ptsd Is This Right, Can They Do This?

[RockyA1911]

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 January 6, 2006 by RockyA1911

[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.

[SLEDGE]

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

[timetowinarace]

>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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Page 21

-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 January 9, 2006 by timetowinarace

[RockyA1911]

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?

[Guest Berta]

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.

[RockyA1911]

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.