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PatriotGames

C&P MENT test implies malingering

Question

HI All, & Happy Thanks Giving and Merry Christmas!

Retired 11 Bravo paratrooper in need of advice.

I recently had a C&P exam review of my TBI , Migraines & PTSD last Tuesday 11-22-2016. I was medically retired by the Army in 2009 The Army rated me at the physical evaluation board at 70% for PTSD and other injuries were rated at 20% but my question here is the C&P I was just given. They had me do a 338 questionnaire by sitting at a computer then I had to drive to a different location  that was not stated on their letter of the appointment. When I arrived the Dr. proceeded to ask me questions pertaining to my PTSD symptoms since my last C&P in 2015, she asked if I feel that the symptoms got worse or the same and I answered I felt as if they were the same.  Symptoms are ; suicidal thoughts, anger issues, flash backs, nightmares, nauseous, anxiety, startled, uneasy, no social life and I have not been employed since being medically retired from the Army in 2009. I was Mede vac'd   from Iraq to Landstuhl Regional Medical Center in Germany hospital then 30 days after I was flown to Walter Reed for 2 1/2 months treated for PTSD and other injuries. Then I was flown to a Medical Warrior transition unit in Alaska for more PTSD treatment which consisted of 30 days at a VA medical hospital in Rose burg , OR all while on active duty, then back to my unit in Alaska for 2 operations and occupational therapy then the Medical board process. So I have been unemployed since 2009, and receive social security disability. I recently moved to Florida from Texas because my situation has got to the point where my wife needs help from my mom to watch over me when I experience very bad moments, I guess it was too  much for her to do all while working and raising a son. I have been taking my prescribed medicine for PTSD and have kept all my appointments. I pulled my health records from my VA Health and in the C&P record the DR. a  neuropsychologists  stated that she gave me a MENT(   Morel Emotional Numbing Test), for my PTSD and that the results suggested that I am Malingering ! she said that I surpassed a cut off score and that according to the manual for the test it indicates the the testee is Malingering. She also stated that the last C&P review was inaccurate because the neuropsychologists did no testing on me.  I am 100% SC  PTSD & major Depressive disorder 70% Migraine headaches 50% TBI 40% strain cervical spine 20% Strain Lumber spine 10% Tendinitis, left shoulder 10% Degenerative changes Left knee and patellofemoral syndrome 10% Also Degenerative changes Right knee and patellofemoral syndrome 10% , Tinnitus 10%, Irritable bowel syndrome 10% , Sprain left ankle 0% Sprain Right ankle 0%, Hearing loss right ear 0% and Erectile dysfunction 0%. These were the rating since July 27, 2007 a VFW Service Officer helped me with the claims while in recovering from my injuries while I was still on active duty. Since then I have had a C&P review in Feb of 2015 and then the most recently a week ago. I have never submitted any other claims since applying for benefits and waiving my Army pension in 2009 why would I malinger?   I guess they review the TBI , PSTD & Migraines every year now. The C&P is in the gathering of information stage. What should I do while waiting for their decision? Should I be talking to a Service Officer ? I just moved to Spring hill Fl from Fort Worth TX and I do not know of a reputable Service Officer. Do I need an Attorney? I have medical ins through tri care standard and medicare should I start using a private Dr for PTSD I do use one for all my physical injuries because I do not trust the VA to inject my knees and spine . Any help from you guys will be a God sent to my family and I .  Thank you for your time and I hope this topic helps others in the future.

Edited by PatriotGames

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Check with your VSO's HQ at your RO, personal visit would be best. They can give you a better idea of why the PTSD Re-exams have been so close.

Might be a good idea to file a FOIA request for your C-File, what are the raters looking at, that's causing the Re-exams.

I don't think you need to worry about an attorney right now, there's no Retro or Appeal-able Decision yet. You should spend sometime getting up to speed, on what you have to do, if the VA proposes a PTSD Reduction. See what the MFIC at your VSO has to say. You definitely want to talk to a VSO-Rep that's had a lot of experience with VA "Intent to Reduce Rating'" Decisions.

What exactly do you know regarding the veracity of the "MENT" test results? This is the 1st time I've seen any recent PTSD post's mention it.

If this was a Rater Requested PTSD re-exam, a PTSD DBQ had to be completed. Can you post redacted 15 & 16 DBQ. Would be interesting to compare the Dueling Psychologist PhD (?) complete opinions. They were both PhDs, right?

Semper Fi

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 Have you been sent a letter  for a proposed reduction?

you have been diagnose by VA for PTSD and currently S.C. at 70% and getting paid a compensation ? correct?

WAS THIS EXAM FOR ''INCREASE'' FOR YOUR PTSD? if yes  why was the other disability's added in this  C&P exam?

you stated you are 70%SC ptsd  and  then you stated you are 100% ptsd depression?

