ptsd Please Help...ptsd Question

[gbachman]

I have just returned home from my 6th tour since 9/11 a few months ago(4 w/ USMC and 2 with Army). As time has gone on, I notice that stuff isnt right, and things have changed. I have alot on my mind about stuff I have done and seen.

I am currently employed in a civilian job, as I am in the National Guard for the military side, and my civilian job has good ins. So with that, my question is this. If I were to ever lose my job for whatever reason, and I was being treated for PTSD, what would be the best way to go about doing things right now, so I could make a service claim in the future if I had too?

Should I go to a civilian doctor first, get diagnosed, and then take that to the VA, or should I go to the VA, and get diagnosed by them? Would a civilian doctor's recommendations hold more weight?

Liked I said, I am not looking to get rich, or even use this until I needed it. I just want yall's opinion into the best way to go about this process.

Thanks for all of your input...

[Berta]

I agree that anyone who needs more info on the new regs for PTSD -should read them over carefully-

http://www.va.gov/PTSD_QA.pdf

I worked at a vet center and have been around the VA block for decades.While this new reg should definitely help many vets get a proper PTSD diagnosis and award sooner that later- I still believe some PTSD vets will have to prove their stressors anyhow.

In part the VA PTSD Q and A states:

"5. How does this final regulation help Veterans?

The final regulation will simplify and streamline the processing of PTSD claims, which will result in Veterans receiving more timely decisions. A Veteran will be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: (1) the Veteran is diagnosed with PTSD; (2) a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; (3) the Veteran's symptoms are related to the claimed stressor; and (4) the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service and the record provides no clear and convincing evidence to the contrary. This will eliminate the requirement for VA to search for records, to verify stressor accounts, which is often a very involved and protracted process. As a result, the time required to adjudicate a PTSD compensation claim in accordance with the law will be significantly reduced.

9. What circumstances will still require stressor verification through DoD’s Joint Services Records Research Center (JSRRC) , VBA’s Compensation &Pension Service (C&P Service), or other entity if a Veteran claims that his or her stressor is related to a fear of hostile or terrorist activity?

The regulatory revision will greatly lessen the need for undertaking development to verify Veterans’ accounts of in-service stressors. Now, stressor development may only need to be conducted if a review of the available record, such as the Veteran’s service personnel and/or treatment records, is inadequate to determine that the claimed stressor is “consistent with the places, types and circumstances of the veteran’s service.” In such circumstances, the Veterans Service Representative (VSR) will determine on a case-by-case basis what development should be undertaken.

However, it is anticipated that in the overwhelming majority of cases adjudicated under the new version of § 3.304(f), a simple review of the Veteran’s service treatment and/or personnel records will be sufficient to determine if the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service. We also believe that, in some cases, a Veteran’s separation document, DD-Form 214, alone may enable an adjudicator to make such a determination. "

This statement is what I mean-

"stressor development may only need to be conducted if a review of the available record, such as the Veteran’s service personnel and/or treatment records, is inadequate to determine that the claimed stressor is “consistent with the places, types and circumstances of the veteran’s service"

The veteran's MOS and place, type, and circumstances have to support the stressor to an adequate level.

I think some vets filing under the new regs should also take the time to get buddy statements, or even contact JSRRC themselves if they feel their inservice records might not quite support what VA would determine to be adequate evidence of a stressor under the new regs.They certainly should get their 201 files and inservice med recs if they dont have them by now because they need to have what the VA will be using for their claim.

Or they can just file the claim and let VA "review" and "determine" the resulting decision from the "available" record.

There have been thousands of cases at the BVA ,to include valid PTSD claims,that VA denied by a "review" of "available" records.

whatever.

Edited August 4, 2010 by Berta

[LarryJ]

I'm unclear what the source of Number 10 is, but is says10. As the regulatory revision seems to require an enhanced role for the examining VA mental health professional, whose role is it to determine whether the claimed stressor is consistent with the Veteran's service?

THE ABOVE IS A QUESTION, NOT A STATEMENT.

