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Rating Disabilities For C&p's


Tower_Rat

Question

Recently I have undergone several C&P's. During the C&P the Dr asks various questions concerning the disability I'm claiming and other ailments or disabilities that may raise problems in the my health. During mine the Dr stated from medical records that I had more than just the one disability and marked down all the other ones along with the major one. My question is do the raters also rate the other disabilites with that or just the claimed one that you file for? Maybe they just take into consideration all the other ones overall and how it makes the Veteran feel. For example in my case PTSD was the claim but, of course they said I had depression as well as agoraphobia, P/D non specific, general anxiety with panic disorder and so forth. Does each one of these gets rated? or is it just a mass rating of overall effect to the sum of total disability? Im confused.

Thanx any help is appreciated.

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  • HadIt.com Elder

Tower Rat,

Generally, the VA will only address the claims you have formally filed. Having said that, there are instances when the VA will "infer" a claim, meaning they saw some condition in the veterans SMR's that really jumped out at them and added that issue to the claim without the veteran actually claiming it. Some regional offices do this more than others. In reference to your PTSD with the other mental conditions associated with it, the VA will only rate the more disabling condition and 'lump' the others with it. The VA can not, by law, assign more than one rating due to a mental disorder, so they will rate the mosre disabling condition.

Vike 17

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  • HadIt.com Elder

Does headaches come under Mental Disorders?

I only ask, because I filed for chronic anxiety, depression with headaches in 1978, again in 2002 and was awarded the pension unable to hold gainful employment due to anxiety, depression and headaches.

Filed in 2002 and the case is open at the BVA for " Acquired Psychiatric Disorder to include anxiety with depression, but no mention of headaches.

Headaches were listed in my NOD, but has never been addressed. I ask and they always say, " it is included as part of the anxiety.

Is this true?

Josephine

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  • HadIt.com Elder

I don't think C&P doctors are looking for inferred claims to rate. They get paid to rate your claimed disabilities. Never have I had a C&P doctor go looking for disabilities to rate that were not claimed by me. That is my experience. If you don't claim it don't expect the VA to rate it. You just have to file a claim on every service connected disability you have. That is the key and many vets don't file for years and lose the EED.

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  • HadIt.com Elder
I don't think C&P doctors are looking for inferred claims to rate. They get paid to rate your claimed disabilities. Never have I had a C&P doctor go looking for disabilities to rate that were not claimed by me. That is my experience. If you don't claim it don't expect the VA to rate it. You just have to file a claim on every service connected disability you have. That is the key and many vets don't file for years and lose the EED
.

Are you stating that I didn't file for headaches. If I didn't then, how did I file for anxiety and depression?

Josephine

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Does headaches come under Mental Disorders?

I only ask, because I filed for chronic anxiety, depression with headaches in 1978, again in 2002 and was awarded the pension unable to hold gainful employment due to anxiety, depression and headaches.

Filed in 2002 and the case is open at the BVA for " Acquired Psychiatric Disorder to include anxiety with depression, but no mention of headaches.

Headaches were listed in my NOD, but has never been addressed. I ask and they always say, " it is included as part of the anxiety.

Is this true?

Josephine

Headaches are rated under the Neurological disease listings as Migraine.

8100 Migraine:

With very frequent completely prostrating and prolonged 50

attacks productive of severe economic inadaptability.........

With characteristic prostrating attacks occurring on an 30

average once a month over last several months................

With characteristic prostrating attacks averaging one in 2 10

months over last several months..............................

With less frequent attacks.................................... 0

The Key word is prostrating.

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  • HadIt.com Elder

Jstacy,

In other words, the headaches have not been addressed.

I gave up and have in my trunk all the emergency records that I have for the headache claim.

Do you have any ideal of why the headaches have not been addressed.

I have all of my paper work for the filing in 1978 and 2002.

For the headaches, I have a standing order, at the emergency room, for Demerol shots, ordered by my physician. I have always taken over the counter drugs. Friorinal and Darvocet for the in between the trips to the hospital. If they didn't work, off I went.

