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PTSD DBQ please review -hoping for 30%


Merlynda

Question

I am having terrible luck with VA C&P exams. Any guess as to my rating?

SC diagnosed and treated by Psychiatrist  while active duty  

Here are highlights of PTSD DBQ. 

Marked:

10%
       [X] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms
 controlled by medication

But examiner checked these symptoms:

[X] Depressed mood                                                                                                                                               [X] Anxiety
       [X] Panic attacks that occur weekly or less often
       [X] Chronic sleep impairment
       [X] Difficulty in establishing and maintaining effective work and social relationships
       [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting


      ———-Redacted DBQ below—————


                                   SECTION I:
                                   ----------
    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:  309.81
       
    2. Current Diagnoses
    --------------------
    a. Mental Disorder Diagnosis #1: PTSD
           ICD code: 309.81

    b. Medical diagnoses relevant to the understanding or management of the
       mental health disorder (to include TBI): see Veteran's medical record for
       pertinent medical conditions

    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 due to mild or transient symptoms
           which decrease work efficiency and ability to perform occupational
           tasks only during periods of significant stress, or; symptoms
           controlled by medication

    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


    2. History

          Post-Military: N/A
          
    d. Relevant legal and behavioral history (pre-military, military, and
       post-military):
          Veteran denied. 
          
    e. Relevant substance abuse history (pre-military, military, and
       post-military):
          Veteran denied
d. 
        
    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. 
          
          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
          
    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).
                   [X] Recurrent distressing dreams in which the content and/or
                       affect of the dream are related to the traumatic 
event(s).
                   [X] Intense or prolonged psychological distress at exposure 
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, 
of 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 negative emotional state (e.g., fear, horror,
                       anger, guilt, or shame).
                   [X] Markedly diminished interest or participation in
                       significant activities.

       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] 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
    [X] Depressed mood
       [X] Anxiety
       [X] Panic attacks that occur weekly or less often
       [X] Chronic sleep impairment
       [X] Difficulty in establishing and maintaining effective work and social
           relationships
       [X] Difficulty in adapting to stressful circumstances, including work or 
a worklike settingrk and social
           relationships
       [X] Difficulty in adapting to stressful circumstances, including work or 
a worklike setting

    6. Behavioral Observations
    --------------------------
    Veteran was cooperative during the examination.

    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
    --------------------------------------------------
    No remarks provided.
    


****************************************************************************


                                  Miscellaneous
                        Disability Benefits Questionnaire

    Please use this DBQ to address 1151 requests, or other issues that are not
    specifically addressed by specific DBQs such as Individual Unemployability
    (UI).
    
                          Mental health - Separation Health Assessment
                           Disability Benefits Questionnaire
                             * Internal VA or DoD Use Only*

 

        
        Was a DD Form 2807-1, Report of Medical History, completed by the
        Service member and available for review at the time of this examination?
        [x] Yes [] No [ ] N/A
        
        Any changes to his/her health status since DD 2807-1 completed?
        [ ] Yes[x] No[] N/A 

        (Proposed) Date of separation from active service: ETS June 2018
        1.  Medical record review
        -------------------------
        Was the Veteran's VA claims file reviewed?
        [x] Yes [ ] No  

        2. Medical history (Review of Systems)
        --------------------------------------
           
        1. Psychiatric:
           [x] Yes[ ] No

        #1. Claimed Condition: PTSD
                    Onset:           
                   History: 
                         
                Prognosis: Unknown.  
        #2.  Claimed Condition:
                Onset:
                History: 
                Prognosis:
           
        (Please follow format if more claims are being addressed)

                  PTSD SCREEN PC-PTSD
                  -------------------
                  In your life, have you ever had any experience that was so
    frightening, horrible, or upsetting that, in the past month,
    you:
                  
    1. Have had nightmares about it or thought about it when you
    did
                     not want to?
                     [x] Yes [] 

                  2. Tried hard not to think about it or went out of your way to
                     avoid situations that reminded you of it?
                     [x] Yes [] No
                     
                  3. Were constantly on guard, watchful, or easily startled?
                     [x] Yes [] No
                     
                  4. Felt numb or detached from others, activities, or your
                     surroundings?
                     [x] Yes [] No
                     
                  Depression screen: PHQ2
                  -----------------------
    Over the past two weeks, how often have you been bothered by
    Any of the following problems?
                  
                  Little interest or pleasure in doing things.
                  [] 0 = Not at all [x] 1 = Several days [] 2 = More than half the days [] 3 = Nearly every day
                     
                  Feeling down, depressed, or hopeless.
    [] 0 = Not at all [x] 1 = Several days [] 2 = More than half
    The days [ ] 3 = Nearly every day

            Total Point Score: 2             
                  Brief Suicide Risk Assessment
                  -----------------------------
                  - (Perform if score positive on Depression or PTSD screens)
                  
                  Are you feeling hopeless about the present or future?
                     [] Yes  [x] No  
                     
    Have you had thoughts about taking your life - if yes - when
    did you have these thoughts and do you have a plan to take your
    life?

