ptsd Need Some Advice... I Want To Apply For Tdiu

[jdman]

Hello everyone,

I just recently was awarded 70% SC for Major Depressive Disorder. That is the only thing currently i am rated for other than a broken hand(0%).

I am a Federal employee. I haven't worked since Sept 2011 due to PTSD and MDD. I did 3 tours in Iraq and Afghanistan. When I have had ALL of my Psych Evaluations they could not differentiate which symptoms are the most debilitating to me so they put them both as co-morbid.

I am wanting to file for TDIU since i am 70% SC for MDD and cannot work. Everyone has deemed me totally disabled. When I apply for TDIU are they going to not award due to my civilian PTSD. They both affect me honestly. Just need some advice on this one.

[free_spirit_etc]

GREAT info free spirit!!!!!! You do very good work here finding this stuff!!!!!!

Today I have been doing a lot of searching... I have read questions where I think -Dang! I just read something about that - and what was I searching for when I found it.

I agree this is a great citation.! And I think it can apply in a lot of claims. I actually first ran across it when I was researching asbestos decisions. When the doctors stated that it was impossible to separate what role smoking played and what role asbestos played -- or to separate the effects of in service exposure from the effects of post-service exposure, the claims were granted.

But this citation can be used in almost any claim -- and is especially used in mental health conditions - as long as someone points out it should be used (or the VA decides to use it on their own).

I think this citation could also be useful when the VA examiners use their famous line that the disability is more attributable to a non-service connected condition. Unless they provide reasoning as to how they arrived at that conclusion -- they really shouldn't be able to use that to deny claims. Okay... he said it was caused more by X... how did he separate out how much was caused by x and how much was caused by y? And you know why they don't separate them out? Because once they do -- you have poof that y DID cause some of it. So I think the VA gets by with just lumping everything together and attributing it all to the non-SC condition A LOT of times on the basis it attributed MORE - but if they really did it like they should - the should decide how much EACH contributed, and even if the SC contributed less, it did contribute. And if they can't state (with medical reasoning) how much was caused by what -- it should all be attributed to the SC condition.

And that is my soapbox for the day.

[jdman]

Free Spirit.... Thank you for the information...

Here is what the Statement of Case states in regards to Panic Disorder...

The QTC Examiner stated your major depression and panic disorder are 2 independent conditions, and each condition is not secondary to the other nor do they have overlapping symptoms. The examiner noted in the narrative that the panic disorder was started sometime in the military, but does not give rationale or supporting evidence for his statement.The service medical records fail to show a diagnosis of panic disorder, or symptoms of a panic or anxiety disorder. Therefore we are not including the panic disorder as part of your service connected major depressive disorder.

I had also appeal my denial for PTSD in service. My friend who worked down the hall from me was killed in the Khobar Towers bombing of 1996. I lived in Khobar Towers in 1995 and This is what the SOC states for PTSD.

You reported to the QTC examiner during examination dated November 25, 2011 that you were not exposed to combat or hostile or terrorist activity while on active duty. You reported exposure to mortar attacks and Islamic terrorists while working as a civilian government employee, not while on active duty. The examiner states the reported stressful events do not meet the criteria for PTSD stressors. The stressor events cannot be linked to your active duty military service and, therefore, do not meet the criteria for service connection.

Here is what the QTC C&P examiner stated in January 2013 to my Depression and PTSD symptoms.

It is not possible to differentiate what portion of the occupational and social impairment is attributable to each diagnosis because both diagnosis are interfering with Mr. Blank's functioning. One diagnosis is likely compounding the other but it is difficult to determine which diagnosis is primary or most distressing.

I know that I do not qualify for service connection for PTSD but my anxiety disorder they are stating be possibly linked to my friend's death in 1996?

Do you think that with that statement that it may be easier for me when I file for TDIU?

BTW thank you for everyone's help on this site!!!

