ptsd Deferred disability

[Braincloud]

Hello,

 

I am new here. I just received a rating of 10% for my back with a completion date of 10/01/16. However my PTSD claim states deferred. My C&P exam shows that I have in-service stressors and have been diagnosed with PTSD. Anyone know why this is happing?

[broncovet]

The idea is that there is evidence established for a disability for your back, but there is an issue with your PTSD claim.  Maybe they are waiting for evidence, for example.  

Have you ordered your cfile so you know what is documented?  That is, you need to know what documentation VA has.  They may or may not have all your records.  

If you order a copy of your cfile, you can find out.  Also, did the VA request any information from you that you have not yet complied with?  You know you have to sign a release of records for any private doctor.  

[Buck52]

What exactly does it mean when your claim is deferred? Simply stated, a deferred decision means you have to wait a little longer for the VA to decide your claim. There are several reasons why the VA may decide to defer a claim, but the most common reason is that they are still evaluating the medical evidence submitted for your claim.

It is important to know that a decision that comes back deferred only occurs when there are multiple claims pending. This situation is best described in the following scenario: Let’s say you filed a claim forPTSD, hearing loss, and headaches. It is possible that the VA would grant your hearing loss, deny your PTSD, and defer your headaches. The VA had enough evidence to approve one claim, deny the other, but not enough make a decision either way on your headaches.

If you only had one claim pending through the VA, they would not send back a deferment. Instead, they would just wait until they were able to either approve or deny the claim before they would send you anything.

This process can be quite confusing, especially when it comes to appealing these claims. 

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

Edited September 23, 2016 by Buck52

[Gastone]

Every Hadit member, myself included, will tell you how important getting your C-File is. The only problem, unless something has drastically changed at the VAROs, your looking at 12 to 14 months after the date you Filed the FOIA Request, before you receive it.

You have a copy of your PTSD C & P DBQ, right? How about posting a redacted copy, their may be some answers to your "Deferred Claim" status.

You indicate that the C & P Exam confirmed you had in-service stressors and "had been Diagnosed with PTSD."  Does the "had been Diagnosed" refer to another Dr's PTSD DX?

Did you have a VSO-Rep complete your initial claim? What do they have to say?

If you didn't use a VSO, might be time to get with one, if only for followup of this claim. VSOs have greater computer access to your claims info, than you do. If you can, drop in at your RO, check in with your VSO MFIC regarding your Claim. Then visit the RO intake Desk, officaly request a C-File Viewing Date with the RO Rating Dept.

Semper Fi

[Buck52]

The one thing I don't know or give out Advise on is 

 Is It better to just file one claim at a time? or if the VA will take those claims and just add to the others?

 some say yes file one claim at a time waiting 3 months apart, depends on how fast they work your claim  or any time a veteran files a claim and that claim is still gathering evidence or pending for what ever reason they will combined the claims, when they do this  it just adds more time for a decision.

I've Known veteran to file one claim at a time & wait for a decision  if Approved in a reasonable amout of time they file for another claim,  this may take longer but if your approved on your claim  it beats the long awaited Appeals Process.

But now they have then ITF (intent to file) covers a year after that if you don't file they close it out...but this is something to think about!!!

I agree any time were dealing with claims Always Request your C-File.  They very well could be more evidence you can add to help bolster your claim in your favor.

[broncovet]

Filing one claim at a time, if you have multiple issues, is ok if you have plenty of money.  Remember, your effective date wont be earlier than when you file (with a few exceptions, like if you just got out of the service.)

So, here is an "example" of how much it would cost you.  Lets assume you get awarded 20% for each of 3 disabilities, and you waited 1 year apart for each, as opposed to getting 3 disabilites, each at 20%

A.  Foot  20%  

B.  Knee 20% WAit one year

C.  Hearing loss 20% wait one year.  

If you applied all at once, this combines to 50% a married Vet would get 917.13 per month.

If you waited a year for each Knee and hearing loss, here is what it would be:

20% for your foot would be 263.23 for the first year.  So you would lose the difference, or 917 minus 263.  Thats 654 per month you would lose in the first year, or you would throw away $7848 the first year. 

The second year, TWO 20% ratings would combine to 40%, so you would get 651.36, and lose out on the difference or 266 per month, times 12 months = 3192 lost in the second year.  

Adding the two years, 7848 plus 3192  equals 11,040 total money lost by waiting and filing claims one at a time.

Of course, there is no guarantee that each will be 20%, you might get zero.  Or you could get more.  Different percentages and different number of months to delay changes it, but in every case you will lose out on the effective date, regardless of how long it takes VA to process your claim.  

