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pyrotaz

Started My MST/PTSD Journey

Question

I met with a VSO on Feb 8th 2019 and started my MST/PTSD claim. To be totally honest I am scared to death. The incidents happened during my Navy duty 88-89. I had hid it from everyone including my wife until this past December. I had went to a VSO  to talk about other claims when it slipped out and I was offered help to form a claim.  We filed an intent to claim in Dec 2018. She suggested I talk with my wife and make an appointment with my doctor. After sitting and having a very emotional talk with my wife and with her support I made an appointment with my personal doctor. I am very lucky to have a great doctor who sat with me and after many tears I was able to explain in detail what had happened. He diagnosed me with extreme anxiety mostly when dealing with other Males ( Authority Figures or when confronted), and PTSD/MST and prescribed an anxiety as needed.

What we submitted:

  1. A two page statement from me ( Timeline form)
  2. A statement from my wife
  3. A statement from from my 20 yr old son detailing my issues with examples of my issues with male authority figures 
  4. A Nexus statement from my Doctor saying he feels that my anxiety and PTSD is definitely caused by what happened while I served. The VSO said that it was the best written Nexus statement she has ever seen  in her 10 years in doing Veteran claims. 

My Questions:

  1. After submitting a claim to the VSO how long before it shows up on ebenefits? Mine still shows as intent to file. The VSO says it has been submitted.
  2. What can I expect at my C & P exam? How can I prepare myself for the exam? This is what I dread/fear most. 
  3.  Is it ok if I post my journey?

I also want to thank all the men and women who have submitted to the MST forum.  I now know I am not alone. Being a male and reading that similar things has happened to other males and reading their journeys  has prepared me to start my journey and start the healing process.

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My pulse always increases when I am at the VA, my blood pressure also goes up.  This is normal for some vets.  I believe if you can walk into a mental health C&P and not be nervous you are abnormal.  It covers a lot of ground, some you do not want to cover.  The examiner should expect some anxiety out of you, it is a tough thing you have decided to do.

Edited by vetquest
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You WILL get it done! Good luck-but you don't need it. Keep us informed.

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On 2/21/2019 at 7:05 PM, pyrotaz said:

I met with a VSO on Feb 8th 2019 and started my MST/PTSD claim. To be totally honest I am scared to death. The incidents happened during my Navy duty 88-89. I had hid it from everyone including my wife until this past December. I had went to a VSO  to talk about other claims when it slipped out and I was offered help to form a claim.  We filed an intent to claim in Dec 2018. She suggested I talk with my wife and make an appointment with my doctor. After sitting and having a very emotional talk with my wife and with her support I made an appointment with my personal doctor. I am very lucky to have a great doctor who sat with me and after many tears I was able to explain in detail what had happened. He diagnosed me with extreme anxiety mostly when dealing with other Males ( Authority Figures or when confronted), and PTSD/MST and prescribed an anxiety as needed.

What we submitted:

  1. A two page statement from me ( Timeline form)
  2. A statement from my wife
  3. A statement from from my 20 yr old son detailing my issues with examples of my issues with male authority figures 
  4. A Nexus statement from my Doctor saying he feels that my anxiety and PTSD is definitely caused by what happened while I served. The VSO said that it was the best written Nexus statement she has ever seen  in her 10 years in doing Veteran claims. 

My Questions:

  1. After submitting a claim to the VSO how long before it shows up on ebenefits? Mine still shows as intent to file. The VSO says it has been submitted.
  2. What can I expect at my C & P exam? How can I prepare myself for the exam? This is what I dread/fear most. 
  3.  Is it ok if I post my journey?

I also want to thank all the men and women who have submitted to the MST forum.  I now know I am not alone. Being a male and reading that similar things has happened to other males and reading their journeys  has prepared me to start my journey and start the healing process.

For the Nexus of Opinion:

Did the doctor state one of these legal statements?

1. " due to" (100% probability)

2. "More likely than not" (greater than 50% probability)

3. "At least as likely as not" (equal to or greater than 50% probability)

That your Anxiety/PTSD is the direct result of MST.

 

For your questions:

#1. If you really need a timeline give it two weeks or more.

#2. You will be asked questions about your in-service event/stressors, Social and Occupational impairment.  Answer the questions as honestly as you can. DO NOT downplay what you experienced and DO NOT overexaggerate either.

