Jump to content
  • veteranscrisisline-badge-chat-1.gif

  • Advertisemnt

  • Trouble Remembering? This helped me.

    I have memory problems and as some of you may know I highly recommend Evernote and have for years. Though I've found that writing helps me remember more. I ran across Tom's videos on youtube, I'm a bit geeky and I also use an IPad so if you take notes on your IPad or you are thinking of going paperless check it out. I'm really happy with it, I use it with a program called Noteshelf 2.

    Click here to purchase your digital journal. HadIt.com receives a commission on each purchase.

  • 14 Questions about VA Disability Compensation Benefits Claims

    questions-001@3x.png

    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
    Continue Reading
     
  • Ads

  • Most Common VA Disabilities Claimed for Compensation:   

    tinnitus-005.pngptsd-005.pnglumbosacral-005.pngscars-005.pnglimitation-flexion-knee-005.pngdiabetes-005.pnglimitation-motion-ankle-005.pngparalysis-005.pngdegenerative-arthitis-spine-005.pngtbi-traumatic-brain-injury-005.png

  • Advertisemnt

  • VA Watchdog

  • Advertisemnt

  • Ads

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

    employment 2.jpeg

    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

Question

Does this sound or look right to anyone?  Denied TDIU...

 

=========================================================================

Date/Time:               20 Jun 2017 @ 0800

Note Title:              C&P MENTAL DISORDER

Location:                Chalmers P Wylie VA Outpatnt

Signed By:               HOULE,ALLISON C

Co-signed By:            HOULE,ALLISON C

Date/Time Signed:        20 Jun 2017 @ 1641

-------------------------------------------------------------------------

 

 LOCAL TITLE: C&P MENTAL DISORDER                               

STANDARD TITLE: MENTAL HEALTH C & P EXAMINATION CONSULT        

DATE OF NOTE: JUN 20, 2017@08:00     ENTRY DATE: JUN 20, 2017@16:41:06     

      AUTHOR: HOULE,ALLISON C      EXP COSIGNER:                          

     URGENCY:                            STATUS: COMPLETED                    

 

   *** C&P MENTAL DISORDER Has ADDENDA ***

 

 

                  Review Post Traumatic Stress Disorder (PTSD)

                        Disability Benefits Questionnaire

 

    Name of patient/Veteran:   xxxxxxx

   

    Is this DBQ being completed in conjunction with a VA 21-2507, C&P

Examination

    Request?

    [X] Yes  [ ] No

   

 

                                   SECTION I:

                                   ----------

    1. Diagnostic Summary

    ---------------------

    Does the Veteran now have or has he/she ever been diagnosed with PTSD?

    [X] Yes  [ ] No

 

    2. Current Diagnoses

    --------------------

    a. Mental Disorder Diagnosis #1: Posttraumatic Stress Disorder

         ICD Code: F43.10

 

       Mental Disorder Diagnosis #2: Opioid Use Disorder, Severe, In early

          remission, on maintenance therapy

         ICD Code: F11.20

 

    b. Medical diagnoses relevant to the understanding or management of the

       Mental Health Disorder (to include TBI):

       No response provided.

      

    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: The veteran's symptoms are primarily related to his PTSD

           since he has not used substances in more than six months.

          

    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?

       [X] Yes  [ ] No  [ ] No other mental disorder has been diagnosed

      

           If yes, list which portion of the indicated level of occupational and

           social impairment is attributable to each diagnosis: The veteran's

           impairment is related to his PTSD.

          

    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

      

                                   SECTION II:

                                   -----------

                               Clinical Findings:

                               ------------------

    1. Evidence Review

    ------------------

    Evidence reviewed (check all that apply):

   

    [X] VA e-folder (VBMS or Virtual VA)

    [X] CPRS

 

    Evidence Comments:

      The veteran's electronic medical records (CPRS & VistAWeb) and military

      records (VBMS) were reviewed.

