ptsd Exam Results Opinions Please

[doubleD]

2. Current Diagnoses

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

a. Diagnosis #1: PTSD

[X] Axis I

b. Diagnosis #2: Depressive Disorder NOS

[X] Axis I

c.b. Diagnosis #2: Panic Disorder with agoraphobia

[X] Axis I

d. Axis V - Current global assessment of functioning (GAF) score: 45

3. Differentiation of symptoms

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

a. Does the Veteran have more than one mental disorder diagnosed?

[x ] Yes

b. Is it possible to differentiate what symptom(s) is/are attributable to

each diagnosis?

[x] yes

c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?

No

4. Occupational and social impairment

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

a. Which of the following best summarizes the Veteran's level of

occupational

and social impairment with regards to all mental diagnoses? (Check only

one)

[X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and or mood

b. For the indicated level of occupational and social impairment, is it

possible to differentiate what portion of the occupational and social

impairment indicated above is caused by each mental disorder?

[ ] Yes[ x] No[] No other mental disorder has been diagnosed

c. If a diagnosis of TBI exists, is it possible to differentiate what

portion

of the occupational and social impairment indicated above is caused by

the

TBI?

[ ] Yes[ ] No[X] No diagnosis of TBI

SECTION II:

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Clinical Findings:

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

1. Evidence review

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

If any records (evidence) were reviewed, please list here:

claims file available and reviewed in its entirety

2. Recent History (since prior exam)

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

a. Relevant Social/Marital/Family history:

Veteran currently lives with husband ......

b. Relevant Occupational and Educational history:

Veteran reports that she has been out of work since July 2013 ........

c. Relevant Mental Health history, to include prescribed medications and

family mental health:

Veteran continues to get treatment for PTSD; she is prescribed

meds. she reports that she feels the

medications do not help. she has been getting treatment since 2006

d. Relevant Legal and Behavioral history:

none

e. Relevant Substance abuse history:

none

3. PTSD Diagnostic Criteria

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

Criterion A is met: The Veteran has

[X] The Veteran experienced, witnessed or was confronted with

an event that involved actual or threatened death or

serious injury, or a threat to the physical integrity of

self or others.

[X] The Veteran's response involved intense fear,

helplessness

or horror.

Criterion B is met: The traumatic event is persistently reexperienced in 1 or

more of the following ways:

[X] Recurrent and distressing recollections of the event,

including images, thoughts or perceptions

[X] Recurrent distressing dreams of the event

[X] Intense psychological distress at exposure to internal or

external cues that symbolize or resemble an aspect of the

traumatic event

[x] physiological reactivity on exposure to internal or external cues

Criterion C : Persistent avoidance of stimuli associated with the trauma

and numbing of general responsiveness (not present before

the

trauma), as indicated by 3 or more of the following:

[X] Efforts to avoid thoughts, feelings or conversations

associated with the trauma

[X] Efforts to avoid activities, places or people that arouse

recollections of the trauma

[X] Markedly diminished interest or participation in

significant activities

[X] Feeling of detachment or estrangement from others

Criterion D: Persistent symptoms of increased arousal, not present before

the trauma, as indicated by 2 or more of the following:

[X] Difficulty falling or staying asleep

[X] Irritability or outbursts of anger

[X] Difficulty concentrating

[X] Hyper-vigilance

[x] exaggerated startle response

Criterion E:

[X] the duration of the symptoms described above in criteria b,c, and d is more than 1 month

Criterion F:

[X] The PTSD symptoms described above cause clinically

significant distress or impairment in social,

occupational, or other important areas of functioning.

4. Symptoms

-----------

For VA rating purposes, check all symptoms that apply to the Veterans

diagnoses:

[X] Depressed mood

[X] Anxiety

[X] near continuous panic or depression affecting the ability to function independently appropriately and effectively

[X] Chronic sleep impairment

[X] difficulty in adapting to stressful circumstances including work or a work like setting

[X] difficulty in establishing and maintaining effective work and social relationships

[X] Disturbances of motivation and mood

[X] Suicidal ideation

2. Restatement of requested opinion

The veteran has a verified PTSD stressor of fear of enemy attacts while stationed in country and in an imminent danger pay area.

3. Medical opinion for direct service connect.

[X] The claimed condition was at least likely as likely as not (50% or greater)

[63SIERRA]

Exactly .. if a rich man decides his son will be a doctor, a doctor he shall be no matter how stupid he is. A white coat and a 20 dollar inkpen dont make them intelligent. or honest. You can send a monkey to harvard, but he will still be a monkey when hes finished.

