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