So it seems that we are saying the same thing, that is that the examing VA mental health professional to decide if the Vet's story about his service is realitic given that Vet's service, NOT adjudicators. At any rate, the Officiail News release is available at VA.gov, so all may read it for themselves and apply one's individual interpretation of the new Reg.

No, we are NOT saying the same thing.

In an effort to repeat my prior posting, I'll stick it on here, one more time:

"VA adjudicators, not the examining psychiatrist or psychologist, will decide whether the claimed stressor is consistent with the Veteran's service."

Now, I do not know where you learned English and Composition, but, where I come from, that sentence says" VA adjudicators WILL decide whether the claimed stressor is consistent with the Veteran's service, NOT the examining psychiatrist or psychologist. You will take note of the commas, in essence seperating the "VA adjudicators will decide whether the claimed stressor is consistent with the Veteran's service from the other portion of the sentence "not the examining psychiatrist or psychologist".

Can't make it any plainer than that. Even though I tried. The VA Regional Office team will decide the claimed stressor is or is not consistent with the Veteran's service. In other words, they will look at the vets service records, DD214, etc. and see if the vet was, in fact, in, for example, Afghanistan, when he says he was involved in an IED explosion, instead of being at Ft. Hood, for example.

And, this is where I got the #10 statement:

From the Dept. of Veterans Affairs Fact Sheet on PTSD:

"New Regulations on PTSD Claims

Quick Facts:

This new rule is for Veterans of any era.

The new rule will apply to claims:

o received by VA on or after July 13, 2010;

o received before July 13, 2010 but not yet decided by a VA regional office;

o appealed to the Board of Veterans' Appeals on or after July 13, 2010;

o appealed to the Board before July 13, 2010, but not yet decided by the Board; and

o pending before VA on or after July 13, 2010, because the Court of Appeals for Veterans Claims vacated a Board decision and remanded for re-adjudication.

QUESTIONS AND ANSWERS

"Stressor Determinations for Posttraumatic Stress Disorder"

1. What is Post-Traumatic Stress Disorder (PTSD)?

Post Traumatic Stress Disorder (PTSD) is a condition resulting from exposure to direct or indirect threat of death, serious injury or a physical threat. The events that can cause PTSD are called "stressors" and may include natural disasters, accidents or deliberate man-made events/disasters, including war. Symptoms of PTSD can include recurrent thoughts of a traumatic event, reduced involvement in work or outside interests, emotional numbing, hyper-alertness, anxiety and irritability. The disorder can be more severe and longer lasting when the stress is human initiated action (example: war, rape, terrorism).

2. What does this final regulation do?

This final regulation liberalizes the evidentiary standard for Veterans claiming service connection for post traumatic stress disorder (PTSD). Under current regulations governing PTSD claims, unless the Veteran is a combat Veteran, VA adjudicators are typically required to undertake extensive record development to corroborate whether a Veteran actually experienced the claimed in-service stressor. This final rulemaking will simplify and improve the PTSD claims adjudication process by eliminating this time-consuming requirement where the claimed stressor is related to "fear of hostile military 2

or terrorist activity," is consistent with the places, types, and circumstances of their service, and a VA psychiatrist or psychologist, or contract psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD.

3. What types of claims for VA benefits does the final regulation affect?

The final regulation will benefit Veterans, regardless of their period of service. It applies to claims for PTSD service connection filed on or after the final regulation's effective date, and to those claims that are considered on the merits at a VA Regional Office or the Board of Veterans' Appeals on or after the effective date of the rule.

4. Why is this final regulation necessary?

The final regulation is necessary to make VA's adjudication of PTSD claims both more timely and consistent with the current medical science.

5. How does this final regulation help Veterans?

The final regulation will simplify and streamline the processing of PTSD claims, which will result in Veterans receiving more timely decisions. A Veteran will be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: (1) the Veteran is diagnosed with PTSD; (2) a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; (3) the Veteran's symptoms are related to the claimed stressor; and (4) the claimed stressor is consistent with the places, types, and circumstances of the Veteran's service and the record provides no clear and convincing evidence to the contrary. This will eliminate the requirement for VA to search for records, to verify stressor accounts, which is often a very involved and protracted process. As a result, the time required to adjudicate a PTSD compensation claim in accordance with the law will be significantly reduced.

