ptsd C&p Exam Finally Pops Up

[out_here04]

envelope came in mail saturday saying i had my first-ever c&p follow-up scheduled for 1 feb 10 to my award a year or two ago of 100 percent temporary, total disability from anxiety/depression. i was pretty surprised at the immediacy, although in the back of my mind i figured it was coming,and had a panic attack of sorts at the idea of feeling that i have to defend my benefits on short notice. i may or not have gotten better, likely just became more apathetic about life in general. this officially gives me about ten days to wrap my mind around this before seeing a contracted c&p psychiatrist for evaluation. i know i could have been more of a student of va strategy by reviewing my c-file (which i haven't, although i got the letter saying i could go three hours away after making an appointment)' i do have a "card" to play to delay this, which i discuss below.

anyway, i have a few other questions to throw at the hadit wall and see if anything sticks...

i am pretty aware of what a psych c&p looks and feels like, although it has been a while. any reminders of what to expect are appreciated.

THE THING i have with this particular exam location and psych doc is THIS:

before i got in the pipeline for seeking tdiu or increased award (was previously rated 50 percent for anxiety/depression, with various others that top the 60 percent mark) i was trying to pursue voc rehab. my primary health plan was NOT va but through tricare. my wife grabbed a phone book looking for a psychologist or whoever for me to, for one, get back on track with mental health services, and two, to meet a requirement for voc rehab to have a psych doc verify that i was mentally stable for three months. i began seeing a psychologist who specializes in cognitive repair and ptsd among other things. during therapy he told me he had interned or whatever at va hospitals and was familiar with veterans issues. i told him initially that i was there to both continue treatment, to get my ticket punched for voc rehab, and to further document how ptsd affected me after viewing morbid remains while on active duty. as i progressed in the treatment i opened up to the doc and he seemed very "vet friendly". he had some ideas on how to "ease my troubled mind" and i was very ready, as always, to do so.

at one point i discussed with him an event in my youth that still bothers me somewhat. i then said "that's when it all started". what i meant was that's when i first became aware of an event that wasn't all hunky-dorey with my idea of a perfect world. he seemed to latch onto it, almost with a "gotcha" attitude reserved for those within the depths of the va rating boards. from that point on i half-heartedly continued therapy with him, finally requesting a decision on whether or not he would deem me three-months stable. oh, but he wasn't in the business of providing such a vocationally-related decision, he informed me. the relationship was becoming more and more adversarial, i thought. and all this from a guy who was, for all practical purposes, supposed to be an imo.

SO, when i submitted my claims package to va for tdiu (which they denied, instead rating me 100 percent temporary for anxiety/depression+60percent, qualifying me for the additional "statutory housebound" allowance) i purposely omitted the psych doc's rendered opinion because, thanks to hadit, i knew that it was not going to benefit my case, most likely to have given va the basis to revoke any award because of "personality disorder". being honest, i also did not include a report from the va resident psych doc who did an initial evaluation of me for voc rehab. he noted all of my challenges but indicated a small arena of highly supervised vocational options for me. i figured if they wanted to use his opinion against me in my claim, let THEM dig it up. however, after i gave social security permission to purge my va files, they used the same report to deny me benefits, so i have all but given up pursuing ssdi and halfway expect their report to make its way into this upcoming c&p process.

BACK TO this latest scheduling of a c&p exam. my initial c&p exam was scheduled for a psychiatrist working out of THE VERY SAME practice as the psychologist i had basically "fired". i called the va contract, what's their names(qtc?), and told them i wanted another psychiatrist because i had a conflict of interest with the practice. i envisioned showing up for an appointment and running into the psychologist who i fired and him chatting with his co-worker and gaining access to my c&p process) apparently, there was a c&p psych doc retirement, limiting options in the vamc city, etc, and i was scheduled hours away to another one, but i had to cancel because i was hospitalized for an unrelated medical issue. by the time i reschedule, it was with another c&p exam psychiatrist. the exam went well, with him apparently documenting and opining enough to support the other items in my package and grant me the subsequent 100 percent temporary award for anxiety/depression.

