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Is This Right, Can They Do This?


RockyA1911

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Hey all,

I made my third trip to the VAMC today, the 5th of Jan 06. The Dr. was supposed to go over the results and discuss it with me. My first trip there was on 9 Dec 05 for a NP evaluation, but the Dr. spent all of the time that day talking to me and obtaining medical history. She did not have any of my records. So, I was set up with another appointment on the 21st of Dec 05 and that is when I took the all day tests, and it took all day.

Today the Dr. told me that she wanted me to come back and redo the true and false question test (370 questions) and also a two page multiple choice questionaire (This looked like the same questionaire they used for PTSD). She said that the results from this test in her opinion does not represent me and that if she turned in the results it would appear text book faking or lying. She said as she put it that my scores on these test in relation to the sickest of patients that it showed I am sicker than the sickest.

Oh! I wanted to add the test I am to retake is called the MMPI? It's all simply true and false, 370 of them short 3 to 4 word questions.

I did not lie or fake answers on any of the tests, I had never seen a lot of this silly stuff before. She said that since I suffered the head injury on the left side of my head all the problems seem to be from the right side of my head which is unusual and that the left side of my brain is functioning normally, but not the right side that wasn't injured.

I agreed to come back and retake the tests on the 19th of Jan 06. I was seeking an increase above the 10% I was awarded back in 1977 under Post Concussion Residuals. I had a compound depressed skull fracture with skull loss both inner and outer measuring 4.5 x 4.5 cm (larger than a 50 cent piece), along with brain debridement, and a cranioplasty during the same while in service injury and the same surgery performed by Great Lakes Naval Hospital while I was active duty in the Marine Corps. (I also have a claim in for the Skull Loss w/hernia and PTSD in addition to the increase for cognitive disorder.)

After having second thoughts I wonder now should I have just told her to submit the tests as they are because I did not fake or lie about anything and just cast my fate to the wind as to whether the RO want to think I was faking or something based on her text book fake test sheet or something like that. She said if the injury that happened to me in 1972 had happened today that I would indeed be receiving more than 10%.

What do you think? Is it ok to go ahead and retake the 2 tests or tell them to leave it as is? Is the VAMC allowed to do things like this, I mean keep having you come back again and again and redo the same tests?

The C&P MD that did my exam last July referred me to this physcologist because the C&P MD diagnosed me with a cognitive disorder and stated the cognitive disorder and memory loss is more than likely attributed to SC traumatic brain injury. Recommended a full neurophyscological exam to evaluate just how much this impacts his daily living. And that is why I am seeing this neurophyscologist.

Meanwhile back at the ranch. The VARO sent me a letter stating they would be making a decision on my other issues within 60 days now. PTSD, Skull Loss w/brain hernia, disfiguring surgical scar on head. The Skull Loss claim was originally filed on the same form back in 1976 and it just wasn't mentioned at all in the rating when they awarded me 10% for post concussion residuals due to brain trauma and that is the max allowed. The Skull Loss is in all the same C&P exam reports and was even mentioned in several of the VA doctors reports, even in the RO decision document, but at the bottom of it there was only 10% awarded for the post concussion residuals due to brain trauma. Yeah, I am asking for back pay. My current open claims are dated 25Mar05 so it's going on a year from filing date so far.

The C&P exam report from last July reported in AXIS I: 1. PTSD, chronic. 2. Cognitive disorder, not otherwise specified, 3. Depression, not otherwise specified

and a GAF of 52.

Edited by RockyA1911
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  • HadIt.com Elder

They had me re-take them, does it mean it's legal I don;t know but I did it, I am the one that wanted to get SC refusing to take it again may hurt your claim. On this one I don't really know the legality.

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"The Skull Loss claim was originally filed on the same form back in 1976 and it just wasn't mentioned at all in the rating when they awarded me 10% for post concussion residuals due to brain trauma and that is the max allowed. The Skull Loss is in all the same C&P exam reports and was even mentioned in several of the VA doctors reports, even in the RO decision document, but at the bottom of it there was only 10% awarded for the post concussion residuals due to brain trauma. Yeah, I am asking for back pay. "

IF THIS SEPARATE ISSUE WAS NOT ADDRESSED PROPERLY BY THE VARO IN 1976

WOULDN'T THIS STILL BE CONSIDERED AN OPEN AND PENDING CLAIM ? ? ?

