ptsd 100% Total And Perm. Or Unemployability. (Ptsd Claim Question)

[bh1981]

Hello Fellow Vets. I recently had a C&P exam for PTSD (among many other things). However, I had a question that I was curious about. I submitted a claim for TDIU but after looking at the Dr.'s notes via Myhealthevet, I am curious to find out if it is possible I that would receive a 100% scheduler rating, even though I submitted a claim for TDIU, based on the Dr.'s notes. I have copied and pasted the majority of the document for your viewing. I am currently rated at 70% for PTSD and 90% total. Thank for your help, opinion, and service.

-Brad

"Given the chronicity of this veteran's diagnosed PTSD and associated features of depression, at the current time he would experience significant problems in vocational and occupational pursuits requiring frequent or prolonged contact with others; sustained attention, focus, concentration, memory, and planning skills associated with goal setting and task completion; and sustained physical and psychic energy (given sleep disturbances). His chromic and intrusive thoughts would interfere with his ability to stay focused on the tasks. Intrusion of associated mood issues would undermine his focus and motivation to complete necessary assignments. In fact, the veteran related that toward the end of his last position (and related to his eventual resignation) he experienced diminished focus on the requirements of the job, given his distraction with internal mental images, stimuli, and emotional disruption. The veteran's continued hypervigilance and distrust of others would impair his ability to work with others naturally and comfortably. His irritability would both distract him from goal and task achievement, as well as undermine his functional relationship with others, including coworkers, supervisors, and/or consumers. The veteran's disrupted sleep functions would continue to undermine physical and psychoemotional energy needed for sustained stamina needed to complete assigned or self-imposed goals and work-related tasks reliably.Overall, the results of this examination indicate the persistence of psychological and functional challenges associated with the veteran's diagnosed PTSD. Given such, the veteran would have trouble at this time, in deploying available cognitive skills and abilities, as well as in working in a sufficiently functional capacity with others, in fulfilling the demands, tasks, and goals typically associated with most employment positions and/or work conditions that could be considered of a substantial and gainful nature."

3. PTSD Diagnostic Criteria

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

Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life threatening situations (non-combat related stressors.) Do NOT mark symptoms below that are clearly not attributable to the Criteria A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #6 - "Other symptoms".

Criterion A: Exposure to actual or threatened a) death, b) serious injury,

c) sexual violation, in one or more of the following ways: [X] Directly experiencing the traumatic event(s)

[X] Witnessing, in person, the traumatic event(s) as they

occurred to others

Criterion B: Presence of (one or more) of the following intrusion symptoms

associated with the traumatic event(s), beginning after the traumatic event(s) occurred:

[X] Recurrent, involuntary, and intrusive distressing memories

of the traumatic event(s).

[X] Recurrent distressing dreams in which the content and/or

affect of the dream are related to the traumatic event(s).

[X] Dissociative reactions (e.g., flashbacks) in which the

were with

individual feels or acts as if the traumatic event(s)

recurring. (Such reactions may occur on a continuum,

the most extreme expression being a complete loss of

awareness of present surroundings).

[X] Intense or prolonged psychological distress at exposure

to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

[X] Marked physiological reactions to internal or external

cues that symbolize or resemble an aspect of the

traumatic event(s).

Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic events(s) occurred, as evidenced by one or both of the following:

[X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with

traumatic event(s).

[X] Avoidance of or efforts to avoid external reminders

(people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts,

feelings about or closely associated with the traumatic event(s).

or dangerous,: "My whole nervous system is permanently ruined").

[X] Persistent negative emotional state (e.g., fear, horror,

anger, guilt, or shame).

[X] Markedly diminished interest or participation in

significant activities.

[X] Feelings of detachment or estrangement from others. [X] Persistent inability to experience positive emotions

(e.g., inability to experience happiness, satisfaction,

loving feelings.)

of

Criterion D: Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more)

the following:

[X] Persistent and exaggerated negative beliefs or

expectations about oneself, others, or the world (e.g.,

am bad,: "No one can be trusted,: "The world is completely

Criterion E: Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

[X] Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.

[X] Hypervigilance.

[X] Exaggerated startle response.

[X] Problems with concentration.

[X] Sleep disturbance (e.g., difficulty falling or staying

asleep or restless sleep).

Criterion F:

[X] The duration of the symptoms described above in Criteria

B, C, and D are more than 1 month.

Criterion G:

[X] The PTSD symptoms described above cause clinically

significant distress or impairment in social, occupational, or other important areas of functioning.

Criterion H:

[X] The disturbance is not attributable to the physiological

effects of a substance (e.g., medication, alcohol) or another medical condition.

4. Symptoms

-----------

For VA rating purposes, check all symptoms that actively apply to the

Veteran's diagnoses:

[X] Depressed mood

[X] Anxiety

[X] Suspiciousness

[X] Panic attacks more than once a week [X] Chronic sleep impairment

[X] Mild memory loss, such as forgetting names, directions or recent events

[X] Flattened affect

[X] Disturbances of motivation and mood

[X] Difficulty in establishing and maintaining effective work and social

relationships

[X] Difficulty in adapting to stressful circumstances, including work or a worklike setting

[X] Obsessional rituals which interfere with routine activities

5. Behavioral Observations: ---------------------------

* Appearance: Arrived on time for appointment. Casually dressed and in good hygiene

* Alert & oriented to time, place, and person

* Oriented to purpose of this evaluation. Confidentiality discussed and veteran concurred

* Behavior: Appropriate with good eye contact

* Attitude toward examiner: Engaged, polite, cooperative, and communicative

* Mood: Anxious and depressed

* Affect: Variable & congruent with material under review and

process

* Thought processes: Logical and goal-directed

* Thought content: No evidence or presentation of hallucinations, delusions, mania

* Speech: Rate/rhythm/volume within expected limits. Articulate.

* Judgment: Intact and assessed as good; Insight: Intact and assessed as good

* ADLs: No observed or reported gross problems with ADLs (Eating;

hygiene,

Household chores, etc.)

* Active/proximate Suicidal or homicidal ideations, plans, or intent: Denied

[bh1981]

Thanks Pete. I think I would stand a reasonable chance and fighting and winning a NOD in the event it isn't backdated appropriately. One of the reasons why I resigned was due to PTSD and what I feel is TBI and the residuals of TBI. So, hopefully, they will consider that when awarding me with whatever it is they choose to reward me. We'll see what happens. At this point it would be extremely hard for me to find and maintain suitable employment without exacerbating any of these conditions. I am curious to see if they give me the 100% scheduler as opposed to TDIU temporary, or TDIU total and permanent. I feel that the worst case scenario would be to get a TDIU temporary because that means going through all of this over and over again potentially. And obviously there are certain additional benefits associated with a permanent rating, be it scheduler or TDIU total & permanent, that aren't attached to a TDIU temporary rating. I just hope I get my fair shake and receive a permanent rating, which I feel is warranted because historically, my conditions have not improved but gradually gotten worse.