Need Help with an unfavorable C&P for PTSD Secondary to MST

[LightningFan75]

I need some unofficial guidance with my claim for PTSD.  I think I have two uphill battles ahead...I just had my C&P and have received the notes from the exam.  The doctor has completely discounted that the event happened, much less any secondary markers, attributing my trauma to a childhood incident.  His notes contradict themselves on multiple occasions.  He states that I denied any history of alcohol abuse, yet states later in the exam that I disclosed that I started abusing alcohol after the incident.  He also discounted and falsely reported several facts surrounding my time in the service.  He stated I was never in combat, never had foreign service or received any combat medals and to view my DD-214 for more information, yet my DD-214 shows multiple combat medals, foreign service and he his report lists my service dates where i received combat pay and hostile Fire/Imminent Danger pay.

His notes are mostly snippets copied and pasted from my past appointments that support his denial, but he leaves out all of the relevant parts of my session.

He never looked me in the eyes and stared at his clip board the entire time

He said I started therapy after I lost my job and that I lost my job in April, when in fact I was therapy months before I lost my job which was 7/16.  I told him all of this and he reported it wrong.

He also put down: 

On the SIMs, a measure of symptom validity, the score of 37 indicated significant symptom exaggeration/over reporting.

On a PTSD symptom validity screen, the score of 25 indicated significant symptom exaggeration/over reporting.

Basically he's calling into question my integrity and makes no reference to my MH sessions with my provider, who never once questions my honesty in our sessions.

My test scores from my MH sessions are:

PHQ-9 (Depression): 23

PHQ-9 was administered and score indicates severe depression.

(RANGES: 0-4 Minimal; 5-9 Mild; 10-14 Moderate; 15-19 Moderately severe;

20-27 Severe)

GAD-7 (Anxiety): 19

GAD-7 was administered and score indicates severe anxiety. (RANGES: 0-4 Minimal; 5-9 Mild; 10-14 Moderate; 15-21 Severe)

PCL-5 (Posttraumatic distress): 64 (very severe symptoms reported)

PCL-5 was administered and the score is > or equal to cutoff score of 33 and may be consistent with a diagnosis of PTSD..

 

That leads me to my next issue...my MH provider continually throws out the term PTSD in our sessions, has started me on a treatment plan that consists of BOTH MST and PTSD therapy and yet WILL NOT put PTSD as a diagnosis.  Instead I'm diagnosed with:

DIAGNOSES (per chart):

Major depressive disorder, single episode, moderate

Anxiety disorder, unspecified

 

On top of that my VA psychiatrist put contradicting statements in my last exam:

DIAGNOSIS:

Mental Health Diagnoses and Relevant Medical Conditions:

Unspecified Trauma-Stressor-related Disorder r/o PTSD

Significant Psychosocial and Contextual Factors: MST (Sexual assault)

CASE FORMULATION AND RESPONSE TO TREATMENT:

35 y/o female veteran with anxiety, depressive Sx's and significant

clinical

distress since index trauma, in 2011. High suspicion for PTSD. No prior MH treatment.

 

So he in essence ruled out PTSD and then stated he had a high suspicion for PTSD.

 

I apologize that these thoughts may seem all over the place, but my treatment notes are a mess and the C&P examiner added 112 pages to it with mostly copy and paste, so it's hard for me to make sense of and I'm very hesitant to upload personal information.  I just don't know what to do when MH provider says I have PTSD from MST, puts me in treatment but won't diagnose me, and then a C&P appointment with a doctor who acted like he had better things to do and went mostly off my test scores and didn't really listen to a word i said since his notes are riddled with inaccuracies.

 

 

 

 

[Buck52]

if you were a combat veteran they consead the stressors  you have the CIB on your DD 214 That should be good enough evidence you were in combat. 

''yet my DD-214 shows multiple combat medals, foreign service and he his report lists my service dates where i received combat pay and hostile Fire/Imminent Danger pay''.

You may already know this? but here it is again.

You need 3 basic things here called the Clauza Triangle

1.Current Diagnosis.   (No diagnosis, no Service Connection.)

2.In Service Event or Aggravation.

