ptsd What Is Va Trying To Do With My Ptsd Claim? What Rating Is Possible?

[saints13]

Any advise please, please on what the Rater/RO/ETC is trying to do? Please also any advise on what percentage may be awarded?

June 2014:

My initial PTSD C&P exam the examiner gave me a 100 questionnaire. Then she called me back to her office asked me a few questions then typed on her computer for 45 mins. I obtained the report a few days later and it was not favorable at all, even went on to say I was malingering, forging and lying, over exaggerating my symptoms. She mentioned I did have depression and anxiety and should have no problem with obtaining employment and this is unrelated to my military experience.

I immediately sent in a request for reconsideration and sent in letters from my VA Psychologist, NP Psychologist, PCP and Neuropsychologist and letter from VA VOCREHAB ILP Program that I'm unemployable and not suitable for training. I saw on Ebenefits that a re-evaluation of the PTSD exam and conflicting medical opinion was being done. I received the below.

Beginning of March 2015:

[ OPINION REGARDING CONFLICTING MEDICAL EVIDENCE ]

I have reviewed the conflicting medical evidence and am providing the following opinion: Opinion & Rationale: According the reports by Dr's., Veteran PTSD symptoms and Major Depressive Disorder are related to his military experiences. The Veteran's PTSD reflects moderately impairment in symptoms of, "intrusive experiences, hyperarousal, attempts at experiential or behavioral avoidance, negative alterations in mood and cognition" related trauma. For this Veteran, there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational task are limitations to employment. Although, there may be limitations in his ability to maintain employment, the Veteran's moderate symptoms do not completely prevent him from engaging in gainful employment with physical or sedentary work.

Psychologist PhD #1

Signed

I sent in a request to the RO asking for a status on my claim and if anymore C&P exams or anymore C&P exam re-evaluations. I never received a response but just saw on ebenefits yet again another C&P re-evaluation but by a different Psychologist just a few days after the above Opinion & Rationale.

Middle March 2015:

MEDICAL OPINION SUMMARY

RESTATEMENT OF REQUESTED OPINION:

a. Opinion from general remarks: The VAMC examination completed on 6/25/2014 shows a diagnosis of Major Depressive Disorder, Recurrent , Moderate with Anxious Distress. The Examiner opined that the condition was less likely than not related to the Veteran's military service. However, the Veteran has submitted a medical opinion from VAMC physicians which state that the Veteran's mental health condition is related to his military service. Please review the cited evidence and state if it is at least as likely as not that the Veteran's currently diagnosed mental health condition is related to his military service. If so, what impact does the condition have on the Veteran's ability to obtain and/or maintain gainful employment?

b. Indicate type of exam for which opinion has been requested: mental health TYPE OF MEDICAL OPINION PROVIDED:

[ OPINION REGARDING CONFLICTING MEDICAL EVIDENCE ]

I have reviewed the conflicting medical evidence and am providing the following opinion: As noted above, the Veteran's C&P PTSD examiner (Dr. XX) did not give the Veteran a diagnosis of PTSD. The Veteran was given a diagnosis of Major Depressive Disorder but was deemed unrelated to his military service. As the examiner (Dr XX) from noted, his initial diagnosis of PTSD was given on by his primary care doctor who did not complete an adequate assessment sufficient for giving such a diagnosis. However, the Veteran was given a diagnosis of PTSD by Dr. Psychologist VAMC based on an extremely thorough evaluation. The Veteran completed the same exam given by Dr. XX (i.e., Trauma Symptom Inventory). During the C&P evaluation, the Veteran completed the TSI but endorsed the items on the exam in a manner that rendered the examination invalid. The Veteran was able to complete the exam without rendering it invalid for Dr. Psychologist VAMC. The findings of this evaluation were consistent with someone who has experienced a trauma event. The Veteran completed three additional PTSD self report measures; each of the measures were positive for PTSD. In addition, the clinical interview given by Dr. Psychologist VAMC was also positive for a PTSD diagnosis. In summary, this informs this examiner that the Veteran has sufficient PTSD symptoms to obtain a PTSD diagnosis without resorting to over‐endorsing symptoms (as done in the C&P exam with Dr. XX). In addition, this examination was given prior to Dr. Psychologist VAMC having fully established a relationship with the patient. This makes it more likely that the exam could be considered unbiased and impartial.

In summary, it is more likely than not that the Veteran meets diagnosis criteria for PTSD and Major Depressive Disorder. Given that the trauma events occurred in the military, it is more likely than not that the Veterans diagnosis of PTSD is related to experiences in the military. It is also likely that the MDD is secondarily related to the Veterans diagnosis of PTSD. This is based on the fact that individuals with PTSD commonly suffer from depression resulting from psychological and other challenges that PTSD creates. The exact relationship of depression to PTSD can best be determined by additional psychological evaluation.

