ptsd Ptsd C&p Revaluation

[USMC_HVEQ]

Hi,

I've read many of the FAQ's and other posts about the topic. I guess the questions I have are specific to my case in nature. I think this is a great site and wished I had found this years ago, when i filed my initial claim.

Background of my case

• I am a OIF vet, served 04-05 in Al Anbar Province.
  
• filed for claim while awaiting diagnosis, back in 2006 but was backdated, since under 1 yr from AD separation date to June 05, paid in July.
  
• was medically retired for PTSD (10%) and ortho problems (40%), so 40% combined rating
  
• Med Board in 06, diagnosed as severe combat related PTSD w/agorophobia, it had no GAF score
  
• been in treatment since at VA outpaitent therapy off/on 2 days a week since 2006.
  
• while gathering evidence for my claim in 2006 VA rated me, based on a letter from the USMC.
  
• It awarded me from july 2005 to present. I was also getting 10% for tinnitus, so 50% combined is what I am currently receiving.
  
  
  
  
  • I was laid off in 2007, mainly due to my behavior at work, although they used different excuses during a merger. I was first told nobody in my group would be laid off, then I was promptly moved and the new group in which I was moved to was laid off. I was given a hard time for having to attend PTSD appts 2-3 times a week while awaiting military medical retirement. I have been unemployed since July 2007-Dec 2008/present).
    
  • I have had more thoughts of suicide to the point that my outpaitent therapist did a risk assesment, which I don't have the notes on (dec 3rd, 2008)
    
  • I had been seen by a different pyschologist but once I lost my job i had to get someone closer to my house. At the time I had positive PTSD test results, major depression screening (pos), alcohol audit (pos).
    
  • I had massive wgt gain of over 100+lbs
    
  • I drank to self medicate until I got meds, but didnt take meds consistently ( I know, hurting my cause, now I'm out of meds-Seratraline 100MG
    
  • I have had constant panic attacks -at least 1 time a day., 1 which required emergency room treatment
    
  • I have been majorly depressed
    
  • I have lost many many Marine corps friends over PTSD stigma from my old unit.
    
  • I stay in my room pretty much most of the time. Only go out to drive thru or get food at market.
    
  • I have had to move 3 times since return, for behavior problems, drinking, loud, messy
    
  • I have turned into a gambler, use to play cards inorder to try and get mind off flashbacks and nightmares.
    
  • I have massive sleeping problems, cant get to sleep and stay a sleep. My body just passes out on its own. Inturn, I am very cranky. I am very irritable and grouchy.
    
  • I am very distant from a very close Irsh catholic family.
    
  • I used to be extremely outgoing, now I am a different person somewhat
    
  • no romantic relationships since 2006, feel disgusting and unable to love someone when I dont love myself
    
  • had close friend die during my tour, still been guilty thoughts
    
  • picked up bodies of gate bombing
    
  • lost interest in mostly every area of fun or leisure
    

  My current pysch eval said

  axis I: ptsd, major depression

  axis 2: (blank)

  axis 3 (previosu ortho and tinnitus probs)

  axis 4: economic stress

  axis 5: GAF score of 50

  said I had suicidal idealtion, panic attacks, nightmares/flashbacks, irritability, social isolation and bunch more stuff. I will elaborate later.

  I was told by my pysch therapist that I had a gaf of 45, but i didnt see it in the notes. I had a 70 on PCL-m test.

  I got with a VSO to help with a NOD. I inquired if NOD was rec'd in dec 08 yet, since I met with rep in nov. They stated they ahd not, so I filed one myself jsut in case. I finally heard back from VSO and said they had sent it in a while ago and sent another one to be walked in by hand by a rep. I sent copies of my VA notes, my stressor letter and a letter from my dad ( only mentioned stuff about me being back form Iraq when i immediately came back, might have misunderstood the extent of letter). I was called the very next day, after 1 year time frame on last award, to come in for a C&P exam

  I scheduled C&P for later that day since I am not working and want this claim to be processed asap.

  C&P results as follows

  clean, cooperative, normal affect, anxious mood, unremarkable speechand pyschomotor activity

  history of violence: yes

  suicide attempts : no but has repeated episodes of S/I as recent as 12/3/08, which poutpatient did formal assesment for suicide risk., conitues to have probelms with road rage as well

  orientation: all fine except off by day and day of week by one.

  spelling backwards: slow, but correct

  sleep impairment: yes, combat related nightmares most nights ( i told him everyday), additionally trouble getting to sleep and staying a sleep

  inappropraite behavior: yes, examples fighting

  serial7's and proverbs: yes, no probelm

  panic attacks: yes, stated panic attacks at least weekly ( i told him daily, sometimes more then 1 a day)

  pressesnece of homicidal thoughts?: no

  pressence of suicide thoughts/: yes, see risk assesment

  Comments

  used to ahve OCD behavior of checking car for bombs until a year ago.

  ADLs-doesnt need assistance but some days just doesnt get up at all, depression.

