ptsd Will The Va Continue Me At 70% Or Increase To 100%?

[Navy04]

As you all know I had a PTSD review last week at VA. As usual some info the Doc forgot to look at or leave out, like the fact that exam notes states no TBI, yet I am SC for TBI/Migraines. Does it look like the VA will continue at 70% or increase to 100%? Also does it look like I might finally get Permanent. If you look at the Occupational and Social impact statement highlighted below, it looks like I will continue at 70%. If you look further down I have a statement in bold, where Psych Doc says that my PTSD symptoms cause Significant distress or impairment in Social, Occupational or other important areas of functioning. Thank you guys so much for the support on Hadit, you guys are God Send and I truly mean that!!!

Review Post Traumatic Stress Disorder (PTSD)
Disability Benefits Questionnaire
Name of patient/Veteran:
SECTION I:

. Diagnostic Summary
---------------------
Does the Veteran now have or has he/she ever been diagnosed with PTSD?
[X] Yes[ ] No
2. Current Diagnoses
--------------------
a. Mental Disorder Diagnosis #1: PTSD
Mental Disorder Diagnosis #2: Other Specified Depressive Disorder
Mental Disorder Diagnosis #3: Obsessive Compulsive Personality Disorder
traits

CONFIDENTIAL Page 4 of 11
b. Medical diagnoses relevant to the understanding or management of the
Mental Health Disorder (to include TBI):
No response provided.
3. Differentiation of symptoms
------------------------------
a. Does the Veteran have more than one mental disorder diagnosed?
[X] Yes[ ] No
b. Is it possible to differentiate what symptom(s) is/are attributable to
each diagnosis?
[ ] Yes[X] No[ ] Not applicable (N/A)
If no, provide reason that it is not possible to differentiate what
portion of each symptom is attributable to each diagnosis and discuss
whether there is any clinical association between these diagnoses:
Current symptoms overlap and are attributable to all three diagnoses,
PTSD, depressive disorder and obsessive compulsive personality
disorder traits.
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
[ ] Yes[X] No[ ] Not shown in records reviewed

4. Occupational and social impairment
-------------------------------------
a. Which of the following best summarizes the Veteran's level of
occupational
and social impairment with regards to all mental diagnoses? (Check only
one)
[X] Occupational and social impairment with deficiencies in most areas,
such as work, school, family relations, judgment, thinking and/or
mood
b. For the indicated level of occupational and social impairment, is it
possible to differentiate what portion of the occupational and social
impairment indicated above is caused by each mental disorder?
[X] Yes[ ] No[ ]

No other mental disorder has been diagnosed
If yes, list which portion of the indicated level of occupational and
social impairment is attributable to each diagnosis: Current symptoms
overlap and are attributable to all three diagnoses, PTSD, depressive
disorder and obsessive compulsive personality disorder traits. His
primary diagnosis is PTSD with PTSD signs and symptoms result in
deficiencies in most of the following areas: work, family relations,
judgment, thinking and mood.
c. If a diagnosis of TBI exists, is it possible to differentiate what
portion
of the occupational and social impairment indicated above is caused by
the
CONFIDENTIAL Page 5 of 11
TBI?
[ ] Yes[ ] No[X] No diagnosis of TBI
SECTION II:
-----------
Clinical Findings:
------------------
1. Evidence review
------------------
In order to provide an accurate medical opinion, the Veteran's claims
folder
must be reviewed.
a. Medical record review:
-------------------------
Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed?
[X] Yes[ ] No
Was the Veteran's VA claims file (hard copy paper C-file) reviewed?
[ ] Yes[ ] No
If no, check all records reviewed:
[ ] Military service treatment records
[ ] Military service personnel records
[ ] Military enlistment examination
[ ] Military separation examination
[ ] Military post-deployment questionnaire
[ ] Department of Defense Form 214 Separation Documents
[ ] Veterans Health Administration medical records (VA treatment
records)
[ ] Civilian medical records
[ ] Interviews with collateral witnesses (family and others who have
known the Veteran before and after military service)
[ ] No records were reviewed
[ ] Other:
b. Was pertinent information from collateral sources reviewed?
[ ] Yes[ ] No
2. Recent History (since prior exam)
------------------------------------
a. Relevant Social/Marital/Family history:
Please refer to previous C&P PTSD review exam dated 2/14/2014 for
additional background and history. Veteran reported he continues in
his
marriage of 11 years. Veteran and spouse have two daughters ages 9 and
6. Veteran reported limited contact with his family members. Veteran
added that his spouse is now his primary caretaker. Veteran added
"The
CONFIDENTIAL Page 6 of 11
VA pays for her to take care of me. I need help with bathing, cooking
and I quit driving in 2013 because I was forgetting where I was
going".
Veteran denied having any hobbies or interest at the present time and
reported "I guess I just sit and look out the window most of the
day".
b. Relevant Occupational and Educational history:
Veteran reported he has an undergraduate degree in "teaching"
and
completed a Master's Degree in 2013. Veteran reported he had
begun
working on an Doctorate in Criminal Psychology in 2013 but was unable to
continue in this program due to "I can't remember things, I
don;t like
being around people, I get angry easy and I just can't function
like I
used to".
Veteran has a rather extensive educational history as evidenced by
information gathered during review PTSD C&P exam dated 2/14/2014
"Was
working for the state as an agent, tracking sex offenders. Resigned
due
to physical and mental issues, couldn't handle it. Has a
Bachelor's in
Criminal Justice and homeland security. Was working on Master's
classes, dropped out in fall due to dropping grades. Has a few classes
left to finish MA. Started MA August 2012, completed 6 classes. Also
has BA in teaching".
Veteran reported he resigned from work with the US Marshall's
office in
2013 and reported he began receiving SSDI for "mental health
problems"
in 2013.
c. Relevant Mental Health history, to include prescribed medications and
family mental health:
Veteran's current psychotropic medications are topiramate,
alprazolam,
risperidone and prazosin.
d. Relevant Legal and Behavioral history:
None
e. Relevant Substance abuse history:
None
f. Other, if any:
No response provided.
CONFIDENTIAL Page 7 of 11

