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C&p Results Don't Look Good.


kate7772
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Question

Looks like my husband's claim for PTSD will be denied. He was diagnosed in Jan. 2914 through VA. Their Psychologist and Psychiatrist concurred on the diagnosis. Has been receiving therapy through PTSD counselor at VA since diagnosis. Counselor says he is a "mess." Severe PTSD and major depressive disorder.

Now the examiner says my husband's problems are the result of his physical health (kidney disease) that was diagnosed two years ago. It's true that the ### really hit the fan at that time with PTSD symptoms becoming more severe. His counselor explained the reason for this is because he had to cut his work schedule to less than 1/2 time and has more time to dwell on things. Counselor said this is a common occurrence with PTSD.

The C&P results have not been posted on Myhealthevet yet; DAV rep gave us this info. I know we will need to wait for the official rating but looks like a long process is in front of us and my husband has very severe and worsening issues at work as a result of the symptoms.

Do you think contacting the VA secretary would help?

Thanks

Kate

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I would wait until you get a decision before you contact Bob. If you get a copy of his C & P exam report, post it so Hadit members can give you their input and suggestions. Black out personal identifying info on the report. JMO

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Hi there and first of all thank you for supporting your hubby!

I would not get too upset yet. You have only heard from the DAV rep meaning you haven't seen the C&P exam -so I would not assume all is lost at the moment. Wait until you can see the C&P Exam on MyHealthyVets and the redact personal info and post it on the forum for all of us to help give you some opinions.

When was the C&P Exam?

What makes you so confident the C&P exam went bad?

Hang in there - baby steps.....let's get the results of the C&P first!

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Hi there and first of all thank you for supporting your hubby!

I would not get too upset yet. You have only heard from the DAV rep meaning you haven't seen the C&P exam -so I would not assume all is lost at the moment. Wait until you can see the C&P Exam on MyHealthyVets and the redact personal info and post it on the forum for all of us to help give you some opinions.

When was the C&P Exam?

What makes you so confident the C&P exam went bad?

Hang in there - baby steps.....let's get the results of the C&P first!

The C&P was last week on Wed. DAV specifically said the mental symptoms were not as a result of PTSD but the physical problems. The examiner checked that my husband does not have PTSD despite the diagnosis from multiple experts. This was after he spent less than an hour with him and watched him fall apart when relating his stressors. He even commented to us that the stressors were bad.

My husband originally filed for anxiety, irritability, etc. in 2011 because we did not have any idea about the PTSD, only that he was having many mental issues and had been for years (Vietnam nam vet.). That claim was denied in 2013 without a C&P. My husband was diagnosed with PTSD in Jan 2014 and we filed for reconsideration. Instead of this, they considered it a new claim. The original filing was before my husband was even diagnosed with the kidney disease.

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I recommend you choose between the following courses of action:

1. Wait and read the C and P exam for yourself and not depend upon a Veteran Service Officer interpretation as it may or may not be accurate. Its too important to your financial health to trust the VSO interpretation. Im wondering even how your VSO got a copy before/instead of you. Can you ask him for a copy? I would.

2. If, indeed, this is a unfavorable C and P, then you need to take steps to correct it. To rebut an unfavorable exam, you need another medical professional opinion. Try asking for another VA doc who may offer a more favorable opinion, or

3. Get an IME/IMO.

Favorable Exam: The Vet is diagnosed with PTSD and its "at least as likely as not" due to events in military service.

Unfavorable exam: The Vet does not have PTSD OR its "at least as likely as not" unrelated to military service.

Edited by broncovet
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Broncovet - you are on the money with your response!

To further add on - you must get a second opinion from a VA doctor. For MH claims you can't enlist an outside doctor to give you the exam.

I am just as confused as to how the DAV is getting his/her info. I would read the C&P exam first before doing anything.....

The reason the PTSD is considered a new claim is b/c it was not claimed in 2011- "My husband originally filed for anxiety, irritability, etc. in 2011 because we did not have any idea about the PTSD, only that he was having many mental issues and had been for years (Vietnam nam vet.). That claim was denied in 2013 without a C&P."

Since your husband is currently under treatment I would review all the treatment notes as well. If any of those treatment notes were not used in his claim decision you can use them if the claim is denied or you don't get a favorable outcome.

