ptsd Reconsideration For Tbi

[ironsoldier77]

I have been seeing the TBI clinic at my va hospital for a few years now. I had previously put in a claim for mild TBI. I had multiple contact with blasts in Iraq. 2 Combat tours with 1st AD Infantry. I also have a PTSD rating of 50% and Tinnitus at 10%, total 60%. I have been unemployed since 2008 and I went through voc rehab and they found me infeasable for work,untrainable,not expected to get gainful employment. I have gone through Neuropsych testing and here is the diagnosis from that testing. I am hoping this will help me get atleast 10% so I can get TDIU. I have already put in a claim for increase on my PTSD rating,mild TBI and TDIU all at the same time. Just did this on wednesday.

CONCLUSIONS AND RECOMMENDATDIONS: Mr. Anderson is a 32 year old,White,married and unemployed when the last testing session was completed. His work ihistory does not reflect stable emplyment. He was referred for a cognitive evaluation by his primary care provider after complaining of difficulty in concentrating and meory problems. He has an unremarkable academic history with a high school graduation and one semester of college. HIs family of origin was stable:however his father died just before he left for Iraq. H has a stable relationship history in his only marriage of eight years. He has three years of credible service in the the army with two combat tours to Iraq. He reports being stunned from multiple blast in juries while serving in Iraq. He has no history of substance abuse , or legal problems. His social life is limited to family due to anxiety associated with being in crowds and other symptoms of PTSD. He generally functions idependently and attends to his activities of daily living.His premorbid level of verbal intellectual functioning was estimated to be high average. Current intellectual functioning was in the average reage. All IQ scores were in the average range except for working memory which was low average. He has mild impairment in concentration and focusing on information in the auditory channel. Mild impairment in concentrating and focusing could contribute to the mild loss of intellectual functioning reflected in the drop from high average to average intelligence. Memory functioning was avearage to low average. Auditory memory, visual working memory and immediate memory were lower than expected for his intellectual functioning. Visual memory was intact despite mild difficulty in focusing and concentrating on visual channel information. He has had significant losses of memory abilities. His observed behavior, history and the test data are consistent with the following diagnoses:

Axis I-Mild Cognitive Impairment likely associated with Blast Injuries

Posttraumatic Stress Disorder

Depression (ICD-9-CM 311./300.4)

Insomnia (ICD-9-CM 780.52)

Tobacco use disorder

Axis II-NONE

Axis III-Brain diseases due to trauma (ICD-9-CM 3)

Acute pharyngitis

Low back pain

Knee: arthralgia

Tobacco use disorder

Axis IV-Exposure to combat and loss of job

Axis V- GAF=55, mild to moderate impairment

Medical problems that could contribute to cognitive impairment include brain disease and pain. PTSD, depression and insomnia could also contribute to impaired concentration. Hearing impairment could contribute to auditory memory problems and a hearing examination may be warranted. HIs past history of having tubes in his ears as a child could have contributed to a failure to develop auditory memory abilities. Medications that could contribute to cognitive impairment include clonazepam, but this is usually seen in much older patients. Mr. Anderson may benefit from medications that target concentration like those used in the treatment to attention deficit disorder,and an evaluation for a trial of one of these medications is recommended. Unfortunately the prognosis for PTSD with mild traumatic brain injury is worse than the prognosis for PTSD without brain injury. Most of the treatments for PTSD involve learning new strategies for managing the symptoms of PTSD, and when learning is impaired, progress in treatment may be slowed. Continued treatment for depression, insomnia and PTSD is recommended. He is also being seen in the speech pathology for cognitive rehabilitation and this should be continued until maximum benefit is achieved. With the recent loss of his employment, a vocational rehabilitation referral may be warranted, depending upon his progress in the PTSD outpatient treatment program.

So, thats the report from the doctor that did the psych testing. When I read this it almost sounds like a "slam dunk" and that I might get awarded a SC for mild TBI. I really hope it does, because it would make me eligable for TDIU, which is what I really need. I was also wondering if its possible that the VA could go ahead and award 100% P & T instead of just TDIU?

I am on full SSD benefits as well and that along with my VA benefits at 60% is all i have to live by. We barely have enough to keep our house. I am almost at the point to where my life just seems meaningless and I really hope I get the TDIU, mild TBI and increase for my PTSD. Im having a hard time gettng an increase for my PTSD. It seems that i have to be some deranged lunatic, murder someone or get locked up. to be even considered for an increase. I dont know what to say when I go to the C&P exams for PTSD increases.

[Berta]

"So, thats the report from the doctor that did the psych testing. When I read this it almost sounds like a "slam dunk" and that I might get awarded a SC for mild TBI. I really hope it does, because it would make me eligable for TDIU, which is what I really need. I was also wondering if its possible that the VA could go ahead and award 100% P & T instead of just TDIU?"

The comp is the same for 100% and for TDIU.Either award would be good here (with P & T)

"I am on full SSD benefits as well and " ...

If the SSA was awarded solely for SC disabilites, then that too should get you TDIU award or 100%

It does appear that you should also definitely be awarded a P & T status.

Does the VA know of the SSA award?

Have you formally applied for TDIU?

Getting 100% SC is more difficult than the TDIU requirements in my opinion.

"I have been unemployed since 2008 and I went through voc rehab and they found me infeasable for work,untrainable,not expected to get gainful employment."

