PTSD rating advise needed please

[PTSD78]

Does the Veteran have a diagnosis of PTSD DSM-5 criteria on today's eval?
 [X] Yes [ ] No
 2. Current Diagnoses,1PTSD 2Panic Disorder 3Agorophobia 4Major Depressive Disorder
 b. Medical diagnoses relevant. obstructive sleep apnea, fibromyalgia, hypothyroidism.
3. Differential
 a. Does the Veteran have more than one mental disorder diagnosed?
 [X] Yes [ ] No
 4. Occupational and social impairment
 [X] Occupational and social impairment with reduced reliability and productivity
 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)
 Vet has multiple co-morbid psych dx and therefore cannot differentiate level of impairment due to each mental disorder due to overlap in symptoms.
Does stressor meet Criterion diagnosis of PTSD)?
 [X] Yes [ ] No
 Is the stressor related to the Veteran's fear of hostile military terrorist activity?
 [X] Yes [ ] No
 Is the stressor related to personal assault, e.g. military sexual trauma?
 [X] Yes [ ] No
 Criterion A: Exposure to
  [X] Directly experiencing the traumatic event(s)
 Criterion B: Presence of
  [X] Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
 [X] Recurrent distressing dreams
[X] Dissociative reactions
[X] Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic
 [X] Marked physiological reactions to internal or externalcues that symbolize or resemble an aspect of the traumatic
Criterion Persistent avoidance of
 [X] Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated
 traumatic event(s).
 [X] Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects,
Criterion Negative alterations
 [X] Persistent and exaggerated negative beliefs or expectations about oneself, others
 [X] Persistent, distorted cognitions about the cause or consequences of the traumatic event that lead the
 individual to blameherself others.
 [X] Persistent negative emotional state
 [X] Markedly diminished interest or participation in significant activities.
 [X] FeelingsofdetachmentEstrangement
 [X] Persistent inability positive emotions
 Criterion E: Marked alterations  arousal
 [X] Irritable behavior angry outbursts
 [X] Hypervigilance.
 [X] Exaggerated startle response.
 [X] Problems with concentration.
 [X] Sleep disturbance
 Criterion F:
 [X] Duration disturbis more than month.
Criterion G:
 [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important
Criterion H:
 [X] The disturbance is not attributable to the physiologicaleffects of a substance
Criterion I: Which stressor contributed to the Veteran's PTSD diagnosis?:
 X] Stressor #1
 5. Symptoms
 [X] Depressed mood
 [X] Anxiety
 [X] Suspiciousness
 [X] Panic attacks more than once aweek
 [X] Chronic sleep impairment
 [X] Mild memory loss, such as forgetting names, directions or recentevents
 [X] Flattened affect
 [X] Impaired judgment
 [X] Disturbances of motivation a
 [X] Difficulty in establishing and maintaining effective work and social
 [X] Difficulty in adapting to stressful circumstances,including worklike setting
 [X] Obsessional ritualsInterfereActivities
 [X] Neglect personalAppearance hygiene
 DSM 5 Diagnosis:PTSD-Panic d/o with agoraphobia-Generalized Anxiety D/o
Vet meets the DSM-5 diagnostic criteria for PTSD as level of severity - severe. Relationship of mental disorders to each other Vet's MDD, recurrent,moderate is secondary to her PTSD.HerPanicDisorder, Agorophobia and FSAD are also secondary to her PTSD. It is my medical opinion that vet's MST stressor is as least as likely as not suppported by and consistent with the in service marker evidence. Her agorophobia preclude her from functioning satisfactorily in work environments.

 

[Berta]

I dont think she will have to argue that point.

This exam was done by someone who had MST expertise.

"It is my medical opinion that vet's MST stressor is as least as likely as not suppported by and consistent with the in service marker evidence." Service markers are always good evidence of MST.

She has the PTSD diagnosis and the nexus statement.

Oddy enough my dead husband would have gotten almost all of the same multiple check offs in this  criteria-almost  all except the MST nexus.

100% P & T SC PTSD- all from combat -BUT that does not minimize at all,  any veteran with a non combat MST stressor.

PTSD78'[s C & P above also states:

Does stressor meet Criterion diagnosis of PTSD)?
 [X] Yes [ ] No
 Is the stressor related to the Veteran's fear of hostile military terrorist activity?
 [X] Yes [ ] No
 Is the stressor related to personal assault, e.g. military sexual trauma?
 [X] Yes [ ] No

To me those 3 YES answers are solid for this claim.They fit into the 2010 PTSD criteria as well, as to fear of hostile fear of hostile military terrorist activity
 

 

[GeekySquid]

29 minutes ago, Berta said:

dont think she will have to argue that point.

@Berta

I hope you are correct, I know you have been on this path a lot longer than I have I just worry that the lack of explicit statement will let a rater sidestep on her claim. I hope not for her sake.

[vetquest]

GeekySquid, please look where it says PTSD "yes" and the following:

 DSM 5 Diagnosis:PTSD-Panic d/o with agoraphobia-Generalized Anxiety D/o
Vet meets the DSM-5 diagnostic criteria for PTSD as level of severity - severe. Relationship of mental disorders to each other Vet's MDD, recurrent,moderate is secondary to her PTSD.HerPanicDisorder, Agorophobia and FSAD are also secondary to her PTSD. It is my medical opinion that vet's MST stressor is as least as likely as not suppported by and consistent with the in service marker evidence. Her agorophobia preclude her from functioning satisfactorily in work environments.
 

[PTSD78]

Thank you all for such excellent advise. I was told not to apply for ssdi until i receive my vet rating letter due to then ss would expedite me through. I had already sent in my completed form,tdiu for unemployability.

[broncovet]

You might want to figure out how much "expiditing" your SSD claim will cost you by waiting.  If you wait until next month, for example, and your ssdi is $1000, then it will cost you 1000 dollars.  That is pretty high even for Federal Express!  

Of course, it could also be January, or later.  I suggest you apply now, then send your VA letter when you get it.  

It sounds like your "I was told" was by a VSO.  Or, maybe by someone from SS.  You should rethink that advice.  I suggest you make an appointment before the end of November, whether you have the VA letter or not.  

[vetquest]

I agree with Broncovet to file for SSDI now.  Claims take at least several months and you should have some documentation by then.  No use losing $1000.00.