ptsd Unsure About Ptsd Claim

[westcoastlv]

My husbad was in the Persian Gulf. His DD214 shows Combat Action Ribbon and Southwest Asia Service Medal w/bronze Star, Kuwait Liberation Medal Saudi Arabia and Kuwait. We have recently (July 2010) filed a claim for PTSD. We have received the VCAA notice, and a letter stating they are still working on the claim. We have a service rep at the VAC who told us that the next letter to expect is to schedule the C&P Exam.

About 5 years ago my husband was diagnosed with BiPolar Disorder by a private psychiatrist. He has been taking medicine for it ever since. Little did we know at the time that the symptoms for Bi Polar and PTSD are very similar, with the exception of the stressor. The private psych didn't ask about any stressors, and we didn't even think there was a connection to the Gulf War. After some research and long thought, we started to pinpoint when my husbands behavior actually began to change. This 'disorder' began during his shore duty, after his time on the ship. He has just started seeing at VA pysch, and we told her about the PTSD, but also had to mention the bipolar (which we said was a misdiagnosis) so that he could keep on his meds. We obtained a copy of his first and only visit with the VA pysch and she mentioned the PTSD and bipolar, had a GAF of 65, and stated that there were some other mental health issues. This has been requested and received by the VA Comp as well. It did not give a definitive diagnosis of PTSD. We have NOT sent any private pysch clinic notes. I spoke with my husbands previous private pysch, and he agrees that his issues are most likely PTSD, but has no notes to that effect because the stressors were never discussed, and he based his diagnosis on what we told him had been previously diagnosed. We have another VA appt tomorrow, and I am thinking that we should stress the PTSD (at least to get it in her notes).

The VAC service rep said that we would most likely get 70% for the PTSD because of the Combat Action Ribbon, but I am concerned that is may not be such a slam dunk. My husband is in desparate need of a rating because he is unable to work. He has an extremely hard time coping with life, even with the medications.

My questions are: should we request that the VA pysch give him a complete PTSD evaluation tomorrow? How does the civilian diagnosis of BiPolar affect the PTSD claim? Or, will this all be resolved in the C&P exam regardless of previous diagnosis? Should we also go to a private pysch and request the PTSD evaluation?

I have written a letter about how my husband's life has been affected by this, and also a letter from him. Who do I show these to?

We've requested other ratings as well: Tinnitus, Bilateral Hearing Loss, and Elbow.

Any advice or insight would be helpful.

[Testvet]

westcoast each C&P exam is different for many of us it may depend on where your Regional Office is some are more anal than others it depends if a VA employee is doing the exam or is a QTC doc doing the exam in some cases it depends on how many months or years of mental health records are available in other cases how was the PTSD diagnosed by one doctor or by a evaluation team that does nothing but PTSD diagnosis some VAMCs have teams set up that is all they do at the VAMC I go to they require all PTSD vets to go to the team it has a shrink a PHD and a resident to administer all of the computer tests I took three sets of them and I can't tell you what they were called one had like 573 questions and took a few hours the other 2 were less than 300 and took about 30 minutes each

my 2 C&P exams were about a year apart the first time they awarded me 50% the C&P took about 15 minutes I filed the NOD the very next day as I felt it was a low ball award based om my treatment records statements and the symptoms I exhibit and have for years after my DRO hearing was cancelled and made a informal meeting they gave me another C&P exam and then awarded me 100% P&T for PTSD and they again denied my "heart problems" where I again filed a NOD on the heart problems the next day despite them giving me the 100% P&T the reason is I have extensive "heart problems" which I felt should be SC either on a direct basis or as a secondary condition and I had medical opinions to justify either issue and since I have had a stroke 7 heart attacks a failed triple bypass and high blood pressure and 2 failed stents and was told that there is no more heart surgery to repair any of the damage and I will not be considered for a heart transplant and I am a medicate only patient that it was important to my wife and kids to have my cardiac problems SC to ensure they keep their CHAMPVA benefits and stay eligible for DIC benefits if I died before I met the 10 year limit for being SC for PTSD alone so no matter what I die from they would keep their benefits which means they would loose our home car etc due to the major loss of financial benefits

It is more likely that I will die from cardiac problems than I would from problems caused by PTSD so I kept appealing the cardiac issues I was lucky in that a lawyer who does nothing but VA cases took my claim pro bono as I was not eligible to hire a lawyer due to the fact that my claim was denied before July 2007 when the law changed and allowed us to pay lawyers to fight the VA and also allowed them to get in the claims process after the initial denial instead of waiting until it got to COVA or CAVC whichever term is used my lawyer wrote some letters tried to get the RO to settle the claim they denied in August 2008 and in Feb 2009 we had the BVA hearing on April 7 I got the award letter from BVA granting CAD and hypertension secondary to PTSD they then sent my C File back to the RO for the award to be granted and rated they screwed me again and rated me at 60% CAD and 10% hypertension which is correct but 60% for CAD when my SSD was granted just on my VA records alone and solely for cardiac issues my ejection fraction is less than 30% and 2 bypasses have closed off and can't be repaired by SSA rules either is automatic for SSD award but since in my case all I wanted was the SC for CAD and it won't change my rate of pay you can only get one SMC S award and that they gave me I dropped arguing with them why waste their time or mine since it won't change anything and I got what I was fighting for security for my wife and now I am almost to the 10 year mark anyway so no matter what she will get DIC and 75% of the SSD check so she will be good financially when I pass now my goal is to keep breathing and cashing their checks just as long as I can each month is a new victory

