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

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GnySkinner

Recommendations welcome on letter for anxiety

Question

I am submitting a claim for anxiety.  My wife wrote a letter where she has included the following to show my military connection and timeline.  I have been retired for 19 years (20yr Marine 0331) and have not submitted a claim for this prior to now.  I am rated at 10% for migraines and service connected for back pain but rated at 0% for that. I do not have my military medical records although I requested them back on January 2nd.  I know they will take a long time to get.  I was seen by a clinical psychologist at the VA clinic and her diagnosis says "Adjustment disorder with mixed emotions r/o Trauma-related stressor".  She is sending me to classes and recommended on-line options as well.  Any suggestions?

My husband served 20 years in the Marine Corp where he was exposed to many conditions that he tries, unsuccessfully, to deal with to this day.

  • He suffers from impaired short and long term memory. He retains only highly learned materials while forgetting to complete simple tasks. This started very early in his military career when he studied long hours for promotion boards. He was trained to memorize and recite.

  • He is suspicious of everyone and everything. Again, this is due to his military training, be aware of your surroundings at all times and be prepared for the worst. He sees the world as a completely dangerous place.

  • He is easy to anger and very irritable. In his military career he was trained to do things at the drop of a hat, always ready to react at a moment's notice. When things don't move at the pace he thinks is appropriate he has difficulty dealing with it. “Little” things easily anger him.

  • He suffers from lack of concentration. If the subject doesn't interest him he zones out. He was taught in the military to focus on the relevant and ignore the irrelevant. This makes it nearly impossible for him to concentrate on learning new things, i.e. new jobs.

  • He served as a drill instructor at both Parris Island and San Diego. During those 4 years he trained many young Marines who later served in combat. He has expressed to me many, many times the feelings of anxiety and guilt he continues to have knowing that some of those young men were either injured or killed. He feels that he should have been there with them instead of on the drill field.


 

His 20 years of training dictate his life to this day. He has a difficult time functioning in the “civilian” world. His nights are restless and his days are frustrating. He sleeps with a CPAP machine to control his breathing. He frequently gets up to check and recheck doors and windows. He is not comfortable in social situations unless he is surrounded by his military buddies. He can not work around other people unless they share the same military background. He believes that if he asks for help it is a sign of weakness. When he was on active duty he did not go to sick call or ever ask for help because he did not want to be labeled a “sick bay commando”.


 

Although most of these conditions have been present since he was on active duty, they have gotten worse over the years. Only recently did he agree to seek help.

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This is a good letter from your spouse  she nailed everything...you will also need a letter from your Dr for a Diagnosis of Anxiety,For PTSD This Diagnoses  has to come from a MH VA Dr.

VA will not accept a MH Diagnoses (PTSD) from a private Dr

The Dr needs to follow the VA Guidelines  and word his opinion as  I have examined this veteran and read his medical records and it is in my opinion it (is likely as not) his PTSD was caused/ related to his military service as his MOS was### and also served as a Drill Instructor for basic training at locations  ******Dates

If you are in MH treatment  get the treatment notes as evidence in part of your claim. list your medications as part of your evidence in part for your claim.

you need a nexus to connect your condition to your military service ,if you were in combat and have the CIB on your DD 214 Then VA will consead your stressors, your lay statement on how this has affected your life  ect,,ect,,,

Elder member and moderator broncovet can cover the 3 things you need  to apply a first time claim for PTSD. 

THIS WOULD BE A GOOD TIME TO APPLY FOR INCREASE OR ANY SECONDARY CONDITIONS THAT PTSD CAN BE RELATED TO  SUCH AS SLEEP APNEA or loss of use of creative organ  ect,,ect,,

Also check out the New pain compensation the VA just came out with for your Back condition.

Edited by Buck52

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2 hours ago, Buck52 said:

,if you were in combat and have the CIB on your DD 214 Then VA will consead your stressors, your lay statement on how this has affected your life  ect,,ect,,,

Elder member and moderator broncovet can cover the 3 things you need  to apply a first time claim for PTSD. 

THIS WOULD BE A GOOD TIME TO APPLY FOR INCREASE OR ANY SECONDARY CONDITIONS THAT PTSD CAN BE RELATED TO  SUCH AS SLEEP APNEA or loss of use of creative organ  ect,,ect,,

Also check out the New pain compensation the VA just came out with for your Back condition.