6. How does VA plan to monitor the need for examiners in various regions of the country, and how does VA plan to respond if is determined that more examiners are needed in a particular region?

The Veterans Health Administration (VHA) has written in to the FY11-13 Operating Plan the need for additional staff to support doing adequate, timely exams. VHA proposes: "A8. Increase mental health field staff to address the increase in C&P examinations and develop monitoring system to ensure clinical delivery of mental health services does not decrease in VHA." Specifically, VHA has requested 125 clinicians for FY11 with additional 63 staff in FY12 if the need exists. If the Operating Plan and the proposed budget are approved, VA proposes asking the Veterans Integrated Service Networks (VISNs) to develop plans for distributing the funds in order to ensure adequate coverage at sites based on number of claims being processed; the VISNs are well positioned to determine these regional needs.

7. How does the regulatory revision affect PTSD service connection claims where an in-service diagnosis of PTSD has been rendered?

The new regulation does not apply to the adjudication of cases where PTSD has been initially diagnosed in service. Rather, under another VA rule, 38 CFR § 3.304(f)(1), if a Veteran is diagnosed with posttraumatic stress disorder during service and the claimed 3

stressor is related to that service, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the Veteran's service, the Veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

8. Is the new regulation applicable only if the Veteran's statements relate to combat or POW service?

No. The rule states that the stressor must be related to a "fear of hostile military or terrorist activity," and the claimed stressor must be "consistent with the places, types, and circumstances of the veteran's service."

9. What circumstances will still require stressor verification through DoD's Joint Services Records Research Center (JSRRC) , VBA's Compensation &Pension Service (C&P Service), or other entity if a Veteran claims that his or her stressor is related to a fear of hostile or terrorist activity?

The regulatory revision will greatly lessen the need for undertaking development to verify Veterans' accounts of in-service stressors. Now, stressor development may only need to be conducted if a review of the available record, such as the Veteran's service personnel and/or treatment records, is inadequate to determine that the claimed stressor is "consistent with the places, types and circumstances of the veteran's service." In such circumstances, the Veterans Service Representative (VSR) will determine on a case-by-case basis what development should be undertaken.

However, it is anticipated that in the overwhelming majority of cases adjudicated under the new version of § 3.304(f), a simple review of the Veteran's service treatment and/or personnel records will be sufficient to determine if the claimed stressor is consistent with the places, types, and circumstances of the Veteran's service. We also believe that, in some cases, a Veteran's separation document, DD-Form 214, alone may enable an adjudicator to make such a determination.

10. As the regulatory revision seems to require an enhanced role for the examining VA mental health professional, whose role is it to determine whether the claimed stressor is consistent with the Veteran's service?

VA adjudicators, not the examining psychiatrist or psychologist, will decide whether the claimed stressor is consistent with the Veteran's service.

11. Is a Veteran's testimony about "fear of hostile military or terrorist activity" alone sufficient to establish a stressor?

Yes, if the other requirements of the regulation are satisfied, i.e., a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a PTSD diagnosis and that the Veteran's symptoms are related to the claimed stressor, and the stressor is consistent with the "places, types, and circumstances of the Veteran's service."

12. Are the stressors accepted as adequate for establishing service connection under new § 3.304(f)(3) limited to those specifically identified in the new regulation?

No. The examples given in the revised regulation do not represent an exclusive list in view of the use of the modifying phrase "such as" that precedes the listed examples. Any 4

event or circumstance that involves actual or threatened death or serious injury, or a threat to the physical integrity of the Veteran or others, would qualify as a stressor under new § 3.304(f)(3).

13. How will the Veterans Health Administration (VHA) work with Veterans Benefits Administration (VBA) on the new regulation?

VHA was actively involved in discussion with VBA of the new regulation and fully supports the new regulation.

The new regulation will provide fair evaluation for Veterans whose military records have been damaged or destroyed, or for whom no definitive reports of combat action appeared in their military records, even though they can report such actions and it is reasonable to believe that these occurred, given the time and place of service.