[cowboys4life]

Thank you all for your replies, I guess I just do not quite get this process yet. So should I wait to hear from the RO, or should I challenge the results with a reply to them before I get their rating which I know from the DAV that I was denied on everything.

[cowboys4life]

Hey you are not going to believe what I learned about the doc that done my C&P exam. Turns out that he has 29 years as an internist in adolescence medicine!!!!! NOW. I have long since passed my puberty and am actually belong heading toward my second childhood. What is an adolescence doctor even allowed to give exams to adult patients and make critical judgments on the lives of others. How can the VA get away with this.

[FormerMember]

So I read this and I see "fear of attack". Were you ever actually attacked? Incoming? Multiple number of deployments? I guess I don't get this. I've dealt with quite a few guys who have PTSD bonafide-complete with stressors a mile wide. A chopper shot out from under them. Gooks inside the wire killing their buddies. The usual stuff but none predicated simply on being in-country. Pardon me if I seem pedantic, stupid and slow, but that's what you sign up for. If going to war is a known risk for bent brain, doesn't it follow that you simply say "Hold the phone. I changed my mind. This ain't gonna fly. I'll take the Big Chicken Dinner but no way am I going into that meatgrinder." This wasn't the draft where you didn't have an option. I strongly support the new regs coming out in the CFRs on MST. That is long overdue and some leeway has to be accorded women Vets because I know they were hit on- some violently-and still are. However, the whole concept of PTSD due to combat is (or was) wrapped up in violent, often graphic physical imagery of death and destruction.

My good friend Gordon is missing a good-sized piece of his noggin and his right eye. One leg is shorter than the other. He has a colostomy bag. "His favorite rejoinder when someone looks at him askance getting out of his car in a wheel chair zone? "Hey. You ever stepped on a land mine buddy? Me neither. The guy in front of me did and it cut him and the guy behind me clean in half. I survived. Weird, huh?" Gordie has two purple hearts and a Bronze Star w/ a V device. He has his CIB and a wound medal. Even a Combat Action Ribbon. Oddly, what he doesn't have is PTSD. He said he didn't have time for it while he raised his four kids on a 100% comp. check. I came home after two years of it and moved to the desert to be alone. They booted me out with a General and called it personality disorder. My first wife took the kids and ran after three years. Help me fill in the gaps here. Is the mere fear that something "might" happen grounds for a 45 GAF?

No anger here. Just a Vet wondering how this works in 2013. Do you get a CIB now for being "close" to the front? I guess they change the rules for every war. I'm glad you're winning. Mostly, I'm glad you came back alive. I'm certainly not vindictive. Uninformed about this SWA war maybe, but not angry or vindictive. I get to hear about the medical side on these boards but rarely hear how one gets from Fallujah to Hadit.

a

cp

Edited December 5, 2013 by asknod

[Navy04]

I can say that I have a hard time with guys that say they hate the Military and never served in a War. I get Docs that say " PTSD " is a made up word, so I always say let me drop you off in Iraq or Afghanistan in the middle of the war and see what they think. I was scared, but proud to deploy even though I was there a lot longer than most. I deployed with Crohn's Disease, Testicular Surgery, MRSA which was cut out of me 7 times including my head, and I didn't use an excuse not to deploy. We knew what we signed up for, we just didn't didn't expect the Military to use us and throw us out to the wolves. I have 7 medals and over 20 ribbons in my Shadow Box my CO presented to me in February when the Navy medically retired me after 9 years, spent half in War Zone. I look at the Shadow Box on top of my Refrigerator from time to time, and it is hard for me to understand that I will never be active duty or in a war again. I feel like a blind man walking in the dark, not knowing which way is the quickest way to happiness.

[FormerMember]

Jez. You're in Texas. There's no quick way to anywhere in Texas. Happiness is highly overrated, too. C&P exams are an exercise in futility for one reason. Most are conducted by your adversary unless you are obtaining one from a private doctor. The results are predictable thus you can expect to be depressed. I was lucky to serve towards the end of the Terry and the Pirates or the Steve Canyon era. At the ass end of the theater, uniforms and saluting were forbidden. You didn't get medals if you weren't there. The AF finally decided (with a little prodding) to give me mine after 40 years. The refer sounds like a good place to let them grow dust.