It is also difficult for this examiner to comment on the Veteran's level of impairment and/or ability to obtain and/or maintain gainful employment at this point in time without some amount of speculation. The Veteran's most recent chart note by Dr. Psychologist VAMC does not provide enough information to give an informed opinion. Therefore, an additional psychological examination is warranted.

Dr. Psychologist eval #2

Signed

The first re-evaluation was done a day after I sent a message to the Director of the RO asking about the reconsideration and letters I submitted to dispute the first PTSD C&P exam and saw it was opinionated in my favor.

The second re-evaluation was done the day after I sent in another request asking the status on my claim and it is favorable but also says additional psychological examination is warranted.

This is happening to a few of my other claims as well. almost same exact as what's happening to the PTSD claim

Thank you so very much for all your time and help!!!!! it is greatly appreciated!!

[Notorious Kelly]

Hang in there and you will win; others with more detailed advice will follow.

We're rooting for you!

[georgiapapa]

saints 13,

Since you are familiar with your PTSD symptoms listed in the medical evidence you submitted in support of your claim, go to 38 CFR part 4.130 and review the schedule of ratings for mental disorders (including PTSD). Compare your symptoms from your medical evidence with the different boxes showing symptoms required for each percentage level. The box containing the majority of your symptoms is the percentage level you should be awarded by the VA. If you have the same amount of symptoms in more than one box, you should receive the rating of the box with the higher percentage level. JMO

Good luck to you.

GP

[saints13]

ThankNotorious Kelly!!!! Just wondering why so many medical opinions and it's funny it only happens the day after I ask the Director of the Regional Office for an update. Probably pissed somebody off. I just don't give a f$;&k anymore. They always said shut up, be tough, etc while in the military and I did. So now there wasn't much in my medical Service records. Then they med board me out for bad knees, go figure!!

Tired of waiting, tired of their games, their special wording, and everything. Seems like I have a case for every VA doctor visit on something they left out, something I didn't say or stuff added that they didn't do. Then rater take it as fact. On top of that then there is almost a CUE in every decision that is made. And the clock starts all over yet again. Sorry for venting, just pisses me off to no end!!!!!

[saints13]

Georgiapapa thanks!!!! Did that but rater is gonna probably just look at the c&p wording alone.

moderately impairment in symptoms of, "intrusive experiences, hyperarousal, attempts at experiential or behavioral avoidance, negative alterations in mood and cognition" related trauma. For this Veteran, there is occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational task are limitations to employment.

Without reading anything else. That only looks like 30% according to their scale but if they read any notes from any of the VA mental healthcare providers, they are are in agreement between 50 to 70% according to all their wordings. My last cognitive test results were severe but I'm positive they will overlook that part.

[saints13]

Next step is honorable McDonald or honorable Hickey. If not them then will go to OIG and keep going up to even the president or to the news. I'm sure with my emails then the timings of these multiple re-Evans of c&p results and medical disagreements things will add up and just be another black eye to the VA. I only want what is necessary and truthful. I would not even care about back pay, etc if they just rated me right and stopped playing these games.

[kate7772]

This sounds similar to my husband's claim. C&P Psych gave that test, then decided my husband was over reporting. He did give wording to indicate 50% level but said it was not ptsd but was an adjustment disorder due to his non service connected kidney disease. After we complained about the crappy C&P, the kidney disease was service connected and adjustment disorder also awarded.

Then we disagreed with the percentage since the examiner had not even bothered to ask about or put any symptoms in the C&P. Due to this, we stated that there was no way the decision could be accurate.

Filed a reconsideration and asked for a new C&P. Well, instead of a new one, they sent it back to the same doctor to complete. Didn't want this since he was so biased and unable to do it right the first time.

He completed it but still left out most of the symptoms that are all through my husband's VA medical treatment notes and would put him in at the 70% level. I truly believe he just went back in a and picked out the symptoms that would agree with his original opinion.

So, now we are complaining again. So tired of this but not giving up.

Kate

[knap-sack]

You are diagnosed with ptsd and they acknowledged this. With that c&p its like taking a dart and throwing what your percentage will be. Just knowledgeable guess would be 50% but you could get 70%. You should know something soon. Hang in there keep seeing your doc too.

[knap-sack]

My Advice is do whatever it is that calms you. I know what it feels like having a million things going on and all the anxiety pulling you down into depression. You have the main thing that your ptsd is service connected. Take it easy do what they ask it will turn out ok.