3. PTSD Diagnostic Criteria
---------------------------
Please check criteria used for establishing the current PTSD diagnosis. The
diagnostic criteria fo
r 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)
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).
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
the
traumatic event(s).
[X] Avoidance of or efforts to avoid external reminders
(people, places, conversations, activities, objects,
situations) that arouse distressing memories, thoughts,
or
feelings about or closely associated with the traumatic
event(s).

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)
of
the following:
CONFIDENTIAL Page 8 of 11
[X] Persistent and exaggerated negative beliefs or
expectations about oneself, others, or the world (e.g.,
"I
am bad,: "No one can be trusted,: "The world is
completely
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.

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] Chronic sleep impairment
[X] Flattened affect
[X] Impaired judgment
CONFIDENTIAL Page 9 of 11
[X] Disturbances of motivation and mood
[X] Difficulty in establishing and maintaining effective work and social
relationships
[X] Impaired impulse control, such as unprovoked irritability with
periods
of violence

5. Behavioral Observations:
---------------------------
The Veteran's thought process and communication skills appeared to
be
within normal limits. The Veteran denied having any symptoms of
delusions
or hallucinations and none were apparent. The Veteran was cooperative,
maintained good eye contact, and exhibited no inappropriate behavior.
The
Veteran denied having any current suicidal or homicidal ideation, plan,
or
intent. The Veteran appeared able to maintain personal hygiene and basic
activities of daily living. The Veteran was well-oriented to all three
spheres. The Veteran's short and long term memory appeared to be
without
gross deficits.

6. Other symptoms
-----------------
Does the Veteran have any other symptoms attributable to PTSD (and other
mental disorders) that are not listed above?
[ ] Yes[X] No
7. Competency
-------------
Is the Veteran capable of managing his or her financial affairs?
[X] Yes[ ] No

[Philip Rogers]

They generally go with the previous exam/award and stick w/the same rating. It sounds like you've been rated about one year or so, so I wouldn't plan on receiving a P&T status, especially since you appear to have done well up until 2013. Once you hit the 5yr mark you'll have a better chance and will probably be awarded P&T, then. I see two things that are detrimental to your claim and they are good eye contact and no suicidal or homicidal ideation. Most of us, even so-called normal people, have suicidal ideation, periodically. You probably just didn't want to admit it. jmo

Good luck!!

pr

[63SIERRA]

The TBI error is unnacceptable.

remember they feed all that stuff into the m -21 deny- a -vet system and it spits out a rating.

Just like the bible, the constitution, the law of the land, everything is hinged on WHAT IS WRITTEN!

Edited February 22, 2015 by 63SIERRA

[USMC_HVEQ]

navy04,

phil was correct. I see them continuing your 70%. If you are IU then I agree as well w/o the 5 yrs of it being 70%, then you may not achieve p&T status. I know that isn't what you want to hear but without an suicidal/homicidal thoughts/plans, i'm not saying to make any up either, or any hospitalization, the 100% schedular does not seem likely either.

i had suicidal thoughts and it didnt matter they contiued my 70% as well, but just gave me p&T since i was 70% on PTSD for 5 yrs.

[Buck52]

I would disagree with the c&p examiner about your TBI IF he/she reviewed the C-file that should have been put in his/her report about your DX on the TBI!

I Differ with the others, I think they will increase rather than keep it the same and you probably will be awarded the 100% P&T.

beings your history OF educational back ground is good with a masters in teaching.

However if you can't do the job because of your service connected disability's I believe you have a good chance they will increase and give you IU.

Don't be to disappointed if they do keep it the same....We never can til which way they will go?

I wish you the best of Luck!

JMO

Buck!

[Buck52]

Navy04

I think it is great you continued your education as long as you could & received your degree's, its unfortunate that your disability's keeps you from doing what you went to school for as for as your employment.

I hope the rater will take all of this into consideration Buddy.

[john999]

I don't know what the VA will do, but get an IME/IMO and appeal the decision unless you get everything you want. You cannot just lay your case in the hands of the VA and expect justice. You need to provide your own medical evidence. If you are TDIU then just go for P&T. You just need to establish that you are not getting better over time. I admit it does sound more like 70% than 100% but what do I know? TDIU or 100% it does not matter if you can't work. If you want to be rated 100% and then return to school or work it gets harder.