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PTSD C&P exam help

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Playtrix

Question

I have some questions and wondering what some of your observations are. I had a c and p exam recently and got ahold of the DBQ. All the boxes the doctor checked were good for me. She checked all the right boxes and checked that I had PTSD and all the symptoms they went with it but in some of the comments she made, they seem really bad. So I'm wondering what matters more, the doctors observations or the boxes she checked? I'm rated at 60% currently with anxiety NOS and Tinnitus. I did not initiate the exam for an increase. It was one of the random c&p to see how things are going.

This is from the PTSD initial DBQ that she filled out

1) yes
2) PTSD, paranoid personality disorder with avoidant features, other specified anxiety disorder with depressive symptoms
3) a. Yes. B.no
4.) A.Occupational and social impairment with deficiencies In most areas work, school , family relations...etc
B. Yes--most impairment is attributed to PTSD and anxiety disorder with paranoia secondary.
Under PTSD criteria she checked 2 in A, 3 in b, 2 in c, 6 in D and  4 in E .

6) Argumentative and irritable veteran who is hiding behind his wife and looks at her instead of the examiner; has poor eye contact; unable to tolerate questions without interrogating examiner about "meaning" of question; makes people want to avoid him due to his paranoid arguing. Hopeless attitude; does not accept hopeful comments; arrogant and appears to think he knows more than others; thinking was designed to perceived threat, not to answer questions; emotional overactivity; exaggerated affect; affect constricted; everything annoys him; meds do not touch symptoms and he does not sleep; problems with lack of trust.
7) " he may be playing this up out of a desire to avoid working at jobs that are low pay---he has no job skills and comes from a highly educated family --father is lawyer, sister a geophysicist; he may prefer the sick role, rather than go back to school and stretch himself; there is an element of malingering and playing to an audience."
I found this highly offensive because I've been going to the VA for at least 5 years. I didn't initiate the exam so I'm not trying to get more money. However, I wasn't honest in my first c&p in 2011 because I was ashamed and held back a lot of the really bad things I experienced. This time around I made sure that I was brutally honest. I know that I'm supposed to tell them about my "worst" day and how bad it really is and I did. And now my sincerity is questioned? The lady was incredulous that my wife married me even though I didn't have a job and still don't. I said that I don't believe I can work which I don't think that I can because I barely can stand to leave the house and that I hate being around people because I'm constantly thinking in my head that I'm going to be attacked or have to attack someone else. I also don't sleep, I have diagnosed insomnia from the VA. Because of all this I don't think I'd be able to hold down a serious job. Is that crazy? I haven't worked in a long time. I stay at home and take care of our kids. I said something like at least I can feel useful like that. The woman seemed stunned by this.

I'll admit I was extremely uncomfortable during the exam because I hate talking about this stuff and prefer to not think about it. And she interpreted it in the way above.
Her comments seem contradictory to all of the boxes she checked.  If I'm "malingering and playing to an audience" why did she check all of the other boxes? It's driving me crazy. This feels really bad for me. I'm having anxiety attacks almost daily thinking about this.


Am I crazy to worry about how this will turn out for me?

This woman was in her late 70s or early 80s. The exam was through VES and was done at her in home  practice

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The last few question are the key as in my VES increase exam to see what the doctor believes is her dx or reasoning for SC what else did the doctor say...

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  • HadIt.com Elder

Hi Tomin, welcome to Hadit.The examiner may be a nice person and knows that typically veterans coming in for C&P's are fairly nervous about the whole thing. Maybe, or maybe that is what the examiner says to just about every veteran at the end of the process. In any case, you are correct; he just provides the medical opinion on whether or not there is a s-c disability, and the extent of those potential disabilities. It is going to be up to the RO to read the tea leaves and make the decision.  Try to relax and find something else to take your mind off of the process. It can be several weeks more before you get a decision. You did your work, now sit back and relax while the VA does its.  When you receive your decision and if it isn't what you expected, come back to us and discuss your options with us. Wish you the best of luck.

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  • HadIt.com Elder

I would say it's a good thing he said that but you won't know if he stab you in the back until you can get and read his report,  so try to get this report as soon as you can.

Most examiners look for the veteran to over exaggerate their symptoms and don't say anything during the exam.

SO IT'S VERY IMPORTANT WHAT BOX'S HE CHECKS YES AND NO ON.

The examiners I am leery of are the ones they come out and say  ok I got everything I need here  just so you know its not me that makes this decision   its the decision makers at your R.O.

but what they write in their report plays a big big roll on these decision makers.

If your in treatment   VA or Private therapy, I would say its a good chance you will be service connected and a proper rating given to you according to your symptoms  that meet the Mental Health Rating Chart Below.

General Rating Formula for Mental Disorders

   Rating

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.100 %

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.70 %

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.50 %

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).30 %

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.10 %

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.0 %

 

 

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The exam sounded positive but the VARO will consider your stressor and I hope you have adequately proven that.

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