hypertension Do I Have Cue?

[Jon1371]

I applied for increase on my 30% PTSD in 08 after my breakdown. I was denied an increase. However, I just received my medical reports from my hospitalization and it looks like the RO ignored or didn't use the medical files from my hospitalization. Down below are some of the diagnosis that I have received. There are more but I think this might be enough to help answer my question. I'm not a doctor, but from what I have read the last couple of months, I was worse off than I was lead to believe. No doctors told me any of this stuff was serious. The doctor's would ask questions and I'd answer honestly and that was all. It seems to me that I meet 50% and possibly 70% rating and that was back in 08. I know that CUE's are hard to prove, but it there enough to start one or am I wasting my time and energy?

AXIS I: Post Traumatic Stress Disorder with anxious and depressed mood
R/O Mood Disorder due to medical condition (Traumatic Brain
I n j u r y )
AXIS II: deferred
AXIS III: Traumatic Brain Injury?
AXIS IV: Sporadice employment, limited family support
AXIS V: GAF = 25

AXISI: Major depressive disorder with anxiety, seasonal component. PTSD.
Agoraphobia without panic d/o. Alcohol abuse. Nicotine dependence.
AXISII: Deferred
AXISIII: ?Hypertension, Migraine HA, Chronic knee, hip, shoulder pain
AXISIV: Poor social support, chronic mental illness
AXISV: GAF 45 at the time of admit, 60 at the time of this interview.

AXISI: Major depressive disorder with anxiety, seasonal component. PTSD.
Agoraphobia without panic d/o. Alcohol abuse. Nicotine dependence.
AXISII: Deferred
AXISIII: ?Hypertension, Migraine HA, Chronic knee, hip, shoulder pain
AXISIV: Poor social support, chronic mental illness
AXISV: 45 AT ADMISSION
51 AT PRESENT

AXISI: Major depressive disorder with anxiety, seasonal component. PTSD.
Agoraphobia without panic d/o. Alcohol abuse. Nicotine dependence.
AXISII: Deferred
AXISIII: Migraine HA, Chronic knee/hip/shoulder pain, ?Hypertension, ?BPV
AXISIV: Poor local social support, chronic mental illness
AXISV: 45 AT ADMISSION
65 AT PRESENT

Axis I PTSD
Depression, Major by history
Possible panic disorder
Axis II Deferred
Axis III Chronic pain hip knee
Migraine HA
Axis IV Unemployment
Combat exposure
Axis V GAF 50

Axis I: PTSD, by history
Major depressive disorder with anxiety, by history, sx severe
without psychotic content
Panic disorder without agoraphobia
Axis II: Deferred
Axis III: See problem list
Axis IV: Exposure to war
Axis V: GAF 50 (current)

Depression: As per HPI. +7/8 SIGECAPS with depressed mood for 2+ yrs.
Mania: Notes feels more irritable in winter months with racing thoughts;
negative for manic/hypomanic episode.
Psychosis: No AH/VH. No delusions. Paranoia related to PTSD.
Anxiety: Has anxiety s/s with physical manifestions of sweating, tachycardia,
tachypnea; more comfortable in home and doesn't like social situations because
of this. Denies panic attacks. Some OCD problems of checking things too often;
doesn't interfere with daily activity. PTSD symptoms as per HPI
CNS pathologies: Denies TBI/LOC/seizures
Other addictive d/o: Denies gambling
Personality d//o screening: appeared negative

Repeaterd disturbing memories, thoughts, or images of a stressful experience
from the past?
5 - E x t r e m e l y
2Repeated, disturbing dreams of a stressful experience from the past?
5 - E x t r e m e l y
Suddenly acting or feeling as if a stressful experience were happening again
(as if you were reliving it)?
5 - E x t r e m e l y
Feeling very upset when something reminded you of a stressful experience from
the past?
4-Quite a bit
Having physical reactions (e.g., heart pounding, trouble breathing, sweating)
when something reminded you of a stressful experience from the past?
5 - E x t r e m e l y
Avoiding thinking about or talking about a stressful experience from the past
or avoiding having feelings related to it?
4-Quite a bit
Avoiding activities or situations because they reminded you of a stressful
experience from the past?
5 - E x t r e m e l y
Trouble remembering important parts of a stressful experience from the past?
5 - E x t r e m e l y
Loss of interest in activities that you used to enjoy?
5 - E x t r e m e l y
Feeling distant or cut off from other people?
5 - E x t r e m e l y
Feeling emotionally numb or being unable to have loving feelings for those
close to you?
5 - E x t r e m e l y
Feeling as if your future will somehow be cut short?
5 - E x t r e m e l y
Trouble falling or staying asleep?
5 - E x t r e m e l y
Feeling irritable or having angry outbursts?
5 - E x t r e m e l y
Having difficulty concentrating?
5 - E x t r e m e l y
Being "super-alert" or watchful or on guard?
5 - E x t r e m e l y
Feeling jumpy or easily startled?
5 - E x t r e m e l y

[john999]

Did you appeal the 2008 decision?

[Jon1371]

Yes, but that was years ago and now the claim is closed. Now, I know I should have kept fighting. I accepted their decision at that time because I really didn't know any better and I thought that if that was their decision that they know more than I do.

[lotzaspotz]

If the information you gave us here was omitted from the list of "Evidence" and was not discussed in that rating decision, OR was listed but still not discussed in the rating decision, I would try for a CUE, JMO. Your GAF measurements varied greatly, but I've been told by a VA clinical psychologist that those scores do not carry the weight they once did in rating decisions. Of course, your claim should be considered by the standards in place in 2008, not those currently in effect. This evidence could significantly affect the outcome of your claim, had it been considered. It was evidence in the VA's custody at the time of the claim and is not new.

[Jon1371]

lotzaspotz, thanks for your input. I don't know if it was omitted from the evidence or not. How do I find out it they used the evidence? I know I need to get a copy of my Cfile and I'm going to request it as soon as I figure out how to. I have read that the GAF score doesn't matter as much anymore. My GAF scores were all over the place so they may be based on medical opinion and not a set in stone score. The last 2 GAF scores were from about a month after I'd gotten out of the hospital. I know my claim is my responsibility and that I should have done more for myself and I didn't. A couple of months ago, I decided to do more than just take what they give me and so I'm trying to find out how to fight for myself.

My current GAF is 60 even though I've been telling the doctor's that I'm hallucinating, suicidal, don't leave the house, spend all day in bed, and have paranoid delusions. I don't understand.

[lotzaspotz]

You find out if they used the evidence by looking for it on the Evidence List outlined in your rating decision. If it's not listed, it wasn't considered. If it's there but nowhere to be found in the actual Reasons and Bases for the decision, it wasn't considered. Either way, if it wasn't considered, I'd go for the CUE.

[john999]

I lost a CUE claim on exactly this issue. The difference was that my CUE happened in 1973. Before 1990 the VA was not even required to list evidence submitted by the vet, so there is no way you can prove or disprove the VA considered your evidence. Even if the VA lists your evidence they don't have to consider it because the assumption is that if they list it then they actually consider it. In my case it was clear that my evidence was never considered, and the BVA even admitted that fact. However, because the VA can fall back on the concept that the evidence omitted must be undebatable I lost at CAVC. I don't think these sorts of claims can be won under present circumstances. The burden of proof it too high and unreasonable. However, I would try and I am still trying. My doctor said I was incapable of working and that I was psychotic. This cut no ice with the VA. They had a ward clerk who wrote in my hospital records that I seemed to get on well with other patients. This was all it took to make my evidence and claim debatable. That was the kiss of death.