I also have a few issues never decided upon from the mid 1970's.

carlie

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Hey all,

I made my third trip to the VAMC today, the 5th of Jan 06. The Dr. was supposed to go over the results and discuss it with me. My first trip there was on 9 Dec 05 for a NP evaluation, but the Dr. spent all of the time that day talking to me and obtaining medical history. She did not have any of my records. So, I was set up with another appointment on the 21st of Dec 05 and that is when I took the all day tests, and it took all day.

Today the Dr. told me that she wanted me to come back and redo the true and false question test (370 questions) and also a two page multiple choice questionaire (This looked like the same questionaire they used for PTSD). She said that the results from this test in her opinion does not represent me and that if she turned in the results it would appear text book faking or lying. She said as she put it that my scores on these test in relation to the sickest of patients that it showed I am sicker than the sickest.

Oh! I wanted to add the test I am to retake is called the MMPI? It's all simply true and false, 370 of them short 3 to 4 word questions.

I did not lie or fake answers on any of the tests, I had never seen a lot of this silly stuff before. She said that since I suffered the head injury on the left side of my head all the problems seem to be from the right side of my head which is unusual and that the left side of my brain is functioning normally, but not the right side that wasn't injured.

I agreed to come back and retake the tests on the 19th of Jan 06. I was seeking an increase above the 10% I was awarded back in 1977 under Post Concussion Residuals. I had a compound depressed skull fracture with skull loss both inner and outer measuring 4.5 x 4.5 cm (larger than a 50 cent piece), along with brain debridement, and a cranioplasty during the same while in service injury and the same surgery performed by Great Lakes Naval Hospital while I was active duty in the Marine Corps. (I also have a claim in for the Skull Loss w/hernia and PTSD in addition to the increase for cognitive disorder.)

After having second thoughts I wonder now should I have just told her to submit the tests as they are because I did not fake or lie about anything and just cast my fate to the wind as to whether the RO want to think I was faking or something based on her text book fake test sheet or something like that. She said if the injury that happened to me in 1972 had happened today that I would indeed be receiving more than 10%.

What do you think? Is it ok to go ahead and retake the 2 tests or tell them to leave it as is? Is the VAMC allowed to do things like this, I mean keep having you come back again and again and redo the same tests?

The C&P MD that did my exam last July referred me to this physcologist because the C&P MD diagnosed me with a cognitive disorder and stated the cognitive disorder and memory loss is more than likely attributed to SC traumatic brain injury. Recommended a full neurophyscological exam to evaluate just how much this impacts his daily living. And that is why I am seeing this neurophyscologist.

Meanwhile back at the ranch. The VARO sent me a letter stating they would be making a decision on my other issues within 60 days now. PTSD, Skull Loss w/brain hernia, disfiguring surgical scar on head. The Skull Loss claim was originally filed on the same form back in 1976 and it just wasn't mentioned at all in the rating when they awarded me 10% for post concussion residuals due to brain trauma and that is the max allowed. The Skull Loss is in all the same C&P exam reports and was even mentioned in several of the VA doctors reports, even in the RO decision document, but at the bottom of it there was only 10% awarded for the post concussion residuals due to brain trauma. Yeah, I am asking for back pay. My current open claims are dated 25Mar05 so it's going on a year from filing date so far.

The C&P exam report from last July reported in AXIS I: 1. PTSD, chronic. 2. Cognitive disorder, not otherwise specified, 3. Depression, not otherwise specified

and a GAF of 52.