 

      The veteran was referred for a compensation and pension examination. The

      veteran was informed verbally of the nature and purpose of the examination

      and confidentiality limits. He appeared to have a basic understanding of

      the purpose of the examination and confidentiality limits. He was provided

      with a chance to ask questions about the evaluation procedures. All

      questions were answered to reasonable satisfaction or referred to other

      resources. He was informed that this examiner is not his treating

clinician

      or the legal determiner of compensation or pension benefits. Instead, he

      was informed that this examiner is an independent provider of clinical

      information and expertise to assist those who review and make legal

      compensation and pension claim decisions and would not be participating in

      her healthcare. He was given information about the Veteran's 24-hour

Crisis

      Line. The veteran indicated understanding of these terms and explicitly

and

      freely consented to the evaluation. The judgments of symptoms and opinions

      in this evaluation report are offered to a reasonable degree of

      psychological certainty and are only based upon the information available

      at the time of the evaluation.

 

      This report was dictated using Dragon Naturally Speaking dictation

      software. The report has been proofread; however, there still may be some

      typographical errors due to the nature of the dictation software.

 

      The veteran began participating in recovery services at the VA in May

2017.

      His last group note was dated 5/31/17.

 

      A note dated 2/26/17, by Dr. Laurie Berger, indicates that the veteran

      began therapy at the Vet Center in October 2016. He attends therapy on a

      weekly basis. He attended six sessions with Dr. Berger when this note was

      written.

 

      The veteran was initially evaluated for a C&P exam by Dr. Janine Schroeder

      on 3/22/17.

     

 

    2. Recent History (since prior exam)

    ------------------------------------

    a. Relevant Social/Marital/Family history:

          The veteran was born and raised in xxxx. He was raised by

his

          mother and father until they divorced when he was 7 years old. The

          veteran then lived with his mother until he was 14 years old. The

          veteran's mother remarried when he was 11 years old and he reported

          that he did not get along well with his stepfather. He went to live

          with his father at 14 years of age due to being disrespectful towards

          his stepfather. The veteran has one older sister and one younger

          brother. The veteran's father did not remarry, but he was in a

          relationship with the same woman for 20 years. He reported physical

          abuse by his father throughout his adolescent years. He recalled one

          incident where he got a black eye after his father hit him. He denied

          any Child Protective Services involvement. The veteran describes his

          father as emotionally absent. His father died in 2007 from a heart

          attack.

 

          The veteran is a 36-year-old, divorced male. He was married in 2001

for

          five years and divorced in 2006. The veteran reported that they

          divorced due to his drug use. They have a 1X-year-old daughter

          together. His ex-wife and daughter live in xxxxx. He

          maintained some contact with his daughter, but has not seen her in

          several years. The veteran reported that he was involved in a

          relationship for a few years following his divorce. They are no longer

          in a relationship, but are close friends.

 

          The veteran reported that he has spends time with three friends from

          high school. The veteran stated that he enjoys gardening.

         

    b. Relevant Occupational and Educational history:

          The veteran reported that he did not enjoy school and did not want to

        

 do the work. He frequently skipped school to go skating. He stated that

          he would "have a few beers and smoked pot" when he skipped school. He

          reported being suspended several times for truancy, fighting, and

          disrespect towards teachers. He was never held back a grade. He was

          expelled his junior year of high school due to nonattendance. He

earned

          his GED in 1997.

          The veteran worked for his father from 1997 until 1999 doing ironwork.

 

          The veteran enlisted in the Navy in October 1999. He reported several

          disciplinary issues while in the service related to going AWOL, being

          late, and underage drinking. He reported that the sexual assault

          occurred in the summer of 2001. The veteran received a general under

          honorable conditions discharge in September 2001 for misconduct.

 

          The veteran worked in Virginia Beach beginning in September 2001 doing

          ironwork. He worked at a company for one year and was fired due to not

          showing up for work and using alcohol and drugs. He then worked for

          Roofing Services Incorporated from September 2002 until August 2003.

