ptsd What Does This Mean For Me Ptsd C&p Results

[smoothc100 27]

STANDARD TITLE: C & P EXAMINATION NOTE

DATE OF NOTE: OCT 27, 2014@08:00 ENTRY DATE: OCT 27, 2014@13:11:21

URGENCY: STATUS: COMPLETED

Medical Opinion

Disability Benefits Questionnaire

Indicate method used to obtain medical information to complete this

document:

[X] Review of available records (without in-person or video telehealth

examination) using the Acceptable Clinical Evidence (ACE) process

because the existing medical evidence provided sufficient information on which

to prepare the DBQ and such an examination will likely provide no

additional relevant evidence.

[ ] Review of available records in conjunction with a telephone interview

with the Veteran (without in-person or telehealth examination) using the

ACE process because the existing medical evidence supplemented with a

telephone interview provided sufficient information on which to prepare

the DBQ and such an examination would likely provide no additional

relevant evidence.

[ ] Examination via approved video telehealth

[ ] In-person examination

Evidence review

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

Was the Veteran's VA claims file reviewed? Yes

If yes, list any records that were reviewed but were not included in the

Veteran's VA claims file:

VBMS/CPRS reviewed

MEDICAL OPINION SUMMARY

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

RESTATEMENT OF REQUESTED OPINION:

a. Opinion from general remarks: Please review and opine if this diagnosis

is related to his claimed stressors from military service. (please see list of

stressors in your exam. If his diagnosis is related to any of these

stressors, please if possible indicate which ones.

MEDICAL OPINION: is veterans diagnosis of unspecified depressive disorder

with anxious distress as least as likely as not related to any of his

claimed stressors from military service. Please provide rationale.

b. Indicate type of exam for which opinion has been requested: PTSD

TYPE OF MEDICAL OPINION PROVIDED: [ MEDICAL OPINION FOR DIRECT SERVICE

CONNECTION ]

b. The condition claimed was less likely than not (less than 50%

probability) incurred in or caused by the claimed in-service injury, event

or illness.

c. Rationale: The veteran's reported stressors occurred in 1999. His

reported symptoms are not consistent with a post-traumatic disorder, including PTSD,

depression or anxiety. Rather, his symptoms are a mild non-specific

depression. As noted in my evaluation, it appears that the veteran has tied

his symptoms to in-service events, but has done so mistakenly. He reported

irritability with anger, poor sleep, loss of interest and anxiety in crowds,

on airplanes and during fireworks. There is no evidence of mental health

treatment until 2012, 13 years after his reported stressors. His report of

symptoms has been rather vague and not consistent with a post-traumatic

disorder. Thus, there is insufficient evidence to link his current mild

depression to reported stressors that occurred in 1999.

I understand it's been years with no treatment but if you don't know anything is wrong how can you get help. I was diagnosed by a civilian doctor and have been going to treatment at the vet center and the VA is giving med meds.

[Berta 4,215]

For PTSD claims under the new PTSD regulations, a VA MH provider MUST diagnose you with PTSD.

The examiner did make this statement:

" Rather, his symptoms are a mild non-specific
depression."

But did not make a nexus statement that would help you.


"I was diagnosed by a civilian doctor and have been going to treatment at the vet center and the VA is giving med "

What did the civilian doctor diagnose you with?
If for depression perhaps the PTSD claim can be re-characterized into a depression claim. Do you have a vet rep?

However the C & P exam states:

"He reported
irritability with anger, poor sleep, loss of interest and anxiety in crowds,
on airplanes and during fireworks."
All of above are consistent with combat PTSD and even non combat vets exposed to explosions ( such as the explosion and fire USS Iowa.) I know a non combat vet who has PTSD from that.And sure avoids fireworks.due to it.

But PTSD involves more than what you reported.

I worked with PTSD vets and all of them had problems with fireworks,but theirs was due to the sounds of war.

There might be some inservice situation you had that involved similar acoustical events such as the USS Iowa accident....???

"There is no evidence of mental health
treatment until 2012, 13 years after his reported stressors. His report of
symptoms has been rather vague and not consistent with a post-traumatic
disorder. Thus, there is insufficient evidence to link his current mild
depression to reported stressors that occurred in 1999."

You have reported "stressors" but they probably were not only too vague but perhaps not consistent with your MOS..

I dont doubt you had stressors and possibly minimized them , and it is Not unusual for a vet to not have MH treatment many years after the fact, but just about everything has to be proven to the VA these days....

please read my link here as to stressors and buddy statements.