Rocky- hope others give opinions here-

I would however- get copy of and submit that initial test myself if I were you-

MMPIs -I worked for a shrink years ago and had to moniter a MMPI test-

the shrink told me the patient was trying to fake some of his problems (to stay in a state psychiatric ward)yet the MMPI would clearly reveal his actual mental/emotional status-

I have a feeling that since :

"referred me to this physcologist because the C&P MD diagnosed me with a cognitive disorder and stated the cognitive disorder "

she might have somehow lost her results/ from the MMPI or misinterpreted already-

or another point- only a Psychiatrist and Neurologist can really opine on this:

"She said that since I suffered the head injury on the left side of my head all the problems seem to be from the right side of my head which is unusual and that the left side of my brain is functioning normally, but not the right side that wasn't injured." She is correct -this is unusual but same MRI picture my husband presented with a brain stem stroke-

It would be easy for VA to try to rule against left side residuals if the left side of brain-in her words- seems to be functioning normally-

As a psychologist-she is not an MD and cannot really make this kind of medical judgement herself-

she also is not qualified to prescribe meds so cannot really opine how those affect you too-

Also the VA can separate cognitive functioning from PTSD pr any other mental status but it could take motre than the MMPI- they gave my husband 6-7 tests for that- and a psychiatrist ran these tests.

Trails Mosing Test , Wechsler, Hand Test , MMPI, put the cube in the box, etc, a whole shibang-

He had 100 % PTSD and considerable brain deficits from stroke, that they could separate from the PTSD.

If you have statements in your med recs from Neurologists and/or psychiatrists-that help your claim, this should outweigh anything negative about her opinion-

If you have a copy and it helps-I dont see why you need to have an additional MMPI.

What do you all think men and women?

Maybe Ricky should show up for the appointment but make it clear to the shrink here that he has submitted her findings already-

sounds like she is trying to play the shell game if you catch my drift-or really screwed up something she doesnt want VA to know.

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  • HadIt.com Elder

Rocky

If you take any other these tests again just answer truthfully. Don't hold anything back and just tell it like it is. Maybe they want to see if the two tests come out the same.

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John,

I answered the questions in the MMPI truthfully the first time as to how I felt, but the VAMC Staff Neuropsychologist said that she didn't want to submit it because it would hurt me and she didn't feel that the first test represented me in her opinion.

Berta,

She is a a VA Neuropsychologist that finished her VA training and began working at the VA as a Staff Neuropsychologist in December of 05 so she is new there and I think I am either her 3rd or 4th patient. She has worked in private practice prior to the VA for a number of years and appears to be about 40 something.

I did have a IMO from a Psychiatrist that included both PTSD and open head injury and associated problems caused by the traumatic brain injury. It was submitted with my claim. The private Psychiatrist was also a Armybattalion surgeon in Vietnam in '68. He did subscribe me two medications and also stated in addition to PTSD that I was unemployable due to my condition. So I have that along with the MD from the C&P exam giving me the same GAF as the private psychiatrist did but she also added in addition to chronic PTSD, Depression, and Cognitive Disorder. That was back in July 05.

Does this neuropsychological opinion based on batteries of test scores carry more weight than the private and VAMC C&P doctors that are actual MDs?

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  • HadIt.com Elder

which one has more wieght? The one the VARO decides to put on it, they will pick and choose the one they want, then if you do not agree with their rating of your claim, you file a NOD or ask for a De Novo Review, or appeal it straight to BVA, then BVA might remand it and ask for another C&P or another opinion or they can grant the claim. I think the RO's pass the buck to BVA and let them grant the awards, then it can't be blamed on them. Some people claim it is the fault of the claimant for not supplying enough evidence, I know for a fact that the VARO refused to even address the issue of my stroke and they have had evidence of it for over 3 years I just had a C&P exam for it last week, they "discovered" new evidence, what new evidence, it's all date stamped in 2002 and 2003. I have been appealing it ever since, once they tried to tell me I had missed an appeal date and it was closed, they were shocked to see I had my date stamped copy to show the day I fioled the appeal, they had to pull the file back out. It's worth the trip to the VARO and hand it to them and get the date stamped copy handed back to you. Just don't lose it.