          The veteran then earned his tanker men certification, z card, and AB

          certification to work on tugboats. He worked on boats from September

          2003 until March 2005. At that time his wife left him and he moved

back

          to Ohio to be closer to his family. The veteran continued working on

          boats in Ohio until the summer of 2005 when he got fired. The veteran

          was incarcerated from 2006 until 2016. After his release from prison,

          he worked with friends doing landscaping and painting. He began

working

          at ABS Money Systems in January 2017, a company that his mother owns.

          The veteran reported that he was working 30-40 hours per week for the

          first two months. He stated that his hours have declined significantly

          since March and he is currently working 5-6 hours per week. He stated

          that his work has declined due to his mental health symptoms. However,

          according to the initial C & P exam, "he is unable to do a lot for her

          because she works serving ATM machines in banks and with his record he

          isn't allowed to work in banks." He also reported that his employment

          since the military has been "short-lived due to his drug and alcohol

          use."

         

         

    c. Relevant Mental Health history, to include prescribed medications and

       family mental health:

          The veteran reported that he was diagnosed with ADHD during childhood

          and received treatment. The veteran reported a suicide attempt in 2001

          after he was discharged from the military. He began attending

treatment

          at the Vet Center in October 2016. He reported that he attends

          individual therapy twice per week with Dr. Berger. The veteran

          described his mood as "anxious, paranoid, and depressed." He stated

          that he feels as though he "can't get a break." He reported having

          passive thoughts of suicide, but stated that he does not have a plan

or

          intention to kill himself. He stated "I couldn't do that to my

family."

          He stated that he has had difficulty dealing with his emotions since

he

          is no longer using substances and does not have an escape. He stated

"I

          don't have the coping skills." He described having difficulty sleeping

          and stated that he does not sleep every night. He stated that he is

not

          feel safe in his bed.

         

    d. Relevant Legal and Behavioral history:

          The veteran reported that he had several misdemeanor offenses as a

          juvenile, including truancy, driving without a license, and theft. He

          reported that he was arrested for selling drugs at 18 years of age and

          was placed on probation for one year. According to the previous exam,

          he was arrested numerous times from June 1998 to September 1999. The

          veteran was convicted of armed robbery for robbing three pharmacies

          with a weapon. He served a 10-year prison sentence beginning in

October

          2006 and was released in September 2016. He is currently on parole for

          five years.

         

    e. Relevant Substance abuse history:

          The veteran reported that he first drank alcohol at 10 years of age.

He

          began regularly drinking alcohol during high school. He began smoking

          marijuana at 15 years of age on the weekends. He also experimented

with

          mushrooms and pain/anxiety medication that he took from his father.

The

          veteran's alcohol use increased significantly while in the military.

He

          denied using any drugs while in the service. After his discharge from

          the service, he continued using alcohol and marijuana. In 2002, he

          began using narcotic pain medication. He also began using heroin and

          reported that he eventually used heroin intravenously. The veteran

          reported using substances throughout his time in prison. He reported

          that he has been clean from drugs and alcohol since October 2016. He

          has maintained sobriety using Suboxone. He currently attends AA

          meetings approximately once per week. He attends substance abuse

groups

          at the VA twice per month.

         

    f. Other, if any:

       No response provided.

      

    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 Criterion 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 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] 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).

                   [X] 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).

                   [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 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, distorted cognitions about the cause or

                       consequences of the traumatic event(s) that lead the

                       individual to blame himself/herself or others.

                   [X] Persistent negative emotional state (e.g., fear, horror,

                       anger, guilt, or shame).

                   [X] Persistent inability to experience positive emotions

                       (e.g., inability to experience happiness, satisfaction,

or

                       loving feelings.)

 

       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.

                   [X] Hypervigilance.

                   [X] Exaggerated startle response.

                   [X] Problems with concentration.

                   [X] Sleep disturbance (e.g., difficulty falling or staying

                       asleep or restless sleep).

