ptsd Rating And C&p Question

[marinevet1]

My case started rating DECEMBER 7th in Los Angeles. has anybody been rated lately and how long did it take

any replies would be apprciated. Last my C&P for PTSD should bring me about a 70%.. I filed also for TDIU since I

havent worked since 2006 and im on SSDI since March 2010for DDD. If the 70% comes for the PTSD and if i filled for TDIU

3 months ago will they consider me for TDIU with 70% if i cant work ? ? my SSDI is for DDD since 1983 and the doctor

doing my C&P for PTSD state my DDD has been in my medical records since 1983. Will the rating people get me

the 100% schedular since i have or should get 70% for the PTSD or will they consider TDIU since i filed with the PTSD ?

Not sure how it works to get P&T..or TDIU. with PTSD 70%. from the result of my C&P it look to be 70%

But they could low ball me and than file and NOD since i have a very good detailed C&P report by the doctor. It looks

as if he helped me not hurt me as part of the exam.

Any suggestions would be grateful.. Thanks to all

Happy Holidays & Bless All

[Berta]

The SSA award will only help you if it is solely for a SC condition.

What is the 10% SC you have now for?

[marinevet1]

10% FOR MALARIA WAITING FOR OUTCOME OF ALL VA CLAIMS FILED

THANK YOU

[Berta]

Is the nexus (link) to your service fully estabished for your claims?

Did the Doc also make a statement as to the disabilty being due to your service?

Your PTSD claim might fall under the new PTSD rules in our PTSD forum.

Is there a diagnosis of PTSD in the C & P exam results?

New PTSD regs require

Diagnosis of PTSD from VA Doctor

Stressor that is consistent with MOS and that can be supported by the VA doctor's statements.

Edited December 13, 2010 by Berta (see edit history)

[marinevet1]

Enclosed is a copy of my C&P results

PCP doctor listed the following

URGENCY:

STATUS: COMPLETED

SUBJECT:

Statement for Claim

DEPARTMENT

OF VETERANS AFFAIRS GREATER

LOS ANGELES HEALTHCARE SYSTEM

11301 Wilshire Blvd.

Los Angeles, California, 90073

Statement

for Mr. XXXXXXXX XXXXXXXX

Mr. XXXXX XXXXXX served a standard tour(8/69-9/70) in Vietnam as a

Combat Medic, he left the service as a Lance Corporal. Although listed as a

rifleman,he served as the combat medic for his assigned unit. During this

period of time he saw and treated many of his fellow soldiers for severe

injuries including lost limbs, decapitations, and destroyed bodies. He also

witnessed the deaths of many of his fellow soldiers. To care for these wounded

soldiers,he exposed himself to enemy fire, exploding grenades, machine gun fire

while under enemy assaults. Mr. XXXXX performed valiantly in his capacity as a

well trained Marine. After leaving the military, he has continued to have

nightmares, flashbacks and feeling of guilt about his Vietnam experience. He

also continues to have emotional numbing with profound sadness and depression.

While coming to the Veteran's Affairs hospital he has also been treated for

Migraine Headaches, Traumatic Arthritis associated with jumping out of helicopters

with a heavy load of equipment and medical supplies, Hypertension,controlled

with medication ringing in the ears associated with close proximity

to loud noises and PTSD. He has actively participated in the PTSD treatment

programs, his mentors are pleased with his performance.

While in country he was treated for an episode of Malaria, his condition remains

stable. MR.XXXX XXXXX is on time for his appointments and takes his medication as

prescribed.

The following conditions should be connected to his military service:

Agent Orange Exposure

Post Traumatic Stress Disorder, combined w/ Bipolar Disorder

Hypertension

Traumatic arthritis, pain in the right shoulder and neck

Tinnitus

Malaria

Erectile Dysfunction, has elevation of the HGB A1C, w/ early Diabetes , as a by

product of taking medication for HTN and possible Agent Orange Exposure

Made part of my Medical file of the VA

This is followed by my C&P Exam November , 2010 Los Angeles

LOCAL TITLE: COMPENSATION & PENSION EXAMINATION REPORT

STANDARD TITLE: C & P EXAMINATION NOTE

DATE OF NOTE: NOV 02, 2010@13:43 ENTRY DATE: NOV 02, 2010@13:44:43

AUTHOR: XXXXXXXXXXX E EXP COSIGNER:

URGENCY: STATUS: COMPLETED

C-FILE WAS: Reviewed

MEDICAL RECORDS WERE: Reviewed

OTHER MATERIAL REVIEWED: Psychometric Tests and Questionnaires, DD-214,

Other Records/Documents

WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes

DATE(S) OF OUTPATIENT TREATMENT: Began outpatient treatment in 2009 after

and began medications and psychotherapy; began VA treatment at West LA and Sepulveda in

12/2009.