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John,

I answered the questions in the MMPI truthfully the first time as to how I felt, but the VAMC Staff Neuropsychologist said that she didn't want to submit it because it would hurt me and she didn't feel that the first test represented me in her opinion.

Berta,

She is a a VA Neuropsychologist that finished her VA training and began working at the VA as a Staff Neuropsychologist in December of 05 so she is new there and I think I am either her 3rd or 4th patient. She has worked in private practice prior to the VA for a number of years and appears to be about 40 something.

I did have a IMO from a Psychiatrist that included both PTSD and open head injury and associated problems caused by the traumatic brain injury. It was submitted with my claim. The private Psychiatrist was also a Armybattalion surgeon in Vietnam in '68. He did subscribe me two medications and also stated in addition to PTSD that I was unemployable due to my condition. So I have that along with the MD from the C&P exam giving me the same GAF as the private psychiatrist did but she also added in addition to chronic PTSD, Depression, and Cognitive Disorder. That was back in July 05.

Does this neuropsychological opinion based on batteries of test scores carry more weight than the private and VAMC C&P doctors that are actual MDs?

Mike is right- it is sure hard tp predict here-I see that you do have excellent MD opinions-

It is just that the best opinion is the one that helps the vet-

I am still trying to get the VA to even look at my IMOs-

By the way what was the GAF score?

Edited by Berta
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Berta,

The GAF score was 52 given by both the independent civilian MD Psychiatrist and also the VA C&P MD.

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Hey all,

I made my third trip to the VAMC today, the 5th of Jan 06. The Dr. was supposed to go over the results and discuss it with me. My first trip there was on 9 Dec 05 for a NP evaluation, but the Dr. spent all of the time that day talking to me and obtaining medical history. She did not have any of my records. So, I was set up with another appointment on the 21st of Dec 05 and that is when I took the all day tests, and it took all day.

Today the Dr. told me that she wanted me to come back and redo the true and false question test (370 questions) and also a two page multiple choice questionaire (This looked like the same questionaire they used for PTSD). She said that the results from this test in her opinion does not represent me and that if she turned in the results it would appear text book faking or lying. She said as she put it that my scores on these test in relation to the sickest of patients that it showed I am sicker than the sickest.

Oh! I wanted to add the test I am to retake is called the MMPI? It's all simply true and false, 370 of them short 3 to 4 word questions.

I did not lie or fake answers on any of the tests, I had never seen a lot of this silly stuff before. She said that since I suffered the head injury on the left side of my head all the problems seem to be from the right side of my head which is unusual and that the left side of my brain is functioning normally, but not the right side that wasn't injured.

I agreed to come back and retake the tests on the 19th of Jan 06. I was seeking an increase above the 10% I was awarded back in 1977 under Post Concussion Residuals. I had a compound depressed skull fracture with skull loss both inner and outer measuring 4.5 x 4.5 cm (larger than a 50 cent piece), along with brain debridement, and a cranioplasty during the same while in service injury and the same surgery performed by Great Lakes Naval Hospital while I was active duty in the Marine Corps. (I also have a claim in for the Skull Loss w/hernia and PTSD in addition to the increase for cognitive disorder.)

After having second thoughts I wonder now should I have just told her to submit the tests as they are because I did not fake or lie about anything and just cast my fate to the wind as to whether the RO want to think I was faking or something based on her text book fake test sheet or something like that. She said if the injury that happened to me in 1972 had happened today that I would indeed be receiving more than 10%.

What do you think? Is it ok to go ahead and retake the 2 tests or tell them to leave it as is? Is the VAMC allowed to do things like this, I mean keep having you come back again and again and redo the same tests?

The C&P MD that did my exam last July referred me to this physcologist because the C&P MD diagnosed me with a cognitive disorder and stated the cognitive disorder and memory loss is more than likely attributed to SC traumatic brain injury. Recommended a full neurophyscological exam to evaluate just how much this impacts his daily living. And that is why I am seeing this neurophyscologist.