 

       Criterion F:

                   [X] The duration of the symptoms described above in Criteria

                       B, C, and D are more than 1 month.

 

       Criterion G:

                   [X] The PTSD symptoms described above cause 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.

 

    4. Symptoms

    -----------

    For VA rating purposes, check all symptoms that actively apply to the

    Veteran's diagnoses:

   

       [X] Depressed mood

       [X] Anxiety

       [X] Suspiciousness

       [X] Chronic sleep impairment

       [X] Disturbances of motivation and mood

       [X] Difficulty in establishing and maintaining effective work and social

           relationships

 

    5. Behavioral observations

    --------------------------

       The veteran arrived 10 minutes late for his appointment and was pleasant

       upon meeting. The veteran was oriented to person, place, situation, and

       time. His grooming and hygiene were adequate. He made appropriate eye

       contact and presented with a depressed mood with a congruent affect. His

       speech was within normal limits for tone, volume, and rate. His thoughts

       were logical, linear, and goal-directed. He did not evidence any

psychotic

       symptoms, including responding to auditory or visual hallucinations and

       delusional beliefs.

       

       On a brief mental status exam he was able to freely recall two of three

       words presented after a brief delay. He was able to recall six digits

       forward and three digits backward. He was able to complete a serial seven

       subtraction task with no errors to seven places. He was able to spell the

       word WORLD forwards and backwards. He was able to complete a two-digit

       addition and subtraction tasks. He was able to compare an apple and

banana

       and was able to reason abstractly when comparing a poem and a statue. His

       response to the proverb "don't cry over spilled milk" was good. He was

not

       able to provide a response to the proverb "people in glass houses should

       not throw stones."

      

      

    6. Other symptoms

    -----------------

    Does the Veteran have any other symptoms attributable to PTSD (and other

    mental disorders) that are not listed above?

    [ ] Yes  [X] No

   

    7. Competency

    -------------

    Is the Veteran capable of managing his or her financial affairs?

    [X] Yes  [ ] No

   

    8. Remarks, (including any testing results) if any:

    ---------------------------------------------------

       The veteran was administered a psychological measurement that is useful

       for interpreting the veracity of other data provided by an examinee

during

       a psychological or neuropsychological examination. This assessment can

       assist in evaluating and making a clinical opinion regarding the veracity

       of an examinee's purported symptoms. Research has determined that this

       tool is a useful instrument to administer in order to screen for possible

       feigning of PTSD symptoms. The following results should be interpreted in

       light of the fact that the measurement that was chosen is a screening

tool

       and not designed as a definitive measure of whether or not an individual

       is feigning mental illness. The Veteran's total score was not elevated

       beyond the cut-off score. Therefore, his PTSD symptoms are considered to

       be credible.

 

       The veteran was administered the Minnesota Multiphasic Personality

       Instrument-2-Restructred Form (MMPI-2-RF), which is a self-report

       psychological assessment used to identify a variety of psychological

       syndromes. The veteran was provided a quiet, private room to complete the

       testing. It appears the veteran understood the items and responded to the

       items in a consistent manner. The veteran over-reported psychological

       dysfunction, which is evidenced by a considerably larger than average

       number of infrequent responses. The veteran also possibly overreported

       symptoms associated with non-credible memory complaints. Although there

is

       evidence of over reporting of symptoms, the profile is considered valid

       and will be interpreted.

 

       Overall, the veteran endorsed considerable emotional distress that is

       likely perceived as a crisis. The veteran reported feeling sad and

       dissatisfied with his currently circumstances. He reported a lack of

       positive emotional experiences, a lack of energy, and a lack of interest

       in activities. He also reported experiencing various negative emotional

       experiences including anxiety, anger, and fear. The veteran also reported

       a significant history of antisocial behavior. This behavior includes

       involvement with the criminal justice system, difficulty with authority

       figures, conflictual interpersonal relationships, impulsivity, juvenile

       delinquency, and substance abuse. The veteran also endorsed various

       unusual thought and perceptual processes.

