ptsd Gaf Scores

[Berta]

I read this decision the other day carefully as I have situation where the vet is questioning his GAF score-long story there-and maybe he will understand better the way VA views GAF-

only one of many records of evidence they use to determine "hypothetical continuum"

"In assessing the evidence of record, it is important to note

that the GAF score is a scale reflecting the "psychological,

social, and occupational functioning on a hypothetical

continuum of mental health-illness."

http://www.va.gov/vetapp06/files2/0609739.txt

The veteran's rep fought for higher rating from 50%:

"The veteran's representative has contended that this

examination is inadequate as the noted symptomatology is not

consistent with the global assessment of functioning (GAF)

score provided. As discussed in the following decision, the

Board finds that the GAF is consistent with the reported

symptomatology and, especially, the findings on the mental

status examination. Therefore, the August 2003 examination

is adequate for rating purposes"

This is a fairly long decision----

"ORDER

Entitlement to an evaluation for PTSD in excess of 50 percent

disabling is denied"

The BVA cites See Mauerhan v. Principi, 16 Vet. App. 436

(2003).

This case might help someone out there understand that the GAF is only part of the whole- an important part but nevertheless there are many other considerations that did not warrant higher PTSD rating in this case.

The BVA raised key issues that did not reflect the veteran should be rated higher-

although I think the vet should appeal to the CAVC-but still the decision seems quite sound.

[RockyA1911]

They are SUPPOSED to consider them and put them in your C-File. The key word is SUPPOSED to. Make sure you also have copies and also send the new evidence to your VARO. Make sure that the VARO and the C&P examiner have the new evidence. If you don't, there are a lot of vets that gave them to the C&P examiner, were rated, and the VARO never addressed or had the new information. So send it the VARO also.

[Berta]

Army- just my opinion-

the C & P doc should have your SMRs there-maybe a statement would help him/her refer to them- but I would take the IMOs themselves and not just refer to them in a statement-

There is a psychological advantage to having the C & P doctor know you have IMos -they may or may not want to consider them but still-

it is easier for a professional to agree with another profession's opinion if the other doctor provides a full rationale and a strong More than likely statement.

A C & P doc- knowing a vet has a positive C & P might well be more inclined to give a complete exam and to follow the C & P criteria by the book.

Even if a C & P doc does not want to consider or discuss your IMOs-it is good idea to tell them what you have already- medical evidence that supports your claim- rgardless of the C & P results.

Even though I emailed just a brief rendition of my evidence when I first contacted Dr. Bash- by phone, when he called me, I told him of the initial recent statement I had gotten from a former VA doctor in email- Dr. Bash loved it- it confirmed his opinion based on what I told him I had- and then when he got all the records from me, he called this doctor to get the email statement on the docs letterhead and incorporated this brief statement into his IMO and attached this additional IMO statement.

Any professional will or should accept a valid finding from another doctor-or at least have very strong evidence to attempt to go against it.

Many vets seem to be getting IMOs as soon as they file a claim- the VBM even recommends this-

even before the VA gives a C & P -the vet can already have the deck stacked in their favor-

[betrayed]

I plan on taking my written and signed statements, one each, specifically tailored to the claim/disability. This I will provide to the examiner(s) (4) and request that it be part of my record and considered in the new C&Ps.

They do have to accept my new statement(s), don't they at these new C&Ps? The statements will reference past C&Ps, SMR, and IMOs... thus, the new C&Ps must review the past records in order to consider these statements.

I have had more C&P Exams than I can count, I finally figured out how to play this game. If they send you a questionaire and they should unless for mental. If they dont send questionaires call the C&P office at the VAMC where your appointments are and ask them to send you the questionaires ahead of time, explain you have memory problems and need time to fill these out, 5 minutes before a C&P exam is not ample time.

Type up everything about your condition, look at the rating schedule and use that as a guideline, then print it on the back of the questionaire, if there isnt enough room continue on separate pieces of paper and staple them all together. Some I did were three pages long. When you fill out the front of the questionaire put "see back" in the place for answers.

This way you will not forget anything, and it will be a part of your official record. I did this for my last C&P's and it worked beautifully, the C&P report was awesome. And believe it or not the doctor never asked me one question her whole report was based on my narratives. When she saw these I guess she thought no need to ask me anything. When it was all over she told me that what I did worked very good for her and she appreciated it. My C&P report was 13 pages long.

As far as the C&P for PTSD write a statement in support of claim. Again use the rating schedule as a guideline so you don't forget anything or leave information un-addressed. I gave my PTSD examiner a very long statement in support of claim and also gave her one from my wife. Get your wife to write about you, what you do, what you dont do and what its like living with you. Have her write about your moods and emotions. Don't leave anything out. They have to make these statements in support part of your record. Again I received a 7 page PTSD C&P report. The longest report I ever got in the past for anythingwas three pages.

When a vet goes in for a C&P they are nervous and forget many things when it comes to answering questions and specifically when they get in front of the doctor.

One other thing, one of the most under used and powerfull pieces of evidence there is a statement in support of claim from family members. The VA must consider these at face value unless the have a reason to not trust the family member.

Follow my advice and you wont be sorry. :)

Edited January 24, 2007 by BETRAYED

[Jazona]

Berta,

I agree in taking an IMO into your C&P and how it SHOULD have a positive impact on the VA C&P Dr. That is, except in the case of a QTC contract Dr. If you are unlucky enough to get a QTC contract "Killer" Dr., no amount of IMO is going to sway this idiot from low-balling you. That is where a strong IMO is so important (as you have said many times before)

One thing you can do to protect yourself is check the QTCs Drs. certification. I ran my QTC Drs'. name through the on line Board of Medical Examiners website and found out he wasn't even certified in that field of expertise. Just about every state has a Board of Medical examiners website and it costs nothing to check up on a Dr. The VAs argument gets rather thin when their Dr. isn't even licensed to make an opinion in your case.

It appears that QTC hires the bottom of the barrel type physicians.

Betrayed,

Excellent advice! I would imagine that Lady Bird has that questionaire somewhere here on Hadit. Maybe someone can post the link to it. Another benefit to the questionaire is if the Dr. fails to ask a question that is on the questionaire and that has particular value to your claim, you can bring it up to make sure it is entered into the record.

jaz

[Jazona]

Army, you said;

How does the VA get-off by spending so much government money on contract C&Ps if they don't use them? Its a waste of public funds.

Simple, they will spend a million dollars just to eventually get a QTC Dr. to deny your sypmtoms and deny your claim so they don't have to pay the pitance they pay to veterans. Penny wise and pound foolish.

jaz

[Berta]

Yeah Jay-so true- I ran a VA doc through Healthgrades-his C & P has just denied one of my local vets- and I found he also was moonlighting for Workman's comp cases so he sure knew how to stick his head in the ground when there was positive medical evidence for the claim.

The vet got a great IMO and it demolished the C & P moon walker and he got his SC award.

Edited January 25, 2007 by Berta