Edited November 4, 2014 by Berta

[smoothc100 27]

The VA Mental Health Intake Clinic initially diagnosed me and then I saw a VA doc who said I didn't have it because I had a job, in school, and didn't even listen to what I had to say, so the VA not only referred me and called the Vet Center 2 weeks later, because they said they couldn't get me in due to my work schedule. Been going to the Vet center ever since 2 years now. I had a 3 day Neuropsychological Evaluation conducted by an outside provider which stated the following:

Axis I: 309.81 Post Traumatic Stress Disorder, Chronic

296.33 Major Depressive Order, recurrent, severe

300.02 Generalized Anxiety Disorder

Axis II: None

Axis III: Herniated Disc with nerve damage, gall balder removed

Axis IV: Problems functioning at work and school

Problems with primary support group

Problems related to the social event

Axis V GAF: 52 (current)

After my initial C&P (this was my second as a Reopen for my claim) the doctor also filled out a PTSD DBQ

and refuted the C&P examiner's statements basically stating that she disagreed with his findings. Plus I

have issues with my working memory as well, which was documented in the evaluation. As far as proof I

type a 2 page letter showing the events and how it is currently impacting my life and relationships. I

received an ARCOM and it stated "working in austere conditions". Not only that my primary job was

casualty reporting among all the foot patrols etc. I guess my next question would be if they deny me for

PTSD shouldn't the VA rate me for Depression? I've been working with the DAV and have followed

everything to the letter of what to do.

[Berta 4,215]

Thanks for that additional info......

"I guess my next question would be if they deny me for
PTSD shouldn't the VA rate me for Depression? I've been working with the DAV and have followed
everything to the letter of what to do.}

I think they "Should" but one never knows what the VA will do.

Did you specifically mention depression in the PTSD claim?

Does the VA know of the ARCOM and if so, did they comment on it in any denial?

This was a reopen and you have not received a decision yet.......

It is possible the VA will award you for depression.

Still I am thinking that something might be missing here and hope others chime in.....

Can you possibly scan (cover your C file number, name and address) the Reasons and Basis and Evidence list from the past denial?

Does the ARCOM write up in any way reflect the stressors you had?

Does VA have this info:

"I had a 3 day Neuropsychological Evaluation conducted by an outside provider which stated the following:"

Did they ever comment on it.?

I regret vets have to go through this BS due to the 2010 new PTSD criteria.

Did the C & P examiner know of the independent Neuro evaluation?

Your MOS alone would depress anyone but we all have to accept the fact ( as we discussed with Dr Bash at our radio show recently) that it does Not pay for vets to minimize their stressors or their reactions to them.

I have been around the VA block a long time and was advising vets 30 years ago that VA often wants the blood and guts stuff.

It certainly might not be that graphic of a stressor but they want to know details and have some proof.

Is there anything in your SMRs or Personnel file that would support a SC depression or anxiety disorder NOS?

Dont give up on this ,due to the C & P exam ...your claim is far from over.....

[Berta 4,215]

PS........ I forgot to ask.........

A re open requires N & M evidence (New and Material) what evidence did they accept in order to re-open the claim?

[Navy4life 699]

What "triggered" this C&P exam?

Why was it not an "in-person exam?"

When were you denied the first time (year) and if so is this on an NOD (notice of disagreement)?

The rationale is what is concerning me....The examiner is stating you don't have PTSD and that you are trying to link it to your in-service but the examiner is stating it is not related to your in-service.

The gap to me is irrelevant as I too got out in 1996 and did not file my initial claim until May 2013. I am currently partially S/C awaiting the remaining claims to be evaluated. So again the gap doesn't matter IMHO.

what does matter is that you have a DIRECT link to AD (Active Duty) - continuity of care linking to the contention (PTSD)

His report of symptoms has been rather vague and not consistent with a post-traumatic disorder. Thus, there is insufficient evidence to link his current mild depression to reported stressors that occurred in 1999.

That above statement at the end of your C&P exam the examiner is clearly stating that not only do you not have PTSD but that the mild depression he/she believes you have is not even related to in-service.

Is there any way to find out why you did not have a "face to face" C&P? I would urge if possible to request a C&P exam with someone in person.

So sorry you are going through this!

