ptsd Upcoming Complicated Multiple C&ps, Please Advise

[Rivet Joint]

Hello everyone,

Here's a little backround info as this is my first post; I submitted an FDC (for Hemiplegic Migraine with secondary left hand and face parasthesias, Intractable Chronic Migraine, PTSD, Shoulder Injury, and Wrist Injury) online on April 7, received a paper confirmation letter dated 9 April 15, and then didn't hear anything until this friday when FedEx delivered two packages with instructions to report for C&P exams on June 9th (migraines) and June 18th (PTSD) both outsourced to VES.

I did try to get help (PTSD symptoms) at the Phoenix VA hospital a while back as a walk in, and was told there was no one there, (not no one available, actually no one present) and to come back another time. I also tried to use the online system to get an appointment, but never heard anything. Since my husbands insurance covers me, I went private instead and for the past two years the Mayo Clinic has been my PCP. I submitted all of my relevant records from Mayo along with copies of my service medical records in the FDC.

The first C&P is with a PA. When I called the number on the form to confirm the appointment I was told it's for "migraines." When I looked through the forms etc I see that I meet the criteria for 50% ratings for both migraines AND hemiplegic migraines independently (both are definitely prostrating, both occur multiple times a week, and both interfere with my ability to maintain employment). Anyone who has ever had a hemiplegic migraine (which is almost no one, they're pretty rare) knows that they are a VERY different beast from "regular" migraines. They also have different diagnostic codes and different treatments, therefore IMO they should be considered separately, which is why I also assume the VA will try to lump them together.

I have an appointment with my neurologist at Mayo this Friday, and he's already said he'll fill out any forms I need. I'm thinking I'll ask him to fill out the DBQ forms, but do two separate migraine forms, one for each type, and also the appropriate DBQ for the parasthesia. But I'm assuming I'd still go to the PA for the C&P unless otherwise notified after faxing in the DBQ's.

As far as the PTSD goes, I was diagnosed by the psychiatrist at Mayo which was in the records I submitted. He also stated that it was a direct result of my first hemiplegic migraine, which happened while flying over Afghanistan (we declared an IFE but were not allowed to divert the aircraft) and I thought I was dying of a stroke, which I relive every time I have one. So would this scheduled C&P on the 18th be the initial since the diagnosis wasn't made by the VA? Or would this count as a review? I also noticed the examiner is a PhD not an MD, should I be worried about that? Should I ask my psychologist at Mayo (the initial eval was by the psychiatrist, but I have regular sessions with the psychologist there to help with anxiety) to do the DBQ form for PTSD review? I also cited a second stressor event in the claim, but due to the nature of te job I can't give any details at all, how does classified material get handled in these cases?

I haven't heard anything about the shoulder and wrist issues yet, but they're both well documented in my service records, so hopefully I'll get notice that something has been scheduled soon. Is there anything else I should be doing in the meantime?

Thanks in advance

[Gastone]

You might want to review the VA PTSD DBQ. All your other Medical claims seem to be SC as long as your SMR's back you up. What SC %? Compare your symptoms to your condition as listed in 38 CFR 4.

The PTSD C & P Dr's opinion will trump your non VA Dr's DX for ratings purposes if they don't agree as to Nexus and or severity. BE PREPARED

Semper Fi

Gastone!

[Berta]

Thank you for your service.

Gastone is correct.

"As far as the PTSD goes, I was diagnosed by the psychiatrist at Mayo which was in the records I submitted. He also stated that it was a direct result of my first hemiplegic migraine, which happened while flying over Afghanistan (we declared an IFE but were not allowed to divert the aircraft) and I thought I was dying of a stroke, which I relive every time I have one. " That certainly would be in your SMRs and is an established nexus....that is the migraine condition.

I also assume VA would consider that to be a stressor.

because I assume you definitely fall into the new 2010 PTSD regulations here, as to "fear of hostile activity" as well as being in "close proximity" to hostile activity.'

I suggest to gather all evidence you have as to proving this event......

"(we declared an IFE but were not allowed to divert the aircraft)"

Morning reports, buddy statements, anything documented that this happened.

I do not doubt you suffered this traumatic experience at all.It would be consistent with your MOS as well.

Please forgive me....I still don't speak USAF and my daughter (veteran ... 7 Years USAF Intel) screams when I say MOS and boot camp and bivouac, reconnoiter, ....etc etc....when talking about the USAF!

I dont doubt this happened but I assume the VA might want documented proof.

The new 2010 regs were for veterans like you (OIF/OEF) to hopefully make PTSD compensation easier for them to attain.

Us hardcore claimants like Gastone and me here and many more of us at hadit, know that is not always the case.

"As far as the PTSD goes, I was diagnosed by the psychiatrist at Mayo which was in the records I submitted."

It would be good to make the C & P doc aware of his opinion ,diagnose and his statement as to your nexus.

But the VA MH diagnosis is critical to your claim.

They wont even accept IMOs on PTSD diagnoses , even if the IMO came from Sigmund Freud.

But an opinion from MAYO might certainly help the VA make that same diagnosis too,and I sure hope he or she does.

Vets can be locked into the 2010 regs, by claiming PTSD when they can also claim depression or acquired psychiatric disorders etc etc, still due to an inservice stressor but sometimes having a VA C & P examiner make the diagnosis , as other than PTSD.,yet still compensable at the same level PTSD is.

I think you will do OK.

It is my VAOLA paranoia kicking in here a bit .....incurred from years (decades)of dealing with them and knowing how they think.

