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Weekend C&p Exam Oddities-In My Favor?

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brokensoldier244th

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I had a weekend C&P ( I thought that was unusual enough-most of the Omaha VAMC was closed when I was there at 0745 this morning, and ive never had one on a weekend before) and the doc said something that I hand't heard before. The C&P doc (Psych) directly contravened my VA doc and PCP here in Lincoln. I used to take zoloft for PME, and it was originally prescribed for that. Many months ago I noted that it wasn't working, since I couldn't raise the mast anyway, so levitra was prescribed. Around the same time I started seeing my VA psychologist, and one of the things she said was that if I felt that the zoloft was helping my depression, keep taking it. I mentioned this to my PCP (a PA) who has continued my prescription. I have not seen anyone else in MH (like a psychiatrist) in all this, just these two.

The C&P doc (a board psychologist) said this morning that, while he can't "Tell me what to do......." and he isn't "judging my care staff in Lincoln", he says that its his recommendation that I get referred into actual Mental Health, because they can write prescriptions, and the 50mg zoloft that I take now is not enough, in his opinion-I should seek more, or a different medication for my depression and symptoms, based on my history, and our hour long discussion today, because what I am doing now isn't working. He had all of my prior notes in the system, and had reviewed them before I came in.

WOW....ive never heard the C&P doc directly call anyone out like that before.

I'm currently 30% for depression, but in the midst of my still submitting evidence my claim was granted, so I continued pursuing it as a request for increase, since I have absence write-ups (warnings), a warning for non-professional conduct to a client, and a letter from my boss explaining the allowances they have made for my job for things that I dont' have to do vs. other support staff. It also states that in the last year my performance has greatly suffered, my productivity has dropped, and my attitudes and mannerisms at work have become more strained and abrasive with co-workers and clients. Right now I am the lead support tech that doesn' travel, doesn't see clients directly, and works a shorter number of hours a week, to cope with my depression. This evidence was still being compiled when my 30% was granted, so im submitting it now, hoping to bolster a claim for increase based on

"Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impairedabstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships ..........."

To me this sounds at least somewhat favorable to me, in some respect, since the doc is recommending different and increased level of care for this. Am I wrong in thinking this? I've attached the letter from my boss for reference to what was submitted. I also submitted as evidence 2 written performance warnings, one dealing with my response to a client (for support), and the other a punitive one RE my absences over the last year. Im 70 percent now, and while no one has said anything about IU (im still working, anyway) my fear is that in my current capacity as lead support im so 'protected' from various aspects of the job because of specialized knowledge that if I left where I work now I wouldn't be able to get another job in IT support anywhere because of my difficulties in dealing with people and adverse/combative attitudes.

Im in grad school now, distance learning, shooting for an information security degree, in the hopes that I can try to turn that into a job as an analyst that doesn't have to deal with clients anymore, but that is still 2 years away. I have a claim in to renew vocational rehab services as well, as my last status of 'rehabilitated' was based on my completion of my B.S. in Info Systems mgt in 2008-which has thus far qualified me for 'tech support' in every other place that I have applied to in the last few years. Add to this that my current specialty at work now will be gone in a few years due to planned obsolescence. My fear is that if I quit, or get fired from my current lead support job, im kind of screwed.....so my request for Voc Rehab services revolves around new training in Information Technology that isn't a support/technician/people type of job.

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Edited by brokensoldier244th
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Many claimants are iffy on many different DC percentage evaluations

because VA owns the scale on how the weight is assigned.

This is especially true with MH evaluations as the majority of symptomology

is subjective rather than verifiable, by means of objective testing.

A great example of this relates to factoring in GAF scores, etc...

It appears that my prior posts were not understood, with the intent aimed for.

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That's okay, Carlie-this is the very meat of the issue. "Occupational impairment, loss of efficiency, etc" What the hell does that mean, anyway? I have a friend that is working on his doctorate in psychology right now and he's looked at my symptoms, the rating scale, my therapist notes, and what not ,and he just laughed and shook his head, glad that he is not constrained by this type of rating system that picks and chooses how to quantify the DSM IV.

Many claimants are iffy on many different DC percentage evaluations

because VA owns the scale on how the weight is assigned.

This is especially true with MH evaluations as the majority of symptomology

is subjective rather than verifiable, by means of objective testing.

