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

[smoothc100]

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.

[smoothc100]

Here are the exam results I received in the mail below. So, I am really confused at this point as they labeled my condition as depression, also claimed as PTSD and basically denying the claim and then saying I meet the criteria for being treated for depression, because I was in the service when it was diagnosed. Maybe I'm just lost as all get out over here. I guess the way I'm reading this is I can claim depression even though they denied the depression as PTSD claim????? I know it sounds confusing but it is confusing to me. Still fight for the PTSD claim and file for depression? At the end of the day I just want to get the right help for my condition, which in my opinion and the Vet center for 2 years is PTSD and my doc at the VA has been treating me for depression and anxiety, but nothing else. They did not even consider the letters from my family.

Issue/Condition depression, also claimed as PTSD

• A claimant may reopen a finally adjudicated claim by submitting new and material evidence. New means that the evidence has not been considered before and material means it applies to the specific issue for which you were previously denied. New and material evidence must raise a reasonable possibility, that when considered with all the evidence or record (both new and old), that the outcome (conclusion) would change. The evidence can't simply be redundant (repetitive) or cumulative of that which we had when we previously decided your claim.

• The evidence from Baltimore VA examination is not new and material evidence because it does not establish a fact necessary to substantiate the claim and does not raise a reasonable possibility of substantiating the claim.

• A claimant may reopen a finally adjudicated claim by submitting new and material evidence. New evidence means existing evidence not previously submitted to agency decisionmakers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim.The VA examiner stated that there was no evidence to suggest a change in diagnosis from your previous VA examination. Consistent with both VA treatment notes and previous VA evaluation, and in consideration of all data submitted by you or on your behalf, criterias are not met for posttraumatic stress disorder per DSM-IV or DSM-5.The VA examiner did provide a diagnosis for unspecified depressive disorder with anxious distress. We then requested a medical opinion if this diagnosis was related to military service. The VA examiner stated that your reported stressors occurred in 1999. You reported symptoms are not consistent with a posttraumatic disorder, including posttraumatic stress disorder, depression or anxiety. Rather, your symptoms are a mild non-specific depression. The examiner further states it appears that you have tied your symptoms to in-service events, but have done so mistakenly. You 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 your reported stressors. Your report of symptoms has been rather vague and not consistent with a posttraumatic disorder. Thus, there is insufficient evidence to link your current mild depression to reported stressors that occurred in 1999.The evidence from Baltimore VA examination and neuropsychological evaluations from Dr Ziskind reviewed in connection with the current claim does not constitute new and material evidence because it does not relate to an unestablished fact necessary to substantiate the claim and does not raise a reasonable possibility of substantiating the claim.

• Entitlement to medical treatment for an active psychosis or mental illness is established because the evidence of record demonstrates you developed this condition within the required time period. You may apply for medical treatment at your local VA Medical Center. Please bring a copy of this notification letter with you if you wish to pursue this entitlement.

• A determination of service connection under 38 U.S.C. 1702 is for the purpose of providing eligibility for hospital and medical treatment for Veterans of World War II, Korean Conflict, or Vietnam era; or for Gulf War Veterans who develop an active psychosis or any active mental illness during or within two years from the date of separation from such service or within two years of the end of the war period, whichever is earlier. The Veteran was discharged on February 14, 2014. A psychosis/mental illness was first diagnosed on September 16, 2014. Entitlement to treatment is established because a psychosis/mental illness was diagnosed within the required period of time.

[Navy4life]

Unfortunately both C&P's (the original from 2013 and your C&P most recent) are not good at all. Both of the C&P's are negative towards you. In the one from 2013 the examiner even states you are not remembering on purpose:

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.

You don't have PTSD according to both exams. Furthermore an outside doctor can not submit a DBQ for you regarding MH DBQ's.

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.

