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  

  • Similar Content

    • By ROMAD
      I submitted a claim for Sinusitis, OSA,, and Tinnitus. My claim was denied for all 3. 
      The tinnitus they claim was neither occurred in nor was caused by service. My job on active duty exposed me to gun fire, explosions, tanks, and tracked vehicles. I submitted the Duty Noise Exposure Spreadsheet that displayed my AFSC was rated as highly likely to be exposed to loud noise. In the first Exam they claimed I said my hearing loss was from jets flying overhead. Never said that, so they scheduled a second exam. This one they acknowledged the correct job but I was still denied. The evidence listed on the second decision dd not include the MOS Noise exposure chart I included on the first claim. I never went to sick call for ringing ears because that is just silly (had I known then) and was not something you did. I have had quiet office jobs since separating from The Air Force. What am I missing?
      For the OSA claim, I submitted Lay statements from my current wife and my ex-wife as well as explained to the doctor my symptoms and  that when I was on Active Duty i had no idea sleep apnea was a thing. I assumed I just snored and was tired because I was working hard. I had a sleep study this past year and was deemed to have severe OSA.  In my claim I listed that I believed my osa was related to my cluster headache disability. They responded Cluster headaches do not cause OSA even if there are many people with cluster headaches and also OSA.  I experienced a stuffy nose during my headaches  on the left side. This was completely different from the closing of my airway when I would sleep. It was just worst if both occurred at the same time. They claimed I have other risk factors such as being male, obesity, and advancing age. Something I did not include in my claim was the fact that I was on the Fat Boy program at one point on Active Duty and my SMR made a reference to obesity. Would this help support my claim. Also in the second decision they said I was a 73 year old male and I am no where near 73 so they probably mixed my records with someone else. What can I do about this?
      And Sinusitis, I have a couple diagnosis in my SMR's specifically listing sinusitis. I have had sinus issues since I was on Active Duty. I use a Netti Pot and have been diagnosed post active duty with sinusitis. The DBQ from the QTC Medical  Doc claims I have rebound sinusitis because I mentioned using Afrin. I have always been aware of the danger of over use and in my VA records I discussed this concern whenever the VA would prescribe a nasal spray. What am I missing and how can I get this  corrected. The errors on the 2 decisions make it seem as if they are not very organized and I have to suffer from their disorganization. Are they supposed to review all of the evidence from the initial claim when you submit a supplemental, or should I have resubmitted all  the documents from the initial claim. Are the documents that contain research that supports your claim supposed to be on the evidence list as well? They were not on there and if they did not give those documents equal consideration what is my recourse. Any assistance would be appreciated Thanks for listening.
       