Again all of this is "what if" stage right now.....GET the C&P exam and review it first.....

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Picked up a copy from our local CBOC. Pretty bad. It is still not posted on Myhealthevet yet. I will attempt to upload here when it is. Tried scanning the hard copy I got buy unsuccessful.

Some things were left out. Some things inserted that not said. Examiner said my husband seemed scripted. I was in with him and maybe he did. He was very nervous and realized the importance of not holding anything back as so often recommended here. He had gone over and over what he needed to include and made sure to try and include everything necessary. He just really opened up and couldn't stop once it started. Examiner said he was over reporting. Cannot win. When describing his military experiences, he fell apart, also something he never did before starting on this journey. He had never discussed any of this until starting counseling early this year. Now, he seems to dwell on it.

Examiner said he has another disorder: adjustment disorder with mixed anxiety and depressed mood. The mental problems increased drastically after cutting back the work hours which his PTSD counselor says is very common. Examiner also mentioned financial problems. We NEVER discussed finances at all except for the worry about possibly getting fired due to the mistakes and lack of concentration.

This is what was said: "It appears that the veteran began to experience difficulties at work and with finances after being diagnosed with significant kidney disease. His kidney disease has caused him to reduce significant amount of time at work due to the result of fatique and lower leg edema and thus limiting his finances which could be the cause of his psychological distress. The only thing true there was the edema part. My husband's original claim before getting his PTSD diagnosis was in 2011 for anxiety, irritability, etc. It was denied because we did not include any evidence. Had a totally worthless VSO that just basically reduced the claim to one sentence. Nothing else. No surprise it was denied. When we attempted to do a reconsideration after the PTSD diagnosis, it was opened as a new claim. This was a year before the kidney issues and needing to reduce his hours. So, obviously not caused by the kidney issues!

Examiner states that "The history and reviewed evidence suggests that his symptoms of PTSD are not as severe as his self-presentation, given that he has been successfully employed since his discharge from the military, no history of mental health treatment and in a stable and loving marriage for 42 years. True, he has worked a lot, usually two jobs during most of our marriage which his PTSD counselor made him realize was a coping mechanism used by many veterans suffering from PTSD. When veterans are no longer able to keep up the long work hours, that is when things really fall apart. And he has had a variety of different jobs. As to his lack of mental health treatment until earlier this year, he refused to admit anything was wrong and just pushed forward. But, he suffered as well as his family for many years with anxiety, short temper, irritability, low self esteem,isolating from others and avoiding social situations. We work with about 100 other people and they are a very social bunch, always getting together for parties and functions. They don't even bother to invite us anymore because my husband has always declined to participate They have referred to us as "snobs" because they don't know the circumstances. As to 42 years of a stable and loving marriage; I do indeed love him and take the "in sickness and health" very seriously but I was also the one that insisted he go to VA for counseling. I hoped they could help. Truthfully, he seems to be worse and now after this, he likely will not want to go back. He always felt he didn't deserve anything because he isn't missing limbs or anything physically noticeable. This examiner has succeeded in validating that feeling. How can this Psychologist not see what the others at VA have as to the delayed onset PTSD and getting worse after burying himself in work for years?

Examiner stated husband is a TV salesman. He sells furniture. Small thing but an example of non-listening.

Also said my husband watches TV and plays video games. Don't know where he pulled that from. Husband told him he can't watch TV shows or play video games because he can't concentrate.

My husband mentioned that is knows he is tough to live with and explodes easily. Examiner stated this but went on to say that my husband could give no examples. Again, not listening. he gave examples. I was right there.

The examiner provided no response for stressors, PTSD diagnostic criteria or symptoms.

Finally, he concluded with a "diagnosis of adjustment disorder with mixed and anxiety and depressed mood as the result of his current medical situation and not incurring or result of his military history". My husband was originally diagnosed by a clinical psychology nurse practitioner, referred to a PTSD clinical social worker for counseling and seen by a VA Psychologist and VA Psychiatrist who agreed with the decision. During counseling, the PTSD was called severe. But, this Psychologist decides in less than an hour that he does not have PTSD. This is very tiring.

Kate

Edited by kate7772
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