ptsd Just Got Back From Appt With Va Psych....grrrrr

[Gridsmasher11]

I just returned from an appointment with my VA psychiatrist....She just seems to want to keep increasing my meds but doesn't really want to help with my claim.....I asked her to specifically write me a nexus letter or to put into my treatment notes that my PTSD 'is more likely than not caused by my time in the Gulf"....She says that she has already stated that it is service connected and that she wants me to be service connected for this but will not write this as I have asked....Are they instructed to not write it plainly so we can support our claims????? She said it would be a conflict of interest.????I asked her how it would be a conflict of interest, wasn't she my treating Phsychiatrist (she said yes) but she just wants to him and haww........GRRRRRRRRR...VA causes us more stress and just wants to dope us up and hope we forget...............................................Did find out some things that may help my claim......The doctor that did my PTSD C&P back in March is only an MD.....According to VA regs it should have been a Psychiatrist or Phsycologist...So I have a point there....Still gathering the stuff to keep fighting my claim.............................GRID

[mobie16r]

ok, i am through with this,because i have no wind. 100% service connected for post traumatic stress disorder

[cooter]

I would imagine this exact conversation is occurring all over the nation.

What is the proper procedure to have one's claim reviewed, re-rated, appealed etc. under these new regulations? File a new claim or wait for the VA to take the initiative to apply these new regulations to all these claims (already a 1,000,000 claim backlog):

All PTSD claims, including appeals, that are received on or after July 13, 2010.

All PTSD claims that were:

•Pending before VA on July 13, 2010

•Pending before the Board of Veterans' Appeals (BVA) on July 13, 2010

•Pending before VA on or after July 13, 2010, because they were overturned by BVA (in cases where the claim was filed before July 13, 2010).

But in these last three situations, we must be reviewing the pending case based "on the merits." That means that the decision must be about the "meat" of the case and not about a mere technicality.

Is having conflicting diagnoses "a mere technicality?"

To the point, the veteran I am assisting falls into the situation outlined by LarryJ and Berta with a couple of twists. First, he has a very long history of PTSD diagnoses from VA mental health providers from both VAMC and Vet Centers as well as a private provider. Secondly, he has been awarded SSDI (2005) based entirely upon his VA medical records.

However, the VA continues to deny service-connected PTSD. For years his was denied because the VA could not, or would not, verify the veteran's presence at a well publicized traumatic event (E Club fragging in VN). The veteran has testimony of a witness who placed the veteran at the event. The VA concluded that the witness was "credible" but the veteran was not. The reasons stated for this, according to the VA, the fact that the veteran has provided several stressors over the years which the VA view as "conflicting" rather the cumulative and evolving renders the veteran and his statements less than credible. Also, the VA states that since neither the witness nor the veteran was listed among the injured and the fact that the witness has never filed for service-connected PTSD, the claimed stressor in not adequate for a service-connected PTSD award. The VA is implying, incorrectly, one or the other (or both) of those elements is required by DSM-IV. The existence of these various other stressors have been revealed during PTSD treatment by VA mental health providers and are noted in the veteran's VA medical records.

JSRRC has confirmed a stressor, but not the stressor claimed (stressor letter) in the original claim for service-connected PTSD. Once the VARO received the confirmation, a new C&P (March 2010) was ordered. The C&P report states that the veteran does not suffer from PTSD but does suffer from a Personality Disorder and Depression disorder. The C&P report conflicts with VA medical records which contain numerous PTSD diagnoses right up to the C&P and continuing until as recently as two weeks ago.

The claim is very old and has traveled a very strange route. The denial was appealed to the Board in 2006 with an in-person hearing with a traveling Board member requested, but sat somewhere at the Houston RO for three years without action. So, like so many others, we cannot determine how these new regulations apply to this veteran's claim nor how to use them for his benefit (or detriment for that matter).

These questions must be answered:

Do 38 CFR "Relative Equipoise" provisions still apply?

(38 U.S.C 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)

Do 38 CFR "Benefit of the Doubt" provisions still apply?

(38 U.S.C.A. § 1110, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303 (2002)

Do 38 CFR "Preponderance of the Evidence" provisions still apply?