                  [x] Yes [x] No

                  Have you ever had a suicide attempt?
                     [ ] Yes [x] No
           
        3.  Physical Exam
        -----------------
           
        1. Psychiatric (Specify any personality deviation)
            [ ] Normal [x] Abnormal [ ] Not examined
           
        5. Diagnosis:
        -------------
            #1.  Claimed condition: PTSD. 
                 Diagnosis/Rationale: Veteran meets the DSM-5 diagnostic 
    criteria forPTSD
            #2.  Claimed condition:
                 Diagnosis/Rationale:

            (for additional Claim/diagnosis, please follow above format)
          
        6. Remarks, if any:
        -------------------
         
           
    

 

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If you go fishing, there is a specific order things must happen: 

1.  You have to put on your fishing gear and load it up in the car. 

2.  You have to drive to the fishing spot, and walk down to the water. 

3.  You have to tie on a hook, lure or sinker, and bait it.  

4.  You have to cast it in and wait for a bite.  

5.  You have to successfully hook the fish, reel it in and clean it. 

6.  You have to keep the fish cool, then cook them.

7.  NOW you can eat your fish.

You skipped to step 5 or 6.  

You missed the biggest one:  Did your doc opine that your PTSD (or depression) was at least as likely as not due to military service?  Also, do you have a current diagnosis and an in service event?  

You need to get service connected before you get a rating.  I did not see a nexus, as I described.  Of course, you may already be at the pond (already sc), so I dont know.  

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Oh my. Interesting response. 

I am still on active duty filing via BDD. 

Diagnosed with PTSD while on  active duty was told b/c diagnosed while on active duty it is SC. 

No?

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Very well, you did not mention that.   Generally our answers cant be more precise than your questions.  

  As far as disability percentages, now that you are apparently SC, you can check the criteria and see which matches up the best. 

  Rating
Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. 100
Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. 70
Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 50
Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). 30
Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. 10
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. 0

 

Knowing how Va loves to lowball, and the fact I was unable to work and rated 30 percent, I would say 10 percent or even 0 percent is more likely.  Later, my rating was increased to 100 percent, but only after about a 5 year fight.  

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I read the report and then the doctor's analysis and think what is going on?  The clutch is that he reported you as a ten percent veteran when his report looks to be a thirty percent rating.  I would expect you to see ten percent and then you will have to fight for a higher rating as Broncovet stated he did.  

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Thanks Vetquest. I agree with your assessment. 

Broncovet:

i did mention SC in my post. Specifically 

SC diagnosed and treated by Psychiatrist  while active duty  

-thanks to all 

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4 hours ago, Merlynda said:

I am having terrible luck with VA C&P exams. Any guess as to my rating?

SC diagnosed and treated by Psychiatrist  while active duty  

Here are highlights of PTSD DBQ. 

Marked:

10%
       [X] Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms
 controlled by medication

But examiner checked these symptoms:

[X] Depressed mood                                                                                                                                               [X] Anxiety
       [X] Panic attacks that occur weekly or less often
       [X] Chronic sleep impairment
       [X] Difficulty in establishing and maintaining effective work and social relationships
       [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting


      ———-Redacted DBQ below—————


                                   SECTION I:
                                   ----------
    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:  309.81
       
    2. Current Diagnoses
    --------------------
    a. Mental Disorder Diagnosis #1: PTSD
           ICD code: 309.81

    b. Medical diagnoses relevant to the understanding or management of the
       mental health disorder (to include TBI): see Veteran's medical record for
       pertinent medical conditions

    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 due to mild or transient symptoms
           which decrease work efficiency and ability to perform occupational
           tasks only during periods of significant stress, or; symptoms
           controlled by medication

    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


    2. History

          Post-Military: N/A
          
    d. Relevant legal and behavioral history (pre-military, military, and
       post-military):
          Veteran denied. 
          
    e. Relevant substance abuse history (pre-military, military, and
       post-military):
          Veteran denied
d. 
        
    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. 
          
          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
          
    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).
                   [X] Recurrent distressing dreams in which the content and/or
                       affect of the dream are related to the traumatic 
event(s).
                   [X] Intense or prolonged psychological distress at exposure 
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, 
of 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 negative emotional state (e.g., fear, horror,
                       anger, guilt, or shame).
                   [X] Markedly diminished interest or participation in
                       significant activities.