[smoothc100 27]

Here is the original C&P below the doctor did determine that I have depression and this was also stated on my Exit Physical from the Active Duty Army as well as sleep issues. What the VA stated they needed for was New and Material Evidence to connection between PTSD and service and they did accept the reopen. I initially provided a Trauma Timeline of the events I was exposed to during my deployment, 214 (Kosovo Campaign Medal, NATO Medal, and Armed Forces Commendation Medal) with medals relevant to deployments in a hostile environment according to the VA guidance have some form of presumptuous evidence, Letter from my therapist at the Vet Center, and Neuropsy. Eval. My current C&P was done via video conference due to the distance.

LOCAL TITLE: C&P EXAM

STANDARD TITLE: C & P EXAMINATION NOTE

DATE OF NOTE: FEB 08, 2013@09:00 ENTRY DATE: FEB 09, 2013@10:55:57

URGENCY: STATUS: COMPLETED

COMPENSATION AND PENSION EXAMINATION

INITIAL EVALUATION FOR POST-TRAUMATIC STRESS DISORDER (PTSD)

============================================================

REVIEW OF RECORDS

=================

C-FILE WAS:

Reviewed

MEDICAL RECORDS WERE:

Reviewed

OTHER MATERIAL REVIEWED:

DD-214

MEDICAL HISTORY

===============

AGE: 35

PERIOD OF SERVICE: Army 1996-2001; Air force reserves 2005-present

PAST MEDICAL HISTORY

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

SIGNIFICANT NON-PSYCHIATRIC ILLNESSES, INJURIES, OR HOSPITALIZATIONS:

Herniated disc

DATES, CURRENT TREATMENT, AND OTHER SIGNIFICANT DETAILS OF NON-PSYCHIATRIC ISSUES:

Navy Medical Center- Nerve ablition Oct 2012. He reports he gets that

Every 6 mos and also gets cortisone shots.

TREATMENT WAS THERE OUTPATIENT TREATMENT FOR A MENTAL DISORDER? Yes

DATE(S) OF OUTPATIENT TREATMENT: 2012-present

CONDITION(S) AND LOCATION OF TREATMENT:

Depression/Insomnia Currently sees,CRNP-CNS for medications management at the Baltimore VA. Also attends Annapolis Vet Center for individual sessions once every 2 weeks since May 2012. He

reported he started sessions there .

HOSPITALIZATION(S)

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

WERE THERE ONE OR MORE HOSPITALIZATIONS FOR A MENTAL DISORDER? No

PRESENT MEDICAL HISTORY

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

SYMPTOMS PRESENT DURING PAST YEAR: Yes

IS THERE CURRENT TREATMENT FOR A MENTAL DISORDER? Yes

SUMMARY OF CURRENT TREATMENT FOR A MENTAL DISORDER:

CURRENT TREATMENT(S): Anti-depressant, Anti-anxiety

SPECIFY MEDICATION AND OTHER COMMENTS: 1) SERTRALINE 100MG TAB (ZOLOFT)

2) TRAZODONE 100MG 3) BUPROPION ORAL SR 150MG

MEDICATION SIDE EFFECT(S): None

GROUP THERAPY: No

INDIVIDUAL PSYCHOTHERAPY: Yes

OTHER THERAPY: None

EFFECTIVENESS OF THERAPY: Good

COMMENT ON EFFECTIVENESS OF THERAPY: Veteran reports he is calmer on the

medications and his overall mood is improved.

*****************************************

FREQUENCY, SEVERITY, AND DURATION OF NON-PTSD PSYCHIATRIC/MEDICAL SYMPTOMS:

Veteran reports daily back pain of 5 (on a scale from 1-10 with 10 being the most pain)and prevents the veteran from physical activity such as running, basketball, and PT.

PTSD INITIAL: PRE-MILITARY HISTORY

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

EDUCATION: Masters

FAMILY STRUCTURE AND ENVIRONMENT WHERE RAISED:

Veteran was raised by mom and dad and moved around often. Both parents were in the military. His mom was in AF and father in Army. They stayed together. He reports a good childhood; denies exposure to abuse/violence. Veteran is oldest of 4 children.

FAMILY PSYCHIATRIC HISTORY:

Sister-diagnosed bi-polar

Mother-mother bi-polar suffers from depression

QUALITY OF PEER RELATIONSHIPS AND SOCIAL ADJUSTMENT:

Was an honor student. Went into the service after graduating from HS.

PERFORMANCE IN SCHOOL:

Completed a BA and 2 Masters degrees in Human Resources and business degree. Veteran received all degree online.