CONDITION(S) AND LOCATION OF TREATMENT: Bipolar disorder; Post-Traumatic Stress Disorder; Chronic

SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER:

Veteran is part of the psychosocial group treatment module at the POST, at VA

West Los Angeles Medical Center and also is managed by

Dr. Warren-psychiatrist from POST. He attends groups twice weekly, Medic PTSD and is

compliant with medication by his report, notes from his psychiatric record

also indicate his compliance with treatment.

CURRENT TREATMENT(S): Anti-manic

MEDICATION SIDE EFFECT(S): Drowsiness, Fatigue, weight gain

GROUP THERAPY: Yes

INDIVIDUAL PSYCHOTHERAPY: Yes

EFFECTIVENESS OF THERAPY: fair

----------------

Veteran was staioned in Da Nang, Vietnam attatched to 1st Marine Div., 1st Recon

Battalion, Charlie company 2nd platoon, team 1; MOS was 0311 and 8651-primarily

Recon: carrying medical supplies, save lives at all expense,

exposed to serious injury, called medi vacs and give morphine; saw and killed VC;

save soldier lives;

DATE(S) OF SERVICE: 4/1969-09/70

BRANCH OF SERVICE: Marine Corps

HIGHEST RANK OBTAINED: E3

TYPE OF DISCHARGE: Honorable

RANK AT DISCHARGE: E3

MILITARY OCCUPATIONAL SPECIALTY: MOS: and 0311; Rifleman; 8651 Reconnaissance medic,

went on patrols and fire-fights, called in artillery strikes; cobra and naval gunships in Da Nang;

DECORATIONS AND MEDALS AWARDED: Combat Action Ribbon; Cross of Gallantry w/ Palm

Frame; Presidential Unit of Citattion; National Defense Service Medal; Vietnam Campaign Medal;

Good Conduct Medal

DISCIPLINARY INFRACTIONS AND ADJUSTMENT PROBLEMS: None.

DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes

WERE COMBAT WOUNDS SUSTAINED: No

LOCATION AND DATE OF COMBAT EXPERIENCE: Da Nang 11/17/69 to 07/30/70;

INSIGHT: Patient understands that he/she has a problem.

DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes

COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILY

ACTIVITY: Veteran sleeps irregularly, has frequent dreams, flashbacks which causes

interrupted sleep; early insomnia, has problem falling asleep, takes 1-2 hours

to fall asleep; sleep is not restful, is fatigued, feels as if he's been fighting in his sleep;

TYPE OF HALLUCINATIONS: None

DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? Yes

INTERPRETS PROVERBS APPROPRIATELY? Yes

DOES THE PATIENT HAVE OBSESSIVE/RITUALISTIC BEHAVIOR? No

DOES THE PATIENT HAVE PANIC ATTACKS? Yes

-------------

STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC:

Combat experience

DESCRIPTION OF STRESSOR: Combat experience

DATE AND LOCATION: 11/1969 to 07/1970 Da Nang Vietnam.

TRAUMA OCCURRED: During Military Service

INTENSE FEAR: Yes

FEELING OF HELPLESSNESS: Yes

FEELING OF HORROR: Yes

OTHER REACTION: Yes

DESCRIBE OTHER: Dissociation

ADDITIONAL COMMENTS: Veteran served as a medic in Vietnam combat zones,

with multiple exposures to seriously wounded, dying soldiers that he

attempted to save. Witnessed horrific trauma involving severed limbs, gun

shots wounds and multiple injuries.