    • By DonaldANG
      Hello everyone and thank you for accepting me in to the forum.
      Last year I filed a new claim for Generalized Anxiety Disorder and Major Depression. For the past 3 years, I have been seeing a civilian psychiatrist for my anxiety and depression. She had already diagnosed me with GAD and Major Depression, and I have been on anti-anxiety medications, antidepressants, and sleep medication. I was on differing types of the same medications since coming out of the service, but it wasn't until about 3 years ago, that I admitted to myself that I needed mental help, and that is when I started seeing my civilian psychiatrist, and that is when I first heard of GAD and Major Depression, when she said she had diagnosed me with them. It was at her suggestion, that I file a claim with the VA for GAD and Major Depression. She said she very much felt like my conditions were associated with my time in the service. When it was finally time to have my C&P exam, I was interviewed by a VA psychologist. I told her about my civilian psychiatrist, and her diagnosis for me, and the medications she had me on. I also talked to her about my time in the service, me being overseas in the Gulf War, and me being in a humanitarian mission in Ecuador. I told her about my friend who was with me during basic training. And how he was shot and killed right in front of me, in a horrible accident, during one of our live ammunition training exercises. I told her how all this had affected me from those moments on, all the way until now. At the end of our meeting, she told me that she felt like my condition was more PTSD, rather than Generalized Anxiety Disorder and Major Depression. At the time I didn't think anything of what she said; that is until I was sent my denial letter. In my denial, it stated that my 2 claims for GAD and Major Depression, was changed to GAD (to include PTSD) and Major Depression (to include PTSD). So the VA psychiatrist did what she said she would. She essentially changed what I had claimed, and added (to include PTSD) on each of my 2 claims. So, for the basis of PTSD, there has to be a proven stressor. The VA used what I had talked to the psychiatrist about the death of my friend during boot camp, as my stressor. The VA said they searched records during the time I was at boot camp, and found no incidents related to what I was saying. So, because the VA psychiatrist took it upon herself, to change my claimed conditions from GAD and Major Depression, to GAD (to include PTSD) and Major Depression (to include PTSD), now it was up to me to prove a stressor, because with claims associated with PTSD, you must prove your stressor. I knew from talking to other Army buddies of mine, how difficult it could be sometimes to find old records of deaths. The death of my friend during boot camp happened in 1962 at Ft. Jackson, SC. My civilian psychiatrist never suggested to me that I had PTSD. She always said it was Generalized Anxiety Disorder and Major Depression. If I had wanted to file a claim for PTSD, I would have done so. But I knew how difficult it would be for the VA to search for and find any record of the death of my friend at boot camp. So I filed GAD and Major Depression, because I was told those claims did not require a specific stressor (exact time, place, person, etc). I was told that GAD and Major Depression, could be claims based on your entire military career, with everything you've done and everything you've experienced, all amounting to intense anxiety and depression. So that is why I claimed GAD and Major Depression, over that of PTSD. But because the VA psychiatrist took it upon herself to change my 2 claimed conditions, and added the words (to include PTSD) to each of my claimed conditions, it was not just GAD and Major Depression any longer; it includes PTSD, which requires a specific and provable stressor. I had a stressor, and very specific one - the death of my friend during live ammunition exercises during our time at Ft. Jackson, SC boot camp in the summer of 1962. But the VA said neither they nor the JSRRC could find any record of that taking place. If my 2 claims had remained what they were suppose to be, simply GAD and simply Major Depression, I do not think I would have been denied. But because the VA psychiatrist added PTSD to each of my conditions, the VA asked for my stressor, the VA and JSRRC said they could find no record of my stressor, so my claims were denied. I believe I would have been approved if not for the VA psychiatrist adding PTSD to my 2 claimed conditions.
      So with all that said (and I apologize for the length of it), is there any hope for me, if I appeal my denial? And do any of you know how I would go about appealing it? Would I simply say to the VA that I disagree with the VA psychiatrist adding PTSD to my 2 claims, when I never claimed PTSD myself?; that that was her decision entirely. I have had a VA Disability Representative for the past couple of years, but he was utterly useless. He never answered my calls or emails. He basically never helped me at all. I did most all myself over eBenefits. But now, since I've had this recent denial, I have considered hiring a VA Disability Law Firm to take my case. I've spoken with 2 so far. They both told me I had a very strong case and that I could win. But they also said they couldn't take my case because of their huge client load. I think it was simply that they could probably win my case, but there wouldn't have been much in the line of backpay, so they wouldn't have gotten much compensation for their work for me. So I guess I will continue searching for other VA Disability Lawyers, or I may have to appeal my denied claim myself over eBenefits.
      Could any of you, please help me with this? I have read many questions on here regarding GAD and Major Depression, but I haven't come across one yet, where they filed a claim for GAD and Major Depression, and then the VA psychiatrist during the C&P exam, decided to change the claim (to include PTSD), thereby changing the criteria for acceptance, by now making me prove a specific stressor, instead of it she had just left my 2 claimed conditions alone, without including PTSD to them, then no specific stressor was required - it would simply go by your overall experiences while in service. I am a 20 year Veteran by the way, with most of my time served in the National Guard. But I was activated numerous times during my 20 years, including during the Gulf War. It isn't my fault that the death of my friend during boot camp, isn't something the VA or JSRRC can locate in records. If the VA psychiatrist had just left my 2 claimed conditions alone, instead of tacking on (to include PTSD), then the VA wouldn't have even had to search for a specific incident, they would have just based my conditions on my overall military experiences.
      Thank you for any help, assistance, or advice you might be able to give.
      Donald
    • By jon15805
      So I just got notices of my upcoming exams. I'm already really worried about them just because of all the horror stories I've read. But I was looking into my examiners, and the one for the mental health evaluation is very poorly rated on Google by other veterans that had him do their exam. They say he did not ask them any pertinent questions to their disability and wrote them off. Is there a way I can request someone different? Or should I just go ahead with it and take the chance?
    • By Mulligan64
      Hi all!  Just found this site and from the looks of it there are more answers here than with the VA or with my VSO, so here goes.
      Several months ago I filed for asbestos exposure issues arising from Naval Service (old snipe on an older no longer existing aircraft carrier).  Everything I've read and printed out for future use, notes that evidence of asbestos exposure typically doesn't rear it's ugly head for 30- 50 years.  Which it has in my case.  Lung fibrosis, calcified and non-calcified pleural plaques and a small lung (possibly benign) lung nodule all revealed initially poorly via an x-ray and later better identified by a CT scan.  All on my dime.  I thought I'd just have to grin and bear it until a Vet informed me about it being related to my naval background so I filed with the VA using a VSO.  (I should point out that as of yet I do not have lung cancer, mesothelioma or asbestosis.)
      Two things.   I get my response from the VA and they tell me that because I didn't file within one year of discharge (1968) I couldn't file for prostate cancer, which I have been operated on for this year, and still have some residuals that I'll probably have for the rest of my life.   Then, they inform me they want a C&P exam, by a contractor,  performed regarding my "pleural plaques."
      (Pleural plaques are evidence of asbestos exposure causing the  moderate lung fibrosis and the lung nodule.  The only concentrated asbestos exposure I had was during my Naval enlistment.)
       So, I went in to the C&P with print-outs noting asbestos exposure has a long latency period, how it can cause pleural and calcified and non-calcified pleural plaques, as well as a copy of my CT scan.  The doctor could have cared less.  He actually pushed away the paperwork I had brought with me.  He never took vitals.  Nothing.  I was there to get a chest x-ray (not worth a crap compared to a CT scan) and to take a pulmonary function test.  He opted not to do the x-ray when he glanced at my CT scan report, that he had previously pushed away, spoke out loud more to himself than me, stating, "I can use this."  And, pretty much dismissed me, stating as he walked out the door that his report would be done in two or three days.  
      Oh, and the chest x-ray was never done.
      The "nurse" then did my PFT exam.  I either flunked it or failed it so miserably, she gave up after administering the test five (not three) times in about as many minutes.  Simply put, I ran out of air, I guess, faster than she thought I should.  Every time I took the test I happened to cough into the tube as I ran out of air.  Twice.  She said the machine read that I was coughing not exhaling.  I told her that I was out of air by that time and of course I was coughing.  So then, she let me hold the machine, I took a deep breathe, exhaled and as I started to cough pushed the machine away from me so I didn't cough (heaven forbid) into the tube.  I did that three times and by then I was about to pass out.  She ultimately left the room and came back in a few minutes later letting me know I could go.
      As to the prostate cancer, I have found several internet articles from medical sites that link asbestos exposure and prostate cancer and have proffered  them with my Request for Reconsideration.
      Assuming this request takes months for yet another denial, does the time it take for their reconsideration adversely impact the year I have to file either a NOD or an appeal?  
      Any like cases or suggestions out there?
       
