Hey all! I just downloaded the mental health dbq from the appt i had the other day. As a precursor the VA for my whole time using the VA has me listed as having GAD, MDD, Panic Attacks w/ Agorophobia and PTSD. Below is the eval that was just done. Appreciate your thoughts as this was done by someone in the same field as my condition. They had scheduled me for 2 exams 1 for PTSD and One for GAD, Panic and Agorophobia.. only did this 1.
Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire
Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No
Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes [ ] No ICD code: F41.0
If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Panic Disorder ICD code: F41.0
Mental Disorder Diagnosis #2: Agoraphobia ICD code: F40.0
b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): n/a
2. Differentiation of symptoms ----------------------------- No response provided.
3. Occupational and social impairment ------------------------------------ No response provided.
SECTION II: ---------- Clinical Findings: ----------------- 1. Evidence Review ----------------- Evidence reviewed (check all that apply): [X] VA e-folder [X] CPRS
2. History --------- No response provided. 3. Symptoms ---------- No response provided. 4. Behavioral observations ------------------------- Duplicate request: Please see the PTSD DBQ completed today.
Initial Post Traumatic Stress Disorder (PTSD)
Disability Benefits Questionnaire
SECTION I:
1. Diagnostic Summary --------------------
Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [ ] Yes [X] No
If no diagnosis of PTSD, check all that apply:
[X] Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria
[X] Veteran has another mental disorder diagnosis. Continue to complete this Questionnaire and/or the Eating Disorder Questionnaire:
b. Medical diagnoses relevant to the understanding or management of the mental health disorder (to include TBI): n/a
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? [ ] Yes [X] No [ ] Not applicable (N/A)
If no, provide reason: The Panic Disorder and Agoraphobia are part of the same problem. Each feeds the other.
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] 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] Total occupational and social impairment
b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [ ] Yes [X] No [ ] Not Applicable (N/A)
If no, provide reason: Panic Disorder and Agoraphobia exacerbate each other
c. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] Not Applicable (N/A)
SECTION II: ---------- Clinical Findings: -----------------
1. Evidence Review ----------------- Evidence reviewed (check all that apply): [X] VA e-folder [X] CPRS
Evidence Comments: They are records from the VA clinic.
2. History --------- a. Relevant social/marital/family history (pre-military, military, and post-military): Says he is "always at home." He does not go out because of panic attacks. Says he has to prepare himself for weeks to go out. If he does leave the house, it is with his wife. They started home schooling the children because his wife couldn't leave him at home. Says he has intrusive thoughts of what if he had the thought of hurting the kids. He is unable to be apart from his wife for over 10 minutes. Being home by himself scares him. His wife and younger children are always in the home now because Veteran won't be alone. Social impairment is extreme and is affecting his family. b. Relevant occupational and educational history (pre-military, military, and post-military): Graduated from high school, worked at a pizza restaurant and joined the Army a year later. He was in the infantry.
After the Army, he has mostly tried to work from home using the Internet. He would build websites and had a marketing company. He quit when he was expected to leave the house and go to conferences to promote the marketing company. He says panic attacks became so debilitating, he couldn't even work from home. He is not currently employed. He has credit card debt and no income.
c. Relevant mental health history, to include prescribed medications and family mental health (pre-military, military, and post-military):
Veteran states that he was "fearless" before he went to Korea. Says he "changed completely" after the death of his friend, Hicks, in 1996. In the STR, there is a note about his having a Mental Status Exam in 1996 at a Mental Health Clinic. No details are available. Veteran says he did not return for treatment because "everybody picks on you" if you get treatment. Veteran had many incidents which caused him to feel anxious in the Army. In basic training, a recruit had a heart attack and was berated. In the Korea DMZ, he was fired upon. Also, the camp was threatened that North Korea was making inroads into the DMZ. The soldiers were told that they had 15 second lifespan. Veteran states that his first "big panic attack" occurred in 1997, shortly after he left the Army. Says he went to a VA in Atlanta, no record is available. He was fearful of having cancer or a heart attack. Veteran was admitted to inpatient psychiatry at the VA in 2004. He was fearful that he had mouth cancer. He declined medication, fearing that medications would cause problems. Because he refused meds, he was in psycyhotherapy at the VA from 2005 to 2011. Veteran's symptoms only worsened. He avoids situations that cause panic attacks so his world has become very restricted. He is not currently in treatment. He went to exposure therapy in 2017 at UNC which helped a very small amount. He is now able to be alone for 10-20 minutes. He says he gets panic attacks when he takes medication, fears addiction, fears being suicidal.
e. Relevant substance abuse history (pre-military, military, and post-military):
Says he does not drink alcohol. "Alcohol about killed me in the military."
f. Other, if any: No response provided.
