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Would This Be Considered A Diagnosis?


kate7772
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Question

Working on getting an official VA diagnosis for my husband's PTSD claim that was recently denied.

This is what the denial said:

"We concede you experienced a stressful event in service or fear of hostile military or terrorist activity while in Vietnam."

"Your VA treatment records show you've been diagnosed with post traumatic stress disorder by a clinical social worker and a clinical nurse specialist. In order to conduct an initial examination for mental disorders, the examiner must meet one of the following criteria:"

Then it goes on to list the professionals qualified to diagnose. The attached medical notes from Myhealthyvet are of an evaluation done by a VA Clinical Psychologist which appears to be one of the ones listed in the denial (licensed clinical Psychologist. The Psychologist that performed the attached evaluation has a PSYD after his name. The evaluation was ordered to rule out cognitive problems but he did a depression test and PTSD evaluation. Would this not be a valid diagnosis? And, if not, what does he need to say?

Thanks

Kate

Document - clinical psych eval - Created Dec 14, 2014.pdf

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Can you attach the denial here...as to the reasons and bases part?

Copy C file # etc prior to scanning it.

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Kate: I think the VA stipulates that only a DX by the C&P examiner determines if a PTSD rating will be awarded. The NEW VA PTSD C&P rules require that only a DR. Psychiatrist or a Specially trained Psychologist with a "PHD" can do the C&P. These C&P Specialists will consider other medical opinions but they don't have to concur. As long as they didn't make a CUE error, your going to have a difficult time with the VA. I don't think this your going to get a quick reversal but send in all the Medical DX's you have. Possibly a piece of New & Material Evidence that wasn't available to the Rater at time of decision will trigger an Automatic VARO Review by a Senior Rater or a Decision Review Officer.

Semper Fi

Gastone

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That was a pathetic exam. They tip toed around you PTSD DX but did say you were severely depressed. If you can get 10-30% for any MH condition then you can get a IME to boost it up. Your exam was so inconsistent and confusing I really think that you will get 30 because they admit severe depression, but your wife says you have been jumpy all your life. Don't bring her any more to exams. Not her fault she just does not believe she is dealing with Satan. If your depression is SC you should get 100%. It says severe depression.

John

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I dont see the the Mississippi Scale for Combat-Related PTSD (M-PTSD)

listed there in the testing list.

The MSCR PTSD is different from the MMPI.

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Yes, he diagnosed you with PTSD, and said the criteria are met using DSM.

In my humble opinion, the VA wont be able to deny this, tho, expect them to try. For a disabity percentage for PTSD, you need to look at the criteria which have been posted here multiple times. The grey area there is Suicidal ideations, which is a big deal in your percentages since SI are present ONLY in the 70% and 100% categories.

quoting your exam:

DIAGNOSIS:
PTSD
Major Depressive Disorder
/es/
CLINICAL PSYCHOLOGIST
Signed: 06/25/2014 16:14
Receipt Acknowledged By:
06/26/2014 09:43 /es/, LISW-S
CLINICAL SOCIAL WORKER
06/26/2014 11:50 /es/
CLINICAL NURSE SPECIALIST
Date/Time: 19 Jun 2014 @ 1450
Note Title: MENTAL HEALTH DIAGNOSTIC STUDY NOTE
Location:
Signed By:
Co-signed By:
Date/Time Signed: 23 Jun 2014 @ 1546
PTSD Checklist M ---
SCALE RAW
DSM-IV PTSD Criteria B IS met
DSM-IV PTSD Criteria C IS met
DSM-IV PTSD Criteria D IS met
*** PTSD Diagnosis IS SUGGESTED
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