There are no DBQs for the following medical examinations:

• Initial Examination for Post-Traumatic Stress Disorder
• Hearing Loss and Tinnitus
• Residuals of Traumatic Brain Injury
• Cold Injury Residuals
• Prisoner of War Examination Protocol

The VA rates depression, along with all other mental disorders, according to a “General Rating Formula for Mental Disorders.” Depression is rated according to how much it impairs a veteran’s social and occupational ability. While depression symptoms are relevant to the particular diagnosis a veteran is given, they have no impact on the actual rating. The rating is based on the effects of the symptoms on a veteran’s ability to function, not on the symptoms themselves.

The available ratings for depression are 0%, 10%, 30%, 50%, 70%, or 100%. A 100% rating is warranted only where a veteran has absolutely no ability to function socially or at work. A 0% rating is assigned where, despite depression symptoms, a veteran’s ability to function is not actually impaired. A 0% rating is still helpful, however, as it entitles the veteran to VA benefits such as health care.

• Gulf War Medical Examination
• General Medical Examination for Compensation Purposes
• General Medical Examination for Pension Purposes

If I were you I would open a totally new claim for MH/Depression & Anxiety. You have to have the diagnose which you do and furthermore the service connection for the disorder. Does any of your medical records while on AD link the depression/anxiety directly?

I am sorry but you just do not have PTSD

[Berta]

"Maybe I'm just lost as all get out over here. I guess the way I'm reading this is I can claim depression even though they denied the depression as PTSD claim????"

That is my take as well but I am surprised they didnt just go ahead and re characterise the disability to depression....

Can you scan and attach here their Reasons and Bases and the evidence list? Cover you name, address and C file number prior to scanning it.

BUT "The VA examiner stated that your reported stressors occurred in 1999. You reported symptoms are not consistent with a posttraumatic disorder, including posttraumatic stress disorder, depression or anxiety. Rather, your symptoms are a mild non-specific depression."

The 'non specific " part there is very troubling however......

Did you experience, and can you prove that an inservice event, accident, death of unit buddy, , combat situation, non combat situation, anything

at all that caused your symptoms , to support a "specific"" finding of a cause for depression , due to your service.?

A well know advocate friend of mine saw many dogs die while in Thailand when he was a dog handler. These dogs are viable security soldiers. He succeeded on his claims due to AO but he always believed the dogs were dying from the AO as well. That caused him great stress and depression.but not to the level to be noted in his SMRs.And it did not follow him after service but it still bothers him.

This is what I mean by a specific finding of a cause for depression.

It isnt a real good example however

I am a civilian but I sure think Many servicemen and women are depressed in service for Many reasons but VA needs something very specific and also proof of it..

If we can read here their rationale in the decision you got maybe we can help more.....

[smoothc100]

Below are the documents the VA used to make their decision, but I do not see the letters from family or the updated one from the Vet Center. I did however dig in my old personnel file and found orders my NCO who was with me for over 1/2 my tour and by luck found him on facebook of all places, so I will ask him for a letter as well as he was present during most of the incidents I address in my letter.

Evidence Considered

In making our decision, we considered:

• DD 214, from September 19, 1996 through March 18, 2001
• 5103 Notice Response and statement from Veteran received July 18, 2014
• Service treatment records, Received April 24, 2014
• Statement from Veteran received August 13, 2013
• Disability Benefit Questionnaire, posttraumatic stress disorder, XXXX, PhD, dated August 13, 2013
• Private treatment records, XXXXXXXs Psychological Associates, Neuropsychological Evaluation, Received August 13, 2013
• Medical Opinion, Dated October 27, 2014
• VA examination, Dated February 8, 2013
• VA examination, Dated September 16, 2014
• VA examination, Dated October 14, 2014
• Rating Decision, Dated March 11, 2013
• VA Form 21-0820 Report of General Information, telephone contact, dated July 7, 2014
• Letter from Disabled American Veterans, reconsideration of claim for posttraumatic stress disorder received August 13, 2013
• Timeline of traumatic events received August 13, 2013
• 5103 Waiver Review Letter dated June 27, 2014
• Letter from Disabled American Veterans received July 24, 2014

What You Should Do If You Disagree With Our Decision

If you do not agree with our decision, please download and complete VA Form 21-0958, Notice

LETTER FROM VET CENTER

10 July 2014

RE: Veteran

To Whom It May Concern;

The veteran named above was self-referred due to emotional detachment, avoidance, intrusive thoughts, anger, anhedonia, and hypervigilance in varying degrees since his deployment in 1999. He did not think in terms of these being related to experiences he had while deployed however, until recently with more public talk about PTSD and war zone trauma. His own experiences are related to some of the patrols he went out on but especially the frequent casualty and injury reports he was exposed to during the course of his job in personnel records.