3. Stressors ----------- Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military):
a. Stressor #1: In Basic Training, a soldier had a heart attack. Says anxiety started that day.
Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [ ] Yes [X] No
Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No
Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No
b. Stressor #2: In Korea, a soldier stepped on a mine and lost his foot. Veteran was told that he was lucky because that mine had been there for decades.
Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No
Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No
Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No
c. Stressor #3: He was on bridge duty in Korea, He came under gunfire one night. He started to run to get ammunition but was called back. .
Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No
Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No
Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No
d. Additional stressors: If additional stressors, describe (list using the above sequential format):
North Korea threatened to attack the DMZ. They were shown satellite photos of the enemy digging into the DMZ. They were put on lockdown.
4. PTSD Diagnostic Criteria --------------------------
Note: Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criterion A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criterion A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violence, in one or more of the following ways: [X] Directly experiencing the traumatic event(s)
[X] Witnessing, in person, the traumatic event(s) as they occurred to others
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).
Criterion C . 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). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Criterion D 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 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] Problems with concentration.
[X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?:
[X] Stressor #3
5. Symptoms ---------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses:
[X] Anxiety [X] Suspiciousness [X] Panic attacks more than once a week [X] Chronic sleep impairment [X] Disturbances of motivation and mood
6. Behavioral Observations ------------------------- Veteran is alert, fully oriented, dressed in clean, casual clothing. Mood is anxious. Affect is constricted. He becomes tearful when talking about the loss of his friend and the effect his anxiey has on his family. He denied suciidal thinking. He avoids eye contact. Speaks in a tremulous voice.
7. Other symptoms ---------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No
8. Competency ------------
Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No
9. Remarks, (including any testing results) if any ------------------------------------------------- Active duty service dates: Branch: Army
DBQ PSYCH Mental disorders:
The Veteran is claiming service connection for agoraphobia, anxiety and insomnia. Please examine the Veteran for a chronic disability related to his or her claimed condition and indicate the current level of severity.
If more than one mental disorder is diagnosed please comment on their relationship to one another and, if possible, please state which symptoms are attributed to each disorder.
************************************************************************** **
DBQ PSYCH PTSD Initial: The Veteran is claiming service connection for PTSD due to the claimed stressor of Inicident at Korean DMZ. Please examine the Veteran for a chronic disability related to his or her claimed condition and indicate the current level of severity.
If more than one mental disorder is diagnosed please comment on their relationship to one another and, if possible, please state which symptoms are attributed to each disorder.
If your examination determines that the Veteran does not have diagnosis of PTSD and you diagnose another mental disorder, please provide an opinion as to whether it is at least as likely as not that the Veteran's diagnosed mental disorder is a result of an in-service stressor related event.
Response: The Veteran has many symptoms of PTSD and has had events that could cause PTSD. However, the more appropriate diagnosis for this Veteran is Panic Disorder along with Agoraphobia. Panic Disorder and PTSD have many overlapping symptoms. This Veteran happens to have incurred a trauma but his presentation more closely resembles Panic Disorder. There is scant evidence to demonstrate that the anxiety started in the Army, namely the note that a Mental Status Examination took place at a Mental Health Clinic with no details provided. This corresponds to the Veteran's report that he was evaluated after his close friend died. His first panic attack occurred within a year of his departure from the Army.
In my opinion, the Veteran's Panic Disorder and Agoraphobia were incurred while he was serving in the Army.
Question
sanktuary
Hey all! I just downloaded the mental health dbq from the appt i had the other day. As a precursor the VA for my whole time using the VA has me listed as having GAD, MDD, Panic Attacks w/ Agorophobia and PTSD. Below is the eval that was just done. Appreciate your thoughts as this was done by someone in the same field as my condition. They had scheduled me for 2 exams 1 for PTSD and One for GAD, Panic and Agorophobia.. only did this 1.