 Quote from you

''I am 100% SC  PTSD & major Depressive disorder 70% Migraine headaches 50% TBI 40% strain cervical spine 20% Strain Lumber spine 10% Tendinitis, left shoulder 10% Degenerative changes Left knee and patellofemoral syndrome 10% Also Degenerative changes Right knee and patellofemoral syndrome 10% , Tinnitus 10%, Irritable bowel syndrome 10% , Sprain left ankle 0% Sprain Right ankle 0%, Hearing loss right ear 0% and Erectile dysfunction 0%. These were the rating since July 27, 2007 a VFW Service Officer helped me with the claims while in recovering from my injuries while I was still on active duty''

''I recently had a C&P exam review of my TBI , Migraines & PTSD last Tuesday 11-22-2016. I was medically retired by the Army in 2009 The Army rated me at the physical evaluation board at 70% for PTSD''???

You will need to wait before you can do anything...see what they say?

look on e benefits and keep your self up-dated.

Also if you have not yet?  go to your new VAMC THERE WHERE YOU LIVE NOW AND REPORT YOUR CHANGE OF ADDRESS   GO TO THE VBA Office and let them know your new address.

I never heard of this ''MENT'' Test either (from the VA?)

Usually the VA does the DSM 5 testing and go by your symptoms your having or report .

sounds like you got a cranky non friendly examiner that loves nothing better to do than have a veterans benefits taken away/they can be rebutted against with a better examiner and more qualified Dr  with  a more detail exam and a more detail report.

Make sure this Examiner is or was qualified to do a DSM 5 PTSD Evaluation? 

Being you have a VA PTSD Diagnose , I suggest you go get a IMO/IME  & Use a qualified board certified psychiatrist  in mental disorders & gives you a DSM 5 PTSD Diagnoses. 

Make sure the New Private Dr Address all and any of the VA PTSD Guidelines  under the DSM 5 Testing.

Take your service medical records so the Dr can read them and test you and give his professional opinion.

have him to state in his pro- opinion its likely as not that your PTSD is due or aggravated by your past military service  or link the two together (Nexus)

Ask him to go into detail about your PTSD and the cause.

jmo

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

Edited by Buck52
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They put at least one doc in every VA who says a Vet is malingering.  Remember, you already have a favorable exam that got you service connected.  

If you have been service connected more than five years, the VA has to prove you "actually improved" under ordinary conditions of life.  See 38 CFR 3.344 , posted below:

(a) Examination reports indicating improvement. Rating agencies will handle cases affected by change of medical findings or diagnosis, so as to produce the greatest degree of stability of disability evaluations consistent with the laws and Department of Veterans Affairs regulations governing disability compensation and pension. It is essential that the entire record of examinations and the medical-industrial history be reviewed to ascertain whether the recent examination is full and complete, including all special examinations indicated as a result of general examination and the entire case history. This applies to treatment of intercurrent diseases and exacerbations, including hospital reports, bedside examinations, examinations by designated physicians, and examinations in the absence of, or without taking full advantage of, laboratory facilities and the cooperation of specialists in related lines. Examinations less full and complete than those on which payments were authorized or continued will not be used as a basis of reduction. Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest. Moreover, though material improvement in the physical or mental condition is clearly reflected the rating agency will consider whether the evidence makes it reasonably certain that the improvement will be maintained under the ordinary conditions of life. When syphilis of the central nervous system or alcoholic deterioration is diagnosed following a long prior history of psychosis, psychoneurosis, epilepsy, or the like, it is rarely possible to exclude persistence, in masked form, of the preceding innocently acquired manifestations. Rating boards encountering a change of diagnosis will exercise caution in the determination as to whether a change in diagnosis represents no more than a progression of an earlier diagnosis, an error in prior diagnosis or possibly a disease entity independent of the service-connected disability. When the new diagnosis reflects mental deficiency or personality disorder only, the possibility of only temporary remission of a super-imposed psychiatric disease will be borne in mind.

(b) Doubtful cases. If doubt remains, after according due consideration to all the evidence developed by the several items discussed in paragraph (a) of this section, the rating agency will continue the rating in effect, citing the former diagnosis with the new diagnosis in parentheses, and following the appropriate code there will be added the reference “Rating continued pending reexamination ___ months from this date, § 3.344.” The rating agency will determine on the basis of the facts in each individual case whether 18, 24 or 30 months will be allowed to elapse before the reexamination will be made.

(c) Disabilities which are likely to improve. The provisions of paragraphs (a) and (b) of this section apply to ratings which have continued for long periods at the same level (5 years or more). They do not apply to disabilities which have not become stabilized and are likely to improve. Reexaminations disclosing improvement, physical or mental, in these disabilities will warrant reduction in rating.

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