TRAUMA EXPOSURE TESTING

-----------------------

TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE:

Combat Exposure Scale, Trauma Questionnaire

RESULTS OF IDENTIFIED TRAUMA EXPOSURE TESTING:

Veteran experienced intensely traumatic combat episodes as a medic in Vietnam

as evidenced by his documented receipt of the Combat Action Ribbon which

corroroborates his DD-214 citation as well as his report of extreme combat

trauma while serving as medic in Vietnam between 1969-1970;

He also received the Cross of Gallantry with Palm and Frame and

the Presidential Unit of Citation.

OVERALL LEVEL OF TRAUMATIC STRESS EXPOSURE: High

PTSD SYMPTOMS

-------------

PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY:

multi times per month

PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA

AND NUMBING OF GENERAL RESPONSIVENESS:

Efforts to avoid thoughts, feelings, or conversations associated with the

trauma, Efforts to avoid activities, places, or people that arouse recollections

of the trauma, Inability to recall an important aspect of the trauma, Markedly

diminished interest or participation in significant activities, Feeling of

detachment or estrangement from others, Restricted range of affect

Sense of a foreshortened future

PERSISTENT SYMPTOMS OF INCREASED AROUSAL:

Difficulty falling or staying asleep, Irritability or outbursts of anger,

Hypervigilance, Exaggerated startle response, reliving experiences.

THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN SOCIAL,

OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: Yes

DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic

FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND:

Veteran experiences severe symptoms of PTSD that occur weekly and that have

lasted for 40 years. Upon examination, Veteran reports that he is bothered at

least several days each week by intrusive, avoidant and hyperarousal symptoms of

post-traumatic stress.

DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? Yes

AXIS I: 309.81 PTSD-chronic, 296.00 Bipolar NOS Moderate to severe

IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE

SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER:

The symptoms of PTSD and Bipolar depression do overlap to a large extent

particularly as it relates to unrelenting presence of persistent, bothersome,

intrusive symptoms of re-experienced thoughts, images and feelings associated

with the trauma and hypervigilance manifesting as insomnia and startle

response, It appears in this case

that the veteran is experiencing both chronic anxiety and a significant,

complex mood disorder, hence both diagnoses are indicated.

SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER:

The symptoms of PTSD and Bipolar depression do overlap to a large extent

particularly as it relates to unrelenting presence of persistent, bothersome,

intrusive symptoms of re-experienced thoughts, images and feelings associated

with the trauma and hypervigilance manifesting as insomnia and startle

response, It appears in this case

that the veteran is experiencing both chronic anxiety and a significant,

complex mood disorder, hence both diagnoses are indicated.

AXIS II: 799.99

AXIS III: Degenerative Disk; Malaria

AXIS IV: Heavy Extreme Combat Exposure

AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING

----------------------------------------

SCORE: 45 TIME FRAME: Current functioning

Combat Exposure Scale Score: 32

INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD:

PTSD Symptom Scale

QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY:

PTSD Checklist for Combat and Non-Combat Trauma, Trauma Symptom Inventory

PSYCHOMETRIC ASSESSMENT SCORES:

Veteran was administered The PTSD Checklist (PCL), which is a 17- item

questionnaire also designed to assess symptoms associated with combat related

PTSD. On this administration of the PCL scale, he obtained a score of 68,

which exceeds the score of 50 that is consistent with a diagnosis of PTSD in

military populations. Of note, he reported within the past month being very bothered by

disturbing memories, thoughts and images of his combat experiences, feeling

cut off from other people, avoiding activities or situations because they remind

him of stressful military experiences, being super-alert, watchful and on-guard,

feeling irritable and having angry outbursts, feeling jumpy and being easily startled,

insomnia and feeling emotionally numb. Additionally, he was also administered

the Trauma Symptom Inventory, a 100-item questionnaire designed to appraise

symptoms of posttraumatic stress disorder, clinical depression, affect regulation and

dysfunctional behavior. He produced a valid, interpretable profile, with

no exaggeration of unusual symptoms. There were clinically significant

elevations on the Tension Reduction Behaviors (T = 93), Intrusive Experiences (T = 98) and

Defensive Avoidance (T = 83) and Dissociation (T = 86) scales.

He also meets criteria for PTSd based on PTSD Symptom Scale (Foa) as evidenced by

at least one re-experiencing symptom (nightmares), three avoidance symptoms

(avoiding, thoughts, feelings, detachment from others) and two hyperarousal

symptoms (insomnia and pronounced irritability).

Thank You