 

       The veteran endorsed a diffuse pattern of cognitive difficulties

including

       memory complaints. He also reported past suicidal ideation and feelings

of

       helplessness. The veteran endorsed feelings of anxiety, being anger

prone,

       and experiencing multiple fears that restrict his activity inside and

 

 

       outside of the home. He also reported being unassertive and shy. The

       veteran endorsed not enjoying social events and avoiding social

       situations. He also reported disliking being around people. On a scale of

       personality pathology, the veteran endorsed being self-critical and

       guilt-prone. He also endorsed being pessimistic and feeling depressed.

 

       The veteran is currently diagnosed with Posttraumatic Stress Disorder and

       Opioid Use Disorder, Severe, In early remission, on maintenance therapy.

       The veteran currently lives alone and is not involved in a romantic

       relationship. He maintains phone contact with his daughter. He has a

close

       relationship with his mother, sister, and two friends. He is currently

       working for his mother's company. He reported experiencing symptoms of

       PTSD. He is attempting to cope with his emotions without the use of

drugs.

       

 

       The veteran has been employed numerous times and has been fired for

       tardiness or alcohol and drug use. He is currently working 5-6 hours per

       week for his mother's company. According to the previous C&P exam, he is

       not able to work many hours due to not being permitted to work inside of

a

       bank due to his felony record. The veteran reported that he was "working"

       during his 10 years in prison selling drugs. He denied having any

       difficulties while in prison. The veteran is capable of following

       instructions and performing simple tasks. He is able to concentrate on a

       simple task and respond appropriately to coworkers and supervisors. 

 

 

      

      

 

 

/es/ ALLISON C HOULE, PHD

C&P Psychologist

Signed: 06/20/2017 16:41

 

06/20/2017 ADDENDUM                      STATUS: COMPLETED

The veteran presented for his appointment. The report from the C&P Exam was

completed in Capri by Allison Houle, PhD; procedure code 99456 and 96101.

 

/es/ ALLISON C HOULE, PHD

C&P Psychologist

Signed: 06/20/2017 16:42

Share this post


Link to post
Share on other sites

Recommended Posts

  • 0

The last C and P examiner said this:

The veteran's use of opiates, cannabis, and alcohol began prior to service, thus current/recent use/abuse is not caused by an in-service related event. Given the veteran's consistent diagnosis and treatment of PTSD, and the frequency of relapse of substance use, it is as least as likely as not that his substance use (to include opioid use disorder) is aggravated beyond its natural progression by his PTSD symptoms.

 

The examiner was mistaken when they said I had used opiates prior to service.  That is factually untrue.  I had tried marijuana and alcohol, what teenager hasn't.  Additionally, I had gotten waivers prior to enlisting for marijuana.

Also, the examiner checked the box stating it was an in-person exam.  It was not.

Share this post


Link to post
Share on other sites
  • 0

Welcome to the Horrors of the VA system brother. You have a solid Claim, my suggestion, hire Robert Friedman and Assosciates. They specialize in PTSD and TDIU Claims, took them less than 2 years to get my Full Benefits win. Once again, just a suggestion, but 20% of your back pay if you win, but better than 0

Share this post


Link to post
Share on other sites
  • 0

 I assume you have not been rated or given a decision yet  correct?

Unfortunately

jmo

it seems to me the C&P EXAMINER MAYBE THINKS YOU OVER EXAGGERATED OR Possibly Malingering 

It may come down to how VA interprets the drug/alcohol use before military?

ONLY MT OPINION, you do meet the dsm 5 criteria for PTSD & 

and you could possibly be rated a 30/50 % rating if not 70%

IF DENIED? file your NOD ,BUT IN THE MEANTIME

you should get into VA Voc Rehab and see if they can help you find a job or maybe go to school , if they can't help you do this  due to your PTSD   then you can ask the counselor to write you a letter stating that this veteran is not feasible to retrain at this time DUE to his  Mental Health Issues of his disability & diagnose of PTSD.

as for as the C&P your addiction for drug use/alcohol use  before and after military. that will not fly with the VA &  One mistake I see you made was stating you never did these things while in the military. Most C&P Examiners will use that against you as(IF) you were malingering.