Meanwhile back at the ranch. The VARO sent me a letter stating they would be making a decision on my other issues within 60 days now. PTSD, Skull Loss w/brain hernia, disfiguring surgical scar on head. The Skull Loss claim was originally filed on the same form back in 1976 and it just wasn't mentioned at all in the rating when they awarded me 10% for post concussion residuals due to brain trauma and that is the max allowed. The Skull Loss is in all the same C&P exam reports and was even mentioned in several of the VA doctors reports, even in the RO decision document, but at the bottom of it there was only 10% awarded for the post concussion residuals due to brain trauma. Yeah, I am asking for back pay. My current open claims are dated 25Mar05 so it's going on a year from filing date so far.

The C&P exam report from last July reported in AXIS I: 1. PTSD, chronic. 2. Cognitive disorder, not otherwise specified, 3. Depression, not otherwise specified

and a GAF of 52.

RockyA1911, At this point I think I would consult an attorney who deals in Veterans affairs. I have asked some of the local Attorneys for thier advice on how to handle things on some subjects with the VARO as most are vets themselves and generaly will give "loose" advice with out any cost.

I might also consider writing the CAVC or telephoning the BVA in DC and ask if this is proper and legal for a RO to keep "fishing" IMHO.

Arch

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  • HadIt.com Elder

Rocky

In my opinion the VA is option shopping; but they have you over a barrel. If you refuse the re-test they will probably use that against you. If you retake the test, and there is more than several points difference in the results, they will use that against you.

This is Catch 22. Nobody can match 300+ answers on one of these stupid tests, no matter how honest. Each time you read it, you see a different meaning in the questions. Usually it is so poorly written that many of the questions are full of ambiguities.

My advice is to go to VARO, in person, and try to talk to a DRO or the SMC, or write to the Director, explaining that since your replies on the test were complete and honest, you would like them to proceed with the claim, based upon the current C&P results.

The VAMC 'Doctor' seems to have already caught the 'screw the veteran' disease.

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Guest Morgan

Rocky,

You are in a Catch 22, but if I were in your shoes, I absolutely would not retake the test. I think you should ask the doctor if she is willing to put in writing why she thinks you are faking or lying. The CAVC is now asking for medical-legal opinions, so she should be reminded of that. You need to find out if she is willing to put her opinion in writing and see whether it would likely hold up under the Court's scrutiny.

You said, "I did not lie or fake answers on any of the tests..."

With that in mind, I would ask that the claim be adjudicated from the evidence of record, and I would write the statement "I did not lie or fake answers, despite the insinuation of the examiner," then send it certified to the RO.

The preponderance of evidence should go in your favor. And you showed up for the exam and you took the test honestly and fully.

If you do retake the test, you know it will be different, so that will be against you; and if you don't retake it, the examiner's opinion will be against you, so there you go. You can't win. How could retaking it HELP you substantiate your case (VA has a duty to assist)? If the test is favorable to your case, then so be it. If you appear sicker than the sickest, well it's the VA's dumb test, which are worth little anyway according to the VA Clinician Guide (see below).

Besides, in your case, the integrity of the test is fatally flawed now. You couldn't possibly retake a test with 3- or 4-word questions without second guessing and trying to answer the way you think she wants you to answer. The way you now would hope it would not be construed as lying. Sort of like looking at inkblots a second time because the doc says you didn't see the right thing.

Examiner's are to report suspected malingering or misrepresentation, but the way I understand it, they are not to opine that the vet is intentionally misrepresenting, but instead are to "quote" exact words from the veteran. Some of the following excerpts from the Clinician Guide might apply in your case:

1.14.2 Board of Veterans’ Appeals (BVA) remand examination

... BVA adjudicators require sufficient medical information to be able to assess the merits of a claim. A substantiated claim for service connection has medical evidence of a current disability, occurrence or aggravation of a disease or injury in service, and established injury, disease, or event in service and a nexus (connection) between the in-service injury, disease, or event and the current disability. Additional examinations may be requested when the available examination report contains insufficient details for rating purposes or does not adequately reveal the current state of the claimant's disability, or when no definite diagnosis is given. Examiners must review the claims folder and any BVA remand instructions carefully before examining the veteran and clearly state this fact in the written summary report. The examiner should answer all questions, if possible. Because of CAVC decisions, examiners are now being asked for medical-legal opinions, and they need to express their opinions and diagnoses so that they will stand up to the scrutiny of the CAVC.

