Imo From Physical Therapist

[vet201060]

I am currently fee based to a Physical Therapist that does not have a doctorate degree. He has been doing it for almost 40 years. He will do a nexus letter to my current problem. I am seeing him for my back which I am already rated for, He is also treating me for my flat feet condition. I am being recommend for orthotics with appointment next wed. I was in the same boat in the service and recommended for orthotics because of being seen for PT for shins splints. I was not aware of the referral in service and never got the orthotics. Now I still have the same problem. The DAV filed for my shins and it was denied. I am going to file for flat feet 25 May. I wanted to know if my physical therapist would work for the IMO nexus letter? He has put it in his notes and sent to my primary doc at the VA.

[vet201060]

Thanks for the advice. I don't even thank my primary doc writes or makes notes when I see him. He is pretty worthless. he just gets me pain meds and muscle relaxers and refers me to other people. My kids could do that. I also noticed that on my C&P exam for my back they put I didn't have numbness for my legs. I have pain and numbness. I have asked my primary doc about the numbness and he told me that is just the way it is going to be. It has been like that for 6 to 7 years. I got denied for the numbness in my left leg. I did my claim in dec 2006. I was told that it is secondary to my DDD. I dont know what to do with that. I was told by one doctor that it is Maralgia Parathesica. Spelling maybe off. I dont know if that can be rated or not.

Hi Vet20,

In my experience my the VA considers the medical professionals in this order for physical disabilities:

MD, Nurse Practitioner / APRN, Chiropractor, Physical Therapist, Acupuncturists, holistic healers.

The also love their own examiners and or VA docs over civilians. If I were you I'd get the nexus letter from the PT and get another from your MD. The MD always seems to carry the heaviest weight unless it's the VA examiner, which is BS. As I'm sure you know half the time the VA examiner is an APRN and is not a specialist in your particular disability.

Even though the PT is down the food chain more positive evidence is always better in my mind.

[john999]

If you have a back problem go to a doctor for an opinion who is an orthopedist or neurologist. If you use a PT the VA can very easily use any MD to blow the PT's opinion out of the water. MD's are God at the VA even the ones who speak Hindi, or some version of English never heard except on a remote island in the South Seas (Easter Island).

[*Bergie*]

I am currently fee based to a Physical Therapist that does not have a doctorate degree. He has been doing it for almost 40 years. He will do a nexus letter to my current problem. I am seeing him for my back which I am already rated for, He is also treating me for my flat feet condition. I am being recommend for orthotics with appointment next wed. I was in the same boat in the service and recommended for orthotics because of being seen for PT for shins splints. I was not aware of the referral in service and never got the orthotics. Now I still have the same problem. The DAV filed for my shins and it was denied. I am going to file for flat feet 25 May. I wanted to know if my physical therapist would work for the IMO nexus letter? He has put it in his notes and sent to my primary doc at the VA.

In plain terms NO. He is not qualified to make a medical diagnosis and his openion although maybe right will do nothing for your claim.

JMO,

Bergie

[vet201060]

Thanks for the info. I am trying to be prepared this time. Does anyone know how they rate PTSD and adjustment disorder anxiety? I didn't know if it is of a score or just the description of percentages.

In plain terms NO. He is not qualified to make a medical diagnosis and his openion although maybe right will do nothing for your claim.

JMO,

Bergie

[Commander Bob]

... Does anyone know how they rate PTSD and adjustment disorder anxiety?

DSM-IV-TR criteria for PTSD

In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The diagnostic criteria (Criterion A-F) are specified below.

Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.

2. The person's response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

Criterion B: intrusive recollection

The traumatic event is persistently re-experienced in at least one of the following ways:

1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

2. Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content

3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.

4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Criterion C: avoidant/numbing

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma

2. Efforts to avoid activities, places, or people that arouse recollections of the trauma

3. Inability to recall an important aspect of the trauma

4. Markedly diminished interest or participation in significant activities

5. Feeling of detachment or estrangement from others

6. Restricted range of affect (e.g., unable to have loving feelings)

7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Criterion D: hyper-arousal

Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

1. Difficulty falling or staying asleep

2. Irritability or outbursts of anger

3. Difficulty concentrating

4. Hyper-vigilance

5. Exaggerated startle response

Criterion E: duration

Duration of the disturbance (symptoms in B, C, and D) is more than one month.

Criterion F: functional significance

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than three months

Chronic: if duration of symptoms is three months or more

Specify if:

With or Without delay onset: Onset of symptoms at least six months after the stressor

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR ( Fourth ed.). Washington D.C.: American Psychiatric Association.