Edited by Buck52

Share this post


Link to post
Share on other sites
  • 0

An Appeal is your only course of action. You might be well served by having an Appeal consult with a local VA Accredited Appeals Lawyer. I don't believe this Denial will be successfully adjudicated at the RO Level, nor should it be considered a DIY Appeal Project.

I think there was mentioned in the PTSD DBQ something about you being "Goal-Directed." One of your Goals is the hunt for the IU Award, right. A 06/18.2018 self-reported suicide attempt could be viewed with some skepticism.

The C & P also contained the Clinicians discussion regarding your results of the MMP1-2-RF Self Reported Psychological Assessment Test. The results indicating "over Reporting of Symptoms" and reference to "Non-credible Memory Problems," definitely doesn't support your IU Claim.

Might be time to go back to the landscaping Job, I didn't see any mention of problems with that line of work. Definitely pays in excess of the $12,440 SGI per year.

Share this post


Link to post
Share on other sites
  • 0

        this was the clarfacation the BVA asked for, and the subsequent opinion:

        The veteran's use of opiates, cannabis, and alcohol began prior to service, thus current/recent use/abuse is not caused by an in-service related event. Given the veteran's consistent diagnosis and treatment of PTSD, and the frequency of relapse of substance use, it is as least as likely as not that his substance use (to include opioid use disorder) is aggravated beyond its natural progression by his PTSD symptoms.    (this is in my favor)

                Per 3/15/2017 initial PTSD exam the veteran was diagnosed with PTSD, alcohol use disorder, cannabis use disorder, and opioid use disorder, all of which were in early remission. The 3/15/2017 medical opinion, the examiner opined that the veteran's opioid use disorder, and substance use in general, was made worse by his MST. The 6/20/2017 review PTSD examination indicates that symptoms present at that time were due to PTSD and not substance use as he had been abstinent from drug use with the exception of his opioid maintenance therapy. The veteran is service connected for the combination of PTSD and substance use disorders however per 11/20/2017 medical opinion regarding unemployability, the examiner noted that the veteran was service-connected only for PTSD and not substance use which is incorrect. Per rating decisions 3/27/2017 and 10/11/2017, the veteran was service connected for "PTSD with secondary alcohol use disorder, cannabis use disorder, and opioid use disorder." They are separate disorders, and not all symptoms are present all of the time. The examiner commented specifically on the veteran's PTSD symptoms and separated the veteran's substance abuse disorder symptoms. The veteran's substance use predated his military service;(sic) thus it was not caused by his reported assault. It was, however, likely aggravated by the residuals of his assault as described in treatment notes which indicate that with worsening PTSD symptoms, the veteran has reported relapsing on substances, particularly heroin.  (again, in my favor)

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Answer this question...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Sign in to follow this  

  • Our picks

    • My claim went back to gathering of evidence after I had my second c&p exam for tbi initial. My vso the Dav said it was a dbq to differentiate the symptoms of tbi and PTSD as far as social and occupational impairment. I recieved at least as likely as not on all exams, PTSD, both tbi exams. Has anyone experienced this or know what it means? Is this a good sign my claim will be granted ? Thank you.
      • 20 replies
    • VA Claims requires a lot of note taking - What  I use for note taking
      Trouble Remembering? This helped me.

      I have memory problems and as some of you may know I highly recommend Evernote and have for years. Though I've found that writing helps me remember more. I ran across Tom's videos on youtube, I'm a bit geeky and I also use an IPad so if you take notes on your IPad or you are thinking of going paperless check it out. I'm really happy with it, I use it with a program called Noteshelf 2.