IRONICALLY OR NOT, the psychiatrist i am most recently scheduled to see on 1 feb is THE VERY SAME psychiatrist i took issue with (because of working at the same practice as the psychologist) before from my initial c&p exam. on a side note, i recently checked out this practice's website and the founder of the practice had been a psych doc at the same local vamc where i get my treatment before going into business himself (and SOMEHOW landing a contract with the va contactor, HMMMM>>>...and swooning at least one other psych doc with the same vamc on his resume, not to mention the other guy, my initial psychologist with this practice whom i "fired". smell it?

TO FURTHER COMPLICATE all of this, i am considering trying to "dumb down" my rating from 100 percent because of the stigma (i believe illegal/unwarranted) of 100 percent mental vs. physical veterans being penalized if they attempt to utilize their gi bills or to seek some form of employment. those of you who remember me, may recall that i have expressed wanting to use my mgib or 90 percent of the post 9/11 gi bill i also qualify for. i would even attempt to self-employ doing something. i admit to feeling cabin fever and like i'm just rotting away doing nothing. i know, volunteer, right?

before i call the va contract schedulers and request another doc this time, i thought i'd run ALL THIS past the minds of hadit. my basic areas of questioning are:

1. thoughts, opinions on requesting an alternate c&p examiner based on "conflict of interest". legal standing of this?

2. thoughts, opinions, experiences on issue of va (to their obvious benefit) of them pursuing "personality disorder", especially considering it was the unsolicited, subjective opinion of one imoish psychologist hired/fired by me? i still have all the hipa, privacy blahblahs, and have wondered what it would take for this to be "leaked" to va. lot of legal potential in my paranoid state, although i am pissed that the psych doc made me feel like i was admitting on record something that has nothing to do with the service-connected stressors that i claimed caused the beginnings of my anxiety/depression and va involvement with this.

3. thoughts, opinions on va-tainted psych docs who wind up in private practice and obtain (likely lucrative) contracts with va to evaluate veterans via supposedly(?) un-biased c&p exams.

4. thoughts, opinions on:

a. holding on like a beachhead to my 100 percent rating, possibly holding out for permanent and total,

b. begrudgingly easing up on a firm grasp of a 100 percent rating, so that at age late 40s, starting to feel old age aggravated by disability, but somehow gathering a second wind and settling for a lower rating, however freeing up the chance to go back to school and possible fulfillment through vocational means. i was initially denied voc rehab, buty may qualify if i reapply, another option.

i eagerly await the good, the bad and, even the ugly on this (i have meds). fire away.

[john999]

Chnonic pain disorder is considered a psychiatric disorder. What you need is your own shrink to write you a report. You cannot depend on the VA to do the right thing.I am SC'ed for chronic pain. They will lump it in with any other emotional disorders you have for one rating.

[blanco63]

Chnonic pain disorder is considered a psychiatric disorder. What you need is your own shrink to write you a report. You cannot depend on the VA to do the right thing.I am SC'ed for chronic pain. They will lump it in with any other emotional disorders you have for one rating.

So a physicians assistant should not have done the c and p? IF the varo tries to reduce/sever me because of this p.a., can i ask for another c and p with at least a doctor? Anyway, wouldn't they need another opinion from another va medical person to show improvement before reduction?

[out_here04]

thanks for responding berta. i'll respond in your text below:

"What is the MH disability you now receive service connection for? PTSD or anxiety, depression ? "

my 100 percent total, yet temporary "schedular" award was for anxiety/depression. this was the response by va to a tdiu claim i submitted. va has documented me with ptsd and i submitted or they had access to that information, too, i believe, but as you know, they only grant one mental health "label".

"In order to attempt to reduce your comp the VA would have to have evidence of any substantial improvement.They can reduce with evidence of fraud too but that type of attempt by VA comes few and far between and I sure dont mean that applies to you at all."

i think i'm pretty much in the same state as i was during the rating. just that staying home doesn't put me in "real world" scenarios where my anxiety/depression is likely to be triggered as often or as deeply. i tell myself sometimes that i want to jump back into "normal" society, but deep inside believe otherwise is best.

