Tdrl Psychiatric Narrative Summary

[indyboi]

AXIS I: Posttraumatic Stress Disorder, Chronic.

LOD: Yes EPTS: None

Impairment from Military Service: Severe

Impairment from Industiral/Social Adaptability: Severe

Panic Disorder with Agoraphobia

LOD: Yes EPTS: None

Impairment from Military Service: Severe

Impairment from Industiral/Social Adaptability: Severe

Any ideas on the ratings? Thank you!

[indyboi]

This determination was made by the Behavioral Physician at fort knox and well documented in her findings that this was service connected. It wasn't something that i was going for, i retire in July 2010 and I'm happy with just that, then after the session with the Behavioral Physician, she uncovered things that I have never revealed to anyone else. But when she asked questions, i just answered them honestly and informed her of what i had gone through. The panic attacks are well documented through several visits to the doctor and emergency room. does any of this make sense.

[john999]

Pretty interesting, Hoppy, I have thought for quite a while that the VA is steering people to file for PTSD when they have well documented other types of service connected emotional disorders. If you have evidence of panic disorder, for instace, why do you need to file for PTSD? PTSD requires a lot of rigamarole. The same with depression. If you have a DX of depression in your SMR's you don't need to try and prove a PTSD claim. The military and VA are focused on PTSD and TBI as of 2009. They want to fit every vet with a mental health issue into that mold.

[Hoppy]

Indyboi

When you say you are retiring are talking about from the military. If so there could be some tax advantage to having your disabilities rated with the VA or from the military. I'm not sure exactly where you're at if you're on active duty. They should probably investigate any disability at the time of your discharge.

The diagnosis of PTSD sounds like it makes complete sense. The doctor should know how to make the diagnosis correctly. Also if you are diagnosed while on active duty the scenario I explained about proving stressor could change dramatically. I actually think that if you're diagnosed with PTSD while on active duty the stressor will be considered as arising while on active duty and a whole new set of laws apply that for the most part waive the burden of proving stressor was related to military service.

If you're not retiring from active duty in the military then you will need to go through a process of verifying the stressor which includes determinations as to whether or not you are combat veteran. there are new proposed rules involving the threat of terrorism. Additionally, if applicable there might be a requirement to produce evidence that supports any situations such as, bombings, fires, personal assaults, rapes etc. At this time it really is no such legal definition of the stressor. Your subjective interpretation of the stressor is all a psychiatrist needs to relate to symptoms.

Veterans who claim their PTSD is the result of a personal assault will often have no problem obtaining a diagnosis. However, if the assault was unreported it becomes more difficult and you might be put in a position to have to prove secondary evidence of the stressor. There are combat veterans who post on hadit who in the last year the VA made it very difficult for them to prove that they were in combat.

In any event keep posting on hadit if you have anymore questions. I have seen PTSD claims be awarded and go very smoothly. However, there are exceptions and that is why hadit is here.

[Hoppy]

carlie and John

This was a really crazy situation. The report was generated by a primary care doctor who stated a diagnosis of PTSD, panic attacks and depression due to explosions and near electrocutions which occurred while the veteran was working aboard a ship that was in port and being prepared to be salvaged. Also in the file were reports from psychological workups that were generated when the primary care doctor referred the veteran to psychiatric treatment.

The reports from psychiatry state the veteran meets criteria “A” of the diagnosis for PTSD. However, the report goes on to say that due to the fact the veteran refused to participate in a treatment program the diagnosis could not be confirmed. There are more criteria for the diagnosis of PTSD than just criteria “A”. So basically, they awarded the veteran a non-service connected pension for PTSD with panic attacks and depression when in fact the veteran does not have a diagnosis of PTSD. That is not to say that the veteran is not totally disabled due to a psychiatric condition. Also in the file are multiple reports over a five-year period that he has panic disorder with comorbid major depressive disorder. His GAF has been as low as 45. Not only is there no evidence to verify the stressor he does not even have a post service diagnosis of PTSD even though he has been in treatment for a psychiatric condition on and off for five years.

The veteran currently has filed a claim for service connection of panic disorder and comorbid major depressive disorder. I have obtained an IMO from a senior VA treating psychologist who specializes in panic disorder and has performed compensation and pension exams for 17 years. This report basically states that the veteran was misdiagnosed in the military and that is military medical records clearly identify that he meets all the diagnostic criteria for a chronic panic disorder which onset while in the military. Additionally, the military advised the veteran that he would not benefit from treatment which is noted in the SMR and compounded the problem by directing the veteran away from treatment. I've read hundreds panic disorder claims that never seen much evidence that comes close to what this veteran has noted in his service medical records. We are waiting a decision on service connection of panic disorder and comorbid major depressive disorder. It would take me too long to explain the BS that the RO has come up with since we filed this claim. However, the psychologist I'm working with is a heavy hitter is 100% behind me after reading this veteran's service medical records.

By the way John, I was going through some really old files to find e-mails I sent to Alex Humphreys back in the late 90s. I also found copies of hadit posts from a guy named John whose last initial was “R”. He actually used his entire last name. I was wondering if this was you on the old board.

[Pete53]

If you have documented panic attacks and its in your records I would take John999's hint and ask for Panic Disorder. Talk to your Doc. The sad fact is that it is much easier for you to get a symptom of PTSD rated as something else than PTSD that unless you were in combat and have been awarded CIB or a medal for it best really think about the easiest way to win your claim.

Good Luck

Hope that we can have a good discussion on this issue with some opinions

[indyboi]

Hoppy, I am retiring from Active Duty on 1 July 2010, I'm AGR in Indiana (Active Guard Reserve) but still active duty with 20 qualifying years and 25 total military year if you include that 5 national guard years, which don’t count and no Combat Time. The Behavioral Medicines Doctor at fort know deemed it in the Line of Duty for PTSD, Chronic Panic disorder and Agoraphobia. And we (This Forum)haven’t even addressed the neck surgery that I an having this month and the Nose surgery for deviated symptom.