3.Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”

[LightningFan75]

They've already denied my combat PTSD claim due to the fact that all of my over seas records are missing and they're stating that a DD-214 is not sufficient enough evidence to prove PTSD.  Basically they're telling me that I may have been in combat but it didn't cause any stress on me.  I've asked my MH provider for a letter of nexus and he said he'd "look into it", so I provided him with the VA policy on medical opinions and a sample letter.  Of course I'm now realizing that he hasn't diagnosed me with PTSD so I don't yet meet criteria 1.  Having to relive these events by telling a new person what happened is taking a toll on my sanity and my family and i feel like I'm experiencing it all over again and then told it didn't happen or I'm exaggerating.  I honestly feel like I'm worse now that I've sought treatment than when I just kept it bottled up.  I'm not sure how to convince my MH provider to actually diagnose me with PTSD.  He's agreed I have it, he's agreed I need to go through specialized treatment and yet he won't write it down.  Almost as if he's been told to reduce the number of PTSD diagnosis he gives and instead come back with Depressive Disorder, or Adjustment disorder with Anxiety.

In the US murderers and thieves are innocent until proven guilty but Veterans are just the opposite.  It didn't happen until you can give us iron clad proof.

 

[GBArmy]

Buck has great advise, and i certainly am not an expert on PTSD/TBI stuff, but one thing I know that applies here. If the examiner is completely bogus as you indicate call immediately and tell the C&P manager that you totally disagree with his report and the reasons why. Do it today! Ask where you can send your confirming arguments in writing. They should re-schedule you again. Have a copy of your comments that you sent in and show them to the new examiner when you get one.

[vetquest]

Yes, he is calling into question your integrity and I would use that to impeach him.  You have combat medals and foreign service so I would bring this up in your letter where he ignored this.  Take your emotion out of it and explain it like you would if you were doing it for another veteran. 

[Buck52]

7 hours ago, LightningFan75 said:

I need some unofficial guidance with my claim for PTSD.  I think I have two uphill battles ahead...I just had my C&P and have received the notes from the exam.  The doctor has completely discounted that the event happened, much less any secondary markers, attributing my trauma to a childhood incident.  His notes contradict themselves on multiple occasions.  He states that I denied any history of alcohol abuse, yet states later in the exam that I disclosed that I started abusing alcohol after the incident.  He also discounted and falsely reported several facts surrounding my time in the service.  He stated I was never in combat, never had foreign service or received any combat medals and to view my DD-214 for more information, yet my DD-214 shows multiple combat medals, foreign service and he his report lists my service dates where i received combat pay and hostile Fire/Imminent Danger pay.

His notes are mostly snippets copied and pasted from my past appointments that support his denial, but he leaves out all of the relevant parts of my session.

He never looked me in the eyes and stared at his clip board the entire time

He said I started therapy after I lost my job and that I lost my job in April, when in fact I was therapy months before I lost my job which was 7/16.  I told him all of this and he reported it wrong.

He also put down: 

On the SIMs, a measure of symptom validity, the score of 37 indicated significant symptom exaggeration/over reporting.

On a PTSD symptom validity screen, the score of 25 indicated significant symptom exaggeration/over reporting.

Basically he's calling into question my integrity and makes no reference to my MH sessions with my provider, who never once questions my honesty in our sessions.

My test scores from my MH sessions are:

PHQ-9 (Depression): 23

PHQ-9 was administered and score indicates severe depression.

(RANGES: 0-4 Minimal; 5-9 Mild; 10-14 Moderate; 15-19 Moderately severe;

20-27 Severe)

GAD-7 (Anxiety): 19

GAD-7 was administered and score indicates severe anxiety. (RANGES: 0-4 Minimal; 5-9 Mild; 10-14 Moderate; 15-21 Severe)

PCL-5 (Posttraumatic distress): 64 (very severe symptoms reported)

PCL-5 was administered and the score is > or equal to cutoff score of 33 and may be consistent with a diagnosis of PTSD..

 

That leads me to my next issue...my MH provider continually throws out the term PTSD in our sessions, has started me on a treatment plan that consists of BOTH MST and PTSD therapy and yet WILL NOT put PTSD as a diagnosis.  Instead I'm diagnosed with:

DIAGNOSES (per chart):

Major depressive disorder, single episode, moderate

Anxiety disorder, unspecified

 

On top of that my VA psychiatrist put contradicting statements in my last exam:

DIAGNOSIS:

Mental Health Diagnoses and Relevant Medical Conditions:

Unspecified Trauma-Stressor-related Disorder r/o PTSD

Significant Psychosocial and Contextual Factors: MST (Sexual assault)

CASE FORMULATION AND RESPONSE TO TREATMENT:

35 y/o female veteran with anxiety, depressive Sx's and significant

clinical

distress since index trauma, in 2011. High suspicion for PTSD. No prior MH treatment.