[saints13]

Thank you very much knap-sack, I make sure to follow every single thing they say to do, what to send, etc. but they still want to play there games.

[knap-sack]

If they give you another c&p take the paperwork that you sent in for your claim copy it hand the it to examiner and then just answer his questions honestly and keep it shortand simple. Your almost there dont worry. Your doing great coming here. Your amamong friends.

[Navy04]

I see the VA granting you SC for PTSD at the 30-50% level, again just a guess. I feel and know how you feel bud. I was awarded 100% Temporary last year, and was supposed to have my conditions reviewed Feb 2016 to include PTSD. Well I submitted an FDC claim in Nov 14 for a few conditions that the VA keeps denying, and for an increase. What happened next is uncalled for, well the VA thought that I was Rocking the Boat and decided to Review most of my SC conditions, even my PTSD. Well had 8 C&Ps over a 2 week period at 2 different VAs. Well the Reviews were brutal especially the PTSD Review, I was in there for over 2 hours, and did that stupid PTSD Test and the one with the facial expressions. What happened next is that not only is the VA going to continue the Reviewed Conditions, but it looks like a few will be increased, and the other new conditions appear to be granted SC. So it backfired in the VAs face. I truly wish you the best. Good luck and God Bless!!!

[saints13]

Thank you knap-sack and Navy04!

Now I'm really irritated, frustrated, pissed off, worried, etc. just received a call that va compensation wants to do a c&p exam for increase of PTSD next week. I never received anything that I was service connected for PTSD officially from the RO.

I just had total knee reconstruction a week ago and they have already did two re-Evals of on my original mental c&p exam that I rebuke to the medical discrepancy and sent in letters from my VA mental providers saying I have a diagnosis of PTSD.

What about my evaluation for severe mental cognition I had? Last time the examiner did not want my wife in the exam or look at any evidence I brought with me.

It is at the same VAMC so I'm sure original examiner is talking to the new examiner. VA playing their games yet again!!!!!!

[saints13]

Has anyone else experienced this type of Torment?

PCP initial PTSD screen

VA NP PTSD screen

VA initial screening, evaluation and testing that took about 2-3 hours

Referral to Neuropsychologist and and eval, testing that took about 4 - 5 hours

PTSD Individual and group therapy for over 15 months

Finally a C&P exam that went wrong and I rebuted it with letters from all mental VA providers and also one from VA PCP

Referral by VA PCP for speech/Cognitive disorder and an evaluation and testing about 2-3 hours long (Weekly appts for 12 weeks)

A re-eval not in person exam that was fair and ended up favorable

Referral by VA PCP for speech/Cognitive disorder and an evaluation and testing about 2-3 hours long (Weekly appts for 12 weeks)

A second re-val, not in person exam that was fair and favorable but also stated warranted another C&P psychology exam

C&P Exam set up within a day of the second re-eval

I would have thought that 4 letters in support of my stressors, etc and diagnosis along with 2 favorable re-evals of the original C&P exam, it would have been a closed case and finally settle, rated and move on so other veterans can be rated.

Or am I just over re-acting, my wife tells me to just calm down and forget about it and do whatever they say. VA only has one more than likely not C&P exam but I have tons of other evidence showing differently.

[Berta]

I know you will get an award, yet I fear they might low ball you...

but if they keep farting around with you contact Ms Allison Hickey.

"letter from VA VOCREHAB ILP Program that I'm unemployable and not suitable for training."

If Voc Rehab said training was not feasible Solely due to your SCs, then you should get 100% or TDIU, depending on when you apply for it..

Do they have a copy that letter?

If one is un voc rehabable,they are unemployable.

I am in a similar runaround myself and , after all the past battles I had, this one is fun...aggravating but still fun

because, the more VA tries to obscure ,obfuscate, and confuse, the more likely they will document stupid stuff that you can get them on.

I found 4 CUEs in each of their last 2 decisions to me.

You aren't over reacting at all. this is BS plain and simple, and many of us hardcore claimants know exactly how this feels,

but the wife is right,

because once we calm down , we can think so much better as to how to combat this negative stuff,,while they just keep spinning on their thumbs.