[free_spirit_etc]

It still could be possible to get the PTSD service connected. But it looks like they aren't even considering a diagnosis of PTSD, but anxiety disorder (not SC) and depression (SC). It sounds like the examiner was saying that the reported stressors from the military don't rise to the level of PTSD, but do rise to the level of panic disorder. So it looks like he was putting aside the PTSD (from civilian employment) but still saying you had both panic disorder and depressive disorder from the military. The RO didn't accept that the panic disorder was related to the military -- because they said you weren't diagnosed with it and that your service medical records don't show any symptoms of it. Ironic, if a VA examiner says something is not related to the military they accept it at face value. Here, your examiner said it WAS related to the military - and they brushed that aside. If events in the military CAUSED your panic disorder, it shouldn't matter if it was treated in service... ---

BUT the good news is they gave you 70% because they couldn't untangle the effect that each one has anyway. (I do find it odd that the examiner stated they were distinct conditions without overlapping symptoms - but then said they can't be separated. But since they have already granted you 70% SC for a mental condition -- they should be able to grant TDIU because the PTSD symptoms probably tangle in with everything else. I think it would be hard for them to say you could work if it wasn't for the PTSD -- when you are already at 70% on a mental disorder.

I am not seeing a diagnosis for PTSD. Do you have a diagnosis from a private doctor?

But when you give statements, etc. make sure to keep the focus on your SC condition - and how that affects your ability to work. Do NOT focus on any PTSD.

I think the fact the examiner said the conditions confound each other is helpful.

Disclaimer -- I am NOT an expert on TDIU claims or PTSD claims. I don't know a whole lot about either of them. There are lots of veterans in here who have SC for both. So I hope they can give you better guidance...

[free_spirit_etc]

Okay.. sorry.. I didn't read -- (acting like the RO here)

The examiner did say the panic disorder and depression were separate and didn't overlap. But he said the PTSD and depression couldn't be separated...

That is kind of odd - but the main thing to keep in mind is that you ARE already 70% SC for mental -- no matter how they diagnosis it.

Do you have copies of the C&P's to see what the examiner actually said???

Never trust the RO to report that correctly...

I think if a SOC is especially confusing -- it can often be because the examiner didn't give them what they wanted... so they distort it a bit - which makes the decision sound puzzling. If they can report what the examiner said without distorting it -- it sometimes makes more sense.

But no matter what they decided to call it - they did determine you are 70% and they determined that 70% is SC. Even if they attributed it to two or three diagnoses - it would still be 70%.

Edited October 27, 2013 by free_spirit_etc

[free_spirit_etc]

Does your record reflect anywhere that you can't work? If so, you may have already have an inferred claim for TDIU - and you could go back for an earlier effective date after you get granted. Or you might even be able to appeal this decision -- in that they didn't consider TDIU.

I am not sure which one is best to do - I am sure someone who has walked that path will know.

[free_spirit_etc]

Here is another one. If you search Board Decisions http://www.index.va.gov/search/va/bva.html and enter some of the terms - it will pull up some decisions that are simliar to your case. I just typed in Mittleider and TDIU.

http://www.va.gov/vetapp13/Files2/1314518.txt

"Given the medical complexity of distinguishing the degree of disability attributable to the in-service injury as compared to the disability attributable to the injury the Veteran sustained after his separation from service, the AOJ, resolving all doubt in the Veteran's favor, has rated the Veteran's lumbosacral strain on the basis of all manifestations present (See January 2009 and August 2009 rating decisions). As the matter of distinguishing the disability attributable to the injury the Veteran sustained in service from the disability attributable to the injury sustained in February 1983 is not within the province of the Board, and the medical professionals qualified to opine on such matters on balance have determined that all present manifestations may be linked to the in-service injury, the Board also will evaluate all manifestations currently present as disability associated with the service-connected disability. See Colvin v. Derwinski, 1 Vet. App. 171, 174 (1991) (holding that the Board may consider only independent medical evidence to support its findings and cannot reach its own unsubstantiated medical conclusions); Mittleider v. West, 11 Vet. App. 181, 182 (1998) (holding that the Board is precluded from differentiating between symptomatology attributed to a service-connected disability and a nonservice-connected disability in the absence of medical evidence which does so)."