Here are some interesting statements about some of the tests:

c. Need for neuropsychologic tests. Most test procedures used in routine clinical assessment are relatively insensitive, detecting only major or obvious degrees of impairment. They are poorly quantifiable at best and have seldom been standardized. These deficiencies render them poorly suited for rating purposes. Standard, quantifiable neuropsychologic test batteries can overcome most of these limitations. Their use is desirable in all cases, except the most classical or severe, and is mandatory whenever the picture is not clear or easily defined. No single psychometric test is adequate for the purpose of diagnosing or grading severity of the loss of integrity of the “higher brain functions.” Rather, a coordinated battery of tests is needed, preferably administered and interpreted by an experienced neuropsychologist.

Sure makes me wonder what they use them at all.

What frustrates me is, if these tests had come out incorrectly negative (supporting claim denial), instead of incorrectly positive (to her), you would just have to live with the results and go through years of appeals with the negative report dogging you! No one would be re-examining you to correct that before sending the report back to the rating team!

Anyway, that's my opinion, for what it's worth. :D

Carrie

Edited by Morgan
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Guest Jim S.

I must partialy disagree with Carrie, No one single test by and of itself can be used to fully judge anyones psychological profile. to take a second test, a repeat of the first, soon after taking it once, makes no since at all. but to do so after a period of time has elapsed, could prove usefull in determining any irregularities that may have been proceived about the first test. Also for areas of a borderline nature the examiner is supposed to quantify your answers to these certain questions to evaluate what it was you were thinking of at the time. To judge you solely on the scores of the tests tells the examiner pratically nothing unless they have some idea of the thought process that went into the answer given by the taker/examinee.

I would talk with the Examiner and ask that another exam, say in three months be given, then offer your input should they question why you would answer certain questions the way you did, Just to show them that you are not trying to be deceptive and rig the test to show your were worse than you are.

Even if you do not discuss the test, having some time laps between tests can only help your cause.

Jim S. :D

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Guest allanopie

>Oh, and the MMPI may 'suggest' mallingering, but cannot prove it.

I've read where its common to have remarks in your records of malingering with brain injury or MS.

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Comrades,

The following stuff is my opinions with a few facts and there's not normally any hard facts to back up my opinions.

Similar to the current attempt to discredit the PTSD vets, the VARO management expects a certain percentage of examinations to say;

"mallingering, but cannot prove it."

or something else that really says the same thing in our records.

If the RO doesn't get it, they will invent it or act like you suddenly don't exist.

The examiners that do not provide the required percentage of "mallingering, but cannot prove it." remarks are likely to be looking for another paycheck very soon.

They fired the doctor that first diagnosed my fibromyalgia and 'never gave him a reason' in 1992.

My second diagnosing doctor can't be located by the RO and the VA system has no record of her ever working for the VA. (I found her and I have her home address, heh-heh).

The 'Powers That Be' know that all claims are not credible and a very small percentage are downright fraudulent.

Inflating the numbers of 'questionable' claims is one way of showing congress that the various ROs are protecting the interests of the government by policing the disability benefits system.

They will never tell you about their intention to brand you as a fraud, they just refuse to legally work your claim.

You become a statistic.

You have to ask yourself if the RO is really making stupid mistakes or sitting on you in order to meet their own special needs.

Once the RO decides that your claim will NEVER be granted under any circumstances, at the RO, and you have figured that out, bail the hell out of the RO and renew your attack from another direction.

When you finally figure out and realize what is going on it's been years since you filed the claim.

In my case 1984 to 1998.

You must get clear of the RO and get a de nova review from a higher authority.

Then appeal your new denial to the Court if the stupid stuff continues.

If the Court remands the case because the RO and BVA did not make any sense you need a lawyer.