A great example of this relates to factoring in GAF scores, etc...

It appears that my prior posts were not understood, with the intent aimed for.

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That's okay, Carlie-this is the very meat of the issue. "Occupational impairment, loss of efficiency, etc" What the hell does that mean, anyway?

I have a friend that is working on his doctorate in psychology right now and he's looked at my symptoms, the rating scale, my therapist notes, and what not ,and he just laughed and shook his head, glad that he is not constrained by this type of rating system that picks and chooses how to quantify the DSM IV.

broken,

My entire point is that your percentage is going to be a mixed bag BECAUSE - the VA decision maker is the one with the authority

to assign weight to the factors involved - THEY OWN THE SCALE.

One decision maker might see you as 30%,

a different decision maker may see you as 50%

and a third decision maker could come along and see you as 70%

or even freaking propose to do a reduction of the current 30%.

There is simply no way to tell.

A decision maker that evaluates you at 70% MIGHT feel like your medical evidence shows

enough severity in Occupational and Social functioning, that your MH warrants 100%

BUT

because you can take classes on line - they grant 70% - because if you can accomplish

taking on line classes you must not have gross impairment in thought processes or communication,

which falls under the 100% criteria.

A decision maker that evaluates you at 50%, might actually feel your situation warrants a 70% rating

because you have Occupational impairments at work due some panic attacks and impaired impulse control

(such as unprovoked irritability with periods of violence) but your employer has accepted these limitations

which now only leaves you with some reduced reliability and productivity, which falls under the 50% criteria.

Subjective symptoms are always a mixed bag.

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Broken, I was in a similiar situation as you...A lot of missed work, flattened affect etc...Based on what I was reading I was fully expecting to recieve a rating of 50% for my PTSD with MDD...I was pleasantly shocked when my letter came and I was awarded 70%.And I am still working..It is difficult at times, and I miss more work than I should but so far have managed to hold onto my job.It is a job where I have limited contact with others, I have my own office that I sit in for 8 hours a day and some days I am JUST HERE....They sent the TDUI form with my rating but I see no reason to send it in as since I am employed it would be denied..I will submit it when I can't work anymore..So wait for your decision and hope for the best.....As Carlie said each person that looks at your claim might think that you should be a certain percentage and they may all differ.......I am proof positive that you can be rated at 70% for PTSD and be employed...........grid

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Im the worst (or best) kind of personality. I fixate on things that engage my brain, so in the line of work im in (software testing/client support/forensic accounting) I get sucked into what I do. I like helping people get their issues fixed, but over the last year and a half even softball fixes don't give me any *whoo hoo* moments, and I relish the days when I can test and don't have to deal with clients at all. We aren't a helpdesk type of environment, so I have no one else to punt issues to, and being promoted to 'lead' means, more and harder work. :-) I identify a large aspect of my life with my job, though. Im a geek through and through. I don't know what I would do if I lost this, you know? Im in school as a means to stay engaged and involved with what I do. Im not sure what i would be like if I was just home all day.

Broken, I was in a similiar situation as you...A lot of missed work, flattened affect etc...Based on what I was reading I was fully expecting to recieve a rating of 50% for my PTSD with MDD...I was pleasantly shocked when my letter came and I was awarded 70%.And I am still working..It is difficult at times, and I miss more work than I should but so far have managed to hold onto my job.It is a job where I have limited contact with others, I have my own office that I sit in for 8 hours a day and some days I am JUST HERE....They sent the TDUI form with my rating but I see no reason to send it in as since I am employed it would be denied..I will submit it when I can't work anymore..So wait for your decision and hope for the best.....As Carlie said each person that looks at your claim might think that you should be a certain percentage and they may all differ.......I am proof positive that you can be rated at 70% for PTSD and be employed...........grid

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I feel like what I was trying to intimate got lost between my brain, my finger, my keyboard, the isp, and the forums servers.

I guess, you'll have that. People sitting with such diverse background, dealing with profound disabilities, attempting to help each other without knowing each other.

My contention in this whole thread was only this: Broke should get an increase. The c and p doctor sounded like he gave a crap. I don't know where that increase will fall, and I don't know if that increase will happen.

I only wanted to lend support. I wanted to say: it sounds good. Your golden Broke. Take a breath, enjoy the day, and go look out the window. That's all. unsure.gif

Edited by scscrewed
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