Mental Disorders (other than PTSD and Eating Disorders) Disability Benefits Questionnaire
Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No
Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes [ ] No ICD code: F41.0
If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Panic Disorder ICD code: F41.0
Mental Disorder Diagnosis #2: Agoraphobia ICD code: F40.0
b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): n/a
2. Differentiation of symptoms ----------------------------- No response provided.
3. Occupational and social impairment ------------------------------------ No response provided.
SECTION II: ---------- Clinical Findings: ----------------- 1. Evidence Review ----------------- Evidence reviewed (check all that apply): [X] VA e-folder [X] CPRS
2. History --------- No response provided. 3. Symptoms ---------- No response provided. 4. Behavioral observations ------------------------- Duplicate request: Please see the PTSD DBQ completed today.
Initial Post Traumatic Stress Disorder (PTSD)
Disability Benefits Questionnaire
SECTION I:
1. Diagnostic Summary --------------------
Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria based on today's evaluation? [ ] Yes [X] No
If no diagnosis of PTSD, check all that apply:
[X] Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria
[X] Veteran has another mental disorder diagnosis. Continue to complete this Questionnaire and/or the Eating Disorder Questionnaire:
2. Current Diagnoses -------------------
a. Mental Disorder Diagnosis #1: Panic Disorder ICD code: F41.0
Mental Disorder Diagnosis #2: Agoraphobia ICD code: F40.0
b. Medical diagnoses relevant to the understanding or management of the mental health disorder (to include TBI): n/a
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? [ ] Yes [X] No [ ] Not applicable (N/A)
If no, provide reason: The Panic Disorder and Agoraphobia are part of the same problem. Each feeds the other.
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [ ] Yes [ ] No [X] 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] Total occupational and social impairment
b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [ ] Yes [X] No [ ] Not Applicable (N/A)
If no, provide reason: Panic Disorder and Agoraphobia exacerbate each other
c. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [ ] Yes [ ] No [X] Not Applicable (N/A)
SECTION II: ---------- Clinical Findings: -----------------
1. Evidence Review ----------------- Evidence reviewed (check all that apply): [X] VA e-folder [X] CPRS
Evidence Comments: They are records from the VA clinic.
2. History --------- a. Relevant social/marital/family history (pre-military, military, and post-military): Says he is "always at home." He does not go out because of panic attacks. Says he has to prepare himself for weeks to go out. If he does leave the house, it is with his wife. They started home schooling the children because his wife couldn't leave him at home. Says he has intrusive thoughts of what if he had the thought of hurting the kids. He is unable to be apart from his wife for over 10 minutes. Being home by himself scares him. His wife and younger children are always in the home now because Veteran won't be alone. Social impairment is extreme and is affecting his family. b. Relevant occupational and educational history (pre-military, military, and post-military): Graduated from high school, worked at a pizza restaurant and joined the Army a year later. He was in the infantry.
After the Army, he has mostly tried to work from home using the Internet. He would build websites and had a marketing company. He quit when he was expected to leave the house and go to conferences to promote the marketing company. He says panic attacks became so debilitating, he couldn't even work from home. He is not currently employed. He has credit card debt and no income.
c. Relevant mental health history, to include prescribed medications and family mental health (pre-military, military, and post-military):
Veteran states that he was "fearless" before he went to Korea. Says he "changed completely" after the death of his friend, Hicks, in 1996. In the STR, there is a note about his having a Mental Status Exam in 1996 at a Mental Health Clinic. No details are available. Veteran says he did not return for treatment because "everybody picks on you" if you get treatment. Veteran had many incidents which caused him to feel anxious in the Army. In basic training, a recruit had a heart attack and was berated. In the Korea DMZ, he was fired upon. Also, the camp was threatened that North Korea was making inroads into the DMZ. The soldiers were told that they had 15 second lifespan. Veteran states that his first "big panic attack" occurred in 1997, shortly after he left the Army. Says he went to a VA in Atlanta, no record is available. He was fearful of having cancer or a heart attack. Veteran was admitted to inpatient psychiatry at the VA in 2004. He was fearful that he had mouth cancer. He declined medication, fearing that medications would cause problems. Because he refused meds, he was in psycyhotherapy at the VA from 2005 to 2011. Veteran's symptoms only worsened. He avoids situations that cause panic attacks so his world has become very restricted. He is not currently in treatment. He went to exposure therapy in 2017 at UNC which helped a very small amount. He is now able to be alone for 10-20 minutes. He says he gets panic attacks when he takes medication, fears addiction, fears being suicidal.
e. Relevant substance abuse history (pre-military, military, and post-military):
Says he does not drink alcohol. "Alcohol about killed me in the military."
f. Other, if any: No response provided.