#3. If you feel you need to share your journey with us up to your discretion. We're here to support you in your continued journey and the claims process.

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16 hours ago, pyrotaz said:

She will stay on the grounds and I will call her when done.

@pyrotaz

The very first thing you need to understand is a technical one. VA compensation is not like SS disability or getting payments from AFLAK or workmans comp. VA Compensation is the measure of how your circumstances impair the ability to earn an income (over marginal income) for an AVERAGE PERSON. You can be a neurosurgeon and you would evaluated on that AVERAGE PERSON criteria. Understanding that technical fact helps understand the rest of the C&P evaluation process.

----------- Beyond the above understanding-------------------

If  you are shaking when you arrive you can ask if your wife can be in the room. All they can say is no. If the doctor comments on the shaking, tell them flatly why you are shaking.

If the doctor tries to engage you in social pleasantries, don't engage. If the say "how are you today" say scared shitless, angry, anxious, frustrated.. .whatever you are feeling. Do NOT say "It's a great day to be alive". If you feel distrust in the DR. say so. If you feel that exposing yourself will turn people against you or laugh at you, say so. If you feel shame (and you should not but it is common) say that.

I cannot emphasize enough that you have to do two things at the same time.

1) BE HONEST! 

2) Describe your WORST DAY(S) not your good days. DO NOT MINIMIZE your problems. Don't say " i have dealt with this fine on my own." you will talk yourself out of a rating or an appropriate higher rating.

This is not a contradiction. They only know what you tell them and what they observe in the meeting. The reality that days can be good and then swing bad cannot really be seen in the moment. So deal only with your WORST moments as if they are today.

Read the DBQs and the rating tables for PTSD and MST!!!!! don't try and say those words exactly ( it will make you sound fake and rehearsed), but understand that the doctor has to hear you and make connections to those words. Each category is NOT exact. You don't have to have every condition outlined in the rating tables. There are many analogous situations and diagnosis for each specific item listed.  you can have 3 from column A, 2 from Column B and none from Column C, but they all can add up to a higher rating

What you have to show is social and employment impairment. The more impaired you are, particularly in employment, the higher rating you are consider for. The rater makes that decision NOT the Dr.

understand what having a flat affect means.

If you have night terrors and have peed the bed, say so and say how often.

If you have ED tell the doc you have it and describe your intimacy problems.

Are you incontinent during the day or night? use pads? tell the doc what situations make you leak.

Yes  I know how uncomfortable those conversations are, but ptsd has many secondary conditions, including ED and bladder issues. bringing them up in this initial C&P can help you get a higher rating or exams for those problems. You want those exams.

Your exam needs to tell a compelling story of why and how your in service nexus events have harmed your life and income.

Understand that saying 'i get mad at coworkers" is not going to get you a rating for impaired employment. Saying Yesterday I tipped over my desk and stormed out because a coworker was whistling and would not stop gives a much better description of the workplace problems (assuming you did that of course).

Do you cause confrontations? are unwilling to be alone in a room with people similar to your attacker? do you have flashbacks to the events? do you run from things, metaphorically, physically, emotionally or intellectually? have you been arrested or detained for anger? have the cops been called to your home for a domestic situation? i am not being personal, I am pointing out possible scenarios that the doctor needs to know.

I will give you a personal example. I am 100% PTSD P&T. One of my conditions is that I can go to a steakhouse today, and the smell of cooking meat will be delicious, tomorrow I can walk by a burger joint and the smell of cooking meat will make be vomit and run away. This happens in the grocery store and at home. I cannot tell you how much meat I have thrown away. The social impairment is obvious, but work wise this has happened at company meetings, trade shows, luncheons, dinners, award events and even in the air traveling to Europe with a group up C-Suite executives on the company jet. The Dr would not know that unless I described it too him to demonstrate the work impairment.

If talking about these things frustrates you, DON"T HIDE IT. Don't attack the Dr, but don't try and pretend you are nifty with the situation and having to disclose this stuff to another human. Don't say "Talking about it has helped me". for gods sake don't say that!!! EVER!!!!

Are you or do you suspect you are Bi Polar? Manic? Chronically depressed? these are all common to PTSD. So are drug use/abuse and alcohol abuse.