The only time the headaches are mentioned is on that pension, that will never amount to a hill of beans for me. Denied due to excessive income.

Berta raised the question, How did I get a pension dated 2003 due to unemployable since 1983 for Chronic Anxiety, depression and headaches, but now that I located all of my psychaitric records. The Va wants to call it a personality disorder. when they are using the same medical records.

Thanks,

Josephine

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At any time did you go to the Doc in service for headaches? You obviously have a history?

If you were seen in service for headaches then you can get service connected. What about hypertension?

What is your BP during a headache?

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  • HadIt.com Elder

Jstacy,

I am going to paste for you my treating physicians letter that you may have already read. In service there is no record of any hypertension, only after service. This would have placed the hypertension at about 8 years of discharge.

Yes there is mention of headaches and tension.

To whom to it concern:

___, formerly, ______, has requested that I write documenting my care of hr during the time period of February and March, 1964, at the US Naval Dispensary, 19th and Constitution In Washington D.C. She was an enlisted person and I was a General Medical Officer practicing at that facility. The question she has asked me to address is whether I helped her obtain a discharge from the Navy.

_____ has provided documents from her medical record as well as a recent letter to me, which is undated. My - evaluation of her on 2/20/64 and a follow up visit on 2/27/64 are available. Two psychiatric consultations are also available for review. The fist performed on 3/12/64 to Dr. J and the second performed on 3/27/64 by Dr. M. Finally the letter from Co H recommends an Honorable discharge by reason of unsuitability. My understanding is that he discharge occurred shortly thereafter.

After phone discussion with ______ I did remember her as an enlisted person at the Dispensary with whom I worked with on occasion. My workup of 2/20/64 concluded that she had tension versus vascular headaches and I added a tranquilizer to her headache medicine for her anxiety. The note from 2.27.64 documents that the lab test were normal and I recognize personal shorthand in my notes that I often used for a counseling session. After 40 years I do not remember whether I started the process for a discharge, but I suspect that I may have been supportive. She had seen a Navy Psychiatrist on 3.12.64 with no indication of further workup or return visit. Two weeks later she saw another Psychiatrist to whom I frequently referred patients who needed special understanding and sensitivity. While there is no documentation that I referred her, the fact that she saw Dr. M. scarcely two weeks after a first consultation and with no worsening of her condition does suggest to me that I may had sent her for the evaluation relative to discharge.

Both C H. and Dr. M. comment on ----- immaturity and that she is uncooperative in her duties. After she reminded me and recalled specific instances, I did recall that she baby-sit in our home on multiple occasions with our two children ages 2 and 1. I know that my wife and I would have not allowed her to stay with the children if there had been any question of her suitability. The Dispensary staff was a closely knit and I would have likely been made aware of any poor behavior on --------part.

While my memory does not allow me confident documentation of my role in her discharge there is circumstantial evidence that her story is credible . I hope that you will give her case every consideration.

BCC

You may have seen this letter on line about a dozen times, but it is all in my SMR'S. The medicine in my Service records is Caffergot for headache and Librium for nervousness.

Thanks,

josephine

Edited by Josephine (see edit history)
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First point is that the headaches were incurred during service and you still have them.

They gave you a NSC pension instead of rating the headaches.

That was an error because you were treated for it during service.

You should file for headaches on a direct service conection basis.

A C@P with the correct doctor will service connect that. There may even be a CUE involved in your case But I do not know what the Regs were back when you filed your claim. I am in the middle of a CUE battle for HTN and headaches right now and I know I won, But have not heard the official result.

I will find a cue case similar and post it later.