 

I dont have 11,000 to throw away, so its better to file all the claims at the same time.    There is no guarntee that your claims will be processed faster, seperately, but its a virtual guarantee you will lose Some money by waiting to file, if you are eventually rated for that condition at 10% or higher.  

 

[Braincloud]

This is my initial claim, so will requesting my c-file actually help. I am also using e-benefits for my completion date and info, but spoke with someone on the benefits who stated that my claim was complete. My mental DBQ is below.

 

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: 309.81
 
 2. Current Diagnoses
 --------------------
 a. Mental Disorder Diagnosis #1: PTSD
 ICD code: 309.81
 Comments, if any:
 This condition is more likely than not (greater than 50%
 probability) related to military service.
 Rationale: Traumatic stressors resulting in PTSD occured while
 active duty and i the line of duty.
 Mental Disorder Diagnosis #2: Major Depressive Disorder, severe
 ICD code: 296.32
 Comments, if any:
 This condition is more likely than not (greater than 50%
 probability) related to military service.
 Rationale: Veteran was seen for Psychiatric counseling with
 depressed mood while active duty.
 
 b. Medical diagnoses relevant to the understanding or management of the
 Mental Health Disorder (to include TBI):
 No response provided.
 
 3. Differentiation of symptoms
 ------------------------------
 a. Does the Veteran have more than one mental disorder diagnosed?
 [X] Yes [ ] No
 
 b. Is it possible to differentiate what symptom(s) is/are attributable to
 each diagnosis?
 [ ] Yes [X] No [ ] Not applicable (N/A)
 
 If no, provide reason that it is not possible to differentiate what
 portion of each symptom is attributable to each diagnosis and discuss
 whether there is any clinical association between these diagnoses:
 Due to the overlapping and intricately interwoven symptoms of PTSD
 and Major Depressive Disorder it is not possible, without 
resorting
 to mere speculation, to differentiate what portion of each symptom
 is attributable to each diagnosis. The two diagnoses have a

strong
 clinical association and likely exacerbate each other.
 
 c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
 [ ] Yes [ ] No [X] Not shown in records reviewed
 
 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 deficiencies in most areas,
 such as work, school, family relations, judgment, thinking and/or 
mood
 b. For the indicated level of occupational and social impairment, is it
 possible to differentiate what portion of the occupational and social
 impairment indicated above is caused by each mental disorder?
 [ ] Yes [X] No [ ] No other mental disorder has been diagnosed
 
 If no, provide reason that it is not possible to differentiate what
 portion of the indicated level of occupational and social impairment
 is attributable to each diagnosis:
 Due to the overlapping and intricately interwoven symptoms of PTSD
 and Major Depressive Disorder, severe, it is not possible without
 resorting to mere speculation to differentiate what portion of the
 indicated level of occupational and social impairment is
 attributable to each diagnosis.
 
 c. If a diagnosis of TBI exists, is it possible to differentiate what 
portion
 of the occupational and social impairment indicated above is caused by 
the
 TBI?
 [ ] Yes [ ] No [X] No diagnosis of TBI
 
 SECTION II:
 -----------
 Clinical Findings:
 ------------------
 1. Evidence Review
 ------------------
 Evidence reviewed (check all that apply):
 
 [X] VA e-folder (VBMS or Virtual VA)
 [X] CPRS
 2. History
 ----------
 

not connect well with others, experienced "mood changes". 
Veteran
 lost a mentor, Lt Col Joseph A. Hoelscher who died April 26, 2006 at
 Eglin AFB. The mentor was doing a physical fitness test and became
 unresponsive, Veteran was a first responder and was unable to save
 him. Wonders now what the mentor's family thinks. Also went to 
2-3
 month course twice in Maryland, University of Maryland in trauma ER 
and
 ambulance training in Baltimore. He had a lot of DNR calls and
 "watched them die". He also had multiple calls on trauma
 resessitations, including children. Had been married and got 
divorced.

b. Relevant Occupational and Educational history (pre-military, military, 
and
 post-military):
 Stayed with parents when out of military, could not work with people,
 became reculsive. Worked five months at a job that brother got for 
him
 as an assistant pressmen. Missed a lot of days and then just quit,
 could not deal with being around people. Wife suggested they come 
back
 to Alaska, he got a job working in a warehouse, pulling lines, but 
quit
 after two weeks due to depression. 
 
