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mstmale

Can someone help me with my C&P results?

Question

Quote

    1. Diagnostic Summary
    ---------------------
    Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria
    based on today's evaluation?
    [ ] Yes   [X] No
    
    If no diagnosis of PTSD, check all that apply:
    
       [X] Veteran's symptoms do not meet the diagnostic criteria for PTSD under
           DSM-5 criteria
       [X] Veteran has another Mental Disorder diagnosis.  Continue to complete
           this Questionnaire and/or the Eating Disorder Questionnaire:

    2. Current Diagnoses
    --------------------
    a. Mental Disorder Diagnosis #1: Unspecified Trauma-and Stressor-Related
       Disorder

       Mental Disorder Diagnosis #2: Unspecified Depressive Disorder

    b. Medical diagnoses relevant to the understanding or management of the
       Mental Health Disorder (to include TBI): defer to medical chart

    3. Differentiation of symptoms
    ------------------------------
    a. Does the Veteran have more than one mental disorder diagnosed?
       [X] Yes   [ ] No
       
    b. Is it possible to differentiate what symptom(s) is/are attributable to
       each diagnosis?
       [X] Yes   [ ] No   [ ] Not applicable (N/A)
       
           If yes, list which symptoms are attributable to each diagnosis and
           discuss whether there is any clinical association between these
           diagnoses:
              Symptoms of Unspecified Trauma-and Stressor-Related Disorder
              include physiological distress upon reminders; avoidance; negative
              self and other beliefs; persistently negative emotional state.
              Symptoms of Unspecified Depressive Disorder include depressed 
mood,
              appetite and weight fluctuations and negative self-image.
              Overlapping symptoms include depressed mood and negative
              self-image.
              
    c. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
       [ ] Yes   [X] No   [ ] Not shown in records reviewed
       
    4. 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 reduced reliability and
           productivity

    b. For the indicated level of occupational and social impairment, is it
       possible to differentiate what portion of the occupational and social
       impairment indicated above is caused by each mental disorder?
       [ ] Yes   [X] No   [ ] No other mental disorder has been diagnosed
       
           If no, provide reason that it is not possible to differentiate what
           portion of the indicated level of occupational and social impairment
           is attributable to each diagnosis:
              symptom overlap
              
    c. If a diagnosis of TBI exists, is it possible to differentiate what 
portion
       of the occupational and social impairment indicated above is caused by 
the
       TBI?
       [ ] Yes   [ ] No   [X] No diagnosis of TBI
       

_________________________________-------

     Does this stressor meet Criterion A (i.e., is it adequate to support
          the diagnosis of PTSD)?
          [X] Yes  [ ] No
          
          Is the stressor related to the Veteran's fear of hostile military or
          terrorist activity?
          [ ] Yes  [X] No
          
              If no, explain:
                alleged MST
                
                
          Is the stressor related to personal assault, e.g. military sexual
          trauma?
          [X] Yes  [ ] No
          
              If yes, please describe the markers that may substantiate the
              stressor.
               xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
                
                
    4. PTSD Diagnostic Criteria
    ---------------------------
    Please check criteria used for establishing the current PTSD diagnosis. Do
    NOT mark symptoms below that are clearly not attributable to the Criterion A
    stressor/PTSD.  Instead, overlapping symptoms clearly attributable to other
    things should be noted under #7 - Other symptoms.  The diagnostic criteria
    for PTSD, referred to as Criterion A-H, are from the Diagnostic and
    Statistical Manual of Mental Disorders, 5th edition (DSM-5).
    
       Criterion A: Exposure to actual or threatened a) death, b) serious 
injury,
                    c) sexual violence, in one or more of the following ways:
                    
                   [X] Directly experiencing the traumatic event(s)

       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] Marked physiological reactions to internal or external
                       cues that symbolize or resemble an aspect of the 
traumatic
                       event(s).

       Criterion Persistent avoidance of stimuli associated with the 
traumatic
                    event(s), beginning after the traumatic events(s) occurred,
                    as evidenced by one or both of the following:
                    
                   [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).

       Criterion 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:
                    
                   [X] 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").
                   [X] Persistent negative emotional state (e.g., fear, horror,
                       anger, guilt, or shame).

       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:
                    No response provided.
                    
       Criterion F:
       
                   [X] Duration of the disturbance (Criteria B, C, D, and E) is
                       more than 1 month.

       Criterion G:
       
                   [X] The disturbance causes clinically significant distress or
                       impairment in social, occupational, or other important
                       areas of functioning.

       Criterion H:
       
                   [X] The disturbance is not attributable to the physiological
                       effects of a substance (e.g., medication, alcohol) or
                       another medical condition.

       Criterion I: Which stressor(s) contributed to the Veteran's PTSD
                    diagnosis?:
                    
                   [X] Stressor #1

    5. Symptoms
    -----------
    For VA rating purposes, check all symptoms that actively apply to the
    Veteran's diagnoses:
    
       [X] Depressed mood
       [X] Anxiety
       [X] Suspiciousness

    6. Behavioral Observations
    --------------------------
    See Remarks.

    7. Other symptoms
    -----------------
    Does the Veteran have any other symptoms attributable to PTSD (and other
    mental disorders) that are not listed above?
       [X] Yes   [ ] No
       
           If yes, describe:
              appetite and weight fluctuations
              
              
    8. Competency
    -------------
    Is the Veteran capable of managing his or her financial affairs?
       [X] Yes   [ ] No
       

 MEDICAL OPINION REQUEST

       TYPE OF MEDICAL OPINION REQUESTED: Military Sexual Trauma (MST)

       OPINION: Military Sexual Trauma (MST)

       This examination is being conducted to assist with determining 
       whether the Veteran experienced an in-service personal assault 
       stressor related to military sexual trauma (MST) that has resulted 
       in a current PTSD diagnosis. Please review the claims file and state 
       in your report that it was reviewed.  In your review of the claims 
       file, please pay special attention to signs, events, or 
       circumstances that may represent markers for the MST stressor 
       described by the Veteran. Your review is not limited to the evidence 
       identified on this request form, or tabbed in the claims folder. If 
       additional testing is required, please obtain it prior to rendering 
       your opinion.

       2. Based upon your review of the evidence, please provide a medical 
       opinion as to whether the MST stressor event described by the 
       Veteran is at least as likely as not (50 percent or greater 
       probability) supported by and consistent with the in-service marker 
       evidence.  Please provide a rationale for the opinion and list the 
       marker evidence used to arrive at your decision.

       The MST stressor event described by the Veteran is at least as likely as
       not (50 percent or greater probability) supported by and consistent with
       the in-service marker evidence. The Veteran reported that he was 
assaulted
       during xxxxxxxxxx

       In addition:
       1.  IF YOUR EXAMINATION DETERMINES  THE VETERAN HAS A CURRENT 
       DIAGNOSIS OF PTSD, please provide an opinion as to whether the 
       current PTSD diagnosis is at least as likely as not (50 percent or 
       greater probability)  caused by or a result of the in-service MST-
       related marker(s), and provide a rationale. Please note that only 
       PTSD can be service connected based on circumstantial marker 
       evidence (38 CFR 3.304(f) (5)).

       The Veteran does not meet full criteria for PTSD. He is diagnosed with
       Unspecified Trauma-and Stressor-Related Disorder. It is at least as 
likely
       as not that the disorder was caused by or a result of the in-service
       MST-related markers.

       2.  IF YOUR EXAMINATION DETERMINES THAT, IN ADDITION TO PTSD, THE 
       VETERAN HAS ADDITIONAL MENTAL DISORDERS, please state whether the 
       additional mental disorders are at least as likely as not (50 
       percent or greater probability) secondary to the PTSD, and provide a 
       rationale.   For each mental disorder diagnosed, identify and 
       clearly list which symptoms are attributed to each diagnosis.  If 
       one or more symptoms overlap and cannot be separated without 
       speculation, please state so and provide a rationale (38 CFR 3.310).

       Vet meets criteria for Unspecified Depressive Disorder. It is
       less likely than not secondary to Unspecified Trauma-and Stressor-Related
       Disorder. It is at least as likely as not a result of the in-service
       MST-related markers.

       3.  IF YOUR EXAMINATION DETERMINES THE VETERAN DOES NOT HAVE PTSD, 
       BUT HAS A DIFFERENT MENTAL DISORDER(S), please review the service 
       treatment records (STRs) and service personnel records for in-
       service direct evidence. Direct evidence is clear, undisputable 
       proof of an event, injury, or disease. Such evidence includes, but 
       is not limited to, mental health treatment, mental health symptoms, 
       or a mental health diagnosis. If direct evidence exists in the STRs 
       or service personnel records, please provide an opinion as to 
       whether the mental disorder(s) diagnosed on examination is at least 
       as likely as not (50 percent or greater probability)  caused by or a 
       result of  the direct evidence noted in service. Please provide a 
       rationale for the opinion and list the evidence used to arrive at 
       your decision. (38 CFR 3.303).

       As above.

       Rationale must be provided in the appropriate section.

       SEE 21-0781A IN VBMS
       SEE BUDDY STATEMENT IN VBMS
       SEE DPRIS  REPORT UNATHORIZED ABSENCE (IN VBMS)

       If more than one mental disorder is diagnosed please comment on 
       their relationship to one another and, if possible, please state 
       which symptoms are attributed to each disorder.

       Unspecified Trauma-and Stressor-Related Disorder and Unspecified
       Depressive Disorder are at least as likely as not the result of the
       in-service MST-related markers. There is overlap among the symptoms of 
the
       two disorders but there is sufficient divergence to diagnose both
       disorders. Symptoms of Unspecified Trauma-and Stressor-Related Disorder
       include physiological distress upon reminders; avoidance; negative self
       and other beliefs; persistently negative emotional state. Symptoms of
       Unspecified Depressive Disorder include depressed mood, appetite and
       weight fluctuations and negative self-image. Overlapping symptoms include
       depressed mood and negative self-image. 

Not sure what to make of this....any help would be great. I really need my med's I can no longer pay to have them out of pocket. 

Edited by mstmale

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My opinion is that they say you do not have PTSD as you do not meet criterion E.  They then go on to say you have MST.  Mental disorders are all classified under the same criterion and I believe you will get some disability for this so you will be eligible for treatment at the VA.  Can anybody else provide more information on this?

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I agree..this doc says you dont have PTSD.  However, people get Service connection for other mental health disorders such as depression, bipolar, etc.  

To be safe, send in the form to apply for :

Quote

Unspecified Trauma-and Stressor-Related Disorder and Unspecified
       Depressive Disorder are at least as likely as not the result of the
       in-service MST-related markers.

...which is what your c and p doc diagnosed you for.  Now, VA "should" award this, but they have been known to simply deny PTSD as you dont have a required PTSD diagnosis.  So, it behooves you to apply for the above quote, to save you a long delay because of PTSD denial.  

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What was this C&P for? what condition you claiming?

You definitely need a PTSD Diagnosis  from the VA &  Only VA  only accepts a Official PTSD Dx. IN RELATION TO OR CAUSED BY THE MST.

This exam should have got you a 70% rating  if you had a PTSD DX..But since you don't have one  they will probably rate you with unspecific depressive Disorders  about 30% maybe rate you with another unspecific disorder.....MST Usually comes with a tramua event and in turn changes behavior changes cause by the trauma  and PTSD is Dx 

you really need to talk with va MH Clinic and talk with either a LCSW or the MST COORNATIOR  about the MST And ask for treatment

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PTSD Dx  is a Diagnosis   and it has to be from a VA qualified Doc  not private or LCSW.

AND IN MY OPINION YOU NEED A PTSD DIAGNOSIS!!!   BASED FROM THIS C&P EXAM. 

Normally MST is not a reason to diagnose PTSD BECAUSE ITS BASICALLY AN EXPERIENCE AND NOT A REASON TO DIAGNOSE IT,  but it can be the trauma you went through to cause you to have the PTSD RELATED TO OR THE CAUSE BY YOUR TRAUMA FROM THE MST EXPERIENCE. V.A.  THEY NEED TO FIGURE THE TWO OUT?   we call it let the VA FIGURE THIS ALL OUT.

YOU WILL PROBABLY GET A RATING FOR YOUR POST ABOVE ABOUT 10/20/30%  But you also need to know if you have PTSD CAUSED BY THE MST/RAPE. ..so you can get help with it in treatment sessions/medications and be rated the correct rating according to your symptoms!

A good VA MST Coordinator should be able to help you and steer you in the right direction. 

Edited by Buck52

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41 minutes ago, Buck52 said:

yWhat was this C&P for? what condition you claiming?

You definitely need a PTSD Diagnosis  from the VA &  Only VA  only accepts a Official PTSD Dx. IN RELATION TO OR CAUSED BY THE MST.

This exam should have got you a 70% rating  if you had a PTSD DX..But since you don't have one  they will probably rate you with unspecific depressive Disorders  about 30% maybe rate you with another unspecific disorder.....MST Usually comes with a tramua event and in turn changes behavior changes cause by the trauma  and PTSD is Dx 

you really need to talk with va MH Clinic and talk with either a LCSW or the MST COORNATIOR  about the MST And ask for treatment

Yep I have two MST PSTD Diagnosis from LCSW's (One from the Vet Center) I have a PTSD MST NEXUS from a Psych(MD) 

This is one of those things that I think I will have to appeal. From what it look like I will be lucky to get 50% 

Mental Disorder Diagnosis #1: Unspecified Trauma-and Stressor-Related Disorder

Mental Disorder Diagnosis #2: Unspecified Depressive Disorder

At this point I just hope to get rated 10%. You guys think I will be rated something though? Also, what's PTSD Dx?

Edited by mstmale

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