ptsd Am I on the right path??

[Dennis1989]

Hey everyone,

This is my first post on any site regarding the issues I deal with. Before I go on with my question I would like explain my situation. I am a former Infantryman with multiple, isolated, combat deployments that has lost many close friends. I have always swept my feelings to the side and told myself that I am strong enough to keep my issues to myself. I have done this for a few years now and it has gotten extremely painful.

I have left jobs to have new beginnings so that I could attempt friendships again. It isn't that I am mean to anyone or disrespectful what so ever, Its that I am so uncomfortable in my own skin I always feel awkward. I am so impatient with every thing in my life, even my wife when all she wants is for me to put forth an effort towards getting things ready for our unborn son. I try to interest myself in things but all it does is result in me pretending to care. I feel so disconnected from every thing that I don't know what to do any more. I moved across the country for a new start at life and I am constantly depressed, anxious and unable to keep relationships. When I go outside and I make contact with a neighbor my heart sinks and I don't know how to react... I end up waving, putting on a fake smile and than for an hour I think about how uncomfortable it was and that I hope they aren't outside when I come back home. I can't put a title on what my issues are but it's so uncomfortable. I don't know if it is PTSD or what but this is not how I was before the Military. Sorry to rant.

I am currently seeking attention from the VA but its taking a while. I made my claim for combat- related PTSD with hopes that the VA would schedule my appointments. (I have never done anything like this so if I am wrong please don't crucify me). The steps I have taken are as follows:

1. Claim has been made through E-Benefits with my DD- 214 attached including "combat/ time in country/ etc."

2. My claim has been accepted and a "development letter" has been sent out.

3. I scheduled an appointment with a civilian LPC therapist. That is later this week.

I have read on many sites that with a Combat Infantryman Badge, proof of a "nexus" and a Diagnosis of PTSD, the claim is usually OK. My question is, am I taking the correct steps for a successful claim? What else should I do?

Thank you guys in advance.

[broncovet]

Do you have a copy of your service medical records?  You are gonna need them.  

As always, you need ALL of the "big 3" for service connection:

1.  Current diagnosis of PTSD.  No diagnosis no benefits.  

2.  In service event or "stressor".  Your "combat" status will "ease" that a bit.

3.  A nexus or link between your current diagnosis and the in service stressor.  This means that your Doc needs to say something close to "The Veterans PTSD symptoms are at least as likely as not due to xxx event(s) in service."  

Once you DO get "service connected", then its a matter of the degree of disability and the effective date.  

A VSO can be helpful, but dont listen to their advice if they say anything close to any of these:

1.  "Dont apply for xxxx, you could get a reduction in yyy instead."

2.  "Dont appeal your claim, file a new one".

3.  "Be happy with zero percent rating, and dont appeal it or you could be reduced, or lose your SC".  

4.  "Your claim will be complete in 90 days, and VA has 95% accuracy, so its a waste of time to appeal."

 

Instead, here are the facts:

1.  The VA can not reduce your benefits for applying for other benefits.  You meet the reduction criteria or you dont, and "Veteran applied for an increase" is NOT one of the criteria for reductions.  

2.  If you are dissatisified with your rating, you need to file a Notice of Disagreement within a year, or you can "lose" your effective date.  

3.  A zero percent rating would almost always indicate you should appeal.    Think about it.  Would you go to all the trouble to file for benefits for nothing?  That is like going to work for McDonald's and they say, "Gee, you mean you think you should get PAID for working here?  I thought you said you liked working with others, so if its fun, that means you dont need to be paid".  

4.  About 85 percent of first time claimants are denied.  This means most Veterans who did get benefits did so upon one or more appeals.  Of the appeals that go to the Board of Veterans Appeals, 46% are remanded, and 21 percent are awarded.  This means that about 67% of the RO claims have one or more errors in them.   A BVA appeal takes about 4-5 years currently, and this number is growing.  This means that only about 15 percent of claimants will get their benefits in less than 4 years.   Alex's took 20 years, mine is 13 years and counting.  You have a less than 15 percent chance of seeing your benefits in 90 days.  And, if you are in the 85% group, a trip to the BVA mostly means you wont see benefits for 4-5 years.  

I have a docket number at the Board of Veterans Appeals that is 2009.  I will be interested to see how much longer it will take.  