TYPE OF JOB(S):

DLA

DATE(S) OF EMPLOYMENT:

1994-1996

ISSUES ASSOCIATED WITH ALCOHOL USE:

No use

ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE:

No problematic effects

BEHAVIORAL DISTURBANCES OR LEGAL PROBLEMS PRIOR TO SERVICE? No

OTHER SIGNIFICANT PRE-MILITARY HISTORY:

None reported.

MILITARY HISTORY

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

DATE(S) OF SERVICE: Army 1996-2001; Air force reserves 2005-present

BRANCH OF SERVICE: Army

HIGHEST RANK OBTAINED: Army E4; Air force E-6

TYPE OF DISCHARGE: Honorable

RANK AT DISCHARGE: Army E-4; Air force E-6

DECORATIONS AND MEDALS AWARDED: Kosovo Campaign Medal

DID THE VETERAN HAVE COMBAT EXPERIENCE: Yes

WERE COMBAT WOUNDS SUSTAINED: No

LOCATION AND DATE OF COMBAT EXPERIENCE: Veteran served with peacekeeping

forces in Yugoslavia, Kosovo in 1999 for 6mos. This was a peace keeping mission.

ALCOHOL USE OR ABUSE: No Problematic Effects

OTHER SUBSTANCE USE OR ABUSE: No Use

OTHER SIGNIFICANT MILITARY HISTORY: Herniated disc from lifting doing a two

man carry during an exercise in 2007 Gulfport Mississippi.

*******************************

PTSD INITIAL: POST MILITARY PSYCHOSOCIAL HISTORY

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

LEGAL HISTORY? No

EDUCATIONAL ACCOMPLISHMENTS? Yes

COMMENTS AND DESCRIPTION OF EDUCATIONAL ACCOMPLISHMENTS:

Veteran has completed 4 year degree and 2 master degrees online.

DESCRIPTION OF MARITAL AND FAMILY RELATIONSHIPS:

1st married 1999-2006. Step daughter 21 and 1 daughter 12 years old. Veteran has a 9 year old son with another German woman that he never married. Veteran provides child support for both of his kids. His kids live in Germany. Veteran reports he ended a 2 year old relationship and is not currently dating.

DESCRIPTION OF DEGREE AND QUALITY OF SOCIAL RELATIONSHIPS:

Veteran reports he is not in any relationships right now. He reports has had 3-5 different relationships that last about 2-3 years.

DESCRIPTION OF ACTIVITIES AND LEISURE PURSUITS:

Reports school was his hobby. He reports he likes to play puzzled computer games like Bewjewled also first person shooters such as Call of Duty. Likes to watch marital arts Movies. Made a point of saying he does not watch military oriented movies anymore.

HISTORY OF SUICIDE ATTEMPTS? No

HISTORY OF VIOLENCE/ASSAULTIVENESS? No

SUMMARY STATEMENT OF CURRENT PSYCHOSOCIAL FUNCTIONAL STATUS:

Veteran reports he has mostly military friends he does not normally associate with people outside of the military.

ISSUES ASSOCIATED WITH ALCOHOL USE:

No problematic effect

ISSUES ASSOCIATED WITH OTHER SUBSTANCE USE:

No use

PSYCH EXAM

==========

GENERAL APPEARANCE:

Clean

PSYCHOMOTOR ACTIVITY:

Unremarkable

SPEECH:

Slow

ATTITUDE TOWARD EXAMINER:

Cooperative

AFFECT:

Normal

MOOD:

Good, Elated

ATTENTION:

Attention Intact

ABLE TO DO SERIAL 7'S? No

ABLE TO SPELL A WORD FORWARD AND BACKWARD? Yes

COMMENTS:

Veteran had some trouble doing serial 7's. His concentration was mildly impaired.

ORIENTATION:

INTACT TO PERSON: Yes

INTACT TO TIME: Yes

INTACT TO PLACE: Yes

THOUGHT PROCESS:

Unremarkable

THOUGHT CONTENT:

Unremarkable

DELUSIONS:

None

JUDGMENT: Understands outcome of behavior

INTELLIGENCE: Average

INSIGHT: Patient understands that he/she has a problem.

DOES THE PATIENT HAVE SLEEP IMPAIRMENT? Yes

COMMENTS AND DESCRIPTION OF EXTENT SLEEP IMPAIRMENT INTERFERES WITH DAILYACTIVITY:

Veteran falls sleep between 12 midnight-5am. Difficulty falling and staying asleep. Wakes up feeling tired. Veteran reports he has night sweets.