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Thanx for the replies everyone it helped alot. I thinking im going to end up filing for everything to make sure that it is all accounted for. My fav thing the dr said to me during the C&P was "do you think your depressed"? That was on the attachment to the standardized list of questions that they ask to see if you can handle your own finances. I told him yes that I thought I was. and he markded it down. Was that easy or maybe I missed something? The other parts of the test included things such as "can you fold this piece of paper and hand it back to me" stuff like that. wierd eh? How bout count backwards and look at a piece of paper that says "close your eyes" and then do as the paper says. I guess that was just to make sure that I was cognitive and had some reasoning to my brain. Everything else was about the past, stressors and the present how im getting along. Relationships, jobs, friends and what i do with my time everyday. things like that. I thought it couldve gone better. The person I took with me said they thought it went really well but, that I came off kinda sounding really angry even though I didnt think I sounded like that. Then again I was caught up in the moment of explaining all the stressors that happened to me which wasnt fun at all. I took a valium before and after my exam to keep from having a panic attack or worse. All and all my C&P was only an hour and 45 minutes long with the psychologist. and about a hour long with all the other dr's and exams that they gave me for secondary conditions.

I think someone else on this board said that Tom Petty said it best "The waiting is the hardest part"

I would like to say that I liked the other song or motto I have by him that has become a part of my life is this one.

I wont back down

Thanx again everyone for your support.

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  • HadIt.com Elder

Tower Rat

The next time you have a C&P don't take meds before to avoid panic attack. You want them to see you having an attack. You want them to see you at your worst. Once they see you in the throws of an attack they will realize just how bad your symptoms are and it will help with the rating. I take pain meds daily but I dont take them when I go for C&P. I want them to see me squirming around and wriggling in my chair. This is what the conditions do to me.

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roger that!!!

let me throw my two cents inthis here,, i went two week ago for ptsd bipolar and what

ever else was bothering me,, i am not able to handle my money, i go on spending

benges, i have no friends dont wont any my wife and i are not getting alone becaue

of by UPS and Downs, never go out to eat, when we do i set with my back to the

wall,, wheni first open the front door of a morning ,,i scan the primeter, for what

ever reason i aint sure, are u with me, alwayin the negative, nothing is going good

,,,dont watch tv at all, not even the war, told the dr been there and done that,,

cry if you feel like it,, i did in his office like a small child,, so ..does it

work i dont know just have to wait and see, but the dr did say it was all service

connected,, good luck and calm seas///bigjim

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Thanx Jim, yeah im with ya, i do some of the same things. Scanning the perimeter is one of them cuz thats what we were taught a long time ago. Im usually in the negative in my bank book cuz I live check to check for social security. I dont go anywhere to eat really except drive throughs. I usually dont drive cuz i take my meds everyday so theres no scenic route. Thanx for your comment It helps me, understand me.

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Tower Rat,

The first question that comes to mind is did the C&P doc say these other conditions were related to your PTSD and/or service.

If so, they are supposed to be considered with your PTSD rating. No seperate claims neccisary. I'd wait for the decision and NOD it if they were not considered.

If not, you may expect a lowball rating with the RO stating that the other diagnosed conditions are not service connected and contribute more to functional limitations than the PTSD. I suggest getting a copy of the report to see wich way this may go.

Josephine,

I may be wrong here, but it sounds like the VA is considering your headaches as a risidual proplem. Meaning, a "symptom" of your depression. That is why it isn't being addressed.

In my opinion, you need to use the word migrane and not headache. (with medical diagnoses of migraine) A tension type "headache" is common and a symtom. A migraine is a condition by itself though it can and often is CAUSED by another condition. What I'm saying is, migraine can be a ratable secondary condition whereas "headache" is more of a symptom.

See how these two phrase's look:

Claim for depression w/headache

Claims for depression and Claim for migraines secondary to SC depression. (or just claim for migraine if nexus can be established)

Time

Edited by timetowinarace (see edit history)
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  • HadIt.com Elder

We all have our pride and we put on a good face to the world. That works against the vet when he walks into the C&P doctor's office. It goes against the vet when he even walks into the VAMC and talks to the primary care doctor. You are better off complaining about everything when you walk into the VA doctor's office. It all goes into your records. You will see it right there in your medical records if you ask for them.

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  • HadIt.com Elder
In my opinion, you need to use the word migrane and not headache. (with medical diagnoses of migraine) A tension type "headache" is common and a symtom. A migraine is a condition by itself though it can and often is CAUSED by another condition. What I'm saying is, migraine can be a ratable secondary condition whereas "headache" is more of a symptom.