I will also suggest you look at the letter  (or online website) for the C&P Doctors Credentials. This is so important these days. The letter should say what type of Dr they are, where they went to school, how long they have practiced medicine, and what type of C&P's they are certified to do.

It is a sad fact the VA contractors are often not qualified in appropriate areas that we are being evaluated for. Make sure you KNOW THIS as it affects what you need to do if you have to file a NOD after the rating results are delivered.

When you leave the session, have a tape recorder at hand with a long battery life. Dump all your observations about the exam, the questions and the doctor onto that tape. Then go home and type it up and email it to yourself.

You will then create what is called a contemporaneous record of the events. Store them both in a cloud account and or a safe.

Humans have selective memory and waiting to write down or record information will frequently change what our perceptions were and what actually happened or was felt/heard in the moment.

Sorry about the long post and I know it may seem a bit dry and unsympathetic. It is not meant to convey that, but you need to know what is happening and there is no touchy feely way to say it that I have ever come up with.

Tell the truth, be honest, describe your worst days not your best day or today (unless today is your worst day) and you will make it through.

I can promise you the next one, and there will likely be other exams, will be slightly less fear inducing.

Keep coming here, venting, asking questions, developing a support system .

We are all veterans and are here because of our own problems. We support each other, even when we disagree on some topics.

There is no shame here, no condemnation. We won't ask personal details and you can share as much or as little as you like.

Let us know what happens after the C&P. and after the rating decision.

 

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So I survived the DBQ. I will admit it was the toughest thing I ever had to do. I had a female Doctor who allowed me time to explain my feeling and I didn't feel threatened or rushed. The questions that were asked opened up a lot of flood gates and to be honest I shed  a lot of tears. She seemed very understanding and allowed me to take breaks as needed. The whole DBQ took about 2 hours.  Before I left she took me aside and stated She definitely feels I suffer from PTSD and should look into counselling, which I am doing.  She was going to finish up her report and submit it by the end of the day. What is roughly the timeline for a rating decision from here? I know it can go back and forth jut wonder the rough estimate.

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      the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: [X] Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad,: "No one can be trusted,: "The world is completely dangerous,: "My whole nervous system is permanently ruined"). [X] Persistent, 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] Markedly diminished interest or participation in significant activities. [X] Feelings of detachment or estrangement from others.
      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] Reckless or self-destructive behavior. [X] Hypervigilance. [X] Exaggerated startle response. [X] Problems with concentration. [X] Sleep disturbance (e.g., difficulty falling or staying asleep or restless 
      Criterion F: [X] Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
      Criterion G: [X] The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
      Criterion H: [X] The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or
      another medical condition. Criterion I: Which stressor(s) contributed to the Veteran's PTSD diagnosis?: [X] Stressor #1
      5. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Suspiciousness [X] Chronic sleep impairment [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting
      6. Behavioral Observations -------------------------- The veteran arrived on time for his scheduled examination. His identity was confirmed by having him provide his full name and date of birth. The veteran presents as a tall, obese, Caucasian male who appears the stated age. He was dressed casually and exhibited good grooming and hygiene. He had tattoos visible on his lower and upper extremities. His posture, gait, and psychomotor activity were within normal limits. His manner of interaction was cooperative, courteous, and friendly. His speech was normal in rate, rhythm, tone, and volume. His thought processes were clear, logical, coherent, and goal-directed. Veteran reported his mood to be depressed, with affect congruent. He denied suicidal ideation, but admitted to thoughts of death and wondering if others would be better off without him. He denied homicidal ideation as well as auditory and visual hallucinations.
      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 -------------------------------------------------- In my opinion, the veteran meets DSM 5 diagnostic criteria for posttraumatic stress disorder, which is more likely than not secondary to military trauma. In this veteran's case, there is a strong component of shame that is also associated with his military service and is foundationally related to his depressive disorder. His experience of freezing during 3 artillery attacks is something that is associated with feelings of overwhelming shame, worthlessness, helplessness, and inadequacy for the veteran. These thoughts and feelings contribute significantly to his depressive condition, and contribute meaningfully to his PTSD symptoms as well. The veteran also experienced significant losses during military service that have likely aggravated his PTSD and depressive conditions. Notably, the veteran's grandfather died in 2011 when the veteran was deployed to Afghanistan, and his best friend committed suicide on Christmas day in 2013. Both losses were experienced by the veteran as emotionally traumatic and contribute to his symptomatology. The veteran has developed a dysfunctional coping mechanism of excessive alcohol intake in his efforts to suppress negative feelings associated with his traumas. As his excessive alcohol use appears to be largely in the service of avoidance of distress and suppression of intrusive/reexperiencing symptoms, it is my opinion that his alcohol use disorder is secondary to his PTSD and depressive disorders. The veteran's mental health symptoms have severely impaired his functional capacity. He is socially disengaged and avoidant. He has difficulty expressing himself emotionally, showing empathy, or forming emotional bonds with others. Occupationally, the veteran has exhibited significant dysfunction as he has been unable to maintain employment due to anxiety, depression, avoidance, alcohol abuse, irritability, shame. Hs shame about his reactions of freezing during artillery attacks prompts him to avoid interpersonal interactions as much as possible as he fears that the topic of his military service will arise. Recently, the veteran has begun outpatient mental health treatment in the form of individual counseling, and he is awaiting an appointment for trial of medication.
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    • Enough has been said on this topic. This forum is not the proper forum for an attorney and former client to hash out their problems. Please take this offline
    • Peggy toll free 1000 last week, told me that, my claim or case BVA Granted is at the RO waiting on someone to sign off ,She said your in step 5 going into step 6 . That's good, right.?
      • 7 replies
    • I took a look at your documents and am trying to interpret what happened. A summary of what happened would have helped, but I hope I am interpreting your intentions correctly:


