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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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75HotelCalifornia

PTSD Raiting 70 or 100%

Question

History,

Going on for over 12+ years since left the militray .First raiting 50% Went for increase this was from my DBQ C&P .. Thoughts all? See below

Is this 70 (most would say 70). could it sway 100%? If you think 100% do you believe sched or temp? I did not apply for IU but I am told they have to consider it anyways.


The doctor also used some verbage that was interesting

It is not possible to differentiate what portion of each symptom is attributable to each diagnosis because all of the veteran'schronic PTSD and bipolar symptoms have been chronic, progressive, biologically and behaviorally interactive, and thesymptoms are concurrent and overlapping. The veteran’s alcohol abuse is in remission but was a result of maladaptive copingand dealing with the PTSD an bipolar symptoms.Per DSM-5 Individuals with PTSD are 80% more likely than those without PTSD to have symptoms that meet diagnosticcriteria for at least one other mental disorder (e.g. depressive, bipolar, anxiety, or substance use disorders) (p 280)It is not possible to differentiate what portion of the impairment is attributable to each diagnosis because all of the veteran'schronic PTSD and bipolar symptoms have been chronic, progressive, biologically and behaviorally interactive, and the symptomsare concurrent and overlapping. The veteran’s alcohol abuse is in remission but was a result of maladaptive coping and dealingwith the PTSD an bipolar symptoms.

[X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinkingand/or mood.


3. PTSD Diagnostic Criteria
Please check criteria used for establishing the current PTSD diagnosis. The diagnostic criteria for PTSD, are from the Diagnostic
and Statistical Manual of Mental Disorders, 5th edition (DSM-5). The stressful event can be due to combat, personal trauma, other life
threatening situations (non-combat related stressors.) 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 #6 – “Other symptoms”.
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)
Witnessing, in person, the traumatic event(s) as they occurred to others
Learning that the traumatic event(s) occurred to a close family member or close friend; cases of actual or threatened death must
have been violent or accidental; or, experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g.,
first responders collecting human remains; police officers repeatedly exposed to details of child abuse); this does not apply to
exposure through electronic media, television, movies, or pictures, unless this exposure is work related
No criterion in this section met.


Page 6 of 8 Contractor: VES
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).
Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such
reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present
surroundings.)
[X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the
traumatic event(s).
Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

No criterion in this section met.
Criterion C: Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(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).

No criterion in this section met.
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:
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).
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”).
Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead to 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.
Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings.)

No criterion in this section met.
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.

Reckless or self-destructive behavior.
[X] Hypervigilance.
Exaggerated startle response.
[X] Problems with concentration.
[X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

No criterion in this section met.
Criterion F:
[X] Duration of the disturbance (Criteria B, C, D and E) is more than 1 month.
Veteran does not meet full criteria for PTSD
Criterion G:
[X] The PTSD symptoms described above cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning.

The PTSD symptoms described above do NOT cause clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
Veteran does not meet full criteria for PTSD
Criterion H:
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 that occur weekly or less often

Panic attacks more than once a week
Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
[X] Chronic sleep impairment
[X] Mild memory loss, such as forgetting names, directions or recent events
Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete
tasks

Memory loss for names of close relatives, own occupation, or own name
Flattened affect
Circumstantial, circumlocutory or stereotyped speech
Speech intermittently illogical, obscure, or irrelevant
Difficulty in understanding complex commands
[X] Impaired judgment
Impaired abstract thinking
Gross impairment in thought processes or communication
[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 work like setting
Inability to establish and maintain effective relationships

Suicidal ideation
Obsessional rituals which interfere with routine activities
[X] Impaired impulse control, such as unprovoked irritability with periods of violence
Spatial disorientation
Persistent delusions or hallucinations
Grossly inappropriate behavior
Persistent danger of hurting self or others
[X] Neglect of personal appearance and hygiene
[X] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene

Disorientation to time or place
IF YOU HAVE PROVIDED ANY ADDITIONAL DIAGNOSES, OR IF THE ESTABLISHEDDIAGNOSIS HAS CHANGED IN ANY WAY, PLEASE SELECT AT LEAST ONE FROM THEFOLLOWING:A. THERE IS NO CHANGE IN THE SERVICE CONNECTED DIAGNOSIS AND NOADDITIONAL DIAGNOSES HAVE BEEN RENDERED.B. THE NEW DIAGNOSIS IS A CORRECTION OF THE PREVIOUS DIAGNOSIS.C. THERE IS A WORSENING OF THE VETERAN’S SYMPTOMS HOWEVER NO CHANGETO THE SERVICE CONNECTED DIAGNOSIS AND NO ADDITIONAL DIAGNOSES HAVE BEENRENDERED.D. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE DIRECTLY DUE TO ORRELATED TO THE SERVICE CONNECTED DIAGNOSIS (I.E. A PROGRESSION).E. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE UNRELATED TO THESERVICE CONNECTED DIAGNOSIS (I.E. A NEW AND SEPARATE CONDITION).***FOR OPTION E, PLEASE SPECIFY WHICH OF THE VETERAN’S SYMPTOMS AND/ORFINDINGS CORRESPOND WITH EACH DIAGNOSIS, IF FEASIBLE.***F. THE SERVICE CONNECTED DIAGNOSIS HAS RESOLVED.

