What Kind of Rating Would this Fall under

[Alcapone1931]

good afternoon all,

i am a new member on this, former US army reservist, and currently employed full time. i separated in 2009 but filed my claim in Aug 2015 (i wasnt aware as a reservist of only 6 yrs total enlistment that i could actually apply for anything). my decision finally moved in the Preparation for Decision phase two days ago, 6/21/2016.  i have two questions:

1 - how quickly does it go from here?...(im guessing the answer is that there is no answer. everyone's claim is handled differently but has anyone experienced the claim to wrap up rather quickly from here?)

2 - i am trying to determine what sort of rating i may get for my mental health based off my C&P results.  anyone with experience please take a look (below) and offer their opinion?

thank you kindly for any assistance and response:

                              SECTION I:
                                   ----------
    1. Diagnostic Summary
    ---------------------
    Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria
    based on today's evaluation?
    [X] Yes   [ ] No
    
       ICD code:  F 43.10
       
    2. Current Diagnoses
    --------------------
    a. Mental Disorder Diagnosis #1: PTSD
           ICD code: F 43.10

       Mental Disorder Diagnosis #2: Unspecified Depressive Disorder
           ICD code: F32.9

--------------------------------------------------------

 4. Occupational and social impairment
    -------------------------------------
    a. Which of the following best summarizes the Veteran's level of 
occupational
       and social impairment with regards to all mental diagnoses? (Check only
       one)
       [X] Occupational and social impairment with occasional decrease in work
           efficiency and intermittent periods of inability to perform
           occupational tasks, although generally functioning satisfactorily,
           with normal routine behavior, self-care and conversation

****i know by definition this summary may fall within the 30% rating, but please continue reading below******

 a. Medical record review:
    -------------------------
    Was the Veteran's VA e-folder (VBMS or Virtual VA) reviewed?
    [X] Yes   [ ] No
    
    Was the Veteran's VA claims file (hard copy paper C-file) reviewed?
    [ ] Yes   [X] No
    
      If yes, list any records that were reviewed but were not included in the
      Veteran's VA claims file:
        
      If no, check all records reviewed:
      
        [ ] Military service treatment records
        [ ] Military service personnel records
        [ ] Military enlistment examination
        [ ] Military separation examination
        [X] Military post-deployment questionnaire
        [X] Department of Defense Form 214 Separation Documents
        [X] Veterans Health Administration medical records (VA treatment 
records)
        [ ] Civilian medical records
        [ ] Interviews with collateral witnesses (family and others who have
            known the Veteran before and after military service)
        [ ] No records were reviewed
        [ ] Other:

3. Stressors
    ------------
    Describe one or more specific stressor event(s) the Veteran considers
    traumatic (may be pre-military, military, or post-military):
    
    a. Stressor #1: [censored]
          
          Does this stressor meet Criterion A (i.e., is it adequate to support
          the diagnosis of PTSD)?
          [X] Yes  [ ] No
          
          Is the stressor related to the Veteran's fear of hostile military or
          terrorist activity?
          [X] Yes  [ ] No
          
          Is the stressor related to personal assault, e.g. military sexual
          trauma?
          [ ] Yes  [X] No

 d. Additional stressors: If additional stressors, describe (list using the
       above sequential format):
          Stressor #4  [censored]

          This stressor meets Criterion A; this stressor is related to the
          Veteran's fear of hostile military or terrorist activity; this stessor
          is not related to personal assualt.

 4. PTSD Diagnostic Criteria
    ---------------------------
    Please check criteria used for establishing the current PTSD diagnosis. Do
    NOT mark symptoms below that are clearly not attributable to the Criteria A
    stressor/PTSD.  Instead, overlapping symptoms clearly attributable to other
    things should be noted under #7 - Other symptoms.  The diagnostic criteria
    for PTSD, referred to as Criteria A-H, are from the Diagnostic and
    Statistical Manual of Mental Disorders, 5th edition (DSM-5).
    
       Criterion A: Exposure to actual or threatened a) death, b) serious 
injury,
                    c) sexual violation, in one or more of the following ways:
          [X] Directly experiencing the traumatic event(s)

       Criterion B: Presence of (one or more) of the following intrusion 
symptoms
                    associated with the traumatic event(s), beginning after the
                    traumatic event(s) occurred:
          [X] Recurrent, involuntary, and intrusive distressing memories of the
              traumatic event(s).