  Memory: normal

  recalls 3 of 3 though he does struggle a bit to get correct answers.

  Symptoms onset: Chronic

  length of remissions and capacity for adjustment: NONE

  Persistent Re-experienceing traumatic event by: recurrent and intrusive distressing recollections of event, including images, thoughts or perceptions, recurrent distressing dreams. Intense pyschological distress at exposure.

  Persistenet avoindence: refforts to avoid thoguths, feeling, conversations assoc w/ trauma. Marekedly diminished interest or participation in siginif activites, feeling of detachment or estrangement from others.

  Peristent sympt of increased arousal: difficulty sleeping (falling or staying alseep), hypervigilance, exaggerated startle response

  Freq, Severity and duration PTSD symptoms found: nightmares many nights, maniced feelings generally daily. Freq problem startle response. Hypervigilences less of a prob than it used to be.

  Employemtn history:

  occupation: accountant

  currently employed : no

  vet retired: no

  vet unemployed but not retired: yes

  duration current unemployment : 1 to 2 years

  reason given: havent found anything since

  Unemployed due to ptsd? NO ( told examiner I thought it was awful strange and thought it was possible).

  Diagnosis

  Axis I: PTSD, Depressive disorder NOS

  Axis II: none

  Axis III: see list

  Axis 4: unemployment of > 1 yr.

  Axis 5: GAF: 53 current functioning (timeframe)

  changes in functional status : performance in employment and family role functioning.

  QUESTIONS

  [*]based on background info, does my claim fall under 50% criteria or 70% criteria?

  [*]if currently already receiving 50% comp (40% shoulders, 10% ptsd, 10% tinnitus), how is backpay calulated. I mean do they say ok now ptsd is increased to say 50%, so that would increase my combined total to 70% and I would be backpayed for the difference of 70% to 50%? (current rate is 1228 for 70% no dependents and 50% is 770, do you take the difference?)

  [*]I tried to give cliff notes verisions, sorry about that. Should I apply for TDIU?

  

[mitchell3006]

HVEQ,

They will only do the 20% from 50 to 70. It is based on overall rate unfortunately.

Mark

[USMC_HVEQ]

HVEQ,

They will only do the 20% from 50 to 70. It is based on overall rate unfortunately.

Mark

Hey Mark, thanks for your response, that helps. I figured that much as well. Now would it be the 20% dollar amount or the amount diffenece from 50 to 70? See how I could be confused easily?

20% amount times number of months

or

Difference from 70% rating to 50% rating amounts?

thanks again,

[john999]

I think you need a shrink to say that you are unemployable due to the PTSD. The biggest factor in mental claims is being able, or unable to work. If you can't work due to SC conditions then you should be getting TDIU or even 100% rating. When I could not work anymore I went from 30% to 70% TDIU. Everything else was the same except I could no longer keep a job. The description of my symptoms were so bad form the doctor I used I am surprised they did not throw a net over me. However, if you can hold a job you could be Charles Manson or Son of Sam and get a 30% rating from the VA.

[USMC_HVEQ]

thanks John for your input, i appreciate it. Once you apply for tdiu and get your doc to say its ptsd realted, what happens? I am trying to focus on one part at a time, even if it hurts me as far as backpay goes. I'd like to work if possible to get into some type of routine. My life has just been a total and utter mess these past 3 almost 4 yrs. I just want to be as much as the same guy I once was. I understand I never will be totally the same. I pretty sure I need meds again and to take them consistently. I found it really difficult to tell the C&P guy all the problems Ive been having the way he asked questions. I baiscally needed open ended questions rather then specific and I would have given specifics within my answer. I guess my stressor letter and effects of ptsd on my life in the letter can best be described within it. I couldnt remember everything, I was like most other things are in my letter. It just seemed like the C&P guy minimized my probelms, when in reality they are huge enought hat I've thought about suicide. The constant nightmares, lack of sleep, social isloation and panic attacks has driven me to the edge. I'm fighting the best I can. Sometimes I want to give up, but the Marine in me, doesn't allow failures or weakness.

Sorry, just venting...

[USMC_HVEQ]

SInce my C&P was already transmitted to VA raters and I sent a form back saying no more info submitting and to rate ASAP, how long would it usually take? I know it can vary, was just wondering the quickest possible timeframe as opposed to a few months, that's all.

thank you for all your help

[john999]

If you have had your C&P exam then your rating should not be far behind. The VA is so inconsistent there is no real way to tell when you will get the rating besides an estimate. Once you apply for TDIU and have sent in the official form for it then the VA treats it like a claim. They make a decision on your TDIU. I know how you feel about never working again. Perhaps you could go to school, but just keep it quite. Maybe at some point you could work again. You probably need some very intense psychotherapy which the VA is not able to give you. If you really want to work again and get it back then I would find some good private therapist and work with him/her for the long haul. If you get TDIU then you can't work or you will lose it. You need to really be ready and feel confident you can work before you put your TDIU at risk.