 

 

[Vync]

Hi Dennis,
First, Welcome to Hadit!

Broncovet's advice is spot on (like usual).

What you are feeling is normal. Because you are a combat vet, you can not only seek counseling/treatment from the VA medical centers, but you can also go to VA Vet Centers. The difference is that the folks at the VA medical centers can provide counseling, in-house treatment (should it become necessary), and medication. The Vet Centers are more laid back. The one here in Birmingham, AL, has coffee, a comfortable couch, and social workers who you can vent to. Either way, you are in good hands should you wish to get treatment. Don't go it alone though. The VA has taken a lot of heat in the past for supposedly leaving vets without definitive help, but they are trying to change for the better. You can also call the crisis hotline if things get hairy. It's ok, even if it is not an emergency. I know you can tell your better half only so much, but the VA does have resources to help 24x7.

Also, congratulations on being a father to be. I have a 19 year old daughter through adoption, but I remarried 5 years ago to a wonderful wife who is 13 years younger. She wants kids and I don't want to disappoint and we are trying, so I am looking forward to it and also simultaneously scared to death if it actually happens. I guess it is the way life works. 

Like you, I also don't have any desire to happily wave out to neighbors and suddenly have BBQ's together. I mostly keep to myself, but make an effort not to be a shut in. Sometimes I want to give them the finger when they walk by, but I know it will not help.

Regarding mental health (MH) ratings, regardless of the number of diagnosed conditions, the VA lumps them all together. The actual rating percentages are based on the type of impact it has on your life, as indicated in the table below:

http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_130.doc

 

Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.	100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.	70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.	50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).	30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.	10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.	0

The above table might be really confusing if you are new to the VA. There are a lot of and's and or's, but the deal is that it is not all encompassing and the VA is supposed to rate based on the worst criteria. This does not always happen. Don't be discouraged if the VA rates you at 10% or somehow cannot confirm you were in combat. You can always appeal. In fact, the great majority of VA claims are typically won on appeal. I attribute this to carelessness or incompetence, but whatever you do, don't give up.

If you file for PTSD, the VA will need one of their doctors to confirm it in a Compensation and Pension (C&P) exam. Being in combat helps, but they will likely still need to confirm it. If they diagnose you with depression or an adjustment disorder, don't be discouraged. Sometimes that is the way they do it. Keep in mind that regardless of the diagnosis, it's the symptoms that provide the rating, not the diagnosis. Getting service connected (SC) is what matters. If you win SC, you can always appeal if they low-balled your rating.

I recommend taking the time to search and browse this site and not only the forums. The more you know the better you will end up. Don't hesitate to ask questions. The only bad questions are those which are not asked.

If you are prescribed medication or receive a certain type of counseling for treatment from the VAMC and it is not effective, don't hesitate to talk with your doc about it. A lot of treatment is trial and error. Try this for a while and try that. Not all treatments fit all vets. Keep in mind that some treatments might require more time than others.

Additionally, it is possible to get SC for secondary conditions. For example, if you are given medication to treat your MH condition and it ends up causing noodle failure or other unwanted side effects, it is possible to get those SC as secondary conditions. Of course, you'll need a primary condition SC, but don't necessary wait for it. Noodle failure would be considered SMC-K, which does not count towards your combined rating (look this up, it's crazy math), but does have the ability to add $ each month.

If  you need help or advice, just ask. There are plenty of folks here at Hadit who can try to help. But remember that you are responsible for all of your own claims, even if you get a VSO to represent you. Some are better than others.

Good luck! I hope this helps!

[Buck52]

Vync is right on!  I totally Agree

.............Buck

[Berta]

Yes, those feeling are normal and when I worked with Vietnam vets at a vet center long ago  they all had the "numbness" that they wanted desperately to overcome. Anyone who has experienced severe trauma can relate to exactly what you described here.

The CAR on your DD 214 should certainly prove your nexus but you will have to get a VA MH professional to diagnose you with PTSD.

If VA does ask for stressor info, give them the best ones that could easily be verified.

I hope they dont even ask and concede the stressor with the CAR on your DD 214 but please be prepared for giving them at least one verifiable stressor.

You will fall under the new 2010 PTSD criteria:

These regulations rest heavily on the veteran's service as being in close proximity to hostile fire and their fear of that.