I was never in combat.  That is a big part of my constant feelings of guilt.  I spent over 20 years in, trained hundreds of others, was in a leadership role and was never in a combat situation.  I was sent all over the world and was always in a zone just prior to or just after a combat situation. I know others have the "why me" feelings of guilt related to surviving when friends they served with weren't as fortunate. I have the "why not me" feelings related to having never been sent.  I trained my whole career for combat.  I worked hard and was good at what I did.  I took pride in learning and retaining knowledge.  Now, in the civilian world, all of that gets me no where, truly.  I don't know if this is labeled as PTSD or just general anxiety.  I figured the professionals would put a label on it.

My VSO didn't think applying for the sleep apnea condition right now was a good idea.  I have another meeting with him next Tuesday so I could ask again then. We did apply for tinnitus, hearing loss, vertigo (I have a diagnosis of this and go for additional testing Monday), gerd (which I also have a diagnosis for), kidney stones (suffer from this all the time and this is definitely in my military medical records), migraines to be reevaluated and back to be reevaluated. (8 issues right now) 

Where can I find the new pain compensation the VA just came out with for the back condition?

Thanks for your help. I really appreciate it.

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You don't have to have combat action to get traumatized  it can happen any time any where, your training for all those years  to teach other how to survive in combat has taken its toll on you  as you feel guilty for not being in combat..you should not feel that way, you did what you were ordered to do and you probably did a great job & you did it. Drill Instructors is not an eazy job..I would think it's stressful and depressing 

look at it this way  just think about all the young lives you did saved by teaching them how to survive,,,that should be a rewarding experience.

I wish I could meet my Drill instructors from basic training.

I took a lot of what they taught me and used it in a combat situation  how to survive was what kept me alive during my Vietnam tour...I have to admit the first year was pretty tough but I made it and I had 7 months left to serve out my time  my CO Ask me if I wanted to extend my tour and then ETS from Nam..and I could stay with my same unit under his command..I choose to extend...one of my reason  I made that decision was because what my Drill Instructors taught me..I was lucky to make it home but I made it home  when a lot of my buddies never did. that haunts at me today and it's been 46/47 years ago

what you did Sir in training young recruits all those years was traumatizing to you and it's just now coming out to haunt at you,think back in all those years about a trauma event that may have happen and you being a Drill instructor just sucked it up and went on and unreported details of what may have occurred?

Ask/Request your VA PCP for a referral to the MH Clinic.

Talk with a VA MH Phyistrist and he/she will most likely give you a PTSD Diagnosis for unspecified anxiety or depression They are several symptoms that can cause or be related to PTSD  but its still  PTSD. After they make an evaluation they can let you know what it is? just be open and honest during your evaluation and if your sent to a Forensic C&P  be honest with your answers.

Tell the Dr's everything you mention here...remember you don't need to be in combat to a traumatic event. it can be anything that traumatized you physically or psychologically speaking.  

And don't be feeling guilty because you were not ordered in a combat zone or had to be in a combat situation you followed orders and that's what all of us had to do.

I applaud your 20 years of military service.

Edited by Buck52

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PTSD Service Connection was liberalized back around 12 or 13. "The Fear Of" just about anything became grounds for a PTSD SC Filing, no actual Combat exposure required. It's up to the VA PTSD Forensic C & P Psychiatrist to determine if a Vet's Claimed Stressor meets the requirements, as well as eliminating Malingering.

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"Anxiety" is not a diagnosis, its a symptom of PTSD, depression and some others.  Have you been diagnosed with depression or PTSD?  I dont recommend you apply for benefits for "anxiety", but instead what your doctor has already diagnosed:  Depression, Bipolar, etc.  Or, apply for "general" mental disorders.  

It would be a shame to delay your benefits for years because you applied for depression and your doc diagnosed you with PTSD, etc.  

The VA sometimes denies for one disorder..because you have not been diagnosed with it..even tho you have been diagnosed with something similar.  PTSD vs depression, etc.  

That usually wont stick in the courts, but do you really want to wait 5 years for appeals?  I dont.  This is why I dont recommend applying for "anxiety", but instead check and see what doc has diagnosed you for, and apply for THAT condition.  PTSD/depression, etc.  