       Criterion C: Persistent avoidance of stimuli associated with the 
traumatic
                    event(s), beginning after the traumatic events(s) occurred,
                    as evidenced by one or both of the following:
          [X] Avoidance of or efforts to avoid external reminders (people,
              places, conversations, activities, objects, situations) that 
arouse
              distressing memories, thoughts, or feelings about or closely
              associated with the traumatic event(s).

       Criterion D: Negative alterations in cognitions and mood associated with
                    the traumatic event(s), beginning or worsening after the
                    traumatic event(s) occurred, as evidenced by two (or more) 
of
                    the following:
          [X] Persistent, distorted cognitions about the cause or consequences 
of
              the traumatic event(s) that lead to the individual to blame
              himself/herself or others.
          [X] Feelings of detachment or estrangement from others.

       Criterion E: Marked alterations in arousal and reactivity associated with
                    the traumatic event(s), beginning or worsening after the
                    traumatic event(s) occurred, as evidenced by two (or more) 
of
                    the following:
          [X] Hypervigilance.
          [X] Problems with concentration.
          [X] Sleep disturbance (e.g., difficulty falling or staying asleep or
              restless sleep).

       Criterion F:
          [X] Duration of the disturbance (Criteria B, C, D, and E) is more than
              1 month.
              
       Criterion G:
          [X] The disturbance causes clinically significant distress or


              impairment in social, occupational, or other important areas of
              functioning.
              
       Criterion H:
          [X] The disturbance is not attributable to the physiological effects 
of
              a substance (e.g., medication, alcohol) or another medical
              condition.
              
       Criterion I: Which stressor(s) contributed to the Veteran's PTSD
                    diagnosis?:
          [X] Stressor #1
          [X] Other, please indicate stressor number (i.e., Stressor #4, #5,
              etc.) as indicated above:
                Stressor #4

    5. Symptoms
    -----------
    For VA rating purposes, check all symptoms that actively apply to the
    Veteran's diagnoses:
    
       [X] Depressed mood [this is a 30% symptom]
       [X] Anxiety [30% symptom]
       [X] Suspiciousness [30% symptom]
       [X] Panic attacks more than once a week [this is a 50% symptom]
       [X] Chronic sleep impairment [30% symptom]
       [X] Flattened affect [50% symptom]
       [X] Disturbances of motivation and mood [50% symptom]

****the symptoms listed above fall under both 30% and 50% criteria, so i am uncertain whether they will consider both or make the decision based off the Summary at the begining of the report, which technically defines the 30% rating******

 9. Remarks, (including any testing results) if any
    --------------------------------------------------
       Based on this examination and a review of the records, it is determined
       that the Veteran meets DSM-5 criteria for PTSD.  It is further determined
       that this diagnosis is at least as likely as not (50/50 probability) a
       result of the identified in service stressors.  The Veteran is also found
       to meet criteria for Unspecified Depressive Disorder.  This diagnosis is
       determined to be at least as likely as not (50/50 probability) 
proximately
       due to or a result of the PTSD.  The Veteran gives a credible account of
       stressors deemed consistent with his MOS, and with service in the
       identified combat theater.  While there are no related service treatment
       records, post-deployment questionnaires suggest that Veteran was
       experiencing subjective distress at the time of his redeployment. The
       claimed anxiety and sleep disturbance are deemed to be symptoms of both 
of
       the current diagnoses.

this ends my report.  thank you again for anyone's response and assistance.

[The Silent Warrior of the Army Team]

 

[ArNG11]

Al and Andy have you guys thought about what the VA claims centers excuse is on getting Veterans records when the system is totally  digital.  

I often wonder on what excuse they will use on Veterans and their attorneys for not following disclosure requirements.  You know the laws and regulations that state they have 20 business days to respond to an FOIA request.  My guess is that suddenly in the United States there will be a shortage of CD's and record requests cannot be fulfilled due to supplies.  

 

[ArNG11]

21 hours ago, Andyman73 said:

I had said elsewhere on here, that as Vets we are guilty(denied) till proven innocent(granted SCD).  The VA is only for us as long as we don't want what is rightfully ours to begin with.  Then they are fully against us.