 
 c. R
elevant Mental Health history, to include prescribed medications and

family mental health (pre-military, military, and post-military):
 Wanted to seek help at Eglin but being a medic he feared others could
 see his records. In England saw a social worker for therapy and Dr.
 Talon. REF Upwood in England for a year. Hospitalized in Providence
 Hospital in 2015 for a week due to suicidal ideation, started on 
Prozac
 and rimron,switched to Effexor 225mg and rimron 15mg and klonipine for
 panic attacks, which he took 3-4 times a month. With rimron he was
 able to get some sleep. Continues to have night sweats and 
nightmares,
 which have to do with not being able to save people. He did attend
 group therapy and saw SW for therapy. Currently has tremendous
 difficulty with motivation. He recognizes that he has avoided therapy
 due to fear. Now that wife is working there are days Veteran does not
 get out of bed at all, wife directs him to take showers, change
 clothes. He does talk with Mom and brother on the phone, feels he
 needs a lot of time alone, goes on walks, smokes a cigarette. No
 social life here, no friends, just spouse. Continues to not be
 comfortable around people. 
 
 
 d. Relevant Legal and Behavioral history (pre-military, military, and
 post-military):
 In veteran's court for domestic violence. Finished Vet Court and 
eight
 months of treatment for PTSD and domestic violence, took 8 months
 instead of 6 months because had difficulty getting out of bed,
 depressive symptoms. 
 
 
 e. Relevant Substance abuse history (pre-military, military, and
 post-military):
 Use to drink some and that seemed to have a relationship to the
 domestic violence, which did involve alcohol, now very seldom uses
 alcohol. Continues to smoke. 
 
 
 f. Other, if any:
 Admitted to Providence Psychiatric Unit 10/13/2015 - 10/19/2015 with
 diagnosis of Major Depressive Disorder, severe; PTSD, and Social
 Anxiety Disorder.
 Medications: bupropion 300 mg 24 hr tablet
 Commonly known as: WELLBUTRIN XL
 Take 1 tablet by mouth Daily.
 Cholecalciferol 2000 UNITS Tabs
 Commonly known as: VITAMIN D-3
 Take 2 tablets by mouth Daily.
 mirtazapine 30 mg disintegrating tablet
 Commonly known as: REMERON SOLTAB
 Take 1 tablet by mouth nightly for 30 days.

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: First responder at the death of his mentor, Lt Col Joseph A.
 Hoelscher who died April 26, 2006 at Eglin AFB. The mentor was doing 
a
 physical fittness test and became unresponsive, Veteran was a first
 responder and was unable to save him. Felt he received no debriefing
 or support.
 
 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
 
 b. Stressor #2: Also went to 2-3 month course twice in Maryland, University
 of Maryland in trauma ER and ambulance training in Baltimore. He had 
a
 lot of DNR calls and "watched them die". He also had multiple 
calls on
 trauma resessitations, including children who died.
 
 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?
 [ ] Yes [X] No
 
 If no, explain:
 Working in Baltimore ER for training in ER medicine, 4-6 months
 total, while active duty, C-STARS class.

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 Criterion 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 Criterion 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 violence, in one or more of the following ways:
 
 [X] Witnessing, in person, the traumatic event(s) as they
 occurred to others
 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 distressing dreams in which the content and/or
 affect of the dream are related to the traumatic 
event(s).
 [X] Intense or prolonged psychological distress at exposure 
to
 internal or external cues that symbolize or resemble an
 aspect of the traumatic event(s).
 [X] Marked physiological reactions to internal or external
 cues that symbolize or resemble an aspect 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 distressing memories,
 thoughts, or feelings about or closely associated with 
the
 traumatic event(s).
 [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] Inability to remember an important aspect of the 
traumatic
 event(s) (typically due to dissociative amnesia and not 
to
 other factors such as head injury, alcohol, or drugs).
 [X] Persistent, distorted cognitions about the cause or
 consequences of the traumatic event(s) that lead the
 individual to blame himself/herself or others.
 [X] Persistent negative emotional state (e.g., fear, horror,
 anger, guilt, or shame).
 [X] Markedly diminished interest or participation in
 significant activities.
 [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] Irritable behavior and angry outbursts (with little or no
 provocation) typically expressed as verbal or physical
 aggression toward people or objects.
 [X] Reckless or self-destructive behavior.
 [X] Hypervigilance.
 [X] Exaggerated startle response.
 [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] Stressor #2
 5. Symptoms
 -----------
 For VA rating purposes, check all symptoms that actively apply to the
 Veteran's diagnoses:
 
 [X] Depressed mood
 [X] Anxiety
 [X] Panic attacks that occur weekly or less often
 [X] Chronic sleep impairment
 [X] Mild memory loss, such as forgetting names, directions or recent
 events
 [X] Flattened affect
 [X] Disturbances of motivation and mood
 [X] Difficulty in establishing and maintaining effective work and social
 relationships
 [X] Difficulty in adapting to stressful circumstances, including work or 
a
 worklike setting
 [X] Neglect of personal appearance and hygiene
 [X] Intermittent inability to perform activities of daily living,
 including maintenance of minimal personal hygiene