This right there is evidence that should warrant you a TDIU award. Does the VA have this VocRehab documentation?

[ironsoldier77]

Yes the VA is aware of my SSD. I dont know what you mean by "formally" applied for TDIU, but my service rep did fill out the form for it and submitted it with the rest of my claims. About the voc rehab. I have submitted the letter where is states that Im unemployable etc etc. My file is not even at the voc rehab center where I went. They dont even have it anymore, they said that St Pete has it now. I was also wondering, do you only get medical insurance benefits if you are P&T?

"So, thats the report from the doctor that did the psych testing. When I read this it almost sounds like a "slam dunk" and that I might get awarded a SC for mild TBI. I really hope it does, because it would make me eligable for TDIU, which is what I really need. I was also wondering if its possible that the VA could go ahead and award 100% P & T instead of just TDIU?"

The comp is the same for 100% and for TDIU.Either award would be good here (with P & T)

"I am on full SSD benefits as well and " ...

If the SSA was awarded solely for SC disabilites, then that too should get you TDIU award or 100%

It does appear that you should also definitely be awarded a P & T status.

Does the VA know of the SSA award?

Have you formally applied for TDIU?

Getting 100% SC is more difficult than the TDIU requirements in my opinion.

"I have been unemployed since 2008 and I went through voc rehab and they found me infeasable for work,untrainable,not expected to get gainful employment."

This right there is evidence that should warrant you a TDIU award. Does the VA have this VocRehab documentation?

[Berta]

If the SSA award is solely for SC conditions-which may yet have to be determined, the SSA award would be very helpful in attaining TDIU.

The TDIU form is a 21-8940 form.

"do you only get medical insurance benefits if you are P&T?" not sure what you mean here?

The P & T status gives your eligible dependents CHAMPVA (Civilian Health and Medical) as well as Chapter 35 (DEA) VA educational benefits.

[john999]

If your VARO is St. Petersburg you need to check to make sure they got all your evidence and material. They are horrible about losing things. I use St. Pete. I had to fight for every single thing I ever got from them. If you don't get what you want the first time ask for Personal Hearing with DRO. Which VSO are you working with? Be sure the VSO has submitted your evidence. Some are miserable, lazy jerks and do almost nothing.....DAV. You should stay onboard here and keep the pressure on your VSO to keep you in the loop. The claim is your responsibility.

[ironsoldier77]

When I was at the social security office I asked them what it said for my disability and she said "anxiety disorder". When I applied for SSD, I remember writing PTSD was what was keeping me from working. So, I guess they just put it down as anxiety disorder.They also wanted $80 for a copy of my SSD records!

The 21-8940 is what my VSO filled out for me.

I was asking if you get the CHAMPVA if you get awarded P&T, not just TDIU without P&T.

If the SSA award is solely for SC conditions-which may yet have to be determined, the SSA award would be very helpful in attaining TDIU.

The TDIU form is a 21-8940 form.

"do you only get medical insurance benefits if you are P&T?" not sure what you mean here?

The P & T status gives your eligible dependents CHAMPVA (Civilian Health and Medical) as well as Chapter 35 (DEA) VA educational benefits.

[ironsoldier77]

Im going to call St. Pete on monday to try and track down my voc rehab records. I already have evidence in hand though from voc rehab. Here is what they said at the bottom of that letter.

"In reaching my decision, I considered the following evidence: It has been determined that the achievement of a vocational goal is not reasonably feasible. The reason this decision was made is based on the severity of your conditions, your self-report and the documentation received from the feasibility evaluation conducted by (name left out to protect identity). It was determined that you do not have any transferable skills that would enable him to work. It was determined you are currently infeasible for employment services under Chapter 31 due to your severe limitations caused by your combined service connected disabilities. It is believed that your have significant disabilities that would be consistent with permanent unemployability and that you would have an inability to be retrained or employed. You are not feasible for Vocationale Rehabilitation and Employment, nor is it believed that other employers would hire you with the numerous limitations to employment."

I have submitted this evidence everytime I applied for TDIU. I have even tried to re-apply for Voc rehab again, but they wont help me. The counselor there said if I ever needed anything to call her and she would be happy to write some kind of statement. So, I guess im going to call her too. Have her explain again why they cant help me.

The VSO I am using now is really good. He knows his stuff. I was using the DAV before and it was rediculous. Very unprofessional. People kept coming in and interupting, when I showed them the results from my TBI neuro psych testing they said it wasnt enough information and I would be denied. THey said I needed somthing that said, "Yes, he has TBI". I called my doctor and asked him about it and he said hes not changing anything and he felt that with the report he wrote, that it shows enough evidence that I have some mild cogniteve impairment likely associated with blast injuries. He also said that 3 other doctors from the TBI team all agree. So, I went back to my original VSO who work for the State of Florida Department of VA. He represented me from the beggining, so Im glad that im back with him and not the DAV.

If your VARO is St. Petersburg you need to check to make sure they got all your evidence and material. They are horrible about losing things. I use St. Pete. I had to fight for every single thing I ever got from them. If you don't get what you want the first time ask for Personal Hearing with DRO. Which VSO are you working with? Be sure the VSO has submitted your evidence. Some are miserable, lazy jerks and do almost nothing.....DAV. You should stay onboard here and keep the pressure on your VSO to keep you in the loop. The claim is your responsibility.