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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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We cannot tell the time for a rating decision.  It could be months to years.  The fact that she spent two hours with you is probably good.  Most C&P's last fifteen minutes to an hour at max.  Please do look into counseling.  One of the things they look for is continued treatment.  If we are not being treated they will try to say your condition is not chronic or has improved.  Hang in there, the second hardest part is the wait for a decision by the VA.

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So a little concerned.  I looked today and noticed the they put in the following request.

Request 4

Optional - We’ve asked others to send this to us, but you may upload it if you have it.

<VA Medical Facility>

 

Anybody want to chime in what this means? 

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Posted (edited)

Here are the results of my C&P exam,  Just wondering what you think about it.

 

1. Diagnostic Summary

    ---------------------

    Does the Veteran have a diagnosis of PTSD that conforms to DSM-5 criteria

    based on today's evaluation?

    [X] Yes   [ ] No

   

       ICD code:  F43.1

      

    2. Current Diagnoses

    --------------------

    a. Mental Disorder Diagnosis #1: PTSD, Chronic

           ICD code: F43.1

 

    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?

       [ ] Yes   [X] No

      

    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] Occupational and social impairment with occasional decrease in work

           efficiency and intermittent periods of inability to perform

           occupational tasks, although generally functioning satisfactorily,

           with normal routine behavior, self-care and conversation

 

    b. For the indicated occupational and social impairment, is it possible to

       differentiate which impairment is caused by each mental disorder?

       [ ] Yes   [ ] No   [X] Not Applicable (N/A)

      

    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

    [X] Other (please identify other evidence reviewed):

          Compensation & Pension (C&P) for Veterans Benefit Administration (VBA)

          and represents a Disability Evaluation - not a comprehensive clinical

          evaluation of the Veteran.

          Items on this DBQ are marked in highly specialized ways that conform

          specifically to the needs of VBA disability rating determination.

          Some items could be left blank because the Veteran's responses or

          physical findings could not be attributed to or are not associated

with

          the current disability claim(s).

          Symptoms and signs may be present, but may not be clinically linked to

          the claim(s) C&P was requested to evaluate by VBA.

 

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

 

          This C&P examination or/and medical opinion does not constitute a

          rating decision.

          by the C&P staff.]

          Rating decisions are made solely by the Regional Office (VBA) after

all

          required data has been reviewed and verified. Any questions or

concerns

          regarding rating procedures should be directed to the Veteran Service

          Organization, Regional Office or an Appeals Board.

          The decision to service connect or not service connect a claimed

          condition is the sole responsibility of VBA.

          The percentage of disability (if awarded) is determined by VBA - not

          C&P.

                   

         

 

    Evidence Comments:

      All evidence gathered pertains to the review of Veteran's VBMS, CAPRI

      documents, own statements and recollections, as well as the WHODAS-2 and

      Mississippi Scale of Combat PTSD (administered to Veteran by this examiner

      today.)

     

    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)

 

       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).

                   [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 😧 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 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).

 

       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)   the following

                   [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] 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

                   [X] Stressor #2

                   [X] Stressor #3

                   [X] Other, please indicate stressor number (i.e., Stressor

#4,

                       #5, etc.) as indicated above:

                         4, 5, 6, & 7

                     

  5. Symptoms

    -----------

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

    Veteran's diagnoses:

       [X] Anxiety

       [X] Suspiciousness

       [X] Panic attacks that occur weekly or less often

       [X] Chronic sleep impairment

       [X] Disturbances of motivation and mood

       [X] Difficulty in adapting to stressful circumstances, including work or a

        Work like setting

 

    6. Behavioral Observations

    --------------------------

    Alert and oriented times three with good eye contact. Casually dressed and

    well groomed. Normal ambulation. Speech was slightly inaudible at times but

    otherwise WNL. Attention and concentration were good. Thought process was

    circumstantial. Thought content was slightly paranoid. Veteran denied SI/HI

    and AH/VH. Judgment was good and impulse control was good. Insight was fair.

    Intellect was average.

 

    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

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

       The WHODAS-II was developed to assess disabilities related to physical

and

       mental disorders experienced within the past 30 days and provides a

       profile of functioning across six activity domains-understanding and

       communicating, mobility, self-care, getting along with others, life

       activities, and participation in society-as well as an overall disability

       score.