TYPE OF HALLUCINATIONS:

None

DOES THE PATIENT HAVE INAPPROPRIATE BEHAVIOR? No

INTERPRETS PROVERBS APPROPRIATELY? Yes

DOES THE PATIENT HAVE OBSESSI

VE/RITUALISTIC BEHAVIOR? No

DOES THE PATIENT HAVE PANIC ATTACKS? No

IS THERE PRESENCE OF HOMICIDAL THOUGHTS? No

IS THERE PRESENCE OF SUICIDAL THOUGHTS? No

EXTENT OF IMPULSE CONTROL: Good

EPISODES OF VIOLENCE: No

EXAMPLES OF EFFECTS ON MOTIVATION/MOOD OR OTHER COMMENTS:

None

ABILITY TO MAINTAIN MINIMUM PERSONAL HYGIENE? Yes

IS THERE PROBLEM WITH ACTIVITIES OF DAILY LIVING: No

COMMENTS OR ELABORATION OF ANY ITEMS IN THE MSE OR FOR ITEMS NOT COVERED OR

OTHER COMMENTS:

None

MEMORY

------

REMOTE MEMORY: Normal

RECENT MEMORY: Mildly Impaired

IMMEDIATE MEMORY: Normal

EXAMPLE(S) OF MEMORY DISORDER:

Veteran was able to immediately recall 4 words pen, clothespin, car, dog. However after a 1 minutes delay veteran started to recall the 4 words again and then stopped and then said he could not recall the

Last three words. Veteran appeared to be underperfoming on purpose.

PTSD STRESSORS

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

STRESSOR EVENT(S) THE VET FOUND PARTICULARLY TRAUMATIC:

Combat experience

DESCRIPTION OF STRESSOR: Combat experience

DATE AND LOCATION: 1999, Kosovo

TRAUMA OCCURRED: During Military Service

INTENSE FEAR: No

FEELING OF HELPLESSNESS: No

FEELING OF HORROR: No

OTHER REACTION: No

ADDITIONAL COMMENTS: He reported that while on patrols he was often fired out by snipers.

*******************************

TRAUMA EXPOSURE TESTING

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

TESTING FOR TRAUMA EXPOSURE VETERAN HAS UNDERGONE:

No testing has been done

PTSD SYMPTOMS

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

PERSISTENT RE-EXPERIENCING THE TRAUMATIC EVENT BY:

No symptoms present

PERSISTENT AVOIDANCE OF STIMULI ASSOCIATED WITH THE TRAUMA AND NUMBING OFGENERAL RESPONSIVENESS:

Restricted range of affect (e.g., unable to have loving feelings)

PERSISTENT SYMPTOMS OF INCREASED AROUSAL:

Difficulty falling or staying asleep, Hypervigilance

THE DISTURBANCE CAUSES CLINICALLY SIGNIFICANT DISTRESS OR IMPAIRMENT IN

SOCIAL, OCCUPATIONAL OR OTHER IMPORTANT AREAS OF FUNCTIONING: No

DESCRIPTION OF THE ONSET OF SYMPTOMS: Chronic

FREQUENCY, SEVERITY AND DURATION OF PTSD SYMPTOMS FOUND:

Veteran reports he has weekly issues with hyper vigilance and sleep but is able to report normally for work every day. He did not report missing work because of feeling sleepy.

LENGTH OF REMISSIONS AND CAPACITY FOR ADJUSTMENT DURING REMISSION:

None

BEHAVIORAL, COGNITIVE, SOCIAL, AFFECTIVE, OR SOMATIC CHANGE THE VETERAN

ATTRIBUTES TO STRESS EXPOSURE:

Veteran reports he has some depression and he said specifically he feels "emotional numbing" and detached from other people. The veteran reports he has violent dreams but did not report reoccurrence of the specific traumas he reported that he saw. In fact his dreams were vaguely described. Veteran had a typed list of a number things any deployed solider would witness while on a deployment however, he did not specifically report fear or feeling traumatized by these events. The veteran seemed very familiar

With the PTSD symptoms and even mentioned very psychological specific terms such as emotional numbness and hyper vigilance which most veterans are not familiar with. Despite the veterans depression and social withdrawal he still works full time as XXX for the air force. Veteran appears very motivated by his work and even handed the examiner a letter of appreciation he received in 2008 for his work in a specific military exercise. The veteran appeared very proud of his accomplishments in the military.

