Appeals Management Center

[Josephine]

Hi everyone,

Recieved a phone call today. My claims file has finally made it to a Rater at the Management Center, don't know yet if I will receive another C&P.

After speaking to so many on this site, I feel that I am more than prepared to take on another shrink at the medical center.

Does anyone know what their qualifications have to be, sure hope they can read better than the Psychiatrist at the medical center and the Regional Office. I am thinking that they just have to be able to breathe.

I do understand that the rater is a male.

After the last C&P with the lady Psychiatrist, things sure couldn't get any worse.

Just wanted to know what success has anyone had with their claims and are they fairer with their decisons than the Regional Offices?

Thanks Bunches,

Josephine

[Berta]

Josephine- that is interesting what you said about the AMC-

I noticed that-in the brief time my claim was at the BVA-they all were really on the ball there-

and they reacted to my remand request very fast.

I think I had four reasons I requested it-still dont know which one they picked but it was great to call the BVA in DC and always get someone who not only understood VA lingo but also understood the regs.

The vet reps at the BVA knew exactly what I was talking about-the ombudsman was great too- BVA had given my request immediate attention and apparently requested expeditious treatment because that is what the VARO is giving me now.

And VA Central Office? exempliary VA employees-some of the best they have----I loved dealing with them years ago even though it was a battle,for a little while, at least they fully understood the regs, my evidence, and my rights-what a difference that makes.

There are wonderful people who work for the VA. I know many, many of them-docs, lawyers, nurses-even RO employees.

Some of us just get stuck with the bad apples.

I know I gripe a lot but I also recognise that there are many great dedicated VA workers in this system who do put veterans first.

Edited September 30, 2006 by Berta

[Hoppy]

Josephine,

One time I went in to the VA system and they worked in teams. One psychiatrist and one PHD in clinical Psych. Another time the team was a Psychiatrist and a case worker who was a social worker. They scheduled appointments with an intern who was workinig on his PHD in clinical. The interns report was screwed up and was signed by a PHD I had never seen. Later, I complained that the report was lacking in accuracy and that I did not think it was ethical for the report to be signed by a PHD who never saw me. I got a series of appointments with the PHD to get things straight.

[Josephine]

Hi Hoppy and Berta.

I am happy to hear from you two again. I have taken the advice of everyone on the site and now I am prepared to put this knowledge into use.

The BVA has given the Management Center the choice of sending my claims file back to the two Psychiatrist to reconcile their difference. They use the word " Should". This tells me if they choose not to, then they won't do it. Next they have the option of giving me another C&P examination.

I thought well, why not just ask for another one and at least I will be prepared for it.

I am going to do as all have told me to do.

First I would like to know what type of Pschological Testing that I had in service to give me the personality disorder in the first place.

The first C&P makes no mention whatsoever of my having any personality disorder, only the personality traits of being immature in service. At 19. this I can see as being feasible.

I will be taking both C&P's and I will be reviewing these with the examiner whether he likes it or not.

I will be nice, but I will not be a whimp this time.

I will be taking all of my private medical records 1965 to date.

The letter from my treating physician in the navy and everything in my possession.

The BVa and The Management Center have been extremely nice to me and the Archives have by sending a letter to the Management Center at my request, that there are no more medical records at the Archives.

They were nice enough to call me at home and tell me that the letter was faxed and then called the Management Center to make sure that it was received.

I have only one last shot at this and I have to prepare and do it right.

Always.

Josephine

Edited October 1, 2006 by Josephine

[john999]

Josephine

They might give you the MMPI. This is what a real mental health evaluation should consist of but the VA likes the 10 minute "feel your pulse" test. If you have a pulse you are OK.

[Josephine]

John 999,

I know what you mean. I have never had any test from the Va and yet they keep hollering that I don't have one in my private medical records.

My duty station, sure didn't give me one, when they stuck me with that Personality Disorder back in 1964.

It was was a talk session.

The same thing that I have with each C&P.

They ask me some questions and then if I answer them, then they say that the examiner wrote down what I had to say.

It is a no win situation.

I have to knock that lady psychiatrist off of her pedestal.

I am going to have to do some fast talking.

If the supervisor of The Management Center grants me this last C&P, it will be my last chance to prove my claim.

The remand states, should go back to the two Psychiatrist to reconcile their difference, but the remand doesnt say that the claims file has to.

If they feel it necessary, they can send me for another C&P.

All I see against me is the lady psychiatrist with her nothing bothered her in service, between me and my benefits.

Thanks bunches!!

Josephine

[Hoppy]

Josephine,

They usually made the diagnosis of personality disorder in the 60's after one short appointment with a psychiatrist. Testing was not involved. The MMPI is a cross sectional test. It tests your condition as it is at the time you take the test. Thus, an MMPI given today would not test for your state of mind in the military. Giving a test today that was based on your recollections of the 60's would not be reliable and the VA would probably not be allowed to use it as evidence anyway.

The diagnosis they made in the 60's can be disputed in many ways. I got a VA PHD to write a report that the process used in the military to make a diagnosis was not sufficiently accurate to be conclusive. The psychiatrists I have seen in recent years usually defer the diagnosis until they have had two months of treatment. Additionally, the VA is required to evaluate psych conditions on the requirements of the DSM IV. Since the diagnostic requirements for personality disorders changed with the DSM IV I argued that a shrink should review the symptoms noted in the 60's and make a diagnosis based on the DSM IV. Symptoms in my case were well documented for a period of over a year in the SMR both my clinic visits and the reports written during three exams by psychiatrists were available for a review by a current PHD. In my case it worked. In effect my in service diagnosis was changed by both the VA treating shrinks and the C&P examiner that the DRO asked for an opinion. I felt that the treating physicians took such a long time and many visits to conclude that the in-service diagnosis of personality disorder was in error and that there was sufficient notation of symptomology in my SMR to make an accurate change of diagnosis. The C&P examiner would have had to take exception to a significant report made by a treating physician. The C&P mentioned to me in the interview that there was a significant amount of effort and time put into the change of diagnosis made by the VA treating PHD. I have suggested before that VA treating shrinks can make notes in the file that are very strong evidence.

In your case it sounds like you have a fair amount of symptoms with meds noted in the SMR. Thus, getting a change of diagnosis could happen. Basically, I think that the only way to get service connected would be to get a change of diagnosis. Just proving the personality disorder was made in error might not be sufficient.

I think it is a disadvantage to take your entire case to a C&P and lay it on the examiner without significant workup by a current treating physician. This is not to say that your claim will be weaker in the long run. It would just be nice to know that you had treating physicians on your side going into the C&P. If the C&P shoots down your claim your recourse would be to start seeing a VA. shrink and getting new and material evidence to get yet another decision and or, yet another C&P.

In a previous post you mentioned that I was an expert. I am really not an expert. I am well educated and know how to prepare an argument. Additionally, I took all the basic courses for a BS in psych in the UC system. I got “A’s” in upper division core classes. I read every DSM and the M-21. The problem is that I forgot more than I remembered.

Considering your symptoms in the military and your long battle with your condition I think it would be best to continue your battle with the VA until both the C&P examiners and the treating shrinks have done everything they can do for you.