Tower Rat,

You are correct. Dr. C and I have been trying to tell the Va. the tension headaches were coming from the anxiety.

I talked to the AMC this morning and I do feel that they are doing their best to settle this long claim.

The Va had the upper hand and I snow balled them, when I discovered the psychiatric records in the archives and the letter from my commanding officer.

They were there for 42 years and when I filed in 1978, they didn't get them and then again in 2002. That is why they gave me the pension.

When they didn't like my results of my first C&P of More Likely than not.

They went for the board of two psychiatrist. They sure did lie in that C&P write up. No service connection.

When the AMC sent the records back to them, by order of the BVA they refused to explaiin the etiology of their C&P findings.

I faxed them my objections to the AMC of the two psychaitrist not following the remand and this gave me another chance to show them line by line all the changing of the wording of my private and military medical records.

I do not want anymore C&P'S. As it stands there are 3 doctors against those two crooked ones and I have placed the doubt law into place.

Thanks a bunch!

josephine

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Hey Time thanx for the info. The Doc didnt say much at all but, just did a basic run down or background on me like they did when i first went to the VA for help. I already had the diagnosis and nexus from 3 other doctors that were psychiatrists at the VA. The pyschologist that I saw for the C&P was actually the initial person I saw for help when all this came about a year and half ago when I filed the claim. I wondered if maybe i shouldve seen a different C&P doctor since I had initially seen this one when it all began (thinking it might be a conflict of interest) but, being that he was just a psychologist for the C&P exams and all the other psychiatrist doctors I saw one of them being his superior and a psychiatrist I thought it might be ok for my C&P since they work together I didnt think they would go against each other. The pyschologist just asked me background how my disability affected me in everyday life and if i could add or not and do basic things like put a tv dinner in a micro wave. He also made me talk about my stressors and wrote them all down again like he had before when I had first seen him a year and half prior to this meeting. I guess they were just double checking the stressors that I had claimed which is understandable. Out of all the ones I listed only one they could prove, and that was with a buddy statement. (which the inciddent happened 18 years ago, and the statement was difficult to get as people seem to just disapear and contact with the old company members seemed to not exist anymore)The original meeting with him a year ago was not a C&P however, he was the only psychologist available at the time for the out patient clinic and also just happened to be the person they used for the C&P. Also he remembered who I was and the stressors (which he had the papers in front of him also) So the Nexus, and diagnosis was already stated from his superiors at the his VA and his superior was also the one who gave me a note that got me social security stating I couldnt work or hold a job, which i was thankful for.

I will say this though I was worried a little because when I went initially a year and a half ago he stated in his notes that my stressors were bizarre leading me to believe the lingo or jargon he was using was leading to a P/D or personality disorder non specific which of course wouldnt have helped my claim. I think they are diagnosing alot of veterans with this instead of whats really wrong with them to save the government money. I was lucky The Psychiatrist I saw was retiring and told me exactly what I had and couldnt understand why these younger psychiatrists were afraid of diagnosing someone. Which seems to be the case along with admitting and righting the nexus down in their notes for them. I was lucky in that regard that he wrote it down the way it truely was and flat out said it was tramautic and caused PTSD. What really sux is that if you switch VA hospitals they treat you like your new and want you to take meds like depression medicine even if you dont require it if you fit the PTSD mold. I found this out when I read the regulation for it which stated that every new patient for the behavioral science area of the VA has to try the medicine for at least 90 days or 3 months to see its effect and the outcome of such medicines. What a bunch of bull if you dont need it. Then you know what happens if you dont comply!! I dont have to tell you that part. So you grin and bear it and swallow your meds hoping theres not to many side effects awaiting the day that you can get off the meds you dont need. Sorry all Im just venting a little bit here. It sux that my whole future life might depend on what a va doctor writes in his notebook to be interpreted by someone who has no medical knowledge at the regional office, and pays according to how much money they have available for the budgeted year. My nerves are so bad ive contracted shingles since my C&P a few weeks ago.

on a lighter note im voting democrat tomorrow and hoping the republicans will be out of office.

Thanx all

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