Concerned About Claim

[tdubya82]

[deleted]

Edited July 21, 2016 by tdubya82

[Gastone]

PTSD Group Therapy, anyone? Things may have changed but I doubt it. Back in 2008, every time I saw my VA Primary Care Dr, she'd ask about PTSD symptoms and I said I really didn't want to talk to anyone. Jump ahead about a year or so. I'm discussing my Sleep Apnea with the VA Sleep Disorder PA. He's a retired USA Col. During our 3rd or 4th meeting he starts asking some very pointed questions. After which he directs me to go immediately down to my Prim Care Dr and tell her I want treatment for PTSD and if there are any questions, to call him. I did as he instructed, a PTSD Symptom sheet was completed and scored by the DR. I was refered to the Mental Health Dept where another PTSD screening was administered by a Nurse and scored again. After which she asked me to choose between seeing a Psych Dr or joining a PTSD Group Treatment program with a Mental Health Social Worker. About 6 mos later I had a PTSD C&P and about 4mos later was SC for PTSD. Attended group sessions on a weekly basis and once a month Individual meetings with the Social Worker for about 21/2 years. To the best of my knowledge, the PTSD Group Sessions are still part of the PTSD treatment options

As for the actual PTSD DX for compensation purposes, the C&P Psychiatrist or Psycologist PhD. determination as to what exact mental health issues are at play, will be the final determination. Other Drs opinions and possible DX will be looked at but under the VA's New PTSD Regs, the C&P Dr's DX is the one that counts. Check out the PTSD DBQ and study the New DSM V. How do your symtoms measure up? Be prepaired. Do the Lawyer thing, try to know the answer to the question before it's asked.

Good Luck

Semper Fi

Gastone

[bionoce]

F VA government doctors. All of them. That goes for the shrinks, social workers, and all mental health workers within the system. Government is not our friend. Get help on the outside if you can brother. Get real treatment for your suffering and use it all as ammunition against the VA if they're not hearing and understanding you. If you go back to the VA every other word out of your mouth should be PTSD and you have to tell them about how much you're suffering. I feel your pain and hope for the best for you.

Edited February 13, 2015 by bionoce

[NavyWife]

Good job being proactive and asking to see a different Healthcare provider. But a month seems like a really long time. If that is not acceptable to you then you need to keep asking for a sooner appointment with a psychologist or psychiatrist only.

It's unfortunate that the social worker is not recording in his notes accurately What you are telling him. But the good news is that he is not a psychologist or psychiatrist and certainly not a doctor. So it should be fairly easy to dispute anything he wrote-if it comes to that.

When you have your appointment with the psychologist say, "I would like to be evaluated for PTSD ". If they give you an official diagnosis that will dramatically help with your VA claim for ptsd.

With your CIB, and combat time, the stressor should be conceded (they accept it).

With the PTSD claim the three main parts are:

1. Get diagnosed by a VA psychologist or psychiatrist

2. Get the stressor approved-yours should be approved automatically

3. Get a proper rating based on how severe your symptoms are. You can do this at the C&P exam as well as in your appointments with the new psychologist. Many veterans will get approved for PTSD but start out with a lowball rating. You can help yourself by accurately describing your symptoms according to how you feel on your worst days, Not just the day you are there. You also want to make sure and point out how this issue is causing you to not be able to work full time.

Here is how the claims are rated.

General Rating Formula for Mental Disorders

Rating

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0

[Gastone]

What Navy said! Just remember, what you say, can and will be used against you. As the PTSD SC % increase due to YOUR reported and DR DX'd symptoms, so does the danger of the Appointment of a VA Fiduciary. The simplest comment by a Vet that his wife "pays all the household bills," can trigger the Fiduciary Appointment. We all have to agree, a Vet with a 100 SC PTSD Rating is obviously more likely to be in need of a VA Fiduciary than say a 20 or 50% SC.

I choose to believe that the majority of Vets that end up with a Fiduciary, actually need them. The VA has to be proactive in protecting the Vet's finances. As with all things, the 10% rule comes into play, you don't want to get caught up in the small percentage that really didn't need the VA Fiduciary. A Vet can always request that a Spouse, or other Trusted Relative or friend be appointed as the Fiduciary. That's just a request and all must meet the VA Fiduciary Qualifications and Requirements, to even be considered. Not a good situation and one to be avoided if at all possible.

Semper Fi

Gastone

[USMC_HVEQ]

group therapy is def an option along with individual thereapy. Group, depending if it is just OEF/OIF vets or is it all vets, may be more directed on topics to keep everyone sort of focused. Individual therapy, whether it is at a Vet Center or @the VA with a Pyschologist or PHD student will be more where you address your specific issues. THe Pyschiatrist, will be the one to administer the drugs, if needed to help you...depending on the Doc, some are more engaging than others and discuss options vs just saying take this or that.

As for your claim, look at the ratings criteria and write down for your own use, examples of each symptom and if it relates to you and how it impacts your life. You may have some, all or none of the symptoms, but only you know. Just saying take an honest assessment for yourself. You will also need this information for claims purposes when you go to the c&P. It's very easy to forget things or not want to tell the c&P person your life story since you really dont know them, but you must tell them all the nitty gritty details, bad or good.

Diagnosis: as others have stated, a PHD pyschologist or Pyschiatrist need to make the DSM-5 diagnosis for VA rating purposes. Speaking to a social worker is great, but their opinion doesn't hold much weight, so don't be worried. Just go over your details and reaffirm what you are saying. Let them do the diagnosing. You shouldn't have a problem, but I do understand it can be very bothersome. Once a DSM-5 diagnosis is establish, you will then have a C&P, if you file a claim for it. The C&P doctors diagnosis and opinion is the one that holds the most weight and is either a confirmation or a denial of sorts on your symptoms and severity.

Again, just keep plugging away and all the rest will eventually take care of itself.

I wish you good luck.

Semper Fi

[Berta]

Dr Fairchild is a retired U.S. Army Clinical Psychologist ,in Florida, with a very impr4ssive background on treating PTSD, but I found nothing on the net to show he is a VA MH doctor.

These days, under the 2010 PTSD regs (Maybe your rep doesn't understand those regs)
the VA would reject a non VA PTSD diagnosis ,even if it was from Sigmund Freud.

MH docs like Dr Fairchild could possibly prepare a good IMO to support a higher rating for established PTSD, but you need the VA diagnosis first.

As Navywife correctly said:

With your CIB, and combat time, the stressor should be conceded (they accept it)."