       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] 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
    [X] Depressed mood
       [X] Anxiety
       [X] Panic attacks that occur weekly or less often
       [X] Chronic sleep impairment
       [X] Difficulty in establishing and maintaining effective work and social
           relationships
       [X] Difficulty in adapting to stressful circumstances, including work or 
a worklike settingrk and social
           relationships
       [X] Difficulty in adapting to stressful circumstances, including work or 
a worklike setting

    6. Behavioral Observations
    --------------------------
    Veteran was cooperative during the examination.

    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
    --------------------------------------------------
    No remarks provided.
    


****************************************************************************


                                  Miscellaneous
                        Disability Benefits Questionnaire

    Please use this DBQ to address 1151 requests, or other issues that are not
    specifically addressed by specific DBQs such as Individual Unemployability
    (UI).
    
                          Mental health - Separation Health Assessment
                           Disability Benefits Questionnaire
                             * Internal VA or DoD Use Only*

 

        
        Was a DD Form 2807-1, Report of Medical History, completed by the
        Service member and available for review at the time of this examination?
        [x] Yes [] No [ ] N/A
        
        Any changes to his/her health status since DD 2807-1 completed?
        [ ] Yes[x] No[] N/A 

        (Proposed) Date of separation from active service: ETS June 2018
        1.  Medical record review
        -------------------------
        Was the Veteran's VA claims file reviewed?
        [x] Yes [ ] No  

        2. Medical history (Review of Systems)
        --------------------------------------
           
        1. Psychiatric:
           [x] Yes[ ] No

        #1. Claimed Condition: PTSD
                    Onset:           
                   History: 
                         
                Prognosis: Unknown.  
        #2.  Claimed Condition:
                Onset:
                History: 
                Prognosis:
           
        (Please follow format if more claims are being addressed)

                  PTSD SCREEN PC-PTSD
                  -------------------
                  In your life, have you ever had any experience that was so
    frightening, horrible, or upsetting that, in the past month,
    you:
                  
    1. Have had nightmares about it or thought about it when you
    did
                     not want to?
                     [x] Yes [] 

                  2. Tried hard not to think about it or went out of your way to
                     avoid situations that reminded you of it?
                     [x] Yes [] No
                     
                  3. Were constantly on guard, watchful, or easily startled?
                     [x] Yes [] No
                     
                  4. Felt numb or detached from others, activities, or your
                     surroundings?
                     [x] Yes [] No
                     
                  Depression screen: PHQ2
                  -----------------------
    Over the past two weeks, how often have you been bothered by
    Any of the following problems?
                  
                  Little interest or pleasure in doing things.
                  [] 0 = Not at all [x] 1 = Several days [] 2 = More than half the days [] 3 = Nearly every day
                     
                  Feeling down, depressed, or hopeless.
    [] 0 = Not at all [x] 1 = Several days [] 2 = More than half
    The days [ ] 3 = Nearly every day

            Total Point Score: 2             
                  Brief Suicide Risk Assessment
                  -----------------------------
                  - (Perform if score positive on Depression or PTSD screens)
                  
                  Are you feeling hopeless about the present or future?
                     [] Yes  [x] No  
                     
    Have you had thoughts about taking your life - if yes - when
    did you have these thoughts and do you have a plan to take your
    life?

                  [x] Yes [x] No

                  Have you ever had a suicide attempt?
                     [ ] Yes [x] No
           
        3.  Physical Exam
        -----------------
           
        1. Psychiatric (Specify any personality deviation)
            [ ] Normal [x] Abnormal [ ] Not examined
           
        5. Diagnosis:
        -------------
            #1.  Claimed condition: PTSD. 
                 Diagnosis/Rationale: Veteran meets the DSM-5 diagnostic 
    criteria forPTSD
            #2.  Claimed condition:
                 Diagnosis/Rationale:

            (for additional Claim/diagnosis, please follow above format)
          
        6. Remarks, if any:
        -------------------
         
           
    

 

Looks like a 10% rating based on the occupational and social impairment the examiner marked, but there's good news; you have two options.

#1. Appeal, obviously. Your other criteria and symptoms lean more towards a 30% rating.

#2. Continue going to therapy through the VA or a private psychologist/counselor and build up evidence at least a year; for any worsening symptoms. What you have to consider is that going from active duty to the civilian world is a difficult transition after leaving service. Even if you were in the civilian world prior to entering the military. There will be challenges. 

I received a 10% rating for PTSD after I left service. I thought that was all I was going to get. I was never told my symptoms could worsen.It wasn't until 8 yrs later that another veteran told me about requesting an increase. I was like,"No way they'll give me an increase." I submitted a request for an increase and I was awarded 70%. Fortunately, I already had two years of regularly attending therapy and on medications to substantiate the increase.

Before you get out, see if you can get set up for a sleep study, ASAP. The examiner did mark CHRONIC SLEEP IMPAIRMENT. It wouldn't hurt to try to get a sleep study done. If you are diagnosed with Sleep Apnea in-service and require a "medically necessary/required" CPAP machine that's rated 50%.