      2003 asthma denied because they said you didn't have 'chronic' asthma diagnosis


      2018 Asthma/COPD granted 30% effective Feb 2015 based on FEV-1 of 60% and inhalational anti-inflamatory medication.

      "...granted SC for your asthma with COPD w/dypsnea because your STRs show you were diagnosed with asthma during your military service in 1995.


      First, check the date of your 2018 award letter. If it is WITHIN one year, file a notice of disagreement about the effective date. 

      If it is AFTER one year, that means your claim has became final. If you would like to try to get an earlier effective date, then CUE or new and material evidence are possible avenues. 

       

      I assume your 2003 denial was due to not finding "chronic" or continued symptoms noted per 38 CFR 3.303(b). In 2013, the Federal Circuit court (Walker v. Shinseki) changed they way they use the term "chronic" and requires the VA to use 3.303(a) for anything not listed under 3.307 and 3.309. You probably had a nexus and benefit of the doubt on your side when you won SC.

      It might be possible for you to CUE the effective date back to 2003 or earlier. You'll need to familiarize yourself with the restrictions of CUE. It has to be based on the evidence in the record and laws in effect at the time the decision was made. Avoid trying to argue on how they weighed a decision, but instead focus on the evidence/laws to prove they were not followed or the evidence was never considered. It's an uphill fight. I would start by recommending you look carefully at your service treatment records and locate every instance where you reported breathing issues, asthma diagnosis, or respiratory treatment (albuterol, steroids, etc...). CUE is not easy and it helps to do your homework before you file.

      Another option would be to file for an increased rating, but to do that you would need to meet the criteria for 60%. If you don't meet criteria for a 60% rating, just ensure you still meet the criteria for 30% (using daily inhaled steroid inhalers is adequate) because they are likely to deny your request for increase. You could attempt to request an earlier effective date that way.

       

      Does this help?
    • Thanks for that. So do you have a specific answer or experience with it bouncing between the two?
    • Tinnitus comes in two forms: subjective and objective. In subjective tinnitus, only the sufferer will hear the ringing in their own ears. In objective tinnitus, the sound can be heard by a doctor who is examining the ear canals. Objective tinnitus is extremely rare, while subjective tinnitus is by far the most common form of the disorder.

      The sounds of tinnitus may vary with the person experiencing it. Some will hear a ringing, while others will hear a buzzing. At times people may hear a chirping or whistling sound. These sounds may be constant or intermittent. They may also vary in volume and are generally more obtrusive when the sufferer is in a quiet environment. Many tinnitus sufferers find their symptoms are at their worst when they’re trying to fall asleep.

      ...................Buck
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