I dont suggest you do "self diagnosis" because your opinion wont matter, anyway, its what the doctor says.  

Have you ordered your cfile and medical records?  If not, you need to.  Are you on antidepressant meds, such as Wellburtron, Zoloft, Atavan, etc?  

PREVENT DENIALS and delays by making sure of what you apply for.  Dont guess.  Read what the doc says.  

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      c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [X] Yes [ ] No [ ] Not shown in records reviewed
      d. Is it possible to differentiate what symptom(s) is/are attributable to TBI
      and any non-TBI mental health diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A)
      If yes, list which symptoms are attributable to TBI and which symptoms
      are attributable to a non-TBI mental health diagnosis see 2b above.
      3. 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 occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [X] Yes [ ] No [ ] Not Applicable (N/A)
      If yes, list which occupational and social impairment is attributable to each diagnosis
      About 80% of vet's current occupational and social impairment is due
      to Unspecified anxiety disorder while about 20% is due to Cognitive disorder due to CHI.
      c. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [X] Yes [ ] No [ ] Not Applicable (N/A)
      If yes, list which impairment is attributable to TBI and which is attributable to any non-TBI mental health diagnosis see 3b above.
      SECTION II:
      ----------- Clinical Findings: ------------------
      1. Evidence Review
      ------------------
      Evidence reviewed (check all that apply):
      [X] VA e-folder
      [X] CPRS
      [X] Other (please identify other evidence reviewed):
      Vet broiught a 4 page typed letter 1/12/19 done by himself describing
      in detail his current ongoing issues("I did not want to forget to tell
      you something important"), and vet admits it took him severalhours to
      complete(and which he kept revising many times). He brought a 2 page
      letter dated 1/27/19 done by his wife ******, a 2 page typed letter dated
      1/17/19 done by mother ********, and a 1 page typed letter dated
      1/27/19 done by vet's friend/combat comrade(served together in Iraq)
      named *******, and all 4 letter were reviewed by me.
      Evidence Comments:
      CPRS was reviewed by me and included my(***** MD) 12/5 18 Review TBI C+P exam report, as well as 5/16/14 C+P exam report done by Dr *****(sa
      well
      as Initial 2/18/11 MH C+P exam aslo done by Dr. ******.
      VBMS was reviewed by me and included vet's Army DD-214 signed b *****
      which included MOS(88M30) Mortor Vehicle Operator,as well as E-6 discharge
      rank. His medals included CAB - among others, and he had Iraq combat dates
      of 1/03 - 7/03, 8/05 - 8/06, and 3/08 - 6/09 - for his 3 seperate Iraq combat tours.
      2. History
      ----------
      a. Relevant Social/Marital/Family history (pre-military, military, and
      post-military):
      Vet is married ****(and they have 2 sons(around ages 5 and nearly 7).
      b. Relevant Occupational and Educational history (pre-military, military, and
      post-military): Vet has been working in his current Passport Agency job since 2015(was at an administrative clerk(for a different agency) before that.
      c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military,
      and post-military):
      Vet has been on sertraline 150mg since 9/10/18 - it takes the "edge" off
      my problems, but he apparently has been having some sexual side effects(delayed ejaculation) related to that .
      d. Relevant Legal and Behavioral history (pre-military, military, and post-military):
      Vet has had no legal problems(and no jail time) since the 5/14/16 C+P exam report date.
      e. Relevant Substance abuse history (pre-military, military, and post-military):
      Vet has had no alcohol misuse disorder problems sicne 5/16/14. He has used no street drugs since 16/14.
      f. Other, if any:
      No response provided.
      3. Symptoms
      -----------
      For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses:
      [X] Anxiety
      [X] Suspiciousness
      [X] Panic attacks that occur weekly or less often
      [X] Chronic sleep impairment
      [X] Mild memory loss, such as forgetting names, directions or recent
      events
      [X] Impairment of short- and long-term memory, for example, retention of
      only highly learned material, while forgetting to complete tasks
      [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
      [X] Obsessional rituals which interfere with routine activities
      4. Behavioral observations
      --------------------------
      Vet was totally genuine at the 1/28/19 Review Mental Health C+P exam.
      5. Other symptoms
      -----------------
      Does the Veteran have any other symptoms attributable to mental disorders that are not listed above?
      [X] Yes [ ] No
      If yes, describe:
      Vet admits to having anger difficulties, 'spacing out' at times, and
      general feeling of being confused/overwhelmed. He reports having lost
      his social "filter" abilities. He reports previously having been very
      "easygoing" prior to the military.
      Vet still gets nervous if seeing sandbags lying on the side of the road -
      left by construction crew(as that is what he looked for over in Iraq as being a potential IED.)
      He has to reorganize plates/trays a certain way, either at home or when leaving a restaurant, respectively.
      He denies having any suicidal thoughts("No, I'm addicted to life, I love
      breathing".).
      6. Competency
      -------------
      Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No
      7. Remarks (including any testing results), if any: ---------------------------------------------------
      Vet owns a pistol. He does not hunt - only tried it once, but did not get anything then.
      He denied having any current active suicidal or homicidal ideation.
       
