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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Most Common VA Disabilities Claimed for Compensation:   

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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Michael.j.greene1

any guesses at my rating

Question

hello i wanted to see what you guys think my rating for ptsd would be based off of my c&p exam for ptsd i am at 90% for other stuff and need 40% to put me over 100%

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:  F43.12
       
    2. Current Diagnoses
    --------------------
    a. Mental Disorder Diagnosis #1: PTSD
           ICD code: F43.12

       Mental Disorder Diagnosis #2: Major depressive disorder

       Mental Disorder Diagnosis #3: Male erectile dysfunction (ED)
           Comments, if any:
              ED secondary to treatment for PTSD and depression (this is
              consistent as a well docuemted side effects of zoloft).

    b. Medical diagnoses relevant to the understanding or management of the
       Mental Health Disorder (to include TBI): Chronic pain - see service
       connected conditions below

    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?
       [X] Yes   [ ] No   [ ] Not applicable (N/A)
       
           If yes, list which symptoms are attributable to each diagnosis and
           discuss whether there is any clinical association between these
           diagnoses:
              It is difficult if not impossible differentiate what portion of
              depression versus PTSD is attributable to each diagnoses. There is
              a high degree of overlap and comorbidity between the disorders.

              Erectile dysfunction is secondary to treatment for PTSD and
              depression. 
              
              
    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?
       [X] Yes   [ ] No   [ ] No other mental disorder has been diagnosed
       
           If yes, list which portion of the indicated level of occupational and
           social impairment is attributable to each diagnosis:
              It is difficult if not impossible differentiate what portion of
              depression versus PTSD is attributable to each diagnoses. There is
              a high degree of overlap and comorbidity between the disorders.

              Erectile dysfunction is secondary to treatment for PTSD and
              depression. 
              
              
    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
    ----------
    a. Relevant Social/Marital/Family history (pre-military, military, and
       post-military):
          Mr. Greene is currently married. 

          He has one son. 

          Grew up in Buffalo NY.

          He had step sibling growing up but outside of that was an only child.
          
    b. Relevant Occupational and Educational history (pre-military, military, 
and
       post-military):
          High school education

          US Army 1998-2016

          5th group special forces

          supply 

          72 months deployed to Afghanistan and Iraq

          Recently started working as a deck hand on a boat.
          
    c. Relevant Mental Health history, to include prescribed medications and
       family mental health (pre-military, military, and post-military):
          Currently in treatment counseling and 100mg of zoloft for depression.
          Experiencing erectile dysfunction as a side effect from the zoloft.
          
    d. Relevant Legal and Behavioral history (pre-military, military, and
       post-military):
       No response provided.
       
    e. Relevant Substance abuse history (pre-military, military, and
       post-military):
       No response provided.
       
    f. 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: Multiple combat situation (Bronze star with valor). Fear of
          IEDs, mortars and rockets.
          
          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
          
    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] Directly experiencing the traumatic event(s)
                   [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, involuntary, and intrusive distressing 
memories
                       of the traumatic event(s).
                   [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] 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] 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.
                   [X] Persistent inability to experience positive emotions
                       (e.g., inability to experience happiness, satisfaction, 
or
                       loving feelings.)

       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] Reckless or self-destructive behavior.
                   [X] Hypervigilance.
                   [X] Exaggerated startle response.
                   [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

    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] Panic attacks more than once a week
       [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

    6. Behavioral Observations
    --------------------------
    Mr. Greene was early to his appointment.

    7. Other symptoms
    -----------------
    Does the Veteran have any other symptoms attributable to PTSD (and other
    mental disorders) that are not listed above?
       [ ] Yes   [X] No
       
    8. Competency
    -------------
    Is the Veteran capable of managing his or her financial affairs?
       [X] Yes   [ ] No
       
    9. Remarks, (including any testing results) if any
    --------------------------------------------------
       PTSD and major depressive disorder would be considered a progression /
       worsening of the previously diagnosed insomnia disorder. This opinion is
       supported the presentation of Mr. Greene's symptoms as consistent with
       PTSD as well has his STRs that document over 70 months deployed to Iraq
       and Afghanistan, having earned a bronze star with valor in the US Army
       special forces. 

       Based on a review of the available records in VBMS, it is the writer's
       medical opinion that Mr. Greene's currently diagnosed PTSD is due to or a
       result of fear of hostile military activity from multiple combat
       deployments. This opinion is supported by the his exposure to threat of
       mortars and other explosive devices during deployment. The veteran
       continues to experience multiple symptoms that are consistent with combat
       related PTSD.
       
    NOTE: VA may request additional medical information, including additional
    examinations if necessary to complete VA's review of the Veteran's
    application.

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You will need at least a 50% rating to make the 95.3 % rounded off at 100%

90% & 40%  won't get you to 100%  its only 94.3  rounded off to 90%  with this crazy VA Math

Looks like to me a 70% /100% depending on that last statement if VA  Request more medical Information?

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thank you for your insight last i remember my vso told me that i need 40% to make 100 i dont know if i would want 100% PTSD i dont want to lose my concealed carry prmite i am waiting on perp for decision 

Edited by Michael.j.greene1

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Its very hard to reach 100% with a combined rating   even at a combined rating of 90%   

40% plus a another rating at 90%   you will only have a combined rating at 90% over all rating   because 40% and 90% is at 94.3 % rounded off at the still 90% rating using VA Math

any rating over  95%  95.1% would make the 100%

You may ask your VSO to recheck on his calculation.

if you get a 70% rating or higher  you should get inferred to a SMC-S Rating.

b/c  if the PTSD is a separate condition  rating than what you have Service Connected at present? this would be a statutory rating.

I'm not familiar with the PTSD % rating That will be subject to cancel out your Firearm permit. check with your state laws on that.

Edited by Buck52

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Michael.j.greene1

If you don't agree with your decision as to a  high or low rating.

You can always Send in a NOD (Notice of Disagreement) and disagree with the VA Raters decision. 

Using the VA Form  VA Form 21-0958

My opinion looking at your PTSD C&P you could be rated at the 70% or maybe a 100% rating for Combat PTSD

  VA Form 21-0958

Edited by Buck52

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I agree with Buck---70 to 100...unless you are substantially employed.

The C & P exam states:

"Recently started working as a deck hand on a boat."
          

Are you still employed as a deck hand?

I looked at this differently----

If this vet was not employed and he filed for TDIU ,solely due to his PTSD, than maybe that might set him up for eventual SMC S if the TDIU is only for one disability and he can get another independent SC he already has established....up to 60% or over....

does that make sense?

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