Your PTSD will rate higher with the depression, most likely in the 50% rate range. And that will make your feet feel like dancing. 

You will need to file for sleep issues secondary to PTSD. 

There is a problem in this.   I don't know but somewhere in the regulations and CFRs the VA has the obligation to assist the Veteran in developing their claim.  You know the duty to assist.   

In claims such as PTSD or lets keep it general say, depression and anxiety claims,  overlapping symptoms are unavoidable, they are present in multiple conditions.  Anger, anxiety, depression, sleep disturbances, occupational and social difficulties, homicidal and suicidal thoughts and tendencies, are some examples.

It is rather obvious that the stronger your claim is the more the Veterans Administration tries to dismiss and restructure the evidence against the claim.

[ArNG11]

I recall specific circumstances when I submitted sleep disturbances and fatigue with my apnea and hypothyroid claim.  They were denied and dismissed, yet later, throughout the appeals process and submission for anxiety and depression suddenly a DRO made a medical determination that fatigue and short term memory was due to my service connected hypothyroidism and that my sleep disturbances was service connected and part of my depression and not my sleep apnea. Convenient I think.

A Veteran must very intimate with the regulations and symptoms that pertain and surround their conditions. Geesh almost like you should be a doctor or something.  Yeah thats right though, Veterans aren't doctors, they can only report symptoms and timelines. They can describe the problems and indicate what symptoms they suffer from. Offer medical evidence and supportive opinions to support their claim, but in no way shape or form can a claimant make a medical conclusion to what symptoms belong to which disease.   Heh just giggling about this fact, I guess a DRO, a claims examiner and such can't do that either only trained medical specialists and MD's can.  Competence is a big thing huh.

I am being an ass this morning but I ask that folks think about these statements.  The crap happens almost to the " T " in many a claims.

 

[ArNG11]

Be careful with the shell game the claim centers pull.  More importantly be informed on what symptoms pertain to multiple conditions. By no means try to be a doctor, but a little reading goes a long way in being able to support and defend your claim.

[Alcapone1931]

arng11 - regarding the FOIA, you mentioned this which made be chuckle.  i opened up an FOIA claim with the VA back in March.  the estimated completion date? 2/2018.  probably later. and everything is overdue. which means i dont think the VA or HRC nor my unit have anything. you would think there would be a digital record. but hell, since im anal retentive, i kept every single damned thing bc. i figured someone will drop the ball and i wanted to ensure it wasnt me.

regarding filing appeals, if i get a rating and get my back pay and the disability amount begins to come in every month, will the appeals process halt all of that until the appeal is complete? or will my initial disability claim/approval still continue to roll in while the appeals is in process to decide whether it should be rated differently?

andyman73 - thanks for the motivation and optimism.  i definitely hope youre right, fingers crossed! i know on paper it seems like it should land in a higher rating, but knowing how the VA works...still keeps me on edge. haha.

thanks again everyone

 

[ArNG11]

22 minutes ago, Alcapone1931 said:

arng11 - regarding the FOIA, you mentioned this which made be chuckle.  i opened up an FOIA claim with the VA back in March.  the estimated completion date? 2/2018.  probably later. and everything is overdue. which means i dont think the VA or HRC nor my unit have anything. you would think there would be a digital record. but hell, since im anal retentive, i kept every single damned thing bc. i figured someone will drop the ball and i wanted to ensure it wasnt me.

regarding filing appeals, if i get a rating and get my back pay and the disability amount begins to come in every month, will the appeals process halt all of that until the appeal is complete? or will my initial disability claim/approval still continue to roll in while the appeals is in process to decide whether it should be rated differently?

andyman73 - thanks for the motivation and optimism.  i definitely hope youre right, fingers crossed! i know on paper it seems like it should land in a higher rating, but knowing how the VA works...still keeps me on edge. haha.

thanks again everyone

 

The timelines they quote now for a simple FOIA request is ridiculous.  But yes it is sadly funny.  I'm beginning to think that my CFIle request which was done in 7 days on my door step are gone forever.  I think my odds were more like 1 out of 500 thousand lucky.  

Now I can't even get a simple one date 3 page copy of a C&P exam.  This is all legitimate now to thats what kills me.  This is the new and improved process.   Hah what a laugh!