ptsd Independent Med. Opinion

[midnight340]

Greetings...

My claim PTSD/TDIU has been in for about 7 months, in the meantime I have learned a whole lot from the great people on this site. I get extremely anxious (often) about this whole deal... or just too depressed to do anything. This morning is better.

I think I have decided (I've made an appointment) to have an independent Phd. psychologist do an exam. He has agreed to write a nexus letter provided I bring all records, VA psychiatrists notes, and a sample letter. This will cost me $500-600 ...which I definitely cannot afford as I am unemployed and without much in resources. From what I read on here and other sites though, the IMO can be very persuasive and helpful. What are your thoughts on this? I don't want to have to try to come up with this amount of money if it is not.

Also...I am trying to make sure everything is in order, and appreciate the advice to "connect all the dots" for the VA. I have decided to write a one page letter listing all the information sent in... basically an overview of my claim. It seems that if there is, at first glance, a clear path through the material that it might help make my claim stronger. (at least I hope so...) I am thinking something like the following list... Or dos the VARO have there own checklist and this is just a duplication? I appreciate any response to these thoughts.

1. Letter stating specifically what I am asking for

2. Incidents

3. Orders which place me there, DD-214, etc.

4. Personal accounts

5. Effect on my life- personal / economic

6. Accounts from others

7. Current treatment / medications

8.. Copies of VA psychiatrists statements in records

9. Independent medical opinion

10. Nexus letter (s)

[midnight340]

Thanks, Carlie.... even though I'd read most of that before in pieces, it did help me. After all I've learned on this site, then reading through this, the process is a little less mysterious.

A question:

From reading this it sounds like normally the VA "official" diagnosis is made after the C&P, and is based on that exam. So do I understand correctly that normally there is no diagnosis from the VA prior to C&Ps? I do have a diagnosis of PTSD that was put into the system previously. (I have been run through interviews covering the DSM-IV criteria by two different VA psychiatrists) Could that mean that possibly they would not require a C&P... or should I still likely expect that to happen?

John999,

thank you for your questions. I have already submitted my stressor letter, but I consider adding another shorter statement more directly addressing some of this. After a lifetime habit of not talking about this mostly, it is hard to remember to actually write down how it did affect me at the time.

[john999]

Midnight

You want to describe how the stressor affected you at the time and how it continues to affect you in the present. I know it is hard to talk about or think about, but this is what the VA wants in cases where there is a noncombat stressor that is not conceded by a combat badge or purple heart. They want the details to see if it rises to the level of the kind of stressor they are looking for. It is all crap since if you have PTSD then you have PTSD. You have to jump through the hoops for them.

[Pete53]

Are you being treated at VA and what are you diagnosed with? What meds do they prescribe?

You can get a copy of your progress notes, your labs and other encounters that you have at the VA. Its important that you get your Medical Records.

At every VA Hospital and Clinic there is an office or window where you can sign a paper and get computer records of your progress notes and medical records generated by computer. If you don't know where it is ask for directions sometimes called FOIA or Medical Records.

[midnight340]

I am being treated for depression, anxiety, and sleep disorder, as well as PTSD issues. I have a psychiatrist I meet with who did the initial PTSD evaluation. She and staff monitor my meds. I also see a VA social worker bi-weekly at my local outreach clinic. I also go the the VA Med Center to meet with a PTSD education group, this was after the second VA psychiatrist ran me through the PTSD eval (DSM-IV, etc.)

Meds are Buproprion (wellbutrin) and citalopram (cylexa) for depression/anxiety, plus trazodone to help with sleep/dream issues, and also vardenafil for ED.

I do have copies of the progress notes and med records, except most recent. I am assuming the VARO will at least have gotten these by now. (7 months) 800 # says it looks like they have everything... they said that there are notes that show someone is working on it.

One maybe unusual thing here.... I have a really good relationship with the VA PA (physicians assistant) that I normally see for medical issues... and have kept him updated on the PTSD evaluations and treatment. He checked my med file some months back, said they had not officially entered the PTSD diagnosis, so he said, "But I can do that." And he did... so I know that that has been done. Whether that was a good thing or not, I don't know.

[wdroberson]

I am assuming the VARO will at least have gotten these by now.

I think that is one of the biggest and most commonly made mistakes. Assuming anything with the VARO. Maybe take Pete's advice and get those records and send them in.