ptsd Re-Evaluation?

[bensonsr]

I am rated overall 80%; 33%PTSD. Ive been seeing a psych for meds at the va hospital. These visits were primarily to keep the meds coming. Ive recently started seeing a psychologist and obtained my records for him to see. THe VA Doctor had continually posted "presents better than the rating would suggest" over and over. Ive seen her 4 times / year for a few minutes each time. The Psychologist Im currently seeing says that she's dead wrong, my PTSD is severe. I'm having him fill out the 0960P-3 form.

Question?

Do I dare submit? I'm afraid the VA will look at the other doctors' notes and lower my rating.

Recommendations?

THanks

[Pete53]

Welcome to Hadit. I have never seen a 33% rating for PTSD or any other one for that matter. I suspect that your professional who says it is severe is your best chance for a higher rating.

[georgiapapa]

Welcome to Hadit. I am not sure how much weight the private psychologist's opinion would carry with the VA when you request an increase but I would definitely obtain copies of your medical records from your private psychologist and also ask your private psychologist for an IMO.

According to posts I have seen on this website, your PTSD diagnosis has to be made by a VA doctor and the VA will not accept a PTSD DBQ from a private doctor. I think this is unfair and the VA is doing this to limit the costs of PTSD claims. However, since you have already been diagnosed for PTSD by your VA doctor, the main question would be the severity of your PTSD. The VA may totally ignore your private medical records but it would not hurt your request for an increase by sending them to the VA.

It may also help if your private psychologist has better credentials to back up their opinion than your VA doctor. For example, you have a VA doctor with only a few years of experience and has never worked anywhere other than the VA and you have a private psychologist who graduated from a highly reputable med school, has 30 years of experience, specializes in PTSD, teaches at the local medical school, has written several articles on PTSD, etc. It would be hard for the VA not to consider the opinion of your private doctor as a more reliable opinion than the VA doctor.

Just my opinion.

[bensonsr]

Thanks for the quick responses. The PTSD is actually 30% (overall 80% rating, 33% was a swag). I feel that my condition has worsened and would like to request a relook. (the term IMO was in a response, not sure what that is). The form ia a disability benefits questionaire VBA 21-0960P-3, and I am having my Pschologist fill it out. My concern is that they see the Psychiatrists notes stating basicly that I dont present at the 30% level of disability and the disability is rolled back. I see her for 15 minutes ata time quarterly. She asks a few questions typing away and deflects any issues I bring up. I did not realize this was happening until I got a copy of my records for my psychologist. My pscychologist today told me that I am indeed much worse than she lets on.

Any advice would be appreciated.

SB

[carlie]

Thanks for the quick responses. The PTSD is actually 30% (overall 80% rating, 33% was a swag). I feel that my condition has worsened and would like to request a relook. (the term IMO was in a response, not sure what that is). The form ia a disability benefits questionaire VBA 21-0960P-3, and I am having my Pschologist fill it out. My concern is that they see the Psychiatrists notes stating basicly that I dont present at the 30% level of disability and the disability is rolled back. I see her for 15 minutes ata time quarterly. She asks a few questions typing away and deflects any issues I bring up. I did not realize this was happening until I got a copy of my records for my psychologist. My pscychologist today told me that I am indeed much worse than she lets on.

Any advice would be appreciated.

SB

The Psychiatrist has no business or authority to opine on what your evaluation (percentage) should be,that authority is held by the VBA decision makers.

The doc's job is to report symptoms and opine on how those symptoms would effect occupational and social functioning and Rx / manage meds if needed.

Sure sounds like this one is trying to play the gatekeeper game.

I would suggest requesting a change in Psychiatrist for your meds.

jmho

[Barbamatt]

I would get a new psychiatrist. You should let the VA know that you are no longer comfortable with her as your provider and you have trouble with trusting her...be open about it and demand a new one. It will be hard to have her changed as the VA doesn't like to change drs but you have the right to "fire" her and if you have to go to the patient advocate to get it done so be it.

You have to be careful not to get into arguments with them, but you have to be forceful when you request a change of providers. I have personal experience with the VA not wanting to let me change drs when I wasn't liking my shrink. They didn't want to change drs...I was still fighting it, but I moved in the process and am seen at a different VA hosp....hope that you don't have to move to get a new provider.

Maybe you won't have the same problem I had. I hope not..but you do have the right to change providers if you feel that the one is not giving you the care that you deserve.

[Gastone]

Have you obtained a copy of your PTSD C&P exam from the VA Hospital Medical Records Dept? Have you carefully reviewed the 38 CFR 4 regarding PTSD ratings? Next bump inrating is to 50%. You must have the symptom requirements of the 30% rating as well as the lion's share of the 50% rating. At your PTSD C&P, the examiner complete a PTSD DBQ for the VA rating dept. The rater uses the DBQ to determine your rating. In your original award, the Rater should have explained the evidence, used to determine your rating.

The new 2010 or 2011 VA regs require a Pschiatrist or PHD Psycologist preform the C&P exam. Their DBQ will trump any from the outside. Just recently the VA started using the New DSM-5 for rating purposes of PTSD. Some changes good, some ?????. The weight of your GAF score is lessened and more realistic. Hopefully, an improved GAF score by 1 clinician, won't be grounds for a possible rate reduction. In your case, I don't think it's medically possible to reverse PTSD from the symptoms of a 30% rating. PTSD Dr's & treating clinicians I've met with over the past 4 years, seem to be of the same mind, they can treat PTSD, but can't cure it. One point to consider, your at 80% SC currently. With VA Math, you need a separate SC condition of 30%,40% or 50% to get to 90% SC rating. Use the 38 CFR, do you rate an increase to 50 or 70%?? After careful research, if you do, FILE AWAY!

We as Vets, sometimes get caught up in how we feel things are or should be. You have to try and distance yourself from feelings regarding your claims. Study the VA 38 CFR 4 Research your conditions and determine exactly how to advance your position.

Good Luck

Semper Fi

Gastone SC PTSD 70% 2010

[bensonsr]

Thanks for the replies. My ratings are 30, 20, and ten 10s for a total of 75.5 %. I cant see the numbers bringing me up to 85+ so Im leaving this alone and requesting a new doctor. Thanks for the great and quick responses.

BTW, I am planning to file for Social Security disability. I do have solid records to back up, cant work etc. Can someone share their experience with me on this?

Thanks

[carlie]

I believe there is no longer any consideration of GAF scores

with DSM-5, for VBA purposes.

[Pete53]

GAF was phoney baloney I am glad that they don't fo that anymore.

[NavyWife]

If the main reason you are not working is due to your PTSD, you should be getting a much higher rating than 30%.

How about filing for TDIU since you aren't working?

I'm a little confused-- is the doctor that said your PTSD is severe a VA doctor or a private doctor?

Read over this link and let us know which percentage you feel most closely represents you. http://www.vva.org/ptsd_levels.html

[bensonsr]

The Dr (Psychologist) is private. Thanks for telling me about TDIU. I cant get there by percentage but am between 50-70 percent as per the link posted. I haven't seen a VA psychologist, hard to get to; am retired and use Tricare Prime to see a private one. I did request a VA one today, we'll see how far out I am from an appointment. Do I wait for a few visits with the VA Dr before I submit?

Thanks