ptsd Shrinks don't Speculate

[jfrei]

This is how they worded it residuals of traumatic brain injury with cognitive disorder, short term memory losses/lapses, difficulty sleeping, problem solving with PTSD (to include cerebral contusion with diffuse axonal injury to bilateral frontal and temporal lo lobes. All they added was the words with PTSD which was at 70% before now 70% with the PTSD. How can they lump physical and Mental health all in one rating?

[broncovet]

The symptoms you described are mental health.  The term "cerebral contusion" is a diagnosis, not a symptom. The diagnosis for the criteria is not that relevant, as long as its SC...PTSD, depression, bipolar, etc., they are all rated the same, once they are service connected.   The VA has one criteria for all mental health disorders and they are based upon the occupational and social impairment.  

If you have "total" occupationial impairment, this suggests you can not work.  Its in the 100% category.  Here is how they are all rated.  "Pyramiding" prevents you from getting paid for a symptom from PTSD AND depression, and Bipolar.  Only one. 

§ 4.130 Schedule of ratings - Mental disorders.

The nomenclature employed in this portion of the rating schedule is based upon the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (see § 4.125 for availability information). Rating agencies must be thoroughly familiar with this manual to properly implement the directives in § 4.125 through § 4.129 and to apply the general rating formula for mental disorders in § 4.130. The schedule for rating for mental disorders is set forth as follows:

9201 Schizophrenia

9202 [Removed]

9203 [Removed]

9204 [Removed]

9205 [Removed]

9208 Delusional disorder

9210 Other specified and unspecified schizophrenia spectrum and other psychotic disorders

9211 Schizoaffective disorder

9300 Delirium

9301 Major or mild neurocognitive disorder due to HIV or other infections

9304 Major or mild neurocognitive disorder due to traumatic brain injury

9305 Major or mild vascular neurocognitive disorder

9310 Unspecified neurocognitive disorder

9312 Major or mild neurocognitive disorder due to Alzheimer's disease

9326 Major or mild neurocognitive disorder due to another medical condition or substance/medication-induced major or mild neurocognitive disorder

9327 [Removed]

9400 Generalized anxiety disorder

9403 Specific phobia; social anxiety disorder (social phobia)

9404 Obsessive compulsive disorder

9410 Other specified anxiety disorder

9411 Posttraumatic stress disorder

9412 Panic disorder and/or agoraphobia

9413 Unspecified anxiety disorder

9416 Dissociative amnesia; dissociative identity disorder

9417 Depersonalization/Derealization disorder

9421 Somatic symptom disorder

9422 Other specified somatic symptom and related disorder

9423 Unspecified somatic symptom and related disorder

9424 Conversion disorder (functional neurological symptom disorder)

9425 Illness anxiety disorder

9431 Cyclothymic disorder

9432 Bipolar disorder

9433 Persistent depressive disorder (dysthymia)

9434 Major depressive disorder

9435 Unspecified depressive disorder

9440 Chronic adjustment disorder

General Rating Formula for Mental Disorders

	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.

[Berta]

PTSD (mental) is rated under 9411, TBI (physical) under  8045.

I posted a few links in another thread as to how VA was handling TBI claims the wrong way.

"How can they lump physical and Mental health all in one rating?" If they can say the symptoms overlap and cannot be separated as to the etiology.

 

If they say that however it might be BS.

I really am wondering if the TBI scandal has really impacted the testing they do for TBI.

 

My husband had organic brain disease, multiple TIAs, and major stroke and also SC PTSD. While the brain trauma was not a TBI, still the VA, after a little battle I had with them, gave him enough tests to determine that

the organic brain residuals etc etc were 100% P & T  under 1151 and the SC PTSD went up from 30% to 100% P & T .

 

I think they used Diagnostic code 8045 for his brain trauma.

These were separate disabilities with separate etiology- PTSD from Vietnam, strokes and dementia, etc etc from piss poor VA health care.

 

 

They could however possibly be correct,in your case, if they did somehow lump the TBI residuals into the PTSD rating.....but that would be explained in the medical rationale in the decision.

And it still might be a valid point of appeal.

If yuopu had a stessor from the TBI and an additional valid PTSD stressor from a diffetrenty cause, that was scable as well... then I feel the TBI and PTSD SHOULD be rated separately.

 

But hard to say until we know exactly word for word what VA decided.

 

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Edited August 23, 2016 by Berta

[jfrei]

Both of the exams were outsourced and still lack the experience needed to give an opinion 

[john999]

I just don't see how the VA can lump organic brain injury or disease together with PTSD.  Do you have private IME?   If you actually read and comprehend what 100% rating for mental health includes it is just about impossible for anyone that is not in an institution to really meet that criteria.  I think they should just say total disability due to mental/emotional impairment if a vet can't work.  To be scheduler 100% for mental condition according to the VA you are insane and out of your mind.   This is just not the case for most 100% vets.  I am not saying they do not deserve the 100% rating but that the VA's idea of 100% is really completely basket case crazy.

[jfrei]

On 8/23/2016 at 9:27 AM, Berta said:

PTSD (mental) is rated under 9411, TBI (physical) under  8045.

I posted a few links in another thread as to how VA was handling TBI claims the wrong way.

"How can they lump physical and Mental health all in one rating?" If they can say the symptoms overlap and cannot be separated as to the etiology.

 

If they say that however it might be BS.

I really am wondering if the TBI scandal has really impacted the testing they do for TBI.

 

My husband had organic brain disease, multiple TIAs, and major stroke and also SC PTSD. While the brain trauma was not a TBI, still the VA, after a little battle I had with them, gave him enough tests to determine that

the organic brain residuals etc etc were 100% P & T  under 1151 and the SC PTSD went up from 30% to 100% P & T .

 

I think they used Diagnostic code 8045 for his brain trauma.

These were separate disabilities with separate etiology- PTSD from Vietnam, strokes and dementia, etc etc from piss poor VA health care.

 

 

They could however possibly be correct,in your case, if they did somehow lump the TBI residuals into the PTSD rating.....but that would be explained in the medical rationale in the decision.

And it still might be a valid point of appeal.

If yuopu had a stessor from the TBI and an additional valid PTSD stressor from a diffetrenty cause, that was scable as well... then I feel the TBI and PTSD SHOULD be rated separately.

 

But hard to say until we know exactly word for word what VA decided.

 

 Like this

• 
   

 

2006 moved back to PA from NC the same time inrecieved a video of my friends dieing moments in a hospital from an IED didn't adjust well to my new Mos was arrested a few times dx chronic adjustment order still around today 2007TBI was caused by a car manufacture defect won my appeal last year, PTSD was war related in 2009 this sounds like a timeline for a Appeal have dx for them all now as seperate ratings.

Edited May 24, 2017 by jfrei