 

Answer Question 1: C. There is a worsening of the veterans symptoms however no change to the service connected diagnosisD. Additional diagnosis is alcohol use disorder in partial remission which is a new and separate conditionbut is related to the service connected conditionsAdditional

Question 2: FOR OPTIONS OTHER THAN A AND C PLEASE PROVIDE YOUR MEDICAL RATIONALE.

Answer Question 2: D. It is related as alcohol use disorder is often secondary to his PTSD and bipolar disorder and is currentlyin remission but was a result of maladaptive coping with his symptoms in the past and he still hasoccasional relapses./

 THE VETERAN’S ESTABLISHED DIAGNOSIS IS POST-TRAUMATIC STRESS DISORDERWITH BIPOLAR DISORDER .IF YOU HAVE PROVIDED ANY ADDITIONAL DIAGNOSES, OR IF THE ESTABLISHEDDIAGNOSIS HAS CHANGED IN ANY WAY, PLEASE SELECT AT LEAST ONE FROM THEFOLLOWING:A. THERE IS NO CHANGE IN THE SERVICE CONNECTED DIAGNOSIS AND NOADDITIONAL DIAGNOSES HAVE BEEN RENDERED.B. THE NEW DIAGNOSIS IS A CORRECTION OF THE PREVIOUS DIAGNOSIS.C. THERE IS A WORSENING OF THE VETERAN’S SYMPTOMS HOWEVER NO CHANGETO THE SERVICE CONNECTED DIAGNOSIS AND NO ADDITIONAL DIAGNOSES HAVE BEENRENDERED.D. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE DIRECTLY DUE TO ORRELATED TO THE SERVICE CONNECTED DIAGNOSIS (I.E. A PROGRESSION).E. ADDITIONAL CONDITIONS WERE FOUND WHICH ARE UNRELATED TO THESERVICE CONNECTED DIAGNOSIS (I.E. A NEW AND SEPARATE CONDITION).***FOR OPTION E, PLEASE SPECIFY WHICH OF THE VETERAN’S SYMPTOMS AND/ORFINDINGS CORRESPOND WITH EACH DIAGNOSIS, IF
FEASIBLE.***F. THE SERVICE CONNECTED DIAGNOSIS HAS RESOLVED.Answer

Question 1: C. There is a worsening of the veterans symptoms however no change to the service connected diagnosisD. Additional diagnosis is alcohol use disorder in partial remission which is a new and separate conditionbut is related to the service connected conditionsAdditional Question 2: FOR OPTIONS OTHER THAN A AND C PLEASE PROVIDE YOUR MEDICAL RATIONALE.Answer Question 2: D. It is related as alcohol use disorder is often secondary to his PTSD and bipolar disorder and is currentlyin remission but was a result of maladaptive coping with his symptoms in the past and he still hasoccasional relapses.

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Welcome to the Hotel called "VA delay and denial".  Your C and P may not result in additional benefits for 2 reasons:

Most importantly, in the part you posted, I did not see anything on "occupational or social impairment".  If you read the criteria for 100% for mental disorders it begins:  "Total Occupational and social impairment".  This means you are unable to work due to mental disorder such as PTSD, depression, etc.  It also means your social relationships crashed.  (divorce, alienated from familiy and friends, etc)

To meet the criteria for 100 percent PTSD, then, by using the criteria, you have to have "total occupational impairment" meaning you can not work.   If you are working, then that is evidence this does not apply.  Of course, I have no idea what your work/family situation is.  But I do know that your occupational and social impairments need to be documented.  

So, lets just say, for example, you were fired from your job, and your wife and family told you to take a hike and wont return your calls.   Im using this as an example, Im not "calling you out" for anything in your life.   You go to the C and P exam, and the doc asks "How are you?"  

You respond:  "Good, how are you, sir".  Since its painful, you dont tell your doctor that your wife moved in with your (former) best friend, your daughter and son wont have anything to do with you, and your ex boss is suing you for getting angry and destroying his workplace.  

I mean, gee, I get that.   I dont want to wear a Tshir that says, "CAution, Im depressed, have no family and no one in their right mind will hire me."  Its okay to not tell your entire life story to your bank teller each time there is a new teller.  

But, still, you have to have all these symptoms DOCUMENTED IN YOUR FILE.  Its not enough that you are homeless, and all your possessions are in your "closet" which is a grocery cart, if you tell all the docs you are fine and dont need anything.    I get it.  If you go to church and someone new says, how are you, you dont want to tell them your life story and all your aches and pains.  You dont need to.  