(38 U.S.C. § 5110(a); 38 C.F.R. § 3.400 (2001)

Do 38 CFR "VA required to analyze and evaluate ... all pertinent medical and lay evidence" still apply?

(38 U.S.C. § 1154(a) (2000); 38 C.F.R. § 3.303(a) (2002)

If the answer to any of these questions is "No", then veterans seeking service-connected PTSD ratings have been handed their butts!

To make it all the more confusing for us, in an IRIS response to the question of where the claim was in the appeals process, the VACO informed the veteran of the new regulations with the inference that the new regulations would help the veteran. However, shortly thereafter another SSOC was received containing yet another denial but this time stating that the veteran has a confirmed stressor but doesn't suffer from PTSD. The veteran submitted another Form 9 which simply said to refer to the 2006 Form 9 and a cover letter requesting that the RO expedite forwarding the appeal to the Board (including the in-person hearing in front of a traveling Board member at a local VA facility) based on the enormous delay that has already occurred. The veteran has received no response to date. So, we have no idea how the new regulations can or will impact the claim. Hell, we really don't even know where the claim actually (physically) is in the appeals process.

Another question has surfaced, at least for us, regarding these new regulations. If we assume, and I believe we have to at least for now, that it takes a PTSD diagnosis from a VA provider**and only a VA provider**would an IMO from a non-VA practitioner with a specialty in employment issues have any value in determining the actual rating % should be veteran succeed in getting an award of service-connected PTSD? More simply asked, "Do private mental health professionals have any relevance to the diagnosis and treatment of veterans suffering from PTSD? (I wonder what those professionals feel about these new regulations!)

While I realize I have asked more questions than I have answered, I hope this adds additional information to advance the conversation. If anyone has any answers or ideas on how to proceed, I suspect many of us would certainly like see them. If we receive more information I will post it.

Thanks.

OK, with all this said I still need a little more clarification on a few subjects. 1. When a vet files for PTSD does he at the time submit evidence from his/her private

psychiatrist with the diagnosed symptoms of PTSD since IMO's and EMO's won't be admissible? 2. What decides the rating %? The vets testimony on the severity of

their symptoms or who or what? I'm kind of confused of what evidence IS admissible.

[retiredat44]

None on my VA doctors would help write me a nexus letter. I used to ask them..

(I also asked a few VA doctors to help me by writing a nexus).. I also told VA surgeons where I was injured when they asked me what my injuries were.. and where I got them..

I had to go pay an outside specialist to write an IMO and it was $1,600

I just returned from an appointment with my VA psychiatrist....She just seems to want to keep increasing my meds but doesn't really want to help with my claim.....I asked her to specifically write me a nexus letter or to put into my treatment notes that my PTSD 'is more likely than not caused by my time in the Gulf"....She says that she has already stated that it is service connected and that she wants me to be service connected for this but will not write this as I have asked....Are they instructed to not write it plainly so we can support our claims????? She said it would be a conflict of interest.????I asked her how it would be a conflict of interest, wasn't she my treating Phsychiatrist (she said yes) but she just wants to him and haww........GRRRRRRRRR...VA causes us more stress and just wants to dope us up and hope we forget...............................................Did find out some things that may help my claim......The doctor that did my PTSD C&P back in March is only an MD.....According to VA regs it should have been a Psychiatrist or Phsycologist...So I have a point there....Still gathering the stuff to keep fighting my claim.............................GRID

Edited August 19, 2010 by retiredat44

[Berta]

Jim- I raised that exact issue with COngressman Filner last night at SVR radio-

Veterans with PD diagnosis have in some cases proven to the VA they had, in fact, PTSD.

The new regs specifiy that the diagnosis MUST come from a VA mental health care practitioner.

This means, I mentioned, that if the VA says the vet doesnt have PTSD but he or she has the diagnosis from an independent doctor and conforms to the stressor criteria then how do these vets receive 38 USC 1154 b Benefit of Doubt- that allows the VA to weigh evidence for and against the claim-and if of equal merit -then veteran will succeed.

His response to this part of the reg was " We are going to look into that." and "Congress can make some changes."

He was fully aware of how this reg was worded. I raised the fact that this could be a situation that impacts on the H VAC hearings on Personality Disorder diagnoses which will be on Sept 15 at the Cannon Building in DC available live in streaming video.