 

So he in essence ruled out PTSD and then stated he had a high suspicion for PTSD.

 

I apologize that these thoughts may seem all over the place, but my treatment notes are a mess and the C&P examiner added 112 pages to it with mostly copy and paste, so it's hard for me to make sense of and I'm very hesitant to upload personal information.  I just don't know what to do when MH provider says I have PTSD from MST, puts me in treatment but won't diagnose me, and then a C&P appointment with a doctor who acted like he had better things to do and went mostly off my test scores and didn't really listen to a word i said since his notes are riddled with inaccuracies.

Prepare in statement of claim. NOD the decision  and keep up with your original filing date,  you may want to add that in your NOD, if your denied? then Request a DRO Hearing at your local R.O. and do this  

What you can do is find all these inaccurate  statements   from this C&P EXAMINER (if you have the report?) copy and past them Over to a new sheet or email them to yourself ....then correct each inaccuracies with your evidence

Do this sorta-like a break down Of the exam...> copy and past all the report  then in between his inaccuracies  and add your evidence , mark your evidence as exabit A   B  C  ect,,ect,ect,,,  see exabit A on page 2  see exabit B on page 3 ect,,,ect,,   this will show the rater how the examiner screwed up   also this might get you another C&P With a different Dr.

while preparing this, up at the top of the page describe what your sending in   and say something like the examiner was not accurate in his report as this evidence will show different .

I have sent in his report with my break down of his inaccuracies.

you need a PTSD Diagnose form your VA MH Clinic Dr' 

Remember evidence is what wins our claims.

The DRO can make a decision on the spot  if he reads all the inaccuracies  the examiner mention.

someone or other members may be able to explain this better that I can.

Note* if your denied and you NOD (Notice of Disagreement)

Do not select the HLR lane  With this New AMA System, you can not submit new & Relevant Evidence in this lane.

Use the supplemental lane as your course of Action.

 

 

 

 

 

 

Edited August 20, 2019 by Buck52 (see edit history)

[SameOldSong]

OK, you've been rope-a-doped by a doc. Buck is right, you need to complain about this soon.  It will take a while for them to reschedule or respond. 

I posted in another post about the way PTSD is decided.  Look at the details on that comment here:

Please pay attention to the Criterion A-F section. 

Also note that you don't necessarily want the doc to say you always abused alcohol. Stating that you started after the stressor is the right thing to do and you did it. If you were abusing drink before the stressor, they can use that to deny you also.

Refute every point in his evaluation that was wrong, step-by-step.  Try to keep your tone even and professional. Denying your combat time was stupid of him because the records are everywhere. Once combat is established then the balance tips to your favor. The doc was trying to rule out 38 USC 1154 (b).  Google that phrase and read the legal doc that comes up and you'll understand why:  38 USC 1154 (b)

Now, 1154 states that the combat engagement will allow the presumption of service connection if the injuries/diseases sustained are consistent with the circumstantial evidence.  This gets twisted a bit with PTSD and especially MST PTSD because there must be a stressing event and then the VA wants to check the existence of that event with an archives center that keeps all the docs. Well, there is one event obviously, but there may not be a military police report because some of these a-holes are people you have to continue to work with while you are out in the field. One of my buddies had her best bud in the field while they were on patrol in Iraq suddenly decide that he was entitled. She had to continue on as if nothing was wrong through the mission, but it was destroying her. And then her Humvee rolled over from an IED causing worse issues.

To present the evidence of that event, are there any buddies/teammates that were out there with you that could write a lay evidence letter on your behalf stating the changes they saw before and after the event? That could help prove the stressor existed even in the absence of any police report or other signs. 