       
       
    • By Poopsy Woopsy
      my husband was 70% PTSD with GAF score of 50% Viet Nam Vet.. He was killed by the VA 41/2 years ago, and so I receive Pension on those grounds.
      But before "They killed him"  we had 3 claims pending:
      Agent orange : (needed to prove in contiguous waters) They are denying AO because he was on a ship and a "Secret Mission" so very hard to get verification. (waiting on C-Files).
      Aid and Attendance : ( I took care of him for several years)  A&A : Outright denial.. He was on oxygen, 80 pills a day and 5 shots a day.. I also have recorded (from another non VA hospital.. he could not take care of any daily activities.  So why the denial.. We were denied twice before he died.
      TDIU : back pay since (at least) PTSD rating. Beyond, because of Gross negligence on the part of the VA (Not including conceeding his death) which has all been very well documented. 
      WHAT I NEED TO DO NOW IS!! figure out how to remove an old Social Security claim. (back trouble, of which he was receiving care for at the Va) but it should not "Supersede"  his claim for TDIU.. (of which we had not been receiving any monies for, for a very long time. I don't know how to move forward.  How would I get it removed or make the VA not use the SSI to deny his Unemployability claim???
      I don't think going to SS office would be beneficial because it has been a "Mute" point with them for a long time.. So I am assuming it would lie somewhere within the VA system. BUT WHERE?? WHO?? and HOW?? 
       
       
  • Ads

  • Our picks

    • Need your support - T-shirts Available - Please buy a mug or a membership
      if you have been thinking about subscribing to an ad-free forum or buying a mug now would a very helpful time to do that.

      Thank you for your support
      • 16 replies
    • OK everyone thanks for all the advice I need your help I called VSO complained about length of time on Wednesday of this week today I checked my E benefits and my ratings are in for my ankles that they were denying me 10% for each bilateral which makes 21% I was originally 80% now they’re still saying I’m 80% 

      I’m 50% pes planus 30% migraine headaches 20% lumbar 10% tinnitus and now bilateral 21% so 10% left and right ankle Can someone else please do the math because I come up with 86% which makes me 90 what am I missing please help and thank you
    • I was denied SC for IBS and GERD IN 2011. In 2019 I was awarded SC for GERD. This CUE  is for 2011, both GERD and IBS. There are some odd aspects regarding the 2011 decision, the way it was written and the C&P report and the way it was written. I've tried to present this as clearly as I can. Note: the decision contradicts itself. the decision also contradicts the C&P Report. Honestly, I think the rater just got confused because the C&P was so poorly written. *THIS CUE HAS NOT YET BEEN SUBMITTED*Please let me know what you think. Appreciate all comments and suggestions. Thanks.

       

      VA RATING DECISION MARCH 23 2011 GERD IBS.pdf C P REPORT 7312010 GERD IBS.pdf GERD IBS CUE 2011(1).pdf

      C P ADDENDUM REQUEST RE DIAGNOSIS 7232010.pdf
      • 56 replies
    • 14 Questions about VA Disability Compensation Benefits Claims
      When a Veteran starts considering whether or not to file a Veterans Affairs 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 when it comes to filing Veterans Affairs Disability Claims. [Reprinted here with permission from Veterans Law Blog]
      • 0 replies
    • Disabled Veterans Property Tax Exemptions by State
      Alabama 
      A disabled veteran in Alabama may receive a full property tax exemption on his/her primary residence if the veteran is 100 percent disabled as a result of service and has a net annual income of $12,000 or less.
      • 0 replies
  • Ads

  • Popular Contributors

  • Ad

  • Latest News
×
×
  • Create New...

Important Information

{terms] and Guidelines