(or someone like Berta in your back pocket).

In my opinion, those folks can't be as under-educated as they make themselves out to be.

(They have a plan).

sledge

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>Oh, and the MMPI may 'suggest' mallingering, but cannot prove it.

I've read where its common to have remarks in your records of malingering with brain injury or MS.

I don't know about MS, but you will not succeed with a brain injury case without neuropsych testing. Not with SSDI either. NP testing is the only concrete proof of cognative problems. Otherwise, the claimant just SAYS he/she cannot remember, has difficulty concentrating, ect. All subjective. Even most of the neurological problems are subjective and untestable. Think about it. How can you PROVE weakness? Maybe your not trying.

When a claim is involved, malingering is suspected.

To the best of my knowledge, no, the MMPI cannot prove malingering. As the origanal poster stated with his test. If it shows that a person is much sicker than thought by examiners, then that person is considered to be possibly mallingering while test taking. But it is allso possible that the examiner made a wrong assessment, or that the test was simply not compatible with the person (after all, the person IS brain injured).

The whole neuropsych battery of tests together CAN determine malingering though. But the MMPI would not be needed to determine this. A full battery of tests cannot be cheated. Unless you are a neurophsychologist trained to give the tests and interpret them.

link below

The critical point here is that Dr. Thomas did not say that the MMPI-2results were not valid. Rather, he said only that the validity of the results wasuncertain. Dr. Thomas recommended that Mr. Hannum’s “test-taking attitudesshould be evaluated for the possibility that he has produced an invalid profile.”R. 255. He also recommended that “the possibility that [Mr. Hannum] could actout in an aggressive manner on his delusional ideas should be further evaluated.”R. 260. And contrary to the ALJ’s statement in his opinion, R. 13, Dr. Thomas didnot state that a true psychotic condition was “less likely” than other explanationsfor the test results. Rather, Dr. Thomas stated:[Mr. Hannum’s] responses to this questionnaire should be interpretedwith caution. He is presenting an unusual number of psychologicalsymptoms. This response set could result from confusion, stress orneed to seek a great deal of attention for his problems. Alternatively,they could represent a true psychotic condition.R. 259. Overall, Dr. Thomas’ report does not indicate that the MMPI-2 resultscould simply be discounted or rejected, as the ALJ did. Rather, Dr. Thomas’statements indicate that the MMPI-2 results may have represented a true

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-20-psychosis or they may have represented an invalid profile. Further investigationwas required to determine which characterization was more accurate. The MMPI-2 yielded striking but questionable results. The medical expert’stestimony indicated that the issue of whether the MMPI-2 results were valid wasin fact decisive for the disability determination. Dr. Thomas indicated in hisreport that the validity of the profile should be evaluated further. If the MMPI-2results were as flawed as the ALJ suggested in his decision, then the ALJ had anobligation to obtain more information on the MMPI-2 results, to request a follow-up MMPI-2, to obtain expert opinion that no MMPI-2 would be reliable applied toMr. Hannum, or at least to discuss whether or not the MMPI-2 was necessary tofully evaluate Mr. Hannum’s psychological condition. In fact, the ALJ suggestedin his decision that further evaluation was needed to confirm or negate........

Time

SSDI

Edited by timetowinarace
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Hey All,

I retook the MMPI-2 test last Thursday and the Neuro-Psycologist said that it came out the same as the first one I took in December. I forgot all the problems she said I had, there were a lot cognitive things related to my brain injury. She also said she was writing up a justification for why the MMPI-2 came out the way it did. She said I was severly depressed and that my hospital records back in 1972 from the Navy showed an abnormal EEG even then. She said she was giving me referrals for services to include a Primary Care Doctor, Neurologist, Psychiatrist, and a PTSD support group. She was very infatic that I be extremely careful when driving or even riding a bike. She also said she was going to address my unemployability in her report also and that in her opinion I am unemployable. She also said that my PTSD also contributes to my brain injury dysfunctions also. She was appalled that I had only been getting 10% since 1976 and the diagnosis of Post Concussion Residuals secondary to traumatic brain injury. I told her I also had a claim for Skull Loss with brain hernia also that was never adjudicated in 1976 and filed at the same time when I was awarded the Post Concussion Residuals at 10%.