This will be especially beneficial to women Veterans, whose records do not specify that they had combat assignments, even though their roles in the military placed them at risk of hostile military or terrorist activity.

This means that more Veterans will become eligible for VA care and thus be able to receive VA care for mental illness related to their military service, as well as receiving full holistic health care.VHA will work actively with VBA on implementing the regulation. VHA staff's main role is as clinicians conducting C&P interviews to establish diagnoses and obtain other information to be used by VBA raters to determine the outcome of claims.

The new regulation will not change the diagnostic elements of the C&P interview, but may change what additional data are collected for use by VBA raters."

I stand on the statement that I originally made.

LJ

Edited August 4, 2010 by LarryJ

[carlie]

"They heal themselves for only they can. I am simply there to promote the healing. If you served in a Combat Zone and DIDN'T get a Dishonorable Discharge. I owe you that."

Cliph,

I have a question - what do Vet Center therapist "owe" a two tour, RVN boots on ground, combat vet,

that got a Dishonorable Discharge due to "willful misconduct" by self medicating and becoming

a Heroin Addict during their second tour of combat ?

Prior to discharge he was busted down from a SPC (E-4) to an E-1.

His MOS was 16F10 Light Air Defense Artillery Crewman.

He was a Quad 50 machine gunner doing perimeter security and convoy escorts on both tours.

Vet was attached to 173rd Airborne Division based out of An Khe.

Vet's unit was 1st Field Forces, 4th Battalion,60th Artillery, E Battery, 41st Machine Guns.

Vet spent first tour operating out of Bao Loc, Phan Rang and Na Trang.

He was attached to same unit on second tour and worked primarily as convoy escort on Hwy QL 19 between

An Khe, Pleiku and Qui Nhon.

His 201 file shows participation as Quad 5o machine gunner during:

Tet 68/ Counteroffensive

Counteroffensive - Phase V

Counteroffensive - Phase VI

Tet 69/ Counteroffensive

Vietnam Summer-Fall 1969 (9 June 31 October 1969)

Sanctuary Counteroffensive (1 May 30 June 1970)

Vietnamese Counteroffensive (1 July 1070 - 30 June 1971) Phase VII

Soooooooooo - what would your vet center offer this combat veteran ?

Ours offers him every service they have plus a DSM-IV Diagnosis of PTSD

in writing.

carlie

[Guest Cliph]

No, we are NOT saying the same thing.

In an effort to repeat my prior posting, I'll stick it on here, one more time:

"VA adjudicators, not the examining psychiatrist or psychologist, will decide whether the claimed stressor is consistent with the Veteran's service."

Now, I do not know where you learned English and Composition, but, where I come from, that sentence says" VA adjudicators WILL decide whether the claimed stressor is consistent with the Veteran's service, NOT the examining psychiatrist or psychologist. You will take note of the commas, in essence seperating the "VA adjudicators will decide whether the claimed stressor is consistent with the Veteran's service from the other portion of the sentence "not the examining psychiatrist or psychologist".

Can't make it any plainer than that. Even though I tried. The VA Regional Office team will decide the claimed stressor is or is not consistent with the Veteran's service. In other words, they will look at the vets service records, DD214, etc. and see if the vet was, in fact, in, for example, Afghanistan, when he says he was involved in an IED explosion, instead of being at Ft. Hood, for example.

And, this is where I got the #10 statement:

From the Dept. of Veterans Affairs Fact Sheet on PTSD:

"New Regulations on PTSD Claims

Quick Facts:

This new rule is for Veterans of any era.

The new rule will apply to claims:

o received by VA on or after July 13, 2010;

o received before July 13, 2010 but not yet decided by a VA regional office;

o appealed to the Board of Veterans' Appeals on or after July 13, 2010;

o appealed to the Board before July 13, 2010, but not yet decided by the Board; and

o pending before VA on or after July 13, 2010, because the Court of Appeals for Veterans Claims vacated a Board decision and remanded for re-adjudication.

