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Papa

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My Doctor has written a letter on my behalf, and I would appreciate some feedback.

Papa is morbidly obese. He has diagnosed and confirmed PTSD from Vietnam. Before he left the military he began overeating to comfort his emotions. This pattern has continued to present. A lap band procedure was performed to help minimize this but it has not been as successful as we had hoped. He currentlt see Dr. X at the VAH for his PTSD. It is likely that his PTSD led to his obesity. His obesity has led to his other medical problems (sleep apnea, diabetes, etc.). Please evaluate him for service connected benefits that apply.

Dr. Y

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in my opinion it needs a lot . cases are won with strong evidence. this does not represent even basic medical evidence. he needs to state that he has viewed your medical history and records and links all this togeher in medical terminology that the va wants. he needs to state more than likely caused by.xyz secondary to etc etc.

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I agree with Jim. The letter needs to include "as least likely as not" for the ptsd to be a causal reason for the overeating... and the nexus needs to be connected dot by dot by a psych doctor diagnosing the ptsd. Which sympton of ptsd could cause the overeating? Denial? Avoidance? See what I mean?

Hope this helps,

Akwidow

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If you have the proven nexus for the PTSD ( is that the rating you get now?) there are many studies on the net associating PTSD and eating Disorders.

http://www.ncbi.nlm.nih.gov/pubmed/17997727

In part:

"OBJECTIVE: Obesity is a significant public health problem in the United States, particularly among military veterans with multiple risk factors. Heretofore, posttraumatic stress disorder (PTSD) has not clearly been identified as a risk factor for this condition. METHOD: We accessed both a national and local database of PTSD veterans. RESULTS: Body mass index (BMI) was greater (P < 0.0001) among male military veterans (n = 1819) with PTSD (29.28 +/- 6.09 kg/m(2)) than those veterans (n = 44 959) without PTSD (27.61 +/- 5.99 kg/m(2)) in a sample of randomly selected veterans from the national database. In the local database of male military veterans with PTSD, mean BMI was in the obese range (30.00 +/- 5.65) and did not vary by decade of life (P = 0.242). CONCLUSION: Posttraumatic stress disorder may be a risk factor for overweight and obesity among male military veterans.

PMID: 17997727 [PubMed - indexed for MEDLINE]"

The doc needs to follow the proper wording as suggested here-and to provide ample medical rationale- the rationale can come from any very good studies or asbtracts such as above to enhance the opinion.

He/she must have your clinical medical records as well and refer to them specifically to make the opinion valid.

It isn't bad- but most IMO dfocs do not know the IMO criteria which is here at hadit.

Also he needs to give his area of expertise to make this opinion valid.

If you already had a C & P exam on this which VA used to deny the claim-the IMO doc needs the C & P results too- so he/she can punch holes in VA's rationale.

If he is a GP or internist and not a psychiatrist ( which would be best bet for this type of IMO) but if the C & P examiner was a NP or PA,he should raise that point as well as that would lend to his MD being greater weight then the VA examiner's.

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Thanks for all the comments. They are about what I expected, and agree with. I saw my doctor today, and it took all my strength not to throw him out of his six story office window. He is not like my doctor before him that was in Vietnam himself. I was informed that even non-military people have PTSD and that I need to get over it. That San Antonio is noted for obesity and diabeses, so why should I be any different. That he was not an expert in AO, PTSD, etc. He told me that I need to go to the VA and be evaluated for service connection. How is this done? I hate to admit it, but the VA medical scares the day lights out of me.

papa

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  • HadIt.com Elder

Papa, all in all, this is probably about all you are gonna be able to get, especially from this doctor (hmmmm, sixth floor, huh? wow, that woulda been dramatic!).

Psychiatrist would be good, Internist, also.

Bound to be someone around San Antonio that you could get to get a good Independant Medical Opinion. Surely one of the local Service Organizations knows of someone, a doc, that'll shoot it straight? Wish I knew someone, a VSO.

The "opinion" that you have is not really all that bad (or that good). It'll work, if you cannot get someone else to opine.

Have you your service medical records, do they indicate any treatment or notations about you weight or problems you were having. I know you said that your PTSD is service connected, anything else that is mentioned along with that service connection?

Berta's link is a very good one, always quote and indicate links such as this in your claim with the VA.

I'm still thinking....................

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  • HadIt.com Elder

I think that you should search BVA for someplace that awarded for PTSD and obesity.

If you walk around the VA you might notice that almost all the Veterans are over weight.My diabetic Doc who is telling me what I need to do is probably north of 300 lbs.

I have lost 39 lbs in about 2 years

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