She said I should be more concerned with the brain injury than anything else. She told me she doesn't know how much compensation I should get for the brain injury problems, but she did say it would be more than 10% for sure.

Anyway I'm still plugging along. I wonder if the VARO that said they would be making a decision on my claims in 60 to 90 days and that was 2 Dec 05 will get the copy of the NP exam opinion report prior to making a decision on my claim. I did sign a ROI and it normally takes about two weeks for me to get a copy of the report. I do know the NP has to turn it in to the C&P doctor that requested the full NP exam and maybe the doctor writes an addendum to the initial C&P exam report. Since that is the case how would I go about finding out what the C&P doctor submitted to the VARO? And will the C&P doctor furnish the full NP exam report to the VARO for review?

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Rocky- you could write to the Records access officer and ask them for a copy of any additional C & P doctor's input-

However I would submit a copy of the Neuro report myself to the VARO- and not depend on it going through the C & P channels-

others might disagree here-

This is excellent evidence and a C & P doctor would also have to be Neuro-shrink to be able to even attempt to somehow go against it-

Then again- you are thinking ahead- they could write some addendum full of crapola and the VARO of course will favor anything negative from any doctor over something probative from an expert.

The 1972 Navy records-the EEG she mentioned- do you also have your SMRs?

This is a great nexus- sounds like she really knew what she was doing and was thorough.

The MMPI- I forget why you had to take two-

This test will always be very consistent no matter how many times it is taken.

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Berta,

Yes, I have all my SMR's to include the three Navy Medical Boards and the report on the first EEG prior to being put on six months limited duty afterwards. I returned to GL Naval Hospital a year later, and that is when they did the crainioplasty, then again I was put on another 6 months limited duty. After that second 6 months, I was re-evaluated and then given another 3 months limited duty (No physical activity, No physical contact, no helmets, and no heights above 5 feet, (That was tough being a Marine and all). After that last 3 months of limited duty I was re-evaluated and returned to full duty and found fit for duty without limitation.

Yes the neuropsyc lady was very thorough and she is one of the only one's that has ever brought up that I had one abnormal EEG in my medical reports, she also said that she also found where the fragments of my skull had penetrated my brain in the left temporal parietal area and the record of surgery reported there was a dural tear with bone fragments imbedded in the brain where a brain debridement was performed.

She asked if I knew that. I told here yes I did but everyone has overlooked it or dismissed it as relavent and when I previously mentioned it to them in the past it was just ignored because back then they did a Neuro-Psychiatric exam that reported normal limits along with a normal EEG that the VA did back in 1976.

The 1976 claim for skull loss with brain hernia is still open since there never was an adjudication of the skull loss claim of 4.5 x 4.5 CM, both inner and outer tables. I know that the size of the skull loss is documented fully both in Navy surgical reports, Med Board reports, VA exam reports, and SMRs. According to the CFR 38 under DC 5296 the skull loss exceeds the 50-cent size and is 50% compensation and I'm not sure whether or not they will grant the brain hernia part, but the records show that I had to have fragments removed from the brain, a brain debridement, and repair of a dural tear that had been lacerated. So I should either get 50% without brain hernia or 80% with brain hernia. The records also showed in x-ray report that there was a star shaped cluster and buldge of the occular? representing a high velocity impact.

I don't know what part they don't see that I suffered a brain hernia also, the records just specifically don't state brain hernia and my conversations with a few other MDs have stated there is no such thing a the term brain hernia.

I always assumed a hernia is a rupture or penetraition of the brain especially when the dura is lacerated and the spinal fluid is lost. But, I am the first to say I am no doctor.

The second MMPI-2 was taken because the NP said the first one could be interpreted as faking it because it portrayed a text book example and with a second test coming out the same she could defend the results showing there was no malingering of faking it, etc.

That's all I know.

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