********************************************************************************

*************************

TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 4--SCHEDULE FOR RATING DISABILITIES

Subpart B--Disability Ratings

4.129 Mental disorders due to traumatic stress.

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to

such symptoms as: gross impairment in thought

processes or communication; persistent delusions

or hallucinations; grossly inappropriate behavior;

persistent danger of hurting self or others;

intermittent inability to perform activities of

daily living (including maintenance of minimal

personal hygiene); disorientation to time or

place; memory loss for names of close relatives,

own occupation, or own name............. 100%

Occupational and social impairment, with

deficiencies in most areas, such as work, school,

family relations, judgment, thinking, or mood, due

to such symptoms as: suicidal ideation;

obsessional rituals which interfere with routine

activities; speech intermittently illogical,

obscure, or irrelevant; near-continuous panic or

depression affecting the ability to function

independently, appropriately and effectively;

impaired impulse control (such as unprovoked

irritability with periods of violence); spatial

disorientation; neglect of personal appearance and

hygiene; difficulty in adapting to stressful

circumstances (including work or a worklike

setting); inability to establish and maintain

effective relationships............... 70%

Occupational and social impairment with reduced

reliability and productivity due to such symptoms

as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic

attacks more than once a week; difficulty in

understanding complex commands; impairment of

short- and long-term memory (e.g., retention of

only highly learned material, forgetting to

complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and

mood; difficulty in establishing and maintaining

effective work and social relationships....... 50%

Occupational and social impairment with occasional

decrease in work efficiency and intermittent

periods of inability to perform occupational tasks

(although generally functioning satisfactorily,

with routine behavior, self-care, and conversation

normal), due to such symptoms as: depressed mood,

anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory

loss (such as forgetting names, directions, recent

events)...................................... 30%

Occupational and social impairment due to mild or

transient symptoms which decrease work efficiency

and ability to perform occupational tasks only

during periods of significant stress, or; symptoms

controlled by continuous medication............ 10%

A mental condition has been formally diagnosed, but

symptoms are not severe enough either to interfere

with occupational and social functioning or to

require continuous medication................... 0%

Edited May 15, 2010 by Commander Bob

[vet201060]

I think anyone that deals with the VA could get 100% PTSD LOL

DSM-IV-TR criteria for PTSD

In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). The diagnostic criteria (Criterion A-F) are specified below.

Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning.

Criterion A: stressor

The person has been exposed to a traumatic event in which both of the following have been present:

1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.

2. The person's response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.

Criterion B: intrusive recollection

The traumatic event is persistently re-experienced in at least one of the following ways:

1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

2. Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content

3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur.

4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

Criterion C: avoidant/numbing

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma

2. Efforts to avoid activities, places, or people that arouse recollections of the trauma

3. Inability to recall an important aspect of the trauma

4. Markedly diminished interest or participation in significant activities

5. Feeling of detachment or estrangement from others

6. Restricted range of affect (e.g., unable to have loving feelings)

7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Criterion D: hyper-arousal

Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following:

1. Difficulty falling or staying asleep

2. Irritability or outbursts of anger

3. Difficulty concentrating

4. Hyper-vigilance

5. Exaggerated startle response

Criterion E: duration

Duration of the disturbance (symptoms in B, C, and D) is more than one month.

Criterion F: functional significance

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than three months

Chronic: if duration of symptoms is three months or more

Specify if:

With or Without delay onset: Onset of symptoms at least six months after the stressor

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR ( Fourth ed.). Washington D.C.: American Psychiatric Association.

********************************************************************************

*************************

TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF

CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 4--SCHEDULE FOR RATING DISABILITIES

Subpart B--Disability Ratings

4.129 Mental disorders due to traumatic stress.

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to

such symptoms as: gross impairment in thought

processes or communication; persistent delusions

or hallucinations; grossly inappropriate behavior;

persistent danger of hurting self or others;

intermittent inability to perform activities of

daily living (including maintenance of minimal

personal hygiene); disorientation to time or

place; memory loss for names of close relatives,

own occupation, or own name............. 100%

Occupational and social impairment, with

deficiencies in most areas, such as work, school,

family relations, judgment, thinking, or mood, due

to such symptoms as: suicidal ideation;

obsessional rituals which interfere with routine

activities; speech intermittently illogical,

obscure, or irrelevant; near-continuous panic or

depression affecting the ability to function

independently, appropriately and effectively;

impaired impulse control (such as unprovoked

irritability with periods of violence); spatial

disorientation; neglect of personal appearance and

hygiene; difficulty in adapting to stressful

circumstances (including work or a worklike

setting); inability to establish and maintain

effective relationships............... 70%

Occupational and social impairment with reduced

reliability and productivity due to such symptoms

as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic

attacks more than once a week; difficulty in

understanding complex commands; impairment of

short- and long-term memory (e.g., retention of

only highly learned material, forgetting to

complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and

mood; difficulty in establishing and maintaining

effective work and social relationships....... 50%

Occupational and social impairment with occasional

decrease in work efficiency and intermittent

periods of inability to perform occupational tasks

(although generally functioning satisfactorily,

with routine behavior, self-care, and conversation

normal), due to such symptoms as: depressed mood,

anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory

loss (such as forgetting names, directions, recent

events)...................................... 30%

Occupational and social impairment due to mild or

transient symptoms which decrease work efficiency

and ability to perform occupational tasks only

during periods of significant stress, or; symptoms

controlled by continuous medication............ 10%

A mental condition has been formally diagnosed, but

symptoms are not severe enough either to interfere

with occupational and social functioning or to

require continuous medication................... 0%