But, when you go to the VA doc...tell em your life story.  They dont read your mind.  Dont lie, but tell em what happened when you and your ex got in a fight and the cops were called last Saturday.  Tell em you are facing domestic violence cases.  

Then, make sure the doc wrote down this stuff.  GET your medical file and see if your symptoms are documented.  If the doc left something out, then tell the same symptoms to another doc and check to make sure he writes those down.  In the VA, if its not documented in your file, then it did not happen.  

Even if it is documented, many rating specialists will "top sheet" your file and not read it.  "Aw, this guy sounds like 40 percent to me.  I dont want to read his exams..I will 

just lowball him.  

The second reason is that a lot of raters think alcohol abuse is "your own fault".  While many PTSD VEts try to self medicate with alcohol, by default the VA tends to "assume" its "willful misconduct" and deny you if the term "alcohol" is in your file.  They also assume you lie about alcohol consumption.  If you say you have 2 beers a week, they right down that you have 4 beers every morning and every afternoon...more on weekends, when you REALLY get drunk.  They acutally do this on purpose.  My wife is a nurse and she said the research shows that people drink or smoke 2-10 times more than they admit.  So this means if a guy says he had "a few beers", that means he got wasted and lost count how many beers after 14.  

Edited by broncovet

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On 6/24/2017 at 6:20 AM, broncovet said:

Welcome to the Hotel called "VA delay and denial".  Your C and P may not result in additional benefits for 2 reasons:

Most importantly, in the part you posted, I did not see anything on "occupational or social impairment".  If you read the criteria for 100% for mental disorders it begins:  "Total Occupational and social impairment".  This means you are unable to work due to mental disorder such as PTSD, depression, etc.  It also means your social relationships crashed.  (divorce, alienated from familiy and friends, etc)

To meet the criteria for 100 percent PTSD, then, by using the criteria, you have to have "total occupational impairment" meaning you can not work.   If you are working, then that is evidence this does not apply.  Of course, I have no idea what your work/family situation is.  But I do know that your occupational and social impairments need to be documented.  

So, lets just say, for example, you were fired from your job, and your wife and family told you to take a hike and wont return your calls.   Im using this as an example, Im not "calling you out" for anything in your life.   You go to the C and P exam, and the doc asks "How are you?"  

You respond:  "Good, how are you, sir".  Since its painful, you dont tell your doctor that your wife moved in with your (former) best friend, your daughter and son wont have anything to do with you, and your ex boss is suing you for getting angry and destroying his workplace.  

I mean, gee, I get that.   I dont want to wear a Tshir that says, "CAution, Im depressed, have no family and no one in their right mind will hire me."  Its okay to not tell your entire life story to your bank teller each time there is a new teller.  

But, still, you have to have all these symptoms DOCUMENTED IN YOUR FILE.  Its not enough that you are homeless, and all your possessions are in your "closet" which is a grocery cart, if you tell all the docs you are fine and dont need anything.    I get it.  If you go to church and someone new says, how are you, you dont want to tell them your life story and all your aches and pains.  You dont need to.  

But, when you go to the VA doc...tell em your life story.  They dont read your mind.  Dont lie, but tell em what happened when you and your ex got in a fight and the cops were called last Saturday.  Tell em you are facing domestic violence cases.  

Then, make sure the doc wrote down this stuff.  GET your medical file and see if your symptoms are documented.  If the doc left something out, then tell the same symptoms to another doc and check to make sure he writes those down.  In the VA, if its not documented in your file, then it did not happen.  

Even if it is documented, many rating specialists will "top sheet" your file and not read it.  "Aw, this guy sounds like 40 percent to me.  I dont want to read his exams..I will 

just lowball him.  

The second reason is that a lot of raters think alcohol abuse is "your own fault".  While many PTSD VEts try to self medicate with alcohol, by default the VA tends to "assume" its "willful misconduct" and deny you if the term "alcohol" is in your file.  They also assume you lie about alcohol consumption.  If you say you have 2 beers a week, they right down that you have 4 beers every morning and every afternoon...more on weekends, when you REALLY get drunk.  They acutally do this on purpose.  My wife is a nurse and she said the research shows that people drink or smoke 2-10 times more than they admit.  So this means if a guy says he had "a few beers", that means he got wasted and lost count how many beers after 14.  

Broncovet:  What's a man to reply about alcohol if he's due for his five year C&P Exam for PTSD????  Great point you make by the way!!

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Your post was 06/17, what's your SC% situation now?

Are you eligible for a Scheduler IU Claim? Over the past 12 months, have you had earned income in excess of the VA SGI $12,400? Your current employment status is?

Has "Inferred IU Claim" been mentioned in any Award Letter? If so, you must still file the IU Claim, it's not an automatic Award.

Semper Fi

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