given that much weight, unless it is higher, then the rater will use it against you all day long. Based on what you have written, I would be prepared to have your rating remain the same, but they will possibly send you a notice to reduce that rating. I'm not saying they will, and you may very well even get your rating increased. I'm just basing this off of what I have seen done to myself, other veterans on this site, and BVA and CAVC cases that I have read.

I would definately seek a IMO at this point, and quickly. I would also seek MH treatment and medication from your VAMC, if you are not already doing so. Best of luck to you.

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My Psychiatrist is a VA doctor and the last evaluator I had about a year ago worked through the VA. She wrote how bad my memory was, emotional, and how I was more likely than not service connected. I submitted a lot of evidence for my original claim. My VA doctor letter is included in this current claim. He states he is treating me for Bipolar (mixed w/ major depression and hypomania) and generalized Anxiety (OCD rituals, Paranoia, PTSD). I take medication for my disorders and I see a psychiatrist about once a month.

This rater makes my disability seem like it isn't as constant as it is. he states these bouts of elation followed by depression occur on averagwe once a year. Trust me, this is more of a constant thing. My medication clams me down, but then I don't feel very productive and have a hard time staying awake making it difficult for me to study and work. I am told not to take supplements to help increase my energy because it may counteract with my medications.

I am prescribed Bipolar meds, anixety meds, and pains meds for my back. My claim is in Waco.

Thanks.

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Also, do you think the raters will notice that in the summary where the examier notes that my history of present illness episodes last for a few months at a time. I have elations and hyperactivity for months before each depression. Then under the specific history for bipolar disorder states that these episodes occur on average once a year. My moods are mixed and occur more often than that. He also confuses when I told him I stopped self medicating with stopping my prescribed medication, noting shortly after that I was arrested. I never stated I stopped taking my medication at anytime during the interview.

I am just so upset when I know how much he got wrong during this evaluation. I don't like people thinking my situation is different than it is. He changed my whole life history.

Also, he states all my memory stuff is "fair" and normal and concentration is mildly impaired. Yet, I know I get very distracted with even the slightest sound. He states that I don't work consistently because I don't get along with people. But I do get along with people. People like me a lot, I just have a problem feeling trapped in work settings. I have had blow ups with people that I feel disrepesct me or play games with me. I have tried to bit my tongue, but eventually I have to leave the environment or I will explode on them.

He views my concentration, judgement, and memory better than I consider it. I spoke to my VA psychiatrist right after my exam because I was feeling very paranoid and anxious. My Va doctor told me that memory doesn't have anything to do with bipolar, but based on the rating scale, I don't like how honest I was doing my exam. Especially since he twisted my entire history. If he had been more accurate with my exam, maybe I would but more value in his opinion. I know I have pressured speech at times and I definately had it then, but he notes that there is not pressured speech unless all my speech is considered pressured.

I also take medication for bipolar that is sometimes used for schizophrenia. One is usually used for people with seizures and the other for schizophrenia, then I take an anxiety med that won't counteract with my other meds.

I don't know. He says I stated I avoid people because they distract me, and not because I distrust most people. I prefer to keep to myself, especially after my military experience. He says I have a hard time getting out of bed in the morning when I am depressed. I have a hard time getting out of the bed period, when I am depressed. I don't even like to leave the house.

For anyone that know much about the raters in Texas, but let me know if they are capable of doing a through job and overlooking this non-sense written from someone that has no clue and a horrible memory.

Thanks

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  • HadIt.com Elder

Who do you have as a VSO. I have the Texas Veterans Commission as my Power of Attorney and I have dealt with their staff in Waco. They are pretty good folks and really do try hard to help us out. I can't recall the young fellow's name that I have been dealing with lately. DARN!

Anyway, let me know who you've been dealing with and I'll see if I can give you any pointers....and in the meantime I'll remember that fellow's name.........drat, I hate these memory lapses.....short-term-memory, WHAT short-term-memory!

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I am currently dealing with the DAV. When I did my original claim, I did it on my own. Currently I am using the DAV. Besides moral support, I don't really feel like they are doing much for me. I can put my own package together. I felt like maybe they would be able to contact the raters and inform them on my situation. But I don't know how Rental knew my claim was in Waco and my DAV rep didn't know it was going there prior to today. He said he knew people in Houston and that is where my claim would go to be rated. I feel my claim in very legimate and deserves an increase, but I just can't stand how the examiner makes me look okay with the exception of my job instability. I am just hoping the raters go through my whole package and rule out the exam I recently had. He needs to be evaluated.

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