An intake assessment was conducted on May 14, 2012, and follow up sessions have occurred approximately biweekly between then and now, at the Annapolis Vet Center.

The veteran completed a 12-week course of Cognitive Processing Therapy (CPT) for PTSD with the undersigned in March of 2014.

Veteran enlisted in the Army in 1996 and deployed to Kosovo in 1999 as a peacekeeper. His duties included going out on patrols and he was also responsible for accountability of the soldiers, and for casualty reporting (military and civilian).

A major part of his duty was to enter casualty and injury reports into the records which exposed him to frequent, graphic information about fellow soldiers as well as civilians.

Veteran endorses the following symptoms under Criterion B (re-experiencing): frequent intrusive thoughts and nightmares about the traumatic experiences, and severe distress when exposed to reminders of the traumatic incidents.

Criterion C (avoidance and numbing): symptoms include avoidance of anything reminding him of or connected to his experiences in deployment, significant lack of interest in any activities, feeling emotionally detached from other people, and severely limited ability to care about the problems of others.

Symptoms endorsed under Criterion D (hyperarousal) include: initial insomnia and outbursts of anger/rage. He is often suspicious and mistrustful of others, and tends to perceive threats even when it is not warranted. He finds it very difficult to concentrate and focus, and frequently reacts to unexpected sounds and movements with an exaggerated startle response.

These symptoms have significantly affected Veteran’s life in the following ways: the break-up of his marriage and other subsequent personal relationships due to excessive anger and diminished ability to relate to any emotions besides anger; living an isolated lifestyle in which he rarely leaves his house except for appointments or to visit his parents' house; extreme discomfort while riding public transportation to and from work due to hypervigilance and perception of threats; and having to recently drop out of school due to inability to concentrate enough to complete his assignments.

XXXXXX, Psychiatric Nurse Practitioner at the XXXXX VA Outpatient Clinic, prescribed XXX, XXmg for sleep; XXXX, XX mg for nightmares; XXXX, XX mg three times a day for anxiety; and XXXX, XX mg twice a day for mood. The results seem to indicate improvement in the Criterion D (hyperarousal) symptoms, slight improvement in the Criterion B (re-experiencing) symptoms, and little to no change in the Criterion C (avoidance and numbing) symptoms.

[DDuck]

"At the end of the day I just want to get the right help for my condition, which in my opinion and the Vet center for 2 years is PTSD and my doc at the VA has been treating me for depression and anxiety, but nothing else."

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219856/

Entitlement to medical treatment for an active psychosis or mental illness is established because the evidence of record demonstrates you developed this condition within the required time period. You may apply for medical treatment at your local VA Medical Center. Please bring a copy of this notification letter with you if you wish to pursue this entitlement.

I maybe missing something but it seems they are granting you access to VA mental health. I linked the article because it shows how closely MMD and PTSD are related and often one can be overlooked in the case of the other. If your mental health (MH) docs find you need PTSD treatment they will treat you for it, because it is a MH condition and you are entitled to that treatment as listed above in your letter.

If you are seeking compensation for that you are going to have to come up with more evidence it seems, and I do not think a buddy letter is going to help you a lot in your case. A buddy letter can help when evidence is present, but it seems that they are saying you lack the evidence needed for the compensation for service connection. I am not saying do not seek the buddy letter but from what you listed that buddy letter does not seem if it is going to be evidence needed to advance your case.

[Mikemmlj]

No matter what happens with your claim you served honorably...nothing takes that away.