PTSD Results are in - DENIED- Advice needed

[IMEF-Gunny]

So, I have my denial letter. I have posted my redacted exam, follow up from same C&P psychologist where he answers the question of aggrivation of pre-existing condition and copy of denial letter. Bear in mind that he failed to include things like our discussion about frequent panic attacks, where he asked me to describe the physical attributes of such but then chose to list it as "none", he made no mention of my friend who died in the Gulf, he handpicked excerpts from my VAMC notes not including the bad, but only snippets of the better comments by my attending psych dr.....standard VA employed C&P examiner tactics.

I currently have two seperate PHD level Psychologist reviewing my entire file to evaluate the Dr's opinion give me their independent medical opinion. One of those Dr's has performed C&P exams for VA as a contracted Psychologist.

My questiona are:

1. What do you think my chances are of getting this remedied and/or getting this SC?

2. Should I file to re-open the claim with IMO's or simply file the NOD, include IMO's and request DRO review?

3. Should I approach this from the pre-existing (Aggravation) aspect or PTSD (considering it would require a VA employed C&P examiner to opine and agree with a PTSD diagnosis, essentially going against the first VA Dr's opinion)

My VSO has been useless, no contact and I'm considering, if I opt to re-open and get shot down again, hiring a law firm to assist. Any advice from seasoned vets is appreciated.

RedactedAggravation.tif

RedactedDenial.tif

RedactedPTSDExam.tif

[IMEF-Gunny]

Thank you for the input. The worst part of this is now I'm going to have to spend a fortune out of pocket and endure 8-10 more hours of psychological testing and questioning. Hell, I can't make it thru a 30 minute psych appointment at my local VA without a breakdown. Just sad that the system is this way. Going to a psychologist employed by the VA is aiken to going to the other guys insurance company to see if they'll pay for the wreck out of the kindness of their heart.....

 

[john999]

There is a reason the VA does not make it easy to win a PTSD claim.  They don't want to spend the money and you are no longer of any use to them.  You and all of us vets are in the liability line.

[Buck52]

Gunney

Unless I didn't read your denial correct (had trouble reading it)

but it states you don't have a Diagnose for PTSD?.

And then in  Explanation of Issue

''What We Decided''  it states that you do Have a Diagnose for PTSD.

(Did you catch that?)

Also if this is combat trauma PTSD if you have a CIB on your DD 214 or any awards ribbons  or citation for valor or in fear for your life while serving in a war zone or conflict  you don't have to prove your stressor's , you can tel them what happen in your statment of the case  but you do not have to relive those stressor's.

Buddy statements from your unit & morning reports are good evidence , dates  you were attact by the enemy or any  Incoming Mortars or RSB/IED go off close to you  ect,,ect,,,, or  Any type of fear  ''Fear for your Life''  ect,,ect,,,

If you have these things  then all you actually need is a VA MH Dr to dx & state what your symptoms are and describe the severity of them.(usually in your statment of case or C&P Examiner Report. Unfortunately  this C&P Examiner never did this for you.

look up PTSD Symptoms and the criteria  for them here on hadit.

What they denied you on was you made the A criterion under the DSM Regs but failed to meet the B Criterion , you need at least one of these criterion's to meet the DSM 5 Regs   which can be anyone of these 

Intrusive Thoughts, Nightmares,Flashbacks, Emotional Distress, After exposure to  traumatic reminders.

 Request another C&P you feel the examiner never address all your Issues under the DSM 5 Cretiria  ,If you can get another C&P you need to mention some of these Criterion to the examiner.

Go back and research ALL your MH Notes in your Myhealthvet...check your C-File for additional favorable evidence of record, ect,,,ect,,, you need to know what all paper work your VSO Filed.

You might go to the FOIA Desk'' Release of Medical Records Dept'' at your VAMC and request your medical records from the date's before you applied for this claim to present.

As I understand it you served about 6 months of Active duty In Southeast Asia  from 11-90   to 4-91? correct?  what is the reason you were discharged?

Do some Intense Research and you may not need to get a Expensive IMO...You need the DSM B Criteria for them to rate you and they rate on the severity of your symptoms .this is the most important part of your claim.

Edited September 29, 2017 by Buck52

[Buck52]

Gunney if your not in treatment at this time?

Ask your VA PCP to refer you to MH for Therapy Sessions.

Create your paper trail and if your having mental problems because of your military service while in Southeast Asia....this treatment will help you cope  better.

You don't have to discuss what happen to you while serving in the military to the therapist ,but  your tired of all the pain and memories and need help, it could help your claim if you did,this is why your reaching out & they are there to help you.

not so much with your claim but help you cope  and they do mention things  you talk about with them in the Notes that are put up in Myhealthvet.

Never mention a claim to the Therapist ....> let them initiate that.

[IMEF-Gunny]

I was diagnosed by my primary VA MH therapist, she is a Psychiatric NP. Unfortunately, her notes are brief and do not include discussions we've had about panic episodes, hypervigilence, etc. My stressors have been verified by VA and have been conceded by VA. If you read the C&P exam, he states that no criteria is met, yet in other areas of the report, he lists symptoms that would meet the criteria. He also states that I have a pre-existing depression but that he cannot determine agrivation % as it would be speculation......then wouldn't it also be speculation to say it didn't become aggrivated by service?

The whole exam was a sham....VA says denied because no criteria met, pre-existing depression....but declared fit for duty, so no connection for pre-existing condition.....Huh?

I'd really like to hear what Berta's advice would be......I'm hoping she will chime in at some point. Called American Legion......they acted like they could give a shit less.....told me to just get the IMO (Which is going to cost me $1500 out of pocket), file to re-open the claim for a re-consideration, if that don't work, file a NOD and ask for DRO review......current appeal wait time average is 5 years per their data.

Edited September 29, 2017 by IMEF-Gunny

[Buck52]

Gunney,

I did read  the C&P Exam and also the denial,you need the DSM  Criterion B part met,   they said that's why you were denied. However you did met the DSM Criterion  A     and that's a good start

You need both of these A&B Criterion met.

This is why you need to request another C&P  your C&P Examiner failed to address this. Maybe because your MH Provider never went into detail about it or sited that you do meet the criterion B   His /her notes don't reflect this. Also if she was just a P.A. and not certified P.A. In Mental Health then she is not qualified to render an opinion on the DSM 5 Criteria

Try this before you spend a lot of $$$ on a IMO that you may not need.

You could request a MH  License VA Phyistrist  to do a DSM 5 Evaluation on you and see if you meet the DSM 5 Criteria.?

The VA MH Clinic is good in helping with this type issue,  just don't mention your claim to them .

They will put it in the notes about your MH Condition and it is their job to see that your evaluated correctly.

Yes I agree maybe Ms berta can chime in on this Her Advise is Gold.

Edited September 29, 2017 by Buck52