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Pstd Imo Letter -- Doctor Can't Write Decent Letter. Aleady Sunk $1000 Into This...

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DrBarbae

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Hello all,

First post here. I have a long story to start with that leads up to some simple questions...

I am SC'd 30% for PTSD, but have filed a NOD. To bolster that NOD with new evidence, I am paying out of pocket for an Independent Medical Opinion (IMO). I chose a doctor than had experience with forensic psychology that had an impressive background based on my Internet research. Well, I converse with him back and forth through email a few times, told him I wanted to meet him for treatment, psychometrics, examinations, etc, then get a report for the VA as a result of our meeting. I asked if he was familiar with the right verbiage to "answer the mail" for the VA, and he said yes; he would charge me $1000 for it all. Well, fast forward a few week later, I have the appointment, pay him the $1000, and now I have the report.

In short, the report does not answer the mail (I explain why in a bit), and I am not that certain that he would be capable of putting the report with the right verbiage, even if I told him what was needed. It's a lot like asking a kindergartner to write a doctoral thesis---it is just not possible. First of all, my last name is inconsistently spelled throughout the report, and the grammar is terrible. The details I provided are vague or missing, especially with what I painfully shared regarding my main PTSD stressor. When asked if I had any thoughts of suicidal ideation, I admitted I had thought of a plan, but have never attempted it (in the report, it mentions I denied any suicidal ideation). I think you all get the picture---there is no beef to this report to make it supportive of any case I would make, whether that my PTSD has gotten better, worse, or stayed the same. Ineed the professional product I paid for if I want to get anywhere with the VA.

Because of this, the only practical way of moving forward with this is if I write the letter, and he sign it. The doctor is likely amenable to this based on some of the conversation we had before I left the office. Thus, I have retyped his letter, and put in the details that need to be there. This feels quite awkward, and is a situation I did not expect or want to find myself in. Since I have already sunk $1000 into this and several weeks of my time, I don't want to start over. I just want to get this behind me and not play this back-and-forth game with the VA for years or decades like my dad did. I just want an effective letter that is quite clear about the findings and submit my new evidence.

Ok....so now the questions:

Is this "letter writing" on behalf of doctors that don't know how to write for the VA common by vets that are gathering new evidence to support a claim?

Is the following quoted statement at the end of the letter with the diagnosis normal? "The overall evidentiary record shows the severity of the patient's disability most closely approximates the criteria for 100% disability as listed in 38 CFR § 4.130-2".

What should I do in this situation? Any suggestions or comments?

Thanks!

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  • HadIt.com Elder

working 80 hours a week you will never get a 100% rating let alone a 70% TDIU there is nothing that would validate a rating that high in anything you have posted here, I hate to say this but you have wasted a thousand dollars if you write the letter and ask the doctor to sign it that would border on fraud if he signed it he is risking his license, and you are risking being prosecuted for fraud.

stay in treatment keep getting the meds refilled and as you progress to a more disabled stage ask for a re-evaluation down the road most of the vets that I know that got to the 100% rating had lost their homes, their families and vehicles and jobs there are few that get 100% schedular more get 70% TDIU but the majority of PTSD vets are rated at 30% and 50% and continue working

stay in mental health clinic or the vet center you will need a treatment history to get rated higher just filing for higher ratings every few years with no new treatment records will see the claims denied, I would give them back their checks in a NY minute if I could get my health back but I can't and honestly being a 100% disabled is a hell of a lot of work and is not for lazy people and the ICU stays usually hurt like hell

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Thanks for the replies...especially Carlie. I hope this post will help others out.

Just a reflection on all this: There is a ex-colleague vet I know that is 70% SC'd for PTSD. He seems perfectly normal. You'd never be able to tell he has PTSD. He's a good employee, no impulsive behavior or anger, no flattened effect. He encouraged me to see a doc, get medical evidence, and submit it to accompany my NOD. I think I am worse off than him with the affliction. I am not sure what to think or do about this claims process. But I do know this site's been a godsend thus far.

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Thanks for the replies...especially Carlie. I hope this post will help others out.

Just a reflection on all this:

There is a ex-colleague vet I know that is 70% SC'd for PTSD.

He seems perfectly normal.

You'd never be able to tell he has PTSD.

He's a good employee, no impulsive behavior or anger, no flattened effect.

He encouraged me to see a doc, get medical evidence, and submit it to accompany my NOD.

I think I am worse off than him with the affliction.

I am not sure what to think or do about this claims process.

But I do know this site's been a godsend thus far.

You can not compare your evaluation to others as you have no idea without going thru their c-file,

what their medical evidence is and how the adjudication process and rating criteria was

applied to their specific evidence.

It's good for this vet you've mentioned, that he has learned someways to pass as what

some may consider to be "normal".

This vet has most likely received some type of therapy / treatment on a regular basis

and learned some great coping skills.

You most likely have little idea what this vet deals with when you don't have

you'r eyeballs on him.

You have no authority to try to judge if another vet is equal to or worse off than you.

You do not know their specifics.

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  • HadIt.com Elder

If you are working 80 hours a week you are lucky to get 10% much less 30%. I think you stand a good chance of being reduced as long as you are able to work such hours. Do as others say and stay in treatment building your documentation for the day you are unable to keep a job. Employment is the biggest factor in rating mental disorders because the VA awards compensation for what you have lost.

If you have lost a leg that is visible and has a rating. For the emtional/mental disorders they have to go by your behavior and how it affects your ability to relate to others and to work. If you are able to work and have relationships of any kind you will never get to 100% for PTSD or any other mental disorder. I was denied once because the VA said I got on well with other mental patients on a locked ward.

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  • Moderator

Similar things happen to disabled people all the time.

Many disabilities are invisible...they dont wear artificial legs, and they are not in a wheel chair. Example:

My hearing loss. You could have a short conversation with me, in some circumstances, and not know that I am severely HOH. Why? For one reason, I am good at guessing what was said, and responding in such a way that I did not NEED to hear everthing said. Next, we may be in a quiet environment, you may have a strong bold voice, and I may be right next to you, all of which increases my chances of hearing most things. Then, often, I tend to dominate the conversation, because I always hear what I said.

This is why they dont have plumbers evaluate my hearing loss. And they dont have carpenters evaluate PTSD.

You dont know what symptoms someone else has...they may not have confided their symptoms, as not everyone wants to wear a T shirt saying

"I have PTSD"

Docs have medical tests..and you have no idea how to interpret them.

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Unfortunately your doctors report is just that a document of your reported symptoms. I honestly dont really see where he states that you ahave a certain severity of PTSD, more just a list of symptoms you have reported having.

I agree with the others, stay in treatment with a PTSD counselor and build a history for when you meltdown and can't work. This report will most likely do you no good, because you have no history with the doctor so he can not provide a true medical opinion of your severity or ability to improve etc.

The biggest killer in the doctor report is this,

"His self-description as disturbed required further consideration because he claimed many more symptoms than most patients do. Two likely possibilities require further evaluation. It is possible that he overstated his symptoms as a result stress and the need to seek a great deal of attention for his problems."

Effectively he just told the VA that you are exaggerating in the hopes of getting a higher rating.

Sure there a bunch of other supporting evidence but as soon as a rater sees this sentence you would be denied.

A good IMO would not even bring this question up because he would need to know the answer to this in order to write his opinion, he has just told therater that he doesn't really know your case, severity or ability to function. DO NOT send this report in because it will be part of you C-File FOREVER!!!!! and VA will use it time and again to deny you in the future even when you have great evidence.

Edited by hawkfire27
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