ptsd Psyche Exam For Ptsd

[Melancholy_Sleestak]

Hello, I have a C&P in a few weeks and have some questions. My claim has some problems. Any help would be appreciated. I filed for PTSD for personal assault for which I have no evidence and PTSD due to SCUD attacks in Saudi Arabia in 1991. I filed in 2009.

My VA psyche doctor diagnosed with Anxiety disorder Not Otherwise Specified

R/O PTSD especially as related to military sexual trauma

R/O Dysthymia

My previous private sector psychiatrist and Clinical Psychologist diagnosed me with PTSD, Generalized anxiety disorder and Major Depressive Disorder. It has been difficult for me to speak with this VA doctor, I'm not comfortable with him, but I have tried to be honest and tell him my symptoms and I believe what I have told him would lead him to diagnose PTSD.

With the new regulation in effect does it seem likely to anyone that he is avoiding PTSD as a diagnosis to derail my claim? I suspect this as he documented especially as related to military sexual trauma and that is not benefited by the new regulation. Will this be a big factor when I have my C&P or do they diagnose you there and then? Is there a way to remedy his diagnosis by appeal?

If I was to be granted a service connection for Anxiety Disorder Not Otherwise Specified or Generalized Anxiety Disorder versus PTSD will I maintain my effective date of when I filed the claim?

Does a C&P exam for PTSD usually involve taking the MMPI-2?

Thanks for any help

[Melancholy_Sleestak]

Thanks for the replis

If you do get the PTSD diagnosis (I didnt understand the R/0 PTSD (rule out) part of your post-

I think the R/O part means he doesn't think this is my major problem or he's unsure even after 3 visits

"With the new regulation in effect does it seem likely to anyone that he is avoiding PTSD as a diagnosis to derail my claim? I suspect this as he documented especially as related to military sexual trauma and that is not benefited by the new regulation. Will this be a big factor when I have my C&P or do they diagnose you there and then? Is there a way to remedy his diagnosis by appeal?"

I guess you mean he did not diagnose PTSD as due to the sexual trauma but was he aware of the SCUD attacks?

I did tell him briefly about the scud attacks on my second visit but it is not in his note. Maybe I wasn't assertive enough about it. To me it seems possible that me admitting to military sexual trauma just maintained his attention more and he disregarded the rest. I have run into this with other people as well... one traumatic event doesn't exclude a second! The third note just stated that I feel like I'm in Saudi Arabia all the time.

perhaps it is best to go with the SCUD attacks as the main stressor.

I filed for both so they are already reported. Since I have no evidence for the MST I will have to hope they develop both.

The new PTSD regs are here and I will find them and post them again as they have to be carefully read and maybe this other post I recently made will help you:

The 2010 new VBM has a one page Addendum the lawyers added as to the new PTSD regs,in the packing box as this info didnt make it in time for publication of the manual.

I cannot copy the entire Addendum here as it is under Copyright law but I am sure this info will be posted at the NVLSP web site at some point.

"It is important to note per the addendum that "the veteran must have been located" either in or within close proximity of the "hostile military or terrorist activity"that produced the "fear of" this activity.

The new reg is Not a "liberalizing" rule and the reg itself is insufficient alone in attempt to re-open a previous denial."

If a veteran's PTSD claim was denied and final prior to July 13,2010 and he/she files a new claims after July 13, 2010 they should give "as much detail as possible" regarding the experience they had or were in close proximity to that led to their "fear of hostile military or terrorist activity."

But as John said any inservice diagnosis of an anxiety disorder would be a better way to claim anxiety for service connection.

Did you claim anxiety disorder as well as PTSD?

No, I just filed PTSD. I didn't know you could file for anxiety.

I'd really like to know if I can expect a diagnosis from the C&P psyche person. I'm sure they have to give you and Axis I diagnosis. Do I have any hope of getting a PTSD diagnosis from my C&P?

'Is there a way to remedy his diagnosis by appeal?"

This is a good question untested as yet by the PTSD regulations.

As I understand the regs only a PTSD diagnosis from a VA provider is acceptable to the VA.This means to me that ,even if a veteran had a PTSD diagnopsis from a top notch independent psychiatrist, the VA would not consider the Benefit of Doubt (Relative Eqipoise) in weighing the evidence for and against the claim.

I spoke in person to Congressman Filner (Chair-House Veterans Affairs Committee)on all this-at SVR radio show in our SVR archives last month- as this part of the regulation seems to hinder (even eliminate) our DTA rights in the appellate process.

None of us who commented on this regulation in the Federal Register expected this odd requirement-and the first time any of us learn of a denial that does not accept an IMO from a board certified psychiatrist on a PTSD diagnosis, if the veteran has a valid and proven stressor,under the new regs-should protest by mail to the H VAC because if we lose one single right in 38 USC we have, they can start chipping away at all of our DTA rights.

To answer your question- Yes , a strong IMO from a board certified psychiatrist with a full medical rationale (and with proof of stressor) Should overcome a lack of PTSD diagnosis from a VA provider.

I hope my unit logs of our location and that we often had to assume MOPP 4 during SCUD attacks will fulfill the places dates circumstances. So, I hope they have them. I hope I have enough evidence with family letters and my letters and my DD214 and whatever they dig up. Just to vent I really think this VA doctor is either slacking off or purposely not diagnosing me.