TESTS

=====

INTERVIEW-BASED DIAGNOSTIC INSTRUMENTS FOR PTSD:

None

QUANTITATIVE PSYCHOMETRIC ASSESSMENT OF PTSD SYMPTOM SEVERITY:

None

DIAGNOSIS

=========

PTSD INITIAL: MENTAL COMPETENCY

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

DOES THE VETERAN KNOW THE AMOUNT OF THEIR BENEFIT PAYMENT? Yes

DOES THE VETERAN KNOW THE AMOUNTS OF MONTHLY BILLS? Yes

DOES THE VETERAN PRUDENTLY HANDLE PAYMENTS? Yes

DOES THE VETERAN PERSONALLY HANDLE MONEY AND PAYS BILLS? Yes

IS THE VETERAN CAPABLE OF MANAGING FINANCIAL AFFAIRS? Yes

EXAMPLE(S) TO SUPPORT THIS CONCLUSION:

Has checking account but no credits cards. Veteran reports that his credit is bad cant get credit cards.

IS A SOCIAL WORK ASSESSMENT NECESSARY TO RENDER AN OPINION? No

EXPLANATION:

See above.

PTSD INITIAL: EMPLOYMENT HISTORY

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

USUAL OCCUPATION:

Contract specialist for the Navy.

IS THE VETERAN CURRENTLY EMPLOYED? Yes

CURRENT OCCUPATION:

TYPE OF EMPLOYMENT: Fulltime

DURATION OF CURRENT EMPLOYMENT: 1 to 2 years

TIME LOST FROM WORK DURING LAST 12-MONTH PERIOD: 2 weeks

CAUSE(S) OF TIME LOST FROM WORK IN LAST 12-MONTH PERIOD:

Veteran reports he has missed work due to medical procedures or for

doctors appointments.

OTHER OCCUPATIONAL HISTORY SINCE DISCHARGE OR SINCE LAST EXAM:

Veteran was air force reserve tech. Worked in that job 2 years.

PROBLEMS RELATED TO OCCUPATIONAL FUNCTIONING:

Decreased concentration

DOES THE VETERAN MEET THE DSM-IV STRESSOR CRITERION? No

DOES THE VETERAN MEET THE DSM-IV CRITERIA FOR A DIAGNOSIS OF PTSD? No

AXIS I: Depression, NOS

IF ANY ADDITIONAL MENTAL DISORDERS HAVE BEEN DIAGNOSED, EXPLANATION OF HOW THE SYMPTOMS ARE RELATED TO OR ARE PART OF EACH MENTAL DISORDER:

None

AXIS II: None

AXIS III: Herniated Disc in back

AXIS IV: Physical Limitations

AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING

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

SCORE: 65TIME FRAME: Current functioning

COMMENTS:

The overall pictures is one of an individual who had made a satisfactory adjustment prior to entering military service to the extent that there were no gross indications of behavior control problems. The veteran did report that both his mother and sister have bipolar disorder and that his father did two tours in Vietnam and probably had PTSD. Veteran does NOT meet diagnostic criteria for PTSD during this examine. However, he does meet crieteria for Depression, NOS. Although the veteran

seemed very convinced he has PTSD and almost seemed to use this as crutch for his current failed relationships with exwife and girlfriends he did not meet full DSM-IV-TR criteria. Veteran does report stunted emotions, but does not meet Criterion 1-A of the stressor criteria despite handing the examiner a typed list of a number of events that any solider would experience in a combat evironment. Veteran was animated almost excited when discussing his stressors. Veteran did not report experiencing fear

for his life while deployed, or, the life of those around him. Veteran was able to openly discuss his deployment in detail almost in too much detail in some cases, giving a running commentary as a reporter would. Veteran does have some mild depressive symptoms that currently seem well controlled on his psychotropic medications.

PSYCH SUMMARY

=============

OTHER COMMENTS:

He does not have PTSD.

WAS A MEDICAL OPINION REQUESTED? No

COMPENSATION AND PENSION EXAMINATION

MENTAL DISORDERS (EXCEPT PTSD AND EATING DISORDERS)

===================================================

REVIEW OF MEDICAL RECORDS

=========================

C-FILE WAS: Reviewed

MEDICAL RECORDS WERE: Reviewed

MEDICAL HISTORY

===============

IS THIS EXAMINATION FOR REVIEW OF AN ALREADY SERVICE-CONNECTED MENTAL

DISORDER?

No

MENTAL DISORDER: PRE-MILITARY HISTORY

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