QUESTIONS AND ANSWERS

"Stressor Determinations for Posttraumatic Stress Disorder"

1. What is Post-Traumatic Stress Disorder (PTSD)?

Post Traumatic Stress Disorder (PTSD) is a condition resulting from exposure to direct or indirect threat of death, serious injury or a physical threat. The events that can cause PTSD are called "stressors" and may include natural disasters, accidents or deliberate man-made events/disasters, including war. Symptoms of PTSD can include recurrent thoughts of a traumatic event, reduced involvement in work or outside interests, emotional numbing, hyper-alertness, anxiety and irritability. The disorder can be more severe and longer lasting when the stress is human initiated action (example: war, rape, terrorism).

2. What does this final regulation do?

This final regulation liberalizes the evidentiary standard for Veterans claiming service connection for post traumatic stress disorder (PTSD). Under current regulations governing PTSD claims, unless the Veteran is a combat Veteran, VA adjudicators are typically required to undertake extensive record development to corroborate whether a Veteran actually experienced the claimed in-service stressor. This final rulemaking will simplify and improve the PTSD claims adjudication process by eliminating this time-consuming requirement where the claimed stressor is related to "fear of hostile military 2

or terrorist activity," is consistent with the places, types, and circumstances of their service, and a VA psychiatrist or psychologist, or contract psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD.

3. What types of claims for VA benefits does the final regulation affect?

The final regulation will benefit Veterans, regardless of their period of service. It applies to claims for PTSD service connection filed on or after the final regulation's effective date, and to those claims that are considered on the merits at a VA Regional Office or the Board of Veterans' Appeals on or after the effective date of the rule.

4. Why is this final regulation necessary?

The final regulation is necessary to make VA's adjudication of PTSD claims both more timely and consistent with the current medical science.

5. How does this final regulation help Veterans?

The final regulation will simplify and streamline the processing of PTSD claims, which will result in Veterans receiving more timely decisions. A Veteran will be able to establish the occurrence of an in-service stressor through his or her own testimony, provided that: (1) the Veteran is diagnosed with PTSD; (2) a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted confirms that the claimed stressor is adequate to support a PTSD diagnosis; (3) the Veteran's symptoms are related to the claimed stressor; and (4) the claimed stressor is consistent with the places, types, and circumstances of the Veteran's service and the record provides no clear and convincing evidence to the contrary. This will eliminate the requirement for VA to search for records, to verify stressor accounts, which is often a very involved and protracted process. As a result, the time required to adjudicate a PTSD compensation claim in accordance with the law will be significantly reduced.

6. How does VA plan to monitor the need for examiners in various regions of the country, and how does VA plan to respond if is determined that more examiners are needed in a particular region?

The Veterans Health Administration (VHA) has written in to the FY11-13 Operating Plan the need for additional staff to support doing adequate, timely exams. VHA proposes: "A8. Increase mental health field staff to address the increase in C&P examinations and develop monitoring system to ensure clinical delivery of mental health services does not decrease in VHA." Specifically, VHA has requested 125 clinicians for FY11 with additional 63 staff in FY12 if the need exists. If the Operating Plan and the proposed budget are approved, VA proposes asking the Veterans Integrated Service Networks (VISNs) to develop plans for distributing the funds in order to ensure adequate coverage at sites based on number of claims being processed; the VISNs are well positioned to determine these regional needs.

7. How does the regulatory revision affect PTSD service connection claims where an in-service diagnosis of PTSD has been rendered?

The new regulation does not apply to the adjudication of cases where PTSD has been initially diagnosed in service. Rather, under another VA rule, 38 CFR § 3.304(f)(1), if a Veteran is diagnosed with posttraumatic stress disorder during service and the claimed 3

stressor is related to that service, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the Veteran's service, the Veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor.

8. Is the new regulation applicable only if the Veteran's statements relate to combat or POW service?

No. The rule states that the stressor must be related to a "fear of hostile military or terrorist activity," and the claimed stressor must be "consistent with the places, types, and circumstances of the veteran's service."

9. What circumstances will still require stressor verification through DoD's Joint Services Records Research Center (JSRRC) , VBA's Compensation &Pension Service (C&P Service), or other entity if a Veteran claims that his or her stressor is related to a fear of hostile or terrorist activity?