Even if you are not diagnosed with Sleep Apnea in-service, you can still Secondary Service-Connect Sleep Apnea to PTSD; if you get diagnosed with Sleep Apnea after-service.

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

Keep in mind that most, not all service-connected disabilities can cause a secondary disability that will be considered service-connected.

 

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Thanks Doc25!

Already have OSA w/ CPAP in record since 2012

I did submit a PTSD DBQ from my private psychologist. It was rated at 70%

My DoD psychiatrist initial PTSD exam scored my PCL-5 at 65

Will the above submitted evidence help?

 

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I would think it could possible be 30% increase, but do you know why you have Sleep Apnea? did you have it while in the military or any sleep disturbance reported while in the military  ect,,ect,, paper trails oF sleep disturbance?

if you have S.C 70%  PTSD rating  at present and you never filed a OSA Claim  then check your C-FILE And see if any of the sleep Dr;s mention why you have sleep apnea that requires you to use a prescribe C-PAP MACHINE FOR YOU WELL BEING OR YOUR HEALTH.

This will tell you which way to file a sleep apnea claim  if you never had any sleep disturbance reported while in the military  then you need to ask your sleep Dr's if your S.A. can ve related to your PTSD or any medications you take prescribe by the VA

If you get a Sleep Apnea rating    its 50% just for using a Required C-Pap Machine   then it depends on the severity of your S.A.  But never the less a 50% rating for Sleep Apnea Will get you to the 100% level

your Sleep Apnea will need to be filed as a secondary claim to your PTSD.

Also I did notice  this examiner never mention  you  over exaggerating your symptoms  for this reason is why I would think you may get a higher rating that 10%

 of course its your option as what to file.

 

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Merlynda

just so you know  if you get a 30% increase on your PTSD that will not get you up to the 100%

VA Math 70% plus 30% equals  out at a 79% rating  to a 80% rating.  unfortunately  there is no 80% rating for PTSD Period.

General Rating Formula for Mental Disorders

   Rating

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.100%

Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships.70%

Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships.50%

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).30%

Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication.10%

A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication.0%

 

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Merlynda:

   The doctor does not diagnose SC, SC is not a diagnosis, it stands for Service connected.  This did not make sense to me.  

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Buck is correct.  Unfortunately, 70 percent plus 30 percent does not equal 100 percent.  

Even worse is you dont "combine" mental health ratings.  It sounds like your thinking is :

Quote

I was diagnosed at 70 percent while in service, so if VA gives me 30 percent, Im at 100 percent. 

    It does not work that way.  If you get a 30 percent rating from VA, that subsumes the 70 percent you got while in service.  That is, your rating drops from 70 to 30. Pyramiding prevents multiple ratings for PTSD or other mental health disorders.  You get "ONE" mental health rating.  So if you have PTSD and also depression, you get ONE rating.  You get the worst of the two, they dont combine.  

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Thanks for the responses. 

I am not trying to get to 100%

I simply do not believe my PTSD affects my work and social functioning at a 10% level. 

I found it insulting and stress inducing. 

If I get a 30% rating I can accept that and focus on recovery. 

If I get 10% rating I have to fight. Which sets off panic attacks. 

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If you have sleep apnea diagnose by the VA. and you use a prescribe C-PAP Machine given by the VA   then if it was me I'd sure try to find out why  you have Sleep Apnea in the first place  what caused it?

if you never had any sleep disturbance reported while in the military  its usually a denial  even with a c-pap(THEY WILL FIGHT YOU FOR IT) 

 you have to prove why you need a c-pap  and in this case the only way to prove that is have a qualified Dr to opine that your Sleep Apnea is related to your S.C. PTSD AND OR MEDICATIONS  from PTSD

then this would be a secondary claim  once they SERVICE CONNECT you for SLEEP APNEA they will give you a rating  once service connected then this condition Sleep Apnea Becomes part of your original condition of PTSD.

If filing for PTSD increase makes your anxiety worse  then hire an Attorney  that's what they are for. or simply don't file.  that's your option.

Edited by Buck52 (see edit history)
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5 hours ago, broncovet said:

Merlynda:

   The doctor does not diagnose SC, SC is not a diagnosis, it stands for Service connected.  This did not make sense to me.  

I think this statment was meant that the condition was diagnosed and treated by psychiatrist  from a military Doc while still in the military hopefully  because VA is the only ones that can make a PTSD Diagnosis 

I am having terrible luck with VA C&P exams. Any guess as to my rating?

SC diagnosed and treated by Psychiatrist  while active duty

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That is wonderful News!- Not wonderful to have PTSD but I am glad you succeeded.

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Congratulations.  And I stand corrected, I was expecting a 30% award.

Edited by vetquest (see edit history)
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