You need something to prove the event happened. It sounds like the problem is the "unspecified event" that the doc mentions that actually will rule out PTSD in the military's eyes even if you have raging PTSD symptoms. They may not be saying that you are untruthful (well, ok, the one doc that thinks the symptom over-reporting is malingering may be trying to say that), but that you don't meet the qualifications for PTSD. Please read the other post that I linked here. It shows you how they make their decisions on a PTSD case.

Ask for your C-file. You will have to file for it and it will take months, but any legal beagle will need it.

It took me 7 years to get my PTSD diagnosis. They denied me once, and it was a freshly scrubbed and new PsyD working at the Univ of MD medical center and in the Baltimore VA hospital (they're side by side and share personnel) that rated me. It was clear from the ratings report that she wanted to rate me higher and did not, but I appreciate the 30% rating because it opened the door to my appeal with a private doc's evaluation.

Patience. Persistence. You will win. The VA will tell you that PTSD is not curable and all we can do is manage the symptoms. I think they are wrong.

Also, very important. If they have you on any psych drugs like anti-psychotics, anti-epileptics, or anti-depressants, get some sublingual B12/B6/methylfolate vitamin tablets. Those drugs suck up all of the B12/B6 in your system and if your stomach/intestine is torn up from stress you can't absorb it in your food easily. Getting it by way of tissues in the mouth keeps your levels from crashing out and increasing psychosis episodes (flashbacks, etc). A daily 1,000 IU sublingual B12 will help. Especially with sleep and cognitive function.

[SameOldSong]

Oh, one last thing, the statement in your VA psych report:

Unspecified Trauma-Stressor-related Disorder r/o PTSD

Does not mean that he denies PTSD. He doesn't have a clear stressor incident to hang PTSD on that you are experiencing. He's trying to say "please rule out PTSD". 

Unspecified Trauma - we don't have a clear single incident that caused the issue

Stressor-related Disorder - we see a disorder that appears to have a root cause/stressor

r/o PTSD - rule out PTSD , we may be seeing PTSD, but we need to find the actual stressor to prove it to the satisfaction of VA rules so please rule out PTSD (which really means "I think she has PTSD. Find another cause that fits or prove it isn't PTSD.")

[seminoles]

19 hours ago, SameOldSong said:

Oh, one last thing, the statement in your VA psych report:

Unspecified Trauma-Stressor-related Disorder r/o PTSD

Does not mean that he denies PTSD. He doesn't have a clear stressor incident to hang PTSD on that you are experiencing. He's trying to say "please rule out PTSD". 

Unspecified Trauma - we don't have a clear single incident that caused the issue

Stressor-related Disorder - we see a disorder that appears to have a root cause/stressor

r/o PTSD - rule out PTSD , we may be seeing PTSD, but we need to find the actual stressor to prove it to the satisfaction of VA rules so please rule out PTSD (which really means "I think she has PTSD. Find another cause that fits or prove it isn't PTSD.")

I would LOVE to agree with you on this opinion but sadly I had this same R/O PTSD in my records for TEN years, yes TEN years!!  Meanwhile every psychiatrist I saw had no problem adding a NEW diagnosis, so I WAS service connected for mental health and it looked like this  Bipolar Disorder (general anxiety disorder, panic attacks with agoraphobia, nightmares, sleep disturbances)   AS  IF that all in parentheses isn't PTSD   PTSD is NOW included in my rating but also in parentheses so I guess I have every anxiety disorder possible?  NO I have PTSD and I just don't argue about the rest of it.    NIGHTMARES??? pretty sure that isn't in the DSM  oi vey 

I see nothing wrong with the R/O PTSD if they actually do something and rule it out or diagnose, but this leaving it in our records for years and va providers being the ONLY ones who can diagnose ptsd for claims, that is a big freaking deal!!

 

 

[Oceanbound]

Welcome to Hadit. 

What happen here is the VA wasted tax payers money and paid this clown to deny you so the RO rater doesn't know how to read and you will have to file a NOD to go to the BVA. 

In the mean time continue getting treatment at the VA. Seems to me you should switch to a new shrink. You can switch doctors just tell the front desk you want a new shrink, they're give you a one page form and all you have to do is sign it. It will a course take time to have the process of switching over but not more than 4 to 6 weeks. 

I would suggest to you getting a real IMEO by a neuropsychologist, the fee for the 5 hour test is two grand. This private IMEO by the neuropsychologist will spank the VA C&P exam out of the water. 

