ptsd Ptsd Va Socal Worker

[usmcgirl]

Having a diagnosis with PTSD the VA issued a social worker to work with me rather than a psychiatrist. Why? I don't know. But I have been seeing the social worker for the last few years on a weekly basis. Having filed a claim for increase since the PTSD is worse and been to the C & P, the psychiatrist there said that I have severe, chronic PTSD, directly related to the military with a GAF score of 47. Will the social workers notes be accounted for since they aren't an actual "doctor" per se but they are still connected and issued by the VA?

[Philip Rogers]

I found, in my 22yrs of receiving counseling w/the VA, that you only see a psychiatrist(shrink) for medications and renewals of psych meds, usually 2-4 times a yr and generally see a counselor, w/an MSW, for your regular counseling. I don't take psych meds, so basically I never see a shrink.

pr

[usmcgirl]

I get my psych meds from the NP at the VA clinic, the same one that refered me to the social worker. they do have psychiatrists at the clinic - i was just wondering if it made a difference for the claim.

[Loose Cannon]

usmcgirl,

Hey there, hope all is well. The important thing you should realize is that ALL progress notes from ANY VA appointment become a part of your file. I suggest going to your local VAMC and requesting copies through their Release of Information office. They'll have you fill at a short release form and print off copies for you. They are supposed to mail copies of any mental health notes but that depends on who's working there. More often than not, I'm able to get my mental health records printed and given to me while I wait- otherwise it takes about a week.

I recommend viewing these often (monthly) so you can see what they are writing in your notes. I saw a LCSW weekly at the VA for many months while seeing my VA Psychiatrist once a month. That's pretty normal from what I hear. The first time I had my progress notes printed I was surprised to see that even the "secure messaging" between me and my Primary VA doctor were included...Be careful what you type if you use this service (it's a part of MyHealthyVet) because someday a VA rater may be reading your messages!

LC

[usmcgirl]

Hey there LC! Things are about as good as the suck can get.- big ohrah to that- I am second guessing myself. When I sent in my claim for increase I didn't know if it included my LCSW notes also. And after coming out of group today I was talking with a woman who said that she had a shrink vise an LCSW....so that got me nervous. I totally agree with you with the secure messaging as I was speaking with a PSA and they were telling me that they read them to foward them to the doctor. ...one of them even wrote back to a person I know rather then the doctor - so much for "secure".

usmcgirl,

Hey there, hope all is well. The important thing you should realize is that ALL progress notes from ANY VA appointment become a part of your file. I suggest going to your local VAMC and requesting copies through their Release of Information office. They'll have you fill at a short release form and print off copies for you. They are supposed to mail copies of any mental health notes but that depends on who's working there. More often than not, I'm able to get my mental health records printed and given to me while I wait- otherwise it takes about a week.

I recommend viewing these often (monthly) so you can see what they are writing in your notes. I saw a LCSW weekly at the VA for many months while seeing my VA Psychiatrist once a month. That's pretty normal from what I hear. The first time I had my progress notes printed I was surprised to see that even the "secure messaging" between me and my Primary VA doctor were included...Be careful what you type if you use this service (it's a part of MyHealthyVet) because someday a VA rater may be reading your messages!

LC

[carlie]

Have you checked out the Vet Center in your area ?

I don't know if this will be of any help for your research or not,

but a Psychologist will always outweigh a LCSW and a Psychiatrist

will always triumph a Psychologist.

JMHO

http://www.va.gov/vetapp10/Files1/1002669.txt

"Initially, the Board observes that the record includes two

separate diagnoses by clinical psychologists of schizophrenia

and one diagnosis of PTSD by a licensed social worker.

Although not disparaging the qualifications of the social

worker or R.N. whose assessment was PTSD, see Goss v. Brown,

9 Vet. App. 109 (1996), their qualifications are less

impressive than those of the clinical psychologists who

specifically ruled out PTSD as a diagnosis. See Black v.

Brown, 10 Vet. App. 297, 284 (1997) [in evaluating the

probative value of medical statements, the Board looks at

factors such as the individual knowledge and skill in

analyzing the medical data]. In addition, it appears from

the record that the social worker determined that symptoms

attributed to schizophrenia in the distant past were more

indicative of PTSD than schizophrenia. This seems to be

inapposite of the findings of the clinical psychologists who

both diagnosed the Veteran with schizophrenia and of the

prior diagnoses of schizophrenia by a psychiatrist, Dr. A.R.

provided in a December 1987 letter of record. This strikes

the Board as being beyond the ken of a social worker and more

in the arena of a clinical psychologist or psychiatrist.

The Board acknowledges the social worker conducted tests

which assist an examiner in making a determination of whether

PTSD is present, but to a large extent, such testing is

dependent on the responses of a Veteran who may be, as in

this case, seeking to validate his belief that he has PTSD.

Given the fact that the Veteran had been diagnosed with

schizophrenia in April 2007, such diagnosis may have made a

difference in the assessment of PTSD by the social worker in

July 2007. However, the social worker's report does not

acknowledge the April 2007 diagnosis. In Reonal v. Brown, 5

Vet. App. 458, 461 (1993), the Court found that the Board is

not bound to accept an opinion based exclusively on the

recitations of a claimant. Similarly, in the context of this

claim, the Board is not bound to accept the test results of

the Veteran who had been diagnosed with a serious

psychological disorder only months prior to responding to the

test questions. This is particularly so when the examiner

does not acknowledge the recent diagnosis of schizophrenia

and does not indicate in the report that the Veteran's VA

claims folder was reviewed.

For those reasons, the Board finds that the VA psychologists'

diagnoses of schizophrenia are more probative than the social

worker's diagnosis of PTSD. Without a proper diagnosis of

PTSD, the Veteran's claim fails."

[usmcgirl]

Hi Carlie! Thanks for that...I read through it and found it quite interesting and am passing it along to another vet who I know that will help.

The issue that is confusing me is I was diagnosed with the PTSD as the main by my primary care, then NP, then LCSW, and then also by the C&P Psychiatrist for the increase. Secondary to that all of them found the severe depression, severe anxiety, insomnia, and anger as secondary to the main of PTSD. I checked into the Vet Centers too late after doing all the leg work and submitting my claim back in december.I thought I covered all of my bases, but I am having some concerns. Especially after I have been following some posts and been in contact with the Vet center. I sent the Vet center an email earlier yesterday - since that is usually faster then a return call - but going there in person you wait HOURS since they only have 2 people for the whole county.