Edited March 24, 2015 by Berta (see edit history)

[saints13]

Thank you so much Queen Berta and I mean that in a good way!!!!!!! Around 3am this morning I sent an email to all the VA RO and asked for help, what is the update and why do they keep this up. I got a call from a social worker saying I stirred up something big, but stuff is moving. I still do not believe it until I see it. And for me that is the biggest issue. Can't seem to trust anyone anymore by what they say. A long time ago people backed up their word. Now it seems it's a practice to keep you quiet for awhile

Yes VA has a copy of the VOCREHAB letter and it is basically service connected. Except for two non connected disabilities that would be low balled or a zero % if I pushed for it. Just tired and need to get back into therapy asap cause everything is worsening daily. Again thank you!!!! If get word from you it is pretty much golden.

[knap-sack]

Saint I have been seeing a psychologist since April last year weekly I also go to group therapy but thats basically a gripe session I dont like it but I go. I had to take a 550 question test the day I had the c&p. Its not been an easy road. The doc has helped me now I know when its a symptom instead of everbody is out to get me. They are really good docs out there and I got a good one. I haven't let my guard down and thats ok its one of my symptoms. The va has a way of doing business and we have to fall in and do what they want.

It gets hard. But never give up

[saints13]

Thanks knap-sack.!!!

I have been going to weekly and group therapy every week except since October 15th. I have total knee reconstruction on one knee then same procedure on other knee in March. I asked for it to be bi-weekly due to other issues. But I need the weekly back!!!! I loved my dr, the VAMC, speciality clinics, mental health, etc. just do not care for any of the c&p examiners and they are located about 200 feet from my VA PCP in the same VAMC!!!! How can you not get or see the current records? Baffles me. Once this is all over I'm done with everything claim wise. Will never submit another one again. Need my mind and health back. Thank you for your advise and trying to calm me down. You and my wife have made it tolerable to live right now. Been stuck in my room since I noticed all this mess they r playing. Guess play along and wait it out. Again thank you!!

[Berta]

"Once this is all over I'm done with everything claim wise. Will never submit another one again. Need my mind and health back."

That is their goal, get us so fed up we won't file any more claims.
I used to feel that way.
"I got a call from a social worker saying I stirred up something big, but stuff is moving." Good.

Then I started to use the war tactic of TTOOB.I made that tactic up but it works for me.

When you really get discouraged and KNOW you are right, you must do all you can to TTOOB. (Take thumbs out of butts)

allison.hickey@va.gov

If I had not contacted her, my claims would still be collecting dust at my VARO.
I was trying to be patient due to the backlog but had not even had an acknowledgement of these claims from my VARO for 2 1/2 years.
When my RO found out I contacted her, the director (as well as Ms. Hickey) sent me many emails and also phone calls,from the RO, and then they immediately denied my claims.

That is they did award the CUE claim but said they didn't owe me anymore accrued money.No legal rationale whatsoever.

The accrued regs are quite clear and the only changes to them in 20 years is that they have become more favorable.

BS to that.

I thought I saw it all with some of their past bogus stuff, and fought back until I won, but
I raised quite a legal ruckus (AGAIN) and my claims are now at VA Central.The case worker there emailed that he got the ten volume files and the C file etc etc would contact me maybe this week, or next week.

[Berta]

I was even thinking of filing an Writ of Mandamus.

This type of writ must show you have exhausted all available appears procedures etc, and you are asking the court to do something.

Most Writs Mandamus are denied because the claimant still has avenues of resolve, via the appeals process, but how about asking the CAVC to order the VAROs to become literate in VA 101?

Why do we need to appeal the fact that they either cannot read or apply VA case law properly.

I figured the writ would get denied but many lawyers would call me or send me letters,as soon as they saw the docket (happened to me before.) Of course no money in Mandamus so they lost interest in my last case at the court.decades ago.(COVA),when they found out what it was for,.

But I would have plenty of lawyers to gripe to and they would get it.

I have already griped to the RC here in NY, the OGC, and to NVLSP.on the ludicrous denials I got 2 weeks ago.

[saints13]

You are a very dedicated, strong woman!!!!!! I appreciate all the advise you have given me. It has gotten me this far. Seems closer I get the stronger they fight.

Just like a CUE I'm thinking about dropping just so my claim gets closed. I don't see how I will be granted for it. Even though it is clear as day it is an error on their part back to 1998 which is about 40,000.00. Denied tinnitus in 1998, 2008 but approved in 2014. Their rationale was 1998 was clear and unmistakable error on their part. They were granting 0 % for 1998 decision and 10% for 2014 decision. I did not submit any new evidence in 2014, only new evidence was the c&p exam they had me do. My exit med board exam clearly stated chronic bilateral knee problems, bilateral hearing loss and tinnitus. You stated or NOD stated it maybe a very hard thing to be granted since they have me 0 % out of nowhere for 1998 decision just so they could get out of the backway I would have been owed.