Edited May 26, 2015 by Berta

[Navy04]

Welcome aboard and good luck. Looks like your claim is moving fast. Just go in there and be honest. Please do not dress nice or try to smell better then the examiner. I have 2 exams on Thursday at a VES. Keep us posted and God Bless

[Berta]

Hemiplegic migraines have rating information in this BVA remand:

http://www.va.gov/vetapp13/Files1/1301318.txt

[Rivet Joint]

You might want to review the VA PTSD DBQ. All your other Medical claims seem to be SC as long as your SMR's back you up. What SC %? Compare your symptoms to your condition as listed in 38 CFR 4.

The PTSD C & P Dr's opinion will trump your non VA Dr's DX for ratings purposes if they don't agree as to Nexus and or severity. BE PREPARED

Semper Fi

Gastone!

I'll go through 38 CFR 4 for each of them thanks! I had looked at DSM-V and the DBQs but not the actual CFRs, good idea.

Thank you for your service.

Gastone is correct.

"As far as the PTSD goes, I was diagnosed by the psychiatrist at Mayo which was in the records I submitted. He also stated that it was a direct result of my first hemiplegic migraine, which happened while flying over Afghanistan (we declared an IFE but were not allowed to divert the aircraft) and I thought I was dying of a stroke, which I relive every time I have one. " That certainly would be in your SMRs and is an established nexus....that is the migraine condition.

I also assume VA would consider that to be a stressor.

because I assume you definitely fall into the new 2010 PTSD regulations here, as to "fear of hostile activity" as well as being in "close proximity" to hostile activity.'

I suggest to gather all evidence you have as to proving this event......

"(we declared an IFE but were not allowed to divert the aircraft)"

Morning reports, buddy statements, anything documented that this happened.

I do not doubt you suffered this traumatic experience at all.It would be consistent with your MOS as well.

Please forgive me....I still don't speak USAF and my daughter (veteran ... 7 Years USAF Intel) screams when I say MOS and boot camp and bivouac, reconnoiter, ....etc etc....when talking about the USAF!

I dont doubt this happened but I assume the VA might want documented proof.

The new 2010 regs were for veterans like you (OIF/OEF) to hopefully make PTSD compensation easier for them to attain.

Us hardcore claimants like Gastone and me here and many more of us at hadit, know that is not always the case.

"As far as the PTSD goes, I was diagnosed by the psychiatrist at Mayo which was in the records I submitted."

It would be good to make the C & P doc aware of his opinion ,diagnose and his statement as to your nexus.

But the VA MH diagnosis is critical to your claim.

They wont even accept IMOs on PTSD diagnoses , even if the IMO came from Sigmund Freud.

But an opinion from MAYO might certainly help the VA make that same diagnosis too,and I sure hope he or she does.

Vets can be locked into the 2010 regs, by claiming PTSD when they can also claim depression or acquired psychiatric disorders etc etc, still due to an inservice stressor but sometimes having a VA C & P examiner make the diagnosis , as other than PTSD.,yet still compensable at the same level PTSD is.

I think you will do OK.

It is my VAOLA paranoia kicking in here a bit .....incurred from years (decades)of dealing with them and knowing how they think.

I do have the referrals and notes in my SMRs starting around a month after the initial hemiplegic migraine from where I told the flight doc that I was having weird problems with anxiety, getting scared of really random things, waking up paralyzed, and insomnia. He prescribed sleeping pills and sent me to "life skills" (mental health clinic) where they decided I just had anxiety and difficulty adjusting to a change of life phase (apparently getting DQ'd from flying is a change of life phase?). I submitted all of those records as well as the ones from Mayo.

I'll check and see if it says there was an IFE on that flight in my flight records, I didn't think of using those records as well. The neurologist who did the formal diagnosis (after I was sent home early from that deployment since I couldn't fly anymore) was an O-6 (and the hospital commander IIRC) and filed 6 pages of notes in my record on just my first visit with him, including saying it occurred during a combat mission in the AOR and mentioning the IFE. He also noted in two later visits that he suspected I was also having non-hemiplegic migraines.

I will definitely let the C&P doc know about the Mayo diagnosis and opinions, can you tell me more about the getting locked into the 2010 regs thing? It sounds like that would be a bad thing.

I'm also still unsure what to do about the other stressor event I submitted. Basically because of something I did, a bomb was dropped on a location, and I'm pretty sure it killed some people. I'm also pretty sure there was no double checking; they just went with what I said. But I also cannot legally say what I did (other than it was within my job description), how I did it, why I did it, why I'm sure people died, or why I think there was no oversight because of classification. Certain aspects of it really bother me, and I feel like it would be helpful to me to talk about it, but I can't even say what happened, let alone do anything to show it occurred as far as the VA goes (sorry, am just venting some frustration now).

Welcome aboard and good luck. Looks like your claim is moving fast. Just go in there and be honest. Please do not dress nice or try to smell better then the examiner. I have 2 exams on Thursday at a VES. Keep us posted and God Bless

Good luck to you too, I hope your exams go well on Thursday and I will keep everyone posted.

Hemiplegic migraines have rating information in this BVA remand:

http://www.va.gov/vetapp13/Files1/1301318.txt

Oh thank you, there is some interesting (probably applicable to me) stuff in there, especially the extraschedular consideration part. Part of my submission included paperwork from my previous employer pointing out that I missed over 180 days of work last year due to regular migraines and hemiplegic migraines, which makes it awfully difficult to be employed.

[Gastone]

And your Earned Income is? If more than $12,400, IU could be a real problem. Then comes your education, college degree = should be able to do Sedentary work that would produce "SGI" as far as VA raters are concerned. You need a Professional Vocational Councilors opinion as to why your unemployed or under employed. Probably need an opinion as to you actually being IU do to your SC conditions from a Professional Employment Councilor, VA Voc Rehab is a free and excellent source.

Semper Fi

Gastone