 

       The WHODAS-II has been used with individuals with PTSD and other

       stress-related disorders and research has shown it to be useful in these

       populations. A notable asset of the WHODAS-II is its relationship with

the

       International Classification of Functioning, Disability, and Health which

       is an internationally recognized system of classifying the consequences

of

       physical and mental health conditions. The WHO has also developed and

       validated a self-report version of the WHODAS-II that can be used in

       instances when an interview is not feasible or efficient.

 

       The scores assigned to each of the items - "none" (0), "mild" (1)

       "moderate" (2), "severe" (3) and "extreme" (4) - are summed. The simple

       sum of the scores of the items across all domains constitutes a statistic

       that is sufficient to describe the degree of functional limitations.

 

       The Mississippi Scale for Combat-Related PTSD (M-PTSD) is a 35-item

       self-report measure that assesses combat-related PTSD in Veteran

       populations. Items sample DSM-III symptoms of PTSD and frequently

observed

       associated features (substance abuse, suicidality, and depression).

 

       Respondents are asked to rate how they feel about each item using

5-point,

       Likert-style response categories. Ten positively framed items are

reversed

       scored and then responses are summed to provide an index of PTSD symptom

       severity which can range from 35-175. Cutoff scores for a probable PTSD

       diagnosis have been validated for some populations, but may not

generalize

       to other populations.

 

       Examination measures were verbally administered by the examiner to the

       examinee instead of administered in written format and should be

       interpreted with this limitation in mind.

 

       It is as likely as not (50 percent or greater probability) that the

       Veteran is diagnosed with PTSD, chronic at moderate severity that

incurred

       in or was caused by military sexual trauma.

 

       Rationale:

       The Veteran's summary score on the WHODAS-2 was 63, indicative of

moderate

       impairment in social and occupational functioning. His score on the

M-PTSD

       was 123, indicative of mild to moderate PTSD symptoms. Records indicate

       that Veteran meets with a D.O. who prescribes Veteran with psychotropic

       medications on a regular basis. In 2016, that provider diagnosed Veteran

       with PTSD and stated the following "it is my professional opinion that it

       is highly likely that the Veterans PTSD is a direct result of traumatic

       events from his military service." Further, the following markers provide

       evidence that his PTSD diagnosis is related to his military stressors:

 

       Markers:

       1. Erectile dysfunction (per Veteran report)

       2. Difficulties engaging in physical intimacy with wife (per wife and

       Veteran report)

       3. Avoidance of male authority figures (per wife and Veteran report)

       4. Veteran waited until 28 years old to engage in sexual relations (per

       Veteran report)

       5. Veteran slit wrists during military service in direct response to

       ongoing harrassment by fellow Navymen, leaving a scar. (per Veteran

       report)

Edited by pyrotaz
edit

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8 hours ago, pyrotaz said:

Just wondering what you think about it.

out of the gate I would read this as a 30-50 percent rating.

there are some things I don't understand though and if you choose to challenge the award I would suggest you consider them.

8 hours ago, pyrotaz said:

The WHODAS-II was developed to assess disabilities related to physical

and

       mental disorders experienced within the past 30 days and provides a

       profile of functioning across six activity domains-understanding and

       communicating, mobility, self-care, getting along with others, life

       activities, and participation in society-as well as an overall disability

       score.

who in the xxxx decided to give you a WHODAS-II? and since when did the VA certify it for PTSD exams?

8 hours ago, pyrotaz said:

The Mississippi Scale for Combat-Related PTSD (M-PTSD) is a 35-item

       self-report measure that assesses combat-related PTSD in Veteran

       populations. Items sample DSM-III symptoms of PTSD and frequently

observed

       associated features (substance abuse, suicidality, and depression).

 

same here? what brain child authorized the M-PTSD as an evaluation standard of C&P Exams?

do the research yourself but I am unaware of either be authorized in a VA C&P exam as an evaluation basis.

8 hours ago, pyrotaz said:

Veteran meets with a D.O. who prescribes Veteran with psychotropic

which psychtropics and at what mg for how many years?

 

8 hours ago, pyrotaz said:

It is as likely as not (50 percent or greater probability) that the

       Veteran is diagnosed with PTSD, chronic at moderate severity that

incurred

       in or was caused by military sexual trauma.

did you ever get an MST exam and C&P? they are different than a PTSD exam and should, I think, have its own separate rating.

 

I would also check the structure of the "magic words" above....it reads you were likely diagnosed PTSD. not likely to have PTSD caused my military service connected events. The phrasing has made the hackles on my neck stand up.

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