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    • So, my lawyer sent an IME w/ IMO and filed a supplemental claim solely for IU on March 20.

      It was closed on March 25, and va.gov just states claim closed and nothing more.

      Hopefully, I get good news.
    • Thanks for the responses. I am filing a new claim but will continue pushing the NOD. My new question is it stated in law or statute that if during the claims process the VA finds conditions that could possibly rate service connection that was not originally filed for, the VA will “invite” the veteran to file the claim on the claims form. Reason I ask is that my private DBQs, NEXUS letter, and even the VA nurse examiner's DBQs lists bilateral upper radiculopathy as present. If it is written in statute or official guidance it might qualify as a CUE. Just looking at all angles. 
    • Everyone needs to read our stories so they can try to avoid these screws by the va...
      Thank you, everyone contributes, good or bad, all of our stories will help others, and yes, they have been stated by others for ages, over and over, but we just get depressed, and the time turns into years as they screw us..

      Welcome to the department of Veterans Affairs!  I can honestly say, "been there, done that".  

      Even after winning my tdiu in 2017, it was back to the drawing board as VA hornswaggeld my effective date.  (but of course).  

      I finally won my tdiu effective date in Feb. 2020, 18 years after I first applied!!!  

      Here is how they managed to drag mine out 18 years:

      1.  They never adjuticated my decison until 2009, where they called it "moot".  

      2.  I appealed, said it was not moot because it could result in an earlier effective date and SMC S under Bradley vs Peake.  The judge agreed with me, and ordered VARO consider me for extra schedular TDIU, under 4.16 b.  

      3.  The VARO piddles with  the remand for 3 years, and hoped I wouldnt notice.  I noticed and raised cane until they adjuticated it.  (denied of course).  

      4.  Finally, after the baord denied again, I hired a lawyer, in 2014, and appealed to CAVC.   

      5.  The lawyer won a remand, got an IMO and I won tdiu in 2017.  But at the wrong effective date, even after 15 years.  

      6.  I hired another lawyer, Chris Attig, and appealed the effective date, and he won a remand for effective date.  Trip 2 to CAVC.  

      7.  Mr. Attig won a remand, and advised me to get another IMO.  

      8.  The board awarded my earlier effective date in Feb. 2020.  

           So, I do have advice fighting VA for TDIU, they fought and fought and I hung in there and won it all.  

      ADVICE:  Dont count on VA, they could easily throw your fax in the trash.  Follow up!  
    • "Keep in mind that due to the nature of the digestive system, VA would most likely combined your conditions and pay you at the higher rate to avoid pyramiding".    That is one of my main gripes.  They are only listing the GERD with hiatal hernia and ignoring the rest of my gastric issues such as the gastritis which I also had in service.  I included it in my 2007 request for increase and again in 2019.  The info from the civilian dr that stated I had the gastritis with H pylori was not even provided to the examiner in 2007, nor did he have my VA health records. The 2019 request was based on an EGD I had AT THE VA in Jan 2019.   I filed for an increase 6 Mar and they did an ACE on 27 Mar and downgraded to noncompensable on that date.  The only reason I was thinking CUE:  38 CFR § 3.326 - Under Examinations  it states (c) Provided that it is otherwise adequate for rating purposes, a statement from a private physician may be accepted for rating a claim without further examination".  
    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
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