"They will either continue your present rating based on all medical evidence or attempt to lower it- hard to know what they would do or even why they could propose to reduce the comp but they will give you full appellate rights if they propose to reduce."

guess i'm just paranoid about possibly having to do battle with people who have the power to change life after it has become somewhat stable for a little while. many veterans here and otherwise deal with this, i know.

"Did the "temporary" rating derive from a hospitalization for PTSD or anxiety?""

i was never hospitalized for either. just sought treatment over a period of 15 years as documented in my service records. this was the core of my claims with va from the beginning.

"Is it actually a convalescence rating? Or a rating-like many others - that get reviewed anyhow every 2 years or so? I think that is what you mean---"

it is not a convalescence rating, but the 2 year type on a schedular award. this is just my first review.

"As you know -any diagnosis of a personality disorder is doomdays for a comp claim.But the VA hasnt diagnosed you with that at all- as far as I can tell here-"

no, they haven't, it's just that i had the feeling that the one psych doc was trying to corner me into such a diagnosis under the guise of "helping" me. it made me start worrying that it would worm it's way into my claim decision, and likely always will.

"If you have fully verified "service connected stressors"-as you mentioned and haven't been working for wages over the poverty level-

and there is no other rationale that VA could use to attempt to lower your comp- maybe it is best not to worry at this point. ALL the blank C & P exams are here to give you idea of what to expect."

the stressors are documented and i haven't been working at all. will try not to worry, just get through this process once again. .....

what are "blank c&p exams" and where are they located?"

[out_here04]

carlie, to answer your questions, comments:

i mentioned hippa because, as i understand it, the one psych doc i took exception to (who was NEVER in the past or present c&p process), has to notify me if he releases any documents from our sessions to anyone. this would not be the case if there was strong evidence of fraud, i guess. i know i am not a fraud, but paranoid about those who have potential to say so.

these docs didn't flock TO va, they flocked TO private practice together.

my "100 percent temporary, total disability from anxiety/depression" rating is not a convalescence rating. they are saying that i am "totally" disabled from one condition .... anxiety/depression. BUT i rated "totally disabled" only on a "temporary" scale because i "may improve," thus my rating itself is not "permanent and total".

i will review all of my rating decision packets.

how long had you held that 50% rating ?

i was rated at 50 percent for anxiety/depression for about three years after my initial claims at discharge from active duty. i was granted an increase just over a year ago with retro pay going back about nine months before that.

correct, there is no proposal for reduction in benefits, only a scheduled c&p exam. just hear so much about folks here having to go through the bva and such. so far i haven't and don't want to.

i actually GOT my 100 percent temporary schedular rating AFTER submitting the tdiu form 21-8940 to va. they came back with the award as such, stating that tdiu "is moot" since they were awarding me 100 percent temporary. i took it, as some here have, as "too soon to tell" how bad off i am. guess this c&p is part of doing just that.

[out_here04]

carlie,

after i filed for ssd, as many on here say we should also do, social security administration processor called me and said in order for them to verify my ssd claim per va treatment medical records and claim items (i guess), as well as some post-service medical records from my last base (where i was able to seek treatment as a retiree through tricare) they needed my written permission, which i gave. this allowed social security to directly contact my last base (not much there) and vamc.

in ss's letter denying my claim, they cited a diagnosis from a vamc staff psychiatrist who was evaluating me for the voc rehab program as saying that although i had this and this and this disability, i may be suited for employment for a highly supervised, non-confrontationalish career (like those exist). don't have the reports with me, but that's basically the deal.

i didn't give ssa permission to disregard medical evidence, it's like they found what they needed to deny(have no idea if they got a stack or just this one report).(now i'm wondering if they got one page or access to my whole claim package... did they just pull from vamc or va ro?) arghgh

[out_here04]

carlie, when i said i gave ssa permission to "purge" my va records, i meant "obtain" or "gain access to". sorry