I was told the average life expectancy for congestive heart failure is 10 years I am past that my wife only lets me carry in bread when we got to the grocery stores and we hire the yard work done and always have since I became disabled she says my job is breathing and I do my best the rest of the time I watch golf, TV and post on vet boards some vets appreciate my words and others seem to get pizzed off so I must be doing something right

my advice to all vets is to keep appealing and filing NODs etc to keep your claims alive until you get the award you want or use up all of your appeal routes just do NOT quit on the claim because when you do that that is when they win if they can frustrate you enough to quit then they win and you and your family lose and to many vets do just that

Berta has a saying that if you didn't have PTSD before you filed a VA claim you are more than likely going to have it before your claim is done the VA gives it to you and in many cases they give it to our spouses as well as many of them are as involved if not more involved than the veteran is in chasing down the documents we need to prove the claims VA claims are a family affair they affect the entire family and from what I have seen most wives are as involved if not more involved than the veteran many vets would just give up and quit if their wives would let them

just don't quit and keep the appeals current full speed ahead

[Sapper]

What I heard was within the last month or so, the VA's had to go back and re-evaluate a TON of claims due to pesticides and herbicides from 1985-91. All of the claims had to be re-opened and decided, quadrupling the VA's rating board workload. (This information coming from my American Legion Rep) Although this is no reason for 6 months at a rating board, it does justify some delay I would think, since some of these vets have been waiting so long for their claims. I filed my claim in June of 2010, and just recieved an answer this week. Hopefully things will pick back up for you. If you have a representing agency, I would give them a call and see if they can check into it for you. Take care and god bless!

[westcoastlv]

The results are finally in for my husbands PTSD exam, as well as tinnitus. Tinnitus' opinion was 50/50.

I couldn't post the results without it being an attachment, so I've just included the medical opinion and diagnosis. I would really like to

get an opinion of what the C&P exam results are all about.

State if the veteran meets the DSM-IV stressor criterion: YES

Identify behavioral, cognitive, social, affective, or somatic changes the veteran attributes to stress exposure: Depression, anxiety, and social isolation.

Describe specific PTSD symptoms present: Depression, anxiety, and social isolation.

Specify onset, duration and typical frequency and severity of symptoms:

Onset: Since military service

Frequency/Duration: Daily

Severity: Moderate

State if current symptoms are linked to the identified stressor or stressors: YES

Diagnosis: The veteran meets DSM-IV criteria for PTSD

Diagnostic Status:

Axis I: Post Traumatic Stress Disorder 309.81

Axis II: None

Axis III: Elbow injury, deferred

Axis IV: Moderate depression, social isolation and lack of employment

Axis V: GAF 45

Stressor statement in relation to veteran's fear to hostile miliary threat or terrorist activity: Is the claimed stressor related to the veteran's fear of hostile military or terroist activity? YES

Statement of opinion:

The veteran has a current disability, PTSD. It is related to an in-service event. PTSD is related to the specific stressor identified above. PTSD symptoms are depression, anxiety and social isolation.

Legally recognized statement:

PTSD is caused by or a result of an in-service event.

Changes in psychosocial functional status and quality of life since the last exam:

Increased social isolation and unemployment.

Describe linkage between PTSD symptoms and aforementioned changes in impairment in functional status and quality of life:

Direct Link

Extent to which discorders other than PTSD are independenty responsible for impairment in psychosocial adjustment to quality of life:

The veterans depression has continuted to be considerable, with substance dependence and multiple psychiatric hospitalizations. Although the depression is not severe enough for a clinical diagnosis.

Prognosis for improvement for psychiatric condition and impairments in fucntional status:

Guarded

Effects of PTSD on occupational and social functioning:

Statement:

There is reduced reliability and productivity due to PTSD signs and symptoms.

Examples/symptoms:

Depressed mood, anxiety and social isolation

Any and all thoughts would be appreciated.

[Berta]

If you click on the Schedule of Ratings under Law at right of the Claim forum- then go to the Mental Disability rating schedule -you can compare the results of the C & P to the ratings for PTSD.

It is difficult to determine how the VA will rate these claims from just the C & P results as there could be other factors too that they might need to consider.

[westcoastlv]

I just saw this information posted on ebenefits. Has anyone else see this or gotten this message? It says that we need to submit a 21-8940, but it was submitted already on 1-13-11, and also shows on the same ebenefits page. Also, I am not sure what other information would be more relevant or recent than the C&P results (12/31/10, 1/12/11 and 1/28/11).

You may be entitled to compensation at the 100 percent rate if you are unable to secure and follow a... substantially gainful occupation because of your service-connected disabilities. If you believe you qualify, complete, sign, and return the enclosed VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability.

Send any treatment records pertinent to your claimed condition(s), especially those which are recent... (within the last 12 months). This includes reports or statements from doctors, hospitals, laboratories, medical facilities, mental health clinics, x-rays, physical therapy records, surgical reports, etc. These should include the dates of treatment, findings, and diagnoses

[westcoastlv]

Hello to All my Hadit Friends,

I just wanted to give a quick update on how things are going with my husband's claim for PTSD.

I gotta call for the RO today, the claim is finally with the Rating Board. Yippee!!. I know that as of today, this is not considered a win, but it is worth being happy about. We are on day 293 since the claim was submitted, almost 10-months.

The C&P exam was favorable, applied for TDIU, got letter from boss, etc. I am happy that we have finally reached this stage. I feel like we are a lot closer to the finish line than the starting line.

I enjoy this site, read it everyday and now I feel very knowledgable. Hopefully, on day I can help a vet.