Does anyone think asking my congressman to look into it would help? That just seems like it could backfire. I want to be assertive but I don't want to seem calculating.

But Will it? that is hard to say-

Congressman Filner told me they (H VAC) are looking into this part of the regulation.

They aren't going to look into it just because I griped on the radio show about it.

They might start looking into it if affected veterans who fall under the new regs begin en force via snail mail to the H VAC ,and faxes, and phone calls to any of their Congressional representatives who are on the H VAC- asking them to.

Congressman Bob Filner

Chairman

House Committee on Veterans Affairs

335 Cannon House Office Building

Washington, DC 20515

[Berta]

Your claim needs to go with what you are formally diagnosed with

"Did you claim anxiety disorder as well as PTSD?

No, I just filed PTSD. I didn't know you could file for anxiety.

I'd really like to know if I can expect a diagnosis from the C&P psyche person. I'm sure they have to give you and Axis I diagnosis. Do I have any hope of getting a PTSD diagnosis from my C&P?"

"With the new regulation in effect does it seem likely to anyone that he is avoiding PTSD as a diagnosis to derail my claim?"

I think this could be p[ossible in many of the claims filed under the new regs.

The new regs have just been challenged!!!!

They are not fair in one respect and I posted that info here today.

"My previous private sector psychiatrist and Clinical Psychologist diagnosed me with PTSD, Generalized anxiety disorder and Major Depressive Disorder."

If I were you I would consider asking them for an IMO that has a definitive diagnosis with a full medical rationale.

The IMO forum here has the criteria they need to follow.

"If I was to be granted a service connection for Anxiety Disorder Not Otherwise Specified or Generalized Anxiety Disorder versus PTSD will I maintain my effective date of when I filed the claim?"

I think you might have to add this as an addendum for the anxiety disorder.

Do you have any service officer or vet rep helping you on this claim?

As to the PTSD -do you have documented proof that fits into this:

"It is important to note per the addendum that "the veteran must have been located" either in or within close proximity of the "hostile military or terrorist activity"that produced the "fear of" this activity."

[Berta]

You asked "Does a C&P exam for PTSD usually involve taking the MMPI-2?"

No-as far as I know -however a private doctor would most surely administer this test in diagnosing a potential PTSD patient.

My husband had PTSD SC at 30% for over 10 years before he was given the MMPI for combat related PTSD and he got finally got numerous other psychological tests.

This resulted after a battle I had with the local VAMC as to his PTSD care along with contact through my Congressman.

Those test results and the clinical records of his new VA psychiatrist and his SSA award were instrumental in his 100% P & T award for PTSD which came 3 years after he died.

Did the VCAA letter you received tell you exactly what evidence you needed for the PTSD claim?

[Melancholy_Sleestak]

Berta,

Thank you for your replies. I feel pretty ignorant about this whole process. I have had some assistance from my veteran service officer but I should have asked for more. With my C&P looming I wish I had just taken the time to learn more earlier. Basically I submitted a claim, have been going to counseling and crossing my fingers which is probably the worst thing I could have done. Now, I feel like calling the whole thing off since the VA doctor is acting like a gatekeeper. The letter did tell me what documentation I need. I will locate it and take another look at it.

Is there a way to suspend a claim? I would like to go into this with as little chance of having to appeal as possible. With such an impediment to my claim I feel like I'm going to a job interview with no pants on. Like no matter what else I submit there is one glaring problem that nullifies the rest.

I will contact my previous psychiatrist about an IMO or Nexus letter. I need to find out what the difference is and which would be better.

I do have a Nexus letter from my private clinical psychologist. I submitted SMRs, private MS letters, VA progress notes, a battalion history and letters to my previous wife that were good indicators of my experiences in Saudi Arabia. I was kind of stunned when her Nexus letter only commented on military sexual assault. I should not have turned it in, but I was panicking because it was one day prior to the 1 yr deadline. Now I feel like I have a nexus letter that defeats my claim for PTSD as a result of my service in the Gulf War. Any thoughts on that or can I ask her to add new evidence to her Nexus letter?

I received imminent danger pay, SW Asia medal with 2 stars. I have been hoping that is all they need for documented proof to fulfill the addendum "the veteran must have been located" either in or within close proximity of the "hostile military or terrorist activity"that produced the "fear of" this activity." I was at King Abdul Aziz Port/Port of Dammam from Dec 1990 to Aug 1991.

I will have to ask my veteran service officer about adding anxiety as an addendum.

Thanks for the advice and guidance and the news that NOVA challenged the new regs. The challenge only makes sense. I hope it succeeds and helps people.

I'm sorry you and your husband had to battle the VA for so long. From your last post it must have been a tremendous ordeal.

You asked "Does a C&P exam for PTSD usually involve taking the MMPI-2?"

No-as far as I know -however a private doctor would most surely administer this test in diagnosing a potential PTSD patient.

My husband had PTSD SC at 30% for over 10 years before he was given the MMPI for combat related PTSD and he got finally got numerous other psychological tests.

This resulted after a battle I had with the local VAMC as to his PTSD care along with contact through my Congressman.

Those test results and the clinical records of his new VA psychiatrist and his SSA award were instrumental in his 100% P & T award for PTSD which came 3 years after he died.

Did the VCAA letter you received tell you exactly what evidence you needed for the PTSD claim?