      Click here to purchase your digital journal. HadIt.com receives a commission on each purchase.
      • 1 reply
    • Do I have to quit my job?
      Hello everyone. See Below for what I received from VA

       

      A little about me currently. I have a job that is very low stress (work nights no people no stress) very secure because I work in a mountain so im surrounded by granite. I work on computers so it engages my mind and keeps me as active as possible and is my passion. So my question is do I have to quit my job? Thanks!

       

      June 23, 1999 June 30, 2019

      VA Benefit InformationSummary of benefit informationYou have one or more service-connected disabilities:Yes         Your combined service-connected evaluation is:100%               You are considered to be totally and permanently disabled due solely to your service-connected disabilities:Yes           The effective date of when you became totally and permanently disabled due to your service-connected disabilities:July 01, 2019

      major depression disorder, recurrent, severe, post traumatic stress disorder, insomnia disorder and eating disorder, NOS


                         100%


                               Service Connected



       

      SMC-S1

      Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of major depression disorder, recurrent, severe, post traumatic stress disorder, insomnia disorder and eating disorder, NOS rated 100 percent and additional service-connected disabilities of migraine including migraine variants, tinnitus, independently ratable at 60 percent or more from 07/01/2019.

      SMC-K1

      Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of major depression disorder, recurrent, severe, post traumatic stress disorder, insomnia disorder and eating disorder, NOS rated 100 percent and additional service-connected disabilities of migraine including migraine variants, tinnitus, independently ratable at 60 percent or more from 07/01/2019.

       

      Thanks all!

       
      • 61 replies
    • Progress Notes on C&P Exam
      Hey guys, 

           I don't know if I'm in the right place but i was needing some clarification. After fighting with the military for six years, the C&P examiner stated that my condition precludes me from any physical occupation. 

      I developed asthma back in 2012, while in service. Is that typical wording for pretty much everyone? I guess my English isn't that great and i would like someone to please explain to me what that entails? The examiner 

      also stated that there is a 50% chance or greater that my injury was incurred in the line of duty, does that mean that they service connected me? 

       

      thank you for responding. 
      • 29 replies
    • I have a 8 year appeal that was granted in May 2019. Entitlement to service connection for acquired psychiatric disorder, to include  post traumatic stress disorders and depression, is granted.

      I live in Missouri, but it looks like the San Diego RO has been tasked with assigning the rating. I am already SC for 10,10,and 10 for shin splints and tinnitus which adds up to 30%. I was trying to determine what would my rating be and timeframe backpay would be paid.

      My symptoms include : nonetheless the examiner opined that is not to say that his issues with pain and tinnitus have not exacerbated mental health symptoms. In this regard the examiner opined that the veterans chronic pain and tinnitus contribute to several depressive symptoms, including depressed mood, sleep impairment, irritability, diminished concentration and interest in activities, relationship problems, and outburst of anger.

      As such the examiner concluded both his tinnitus and issues with chronic pain (not simply limited to shin splints) Are judged to have aggravated and contributed to multiple mental health symptoms. Therefore the examiner concluded that “it is at least as likely as not” that the diagnosis of bilateral shinsplints and tinnitus has  aggravated depressive and overlapping PTSD symptoms beyond their natural course. My diagnosis includes Anxiety disorders too. 

      My grant is secondary to existing disabilities.

      There is a Remand for Inextricably intertwined with the grant of service connection for an acquired psychiatric disorder, granted in the boards decision herein, because it may be affected by the assignment of the disability rating and effective date for the grant of service connection. Once the disability rating and affective date for the grant of service connection for an acquired psychiatric disorder has been assigned, and after completing any other development deem necessary, readjudicate the claim of entitlement to TDIU are you in light of all pertinent Evidence  and legal authority.

      I am not sure but I hope my rating and backpay would be issued before they decide in another possible year for TDIU?

      I am also one of the ones who constantly check Benny’s for a rate change or any updates, but it is the same since May 23rd 2019. Has anyone received a deposit before benny’s Update. Since the new process has been implemented?

       
      • 14 replies
  • Ads

  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines