ptsd From S to R2?

[jfrei]

I was most recently diagnosed with a seizure disorder and was referred to University of Pittsburgh for a case study along with the Mayo Clinic. Here is his letter

Attention Mayo Clinic/University of Pittsburg concussion Center ;

 

As noted in Mr. Frei’s history, he underwent severe trauma while active duty military.  He has since been retired from the military with posttraumatic stress disorder and traumatic brain injury which is not fully been compensated yet.  Traumatic brain injury is definitely a component.

 

I have been his primary care physician for approximately the last year as he has started with the VA in Wilmington, Delaware.  After his military career.  He was a helicopter pilot in the military, then a aircraft mechanic at Philadelphia international Airport.  However, his memory was so impaired and headaches as well as circadian rhythm disturbance due to his union schedule.  He lost his job at Philadelphia and was until recently working on helicopters down in Maryland.  Once they found out memory issues.  They terminated his employment.

 

Most importantly patient has the chronic symptoms of PTSD associated with anxiety as well as some slight physical residual symptoms from the motor vehicle.  He suffered while active duty.  On several occasions approximately 2 times per year.  He has had sudden episodes of loss of consciousness where he is found on the ground and after just a minute or so is conscious.  He has never swallowed his tongue.  He has never been foaming at his mouth.  He has never had loss of urine.  MRI shows consistency with TBI.  There is no evidence of significant seizure workup as well as etiology and combination to create one full situation of posttraumatic stress disorder associated with seizure disorder associated with traumatic brain injury.

 

At this point, I believe Jamie Frey would be most benefited by a a full team approach medical evaluation by the Mayo Clinic for University of Pittsburg concussion Center as the current system of addressing one issue at a time at different facilities is not coming up with an answer and this is a 31-year-old white male in very good physical condition with physical injuries and former military service.

 

If accepted to the program.  I suspect we will have a good chance of having her in the Veterans Administration cover costs, but cannot guarantee.  Until that is actually submitted

 

 

If the hospital turns it down he said it a good chance it will be approved couldn't I use this as a way to get SMC-R2? This makes my life a living hell with the timing my wife's pregnant, has lymphoma during pregnancy doctor thinks. Son has a minor birth defect my daughter has a heart defect. Worrying about my own health issues is

trivial in my eyes. Dealing with 2 black outs a year and headaches with short term memory problems seem minor to my pregnant wife. Life's full of curveballs 

 

[FormerMember]

To get to R2 from S, you will have to meet all the requirements of SMC O or be totally disabled and have the last name of Shulkin. Being  married to his daughter might work, too. I think I'd be concentrating on making the leap from SMC S to SMC L based on the need for Aid and Attendance as a preliminary goal. Use VAF 21-2680 as a template for feasibility. 

[jfrei]

Well I guess I know what to look into Thanks Nod

Edited March 13, 2017 by jfrei

[jfrei]

SO NOD I am permanent and total rated due to my TBI and PTSD is that under a SMC criteria? I just went in for review for both issues. 

Edited September 7, 2017 by jfrei

[FormerMember]

TBI is rated under DC 8045. PTSD is rated under DC 9411. Since there is some overlap of symptomatology, they try to scream pyramiding but it isn't. TBI is neurological; PTSD is mental. SMC criteria is blind to actual dx. It's the compendium of the disabilities and the need for either A&A 1 (SMC L) or A&A 2 (R1 or R2). 

[jfrei]

Thanks I was called today by the white house hotline I said I have my claim they sent me in for an exam then 3 months later they ordered increases for my sTBI residuals and my PTSD. She  explained I can only have on rating and that my TBI isn't considered a Mental issue I said then how is it the past 7 years the VA has said otherwise and listed PTSD as a symptom of my TBI along with post traumatic amnesia I lost about 4 months of my memory about 2  prior to the accident and 2 after my tbi/coma. She said she was just calling me to tell me the rater is currently rating my claim and appeal since its was remanded back to my RO. This scattered claims so scattered I cant even keep my eyes straight I just try to get with life...  But all three doctors separated my symptoms now and the level of impairment attributed to each 70% TBI 30% PTSD. Reading the exam he and she marked me for my PTSD as being 70% for the occupational Impairment. But the one doctor saying it only contributes tto 30% of my impairment and the rest due to my TBI where does that live that at? Would it be 70% or 30% due to that's all it contributes with the 70%TBI? Those 3 questions on the DBQ are so intertwined its hard to say how they could ever separate my conditions... so BASICALLY my neuro psych test revealed my cognitive disorder which my VA doctor dx me with that I never said anything about that she had the results and added this dx neurocognitive disorder due to TBI which is a mental condition with PTSD. So typing this my brain starts to function this is how I believe they may be separated because looking done in the medical dx it also just lists sTBI. If I never filed a claim for neurocognitive disorder they would not just give it to me or could they say my PTSD combined with this disorder is 100%? and my TBI remains at 70% which is already considered P and T?

 

4b can you differentiate between each mental disorder dx?

Yes

4b indicated level of occupational impairment and social attributable to ead dx?

neurocognitive disorder due to TBI 70% PTSD 30%

4C.dx of TBI exists indicate my level of impairment each dx?

TBI 70% PTSD 70%

[Buck52]

I think some times  they don't know how to word certain disability's that can factor into others  and they try to ''sneek the symptomatology in as pyramiding as Alex mention above

Looks like to me if they are giving you a 70% rating for PTSD AND 70%Rating for TBI  that's just 100%.

Now if you don't agree with the decision look up what the rating % should be according to the CFR Regs for both symptoms (as what the Dr's are stating) I personally think you should get 100% for both of these .

if you only had one and not the other you can bet they would rate it at 100%   so why not do what is right and rate then both at 100%

 I think its b/c they don't want to give out more $$$ to you  and let you meet the higher SMC Creteria .....  but this is just my opinion.

if you let them know you know the rating regulations on this issue  it could change their minds somewhat!

jmo