I intend to send him a letter too again mentioning these concerns that every vets advocate should be concerned about as well.

If VA can attempt to erode any of our DTA and Benefit of Doubt rights we cannot sit by and allow them to do that.

The VA is probably the best in the world at diagnosing and treating PTSD hands down-

but they have certainly misdiagnosed PTSD as PD or any other non service connectable disability- Congressman Filner even briefly mentioned with no names the PTSD fiasco a few years ago (it was the Norma Perez bull crap)

and the H VAC is very aware of how PTSD has been "downplayed" by VA in attempts to not award compensation for it.

We cannot allow any VA erosion to any of these regs you stated:

"Do 38 CFR "Relative Equipoise" provisions still apply?

(38 U.S.C 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)

Do 38 CFR "Benefit of the Doubt" provisions still apply?

(38 U.S.C.A. § 1110, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303 (2002)

Do 38 CFR "Preponderance of the Evidence" provisions still apply?

(38 U.S.C. § 5110(a); 38 C.F.R. § 3.400 (2001)

Do 38 CFR "VA required to analyze and evaluate ... all pertinent medical and lay evidence" still apply?

(38 U.S.C. § 1154(a) (2000); 38 C.F.R. § 3.303(a) (2002)"

RE and BOD regs are the foundation of -and as I mention to COngressman Filner the reason why- many many claims that do get awarded.

[john999]

My impression was that Filner believes PTSD started with the OIF?OEF wars. There were no vets with PTSD before this time. Everything this guy thinks about started in 2001. Trusting the VA to do the right thing with PTSD vs PD DX is like believing in the tooth fairy.

[Chu Lai69]

Jim- I raised that exact issue with COngressman Filner last night at SVR radio-

Veterans with PD diagnosis have in some cases proven to the VA they had, in fact, PTSD.

The new regs specifiy that the diagnosis MUST come from a VA mental health care practitioner.

This means, I mentioned, that if the VA says the vet doesnt have PTSD but he or she has the diagnosis from an independent doctor and conforms to the stressor criteria then how do these vets receive 38 USC 1154 b Benefit of Doubt- that allows the VA to weigh evidence for and against the claim-and if of equal merit -then veteran will succeed.

His response to this part of the reg was " We are going to look into that." and "Congress can make some changes."

He was fully aware of how this reg was worded. I raised the fact that this could be a situation that impacts on the H VAC hearings on Personality Disorder diagnoses which will be on Sept 15 at the Cannon Building in DC available live in streaming video.

I intend to send him a letter too again mentioning these concerns that every vets advocate should be concerned about as well.

If VA can attempt to erode any of our DTA and Benefit of Doubt rights we cannot sit by and allow them to do that.

The VA is probably the best in the world at diagnosing and treating PTSD hands down-

but they have certainly misdiagnosed PTSD as PD or any other non service connectable disability- Congressman Filner even briefly mentioned with no names the PTSD fiasco a few years ago (it was the Norma Perez bull crap)

and the H VAC is very aware of how PTSD has been "downplayed" by VA in attempts to not award compensation for it.

We cannot allow any VA erosion to any of these regs you stated:

"Do 38 CFR "Relative Equipoise" provisions still apply?

(38 U.S.C 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)

Do 38 CFR "Benefit of the Doubt" provisions still apply?

(38 U.S.C.A. § 1110, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303 (2002)

Do 38 CFR "Preponderance of the Evidence" provisions still apply?

(38 U.S.C. § 5110(a); 38 C.F.R. § 3.400 (2001)

Do 38 CFR "VA required to analyze and evaluate ... all pertinent medical and lay evidence" still apply?

(38 U.S.C. § 1154(a) (2000); 38 C.F.R. § 3.303(a) (2002)"

RE and BOD regs are the foundation of -and as I mention to COngressman Filner the reason why- many many claims that do get awarded.

Berta, I would like to ask you a question and I hope you do not take it the wrong way. I listened to the radio show last night and you were quoted as saying that YOU can tell when some vets have ptsd or are just typing what they think is ptsd but you know they dont have it just because you also quoted you have been around along long time and can tell when someone has ptsd are not. My question to you is are you a licensed pshyc or psychologist that is qualified to make such statements in that radio show?? If not, how in the world can you make that statement?? Just asking?