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?

  

[USMC_HVEQ]

thanks John for your advice. I am going to hold off on TDIU for the time being. I was just checking my retiree pay (TDRL) and noticed the VA waiver amount. I previously did not have any VA money waved. Well I hope my claim gets processed ASAP, because I saw what I am due to rec next montha nd its a far cry from normal. Even normal I was struggling to get by. Now I am almost certainly in much deeper financial crisis. I was previously rec 865 take home retiree pay, now I will be only taking home 186 as of January, like perfect timing, broke as it is going into the holidays and broke coming out. I will make a determination as far as TDIU goes once I see the award and take a look at my entire job picture or lack their of. I'm basically looking for tdiu, until I find a job, is that possible? or do you have to just never work again?

I had rec'd sep pay from marines by accident and I gambled it away, so VA has already been recouping that money by taking 540 a month since last April I rec 216 ouf the 770 pmt, sorry math is off). so now I will rec 216 plus the 186 retiree pay, which I cant live off of...I dont know what to do now? im more depressed jsut thinking about it and how Im going to survive. I already was scraping by......any advice???

[USMC_HVEQ]

Anyone else want to comment on my case??

[USMC_HVEQ]

I was wondering if anyone had any advice, i know everyone was busy with xmas, but your opinions would be much appreciated.

[Commander Bob]

Happy Birthday, USMC HVEQ

Cmdr. Bob