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

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saints13

Question

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!!

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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.

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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.

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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.

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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.

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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!!!

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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!!!!!!

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