ptsd C&P Exam/ PTSD-MST

[Firewalker]

. Other, if any: No response provided. 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: Rape in 1989 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: not related to military conflict Is the stressor related to personal assault, e.g. military sexual trauma? [X] Yes [ ] No If yes, please describe the markers that may substantiate the stressor. there are no markers of the assault 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 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] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [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] 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 5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Chronic sleep impairment [X] Disturbances of motivation and mood [X] Impaired impulse control, such as unprovoked irritability with periods of violence [X] Persistent delusions or hallucinations 6. Behavioral Observations -------------------------- The veteran was seen for 60 minutes. Her VBMS file and CPRS notes were reviewed prior to the interview. It was explained to the veteran that these exams are not full psychological evaluations, but rather evaluations for rating purposes that include questions and language dictated by the VARO. The limits of confidentiality were explained to her and she agreed to participate in the C&P evaluation. She was alert, fully oriented and cooperative. She was well groomed. Her reported mood was good, her affect was flat. Speech and thought content were within normal limits. Thought processes were logical and goal-directed. No evidence or report of delusions or hallucinations. Memory and attention appeared grossly intact. Insight and judgment were intact. The veteran denied current suicidal or homicidal ideation. 7. Other symptoms ----------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [X] Yes [ ] No If yes, describe: manic and psychotic symptoms are managed at this time with risperidone (IM) 8. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 9. Remarks, (including any testing results) if any -------------------------------------------------- The veteran's bipolar disorder, when she is noncompliant with medications or using alcohol, has contributed to severe functional limitations, loss of custody of her children, loss of her home and inability to work. She is likely able to function in a work environment that is low in stress as long as she maintains medication compliance. There is no significant evidence of a military sexual trauma. Nevertheless, her PTSD symptoms are based upon trauma experienced both prior to and during the military. She has been in treatment for PTSD since 2013. Her bipolar disorder and alcohol use disorder, both of which have contributed to severe impairment in functioning, are not causally related to the PTSD. Her PTSD symptoms, when other disorders are managed, cause less impairment and have responded well to treatment. NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application

Edited November 1, 2016 by Firewalker

[seminoles]

What are you asking?  My concern honestly would be that there is note of mental health issues and childhood abuse. 

[Firewalker]

Hi Seminoles. Thanks for taking your time and reading over it. Im a nervous wreck right now....literally shaking. It was really difficult to post that. It took all my nerves. There are many problems with this exam. Many inconsistencies on the examiners part and straight out lies as well. I guess first off I just wanted to post it and see what people thought about the exam and its contents and their opinions on ratings outcomes then I would clarify things. I agree your points about mental health issues and childhood abuse are pertinent and need to be clarified. I had a very difficult childhood and I attempted suicide the first time at 15 yrs old. I was taken to the ER and sent home after the attempt....no psych evals, no hospitalization, no treatment, no diagnosis,nothing....that was 1985 in the rural town where I lived. A year later I graduated from high school and during that whole senior year the Army recruiter would come to my house and interact with me every month. Point being, if I was mentally ill or unfit to serve why was I allowed to enlist? Obviously the US Army thought I was fit enough to serve. Personally, I feel like that recruiter saved my life getting me away from that situation. My first mental health evaluation was in the service after the rape....summer of 1989. I have no idea if I was given a diagnosis, I was suicidal, alcoholic and they just shuffled me around to another unit afterwards. No counseling, no therapy, nothing. The rape happened 6 months before my ETS and I was so disgusted about what transpired( I was actually arrested and handcuffed after the rape cuz I fought back so hard and the bastard was xxxxxx up!) and how the Army didnt give 2 shits about what happened. Fast forward to 1993. My first involuntary commitment. 3 yrs and 3 months after I got out. I have no idea what the diagnosis was...I was totally insane in a State Mental Institution where  more horrible traumatic shit occurred. My question is....how can they differentiate between childhood trauma causing PTSD or mental health issues or the rape being the straw that broke the camel's back? Getting a proper diagnosis is tricky too...Bipolar was the new thing back in 93 and it seemed anything they didnt know what to do with got slapped with that diagnosis. I've been seeing a VA shrink for 2 years straight now and he isnt convinced I have anything other than PTSD. From 1993-2011 I had no therapy, no meds, and no involuntary committments. If I were truly bipolar how is that even possible? I didnt start having any problems again until 2011 when I started having flashbacks about the rape which I literally had not thought nor spoken of since it happened in 89. That is in the exam as well.

[seminoles]

17 minutes ago, Firewalker said:

Hi Seminoles. Thanks for taking your time and reading over it. Im a nervous wreck right now....literally shaking. It was really difficult to post that. It took all my nerves. There are many problems with this exam. Many inconsistencies on the examiners part and straight out lies as well. I guess first off I just wanted to post it and see what people thought about the exam and its contents and their opinions on ratings outcomes then I would clarify things. I agree your points about mental health issues and childhood abuse are pertinent and need to be clarified. I had a very difficult childhood and I attempted suicide the first time at 15 yrs old. I was taken to the ER and sent home after the attempt....no psych evals, no hospitalization, no treatment, no diagnosis,nothing....that was 1985 in the rural town where I lived. A year later I graduated from high school and during that whole senior year the Army recruiter would come to my house and interact with me every month. Point being, if I was mentally ill or unfit to serve why was I allowed to enlist? Obviously the US Army thought I was fit enough to serve. Personally, I feel like that recruiter saved my life getting me away from that situation. My first mental health evaluation was in the service after the rape....summer of 1989. I have no idea if I was given a diagnosis, I was suicidal, alcoholic and they just shuffled me around to another unit afterwards. No counseling, no therapy, nothing. The rape happened 6 months before my ETS and I was so disgusted about what transpired( I was actually arrested and handcuffed after the rape cuz I fought back so hard and the bastard was xxxxxx up!) and how the Army didnt give 2 shits about what happened. Fast forward to 1993. My first involuntary commitment. 3 yrs and 3 months after I got out. I have no idea what the diagnosis was...I was totally insane in a State Mental Institution where  more horrible traumatic shit occurred. My question is....how can they differentiate between childhood trauma causing PTSD or mental health issues or the rape being the straw that broke the camel's back? Getting a proper diagnosis is tricky too...Bipolar was the new thing back in 93 and it seemed anything they didnt know what to do with got slapped with that diagnosis. I've been seeing a VA shrink for 2 years straight now and he isnt convinced I have anything other than PTSD. From 1993-2011 I had no therapy, no meds, and no involuntary committments. If I were truly bipolar how is that even possible? I didnt start having any problems again until 2011 when I started having flashbacks about the rape which I literally had not thought nor spoken of since it happened in 89. That is in the exam as well.

I am sorry I don't know more, I know there are folks who have filed for MST/PTSD with much more experience than I.  I know that my latest cp exam the examiner also lied.  I am service connected for bipolar (and yes I agree they like to slap that diagnosis on folks, not sure why?)  I don't know how they differentiate between prior trauma and in service trauma honestly, I do know that I have seen on this board and many others that if prior service mental health issues are documented that it is very hard to get sc for mh after that.  Are you currently rated for mh?  

[Buck52]

 I am sorry to hear this bad thing happen to you.

C&P Don't look to good,

you might try to PM Member Navy4life, she got her  grant for MST/PTSD.

she can let ya know how and what she used for evidence and how she worked her claim

Even though you were ok at time of enlistment they do go back to childhood days and see if you was abused or any kind of mental health problems.

 on the assaults agianst you  if they went un -reported  then that will hurt you too all these things that happen to you , you need documenntion/or buddy letter to describe what happen  or if you mention anything to them about all this. law enforcement reports ect,,ect,, any type of documentation with  help your claim

get treatment and stay in treatment.

[Firewalker]

1 hour ago, seminoles said:

I am sorry I don't know more, I know there are folks who have filed for MST/PTSD with much more experience than I.  I know that my latest cp exam the examiner also lied.  I am service connected for bipolar (and yes I agree they like to slap that diagnosis on folks, not sure why?)  I don't know how they differentiate between prior trauma and in service trauma honestly, I do know that I have seen on this board and many others that if prior service mental health issues are documented that it is very hard to get sc for mh after that.  Are you currently rated for mh?  

That is the thing though....there is no documented evidence of any mental health diagnosis prior to me serving other than my own confession of a suicide attempt at 15. I didnt have any diagnosis of anything until after I served. In 1993 after I managed to talk myself out of the state institution....still crazy as hell...I walked 15 miles barefoot to the Baltimore VA Hospital twice and they refused to help me....I dont have a rating for mental health....I heard you could only file for one mental health condition or something like that so I chose the PTSD cuz the reality is after the rape I totally lost my shit in service....I truly dont think I have Bipolar....how could I if for almost 20 years I never took meds and was never hospitalized...that just makes no sense....Do you know how to gain access to psychiatric files for inservice time? I remember about 15 years ago I got medical records from the VA...paper ones sent to me and there were no psych records at all...that was the whole reason I got them!...Anyhow, I've been homeless so many times I dont even have the files they did send to me....you tend to travel light.....this whole friggin system is so hard to navigate when your head is as screwed up as mine...and my lawyer is worthless

[seminoles]

1 minute ago, Firewalker said:

That is the thing though....there is no documented evidence of any mental health diagnosis prior to me serving other than my own confession of a suicide attempt at 15. I didnt have any diagnosis of anything until after I served. In 1993 after I managed to talk myself out of the state institution....still crazy as hell...I walked 15 miles barefoot to the Baltimore VA Hospital twice and they refused to help me....I dont have a rating for mental health....I heard you could only file for one mental health condition or something like that so I chose the PTSD cuz the reality is after the rape I totally lost my shit in service....I truly dont think I have Bipolar....how could I if for almost 20 years I never took meds and was never hospitalized...that just makes no sense....Do you know how to gain access to psychiatric files for inservice time? I remember about 15 years ago I got medical records from the VA...paper ones sent to me and there were no psych records at all...that was the whole reason I got them!...Anyhow, I've been homeless so many times I dont even have the files they did send to me....you tend to travel light.....this whole friggin system is so hard to navigate when your head is as screwed up as mine...and my lawyer is worthless

I don't think it matters honestly if they have proof, like hospital records etc. of your prior mental health issues.  The fact that you disclosed them are enough for them to say some mh issue/trauma existed before service.  I know it sucks.  You can request copies of your medical records be sent to you through a vso or ebenefits.  If you haven't talked to a veteran service officer (a very good one) I would, you may also want to file for Social security disability if you haven't already.   Also, there have been a few threads recently about mst, you may want to read through some of them and maybe try to message some of those folks.