The regulatory revision will greatly lessen the need for undertaking development to verify Veterans' accounts of in-service stressors. Now, stressor development may only need to be conducted if a review of the available record, such as the Veteran's service personnel and/or treatment records, is inadequate to determine that the claimed stressor is "consistent with the places, types and circumstances of the veteran's service." In such circumstances, the Veterans Service Representative (VSR) will determine on a case-by-case basis what development should be undertaken.

However, it is anticipated that in the overwhelming majority of cases adjudicated under the new version of § 3.304(f), a simple review of the Veteran's service treatment and/or personnel records will be sufficient to determine if the claimed stressor is consistent with the places, types, and circumstances of the Veteran's service. We also believe that, in some cases, a Veteran's separation document, DD-Form 214, alone may enable an adjudicator to make such a determination.

10. As the regulatory revision seems to require an enhanced role for the examining VA mental health professional, whose role is it to determine whether the claimed stressor is consistent with the Veteran's service?

VA adjudicators, not the examining psychiatrist or psychologist, will decide whether the claimed stressor is consistent with the Veteran's service.

11. Is a Veteran's testimony about "fear of hostile military or terrorist activity" alone sufficient to establish a stressor?

Yes, if the other requirements of the regulation are satisfied, i.e., a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a PTSD diagnosis and that the Veteran's symptoms are related to the claimed stressor, and the stressor is consistent with the "places, types, and circumstances of the Veteran's service."

12. Are the stressors accepted as adequate for establishing service connection under new § 3.304(f)(3) limited to those specifically identified in the new regulation?

No. The examples given in the revised regulation do not represent an exclusive list in view of the use of the modifying phrase "such as" that precedes the listed examples. Any 4

event or circumstance that involves actual or threatened death or serious injury, or a threat to the physical integrity of the Veteran or others, would qualify as a stressor under new § 3.304(f)(3).

13. How will the Veterans Health Administration (VHA) work with Veterans Benefits Administration (VBA) on the new regulation?

VHA was actively involved in discussion with VBA of the new regulation and fully supports the new regulation.

The new regulation will provide fair evaluation for Veterans whose military records have been damaged or destroyed, or for whom no definitive reports of combat action appeared in their military records, even though they can report such actions and it is reasonable to believe that these occurred, given the time and place of service.

This will be especially beneficial to women Veterans, whose records do not specify that they had combat assignments, even though their roles in the military placed them at risk of hostile military or terrorist activity.

This means that more Veterans will become eligible for VA care and thus be able to receive VA care for mental illness related to their military service, as well as receiving full holistic health care.VHA will work actively with VBA on implementing the regulation. VHA staff's main role is as clinicians conducting C&P interviews to establish diagnoses and obtain other information to be used by VBA raters to determine the outcome of claims.

The new regulation will not change the diagnostic elements of the C&P interview, but may change what additional data are collected for use by VBA raters."

I stand on the statement that I originally made.

LJ

[Guest Cliph]

OK you're right and I'm all wrong. Still, there is no need to insult my intelligence. I only posted when a Veteran was overly anxious about his C&P and I tried to reduce that anxiety, that's all. I'm tired of neing insulted and flamed over every message I send. So I am gone, never to return.

[billy2]

My journey

I now see the nurse at the MH office every 6-8 weeks for my drugs. We talk for about 20 min and thats it.

I go to the Vet Center about every 3 weeks and see the psychologist for an hour. BORING, BORING

I got the impression when I first went to the Vet Center the guy thought I was faking. He would say you

were sucessful and educated and lived a good life.

Just because I wear good clothes and drive a nice car, does not mean that I don't have PTSD.

He would ask me on different ocassions "Do you think you have PTSD"

I said your the expert, tell me what you think? They don't know.

Finally I had a C&P with a PHD shrink and he said I suffered from PTSD. I won my claim but appealed the

rating. Now the fellow at the Vet Center believes I have PTSD in spite of my appearance.

I never knew I had PTSD all these years. I just though I had a personality disorder and was a mean and

angry person. Now I know and I feel much better about myself. There was something that caused my bad

behavior.

I told him last week that I was going to stop coming to the Vet Center in the fall and it was time to move on.

Bill