3. Stressors ----------- Describe one or more specific stressor event(s) the Veteran considers traumatic (may be pre-military, military, or post-military):
a. Stressor #1: In Basic Training, a soldier had a heart attack. Says anxiety started that day.
Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [ ] Yes [X] No
Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No
Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No
b. Stressor #2: In Korea, a soldier stepped on a mine and lost his foot. Veteran was told that he was lucky because that mine had been there for decades.
Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No
Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [ ] Yes [X] No
Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No
c. Stressor #3: He was on bridge duty in Korea, He came under gunfire one night. He started to run to get ammunition but was called back. .
Does this stressor meet Criterion A (i.e., is it adequate to support the diagnosis of PTSD)? [X] Yes [ ] No
Is the stressor related to the Veteran's fear of hostile military or terrorist activity? [X] Yes [ ] No
Is the stressor related to personal assault, e.g. military sexual trauma? [ ] Yes [X] No
d. Additional stressors: If additional stressors, describe (list using the above sequential format):
North Korea threatened to attack the DMZ. They were shown satellite photos of the enemy digging into the DMZ. They were put on lockdown.
4. PTSD Diagnostic Criteria --------------------------
Note: Please check criteria used for establishing the current PTSD diagnosis. Do NOT mark symptoms below that are clearly not attributable to the Criterion A stressor/PTSD. Instead, overlapping symptoms clearly attributable to other things should be noted under #7 - Other symptoms. The diagnostic criteria for PTSD, referred to as Criterion A-H, are from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Criterion A: Exposure to actual or threatened a) death, b) serious injury, c) sexual violence, in one or more of the following ways: [X] Directly experiencing the traumatic event(s)
[X] Witnessing, in person, the traumatic event(s) as they occurred to others
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).
Criterion C . 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). [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Criterion D 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 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] Problems with concentration.
[X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.
Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?:
[X] Stressor #3
5. Symptoms ---------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses:
[X] Anxiety [X] Suspiciousness [X] Panic attacks more than once a week [X] Chronic sleep impairment [X] Disturbances of motivation and mood
6. Behavioral Observations ------------------------- Veteran is alert, fully oriented, dressed in clean, casual clothing. Mood is anxious. Affect is constricted. He becomes tearful when talking about the loss of his friend and the effect his anxiey has on his family. He denied suciidal thinking. He avoids eye contact. Speaks in a tremulous voice.
7. Other symptoms ---------------- Does the Veteran have any other symptoms attributable to PTSD (and other mental disorders) that are not listed above? [ ] Yes [X] No
8. Competency ------------
Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No
9. Remarks, (including any testing results) if any ------------------------------------------------- Active duty service dates: Branch: Army
DBQ PSYCH Mental disorders:
The Veteran is claiming service connection for agoraphobia, anxiety and insomnia. Please examine the Veteran for a chronic disability related to his or her claimed condition and indicate the current level of severity.
If more than one mental disorder is diagnosed please comment on their relationship to one another and, if possible, please state which symptoms are attributed to each disorder.
************************************************************************** **
DBQ PSYCH PTSD Initial: The Veteran is claiming service connection for PTSD due to the claimed stressor of Inicident at Korean DMZ. Please examine the Veteran for a chronic disability related to his or her claimed condition and indicate the current level of severity.
If more than one mental disorder is diagnosed please comment on their relationship to one another and, if possible, please state which symptoms are attributed to each disorder.
If your examination determines that the Veteran does not have diagnosis of PTSD and you diagnose another mental disorder, please provide an opinion as to whether it is at least as likely as not that the Veteran's diagnosed mental disorder is a result of an in-service stressor related event.
Response: The Veteran has many symptoms of PTSD and has had events that could cause PTSD. However, the more appropriate diagnosis for this Veteran is Panic Disorder along with Agoraphobia. Panic Disorder and PTSD have many overlapping symptoms. This Veteran happens to have incurred a trauma but his presentation more closely resembles Panic Disorder. There is scant evidence to demonstrate that the anxiety started in the Army, namely the note that a Mental Status Examination took place at a Mental Health Clinic with no details provided. This corresponds to the Veteran's report that he was evaluated after his close friend died. His first panic attack occurred within a year of his departure from the Army.
In my opinion, the Veteran's Panic Disorder and Agoraphobia were incurred while he was serving in the Army.
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