Also considered lawyering up, I did with GloverLuck, because I Hadit with the VA circus. 

[vetquest]

I was diagnosed with many mental disorders before I was settled into PTSD.  They tried hypochondriac, obsessive compulsive, psychotic, and the icing on the cake borderline personality disorder along with a few others.   Sometimes the VA will try to label you with everything except to keep you from being diagnosed with PTSD.  I had a panel of psychiatrists from the University of Connecticut take the VA to task on all of the opposing diagnoses.     

[LightningFan75]

On 10/19/2019 at 8:47 PM, Oceanbound said:

I would suggest to you getting a real IMEO by a neuropsychologist, the fee for the 5 hour test is two grand. This private IMEO by the neuropsychologist will spank the VA C&P exam out of the water. 

Also considered lawyering up, I did with GloverLuck, because I Hadit with the VA circus. 

I would love nothing more than to get a private IMEO.  Unfortunately, my PTSD has cost me my job and my IU is getting the run around too.  We're blowing through our savings like water and barely making ends meet as it is, so 2K is mighty hard to scrape together right now.  I'm in the process of getting a new Primary MH doctor (I'd love to force them to send me outside using the MISSION ACT, but that seems like a whole other roadblock).  Since my last post, I've requested a Nexus letter from my current one and his messages gave me less than warm feelings about his handling of my case or recollection of who I am.  Not only that but I think I hurt his ego when I sent him the VA rules on NEXUS and a sample letter.  Now he's butt hurt that I'm including the local VA chief of staff on all my communications so he can't deny what he's saying.  It's a match of wits and rather than being a professional and approaching as a psychologist he's trying to beat me into the ground and tear me apart like I don't know what I'm talking about.  The only bright spot in all of this is that I start Prolonged Exposure next week with a new doctor who is the ONLY MH provider who comes out and greets my without calling my name like a roster.  He actually makes me feel like he knows who I am.  My psychologist and psychiatrist come out read off my name and wait for me to come up...real impersonal.   Unfortunately my PE therapist doesn't believe in Nexus letters so that's a dead end.  Now my MH "team" thinks I'm in it for a pay day and not therapy.  Nevermind the fact that the VBA put me in this spot and it's VBA that's causing me to prove everything at every turn.  

 

I did finally get a buddy letter from a shipmate who reached out and actually remembered more about the incident than I remembered...so that's been uploaded to ebenefits.  

 

End of the day, I'd love to get an IMO or a lawyer...it's just not financially in the cards right now. 

 

Thanks all for your input...it's all valuable and more helpful than anything and everything I get from VA.

[Buck52]

 I have not read all your post  so this is only my opinion.

you may know the three main elements to file a claim

1.A current, diagnosed disability;

2.An in-service event, injury, or illness; and

3.A medical nexus between the current disability and the in-service event, injury, or illness.

Have you ask the VA MH MST COORDINATOR?  as for as how to come up with your medical records  to file a claim? or help you get it started? they are not obligated to ,but some compassionate VA  MST Coordinators will.

...this is what you need to do...you need the records of the event that traumatized you,   if you were raped you need the Law Enforcement Records and if it was on a military base you need the records for that ..who seen it happen or at least the report from the police ant help from a unit member.(buddy statments)..your NCO OR Company Commander..once you proved it happen while in military  then that's your nexus..

You need to get a VSO to help you figure this all out...there are some MST Survivors on here that has filed a MST Claims  and any secondary conditions that this has caused from.

It's hard to answer all these questions and may bring back some horrified memory's  but its something you got to do   to claim MST.

you need treatment records and all medical records from the VA or Private...Law enforcement records  and the dates all need to be in order from the date the MST Occurred. 

IF YOU HAVE THE THREE MAIN ELEMENTS  THEN I SEE KNOW PROBLEMS?  But dealing with the VA is always a problem they don't make anything easy,  this is why most of us has had to fight for years to get our benefits.

As for as getting a certified Attorney  or a VA Accredited Claims Agent   they charge a 20% fee when you win your claim from Retro  or in a special circumstance  the VA Pays the Attorney fees..your not out any $$$   it well worth it when you Win. 

check with broncovet on this  he knows all about attorney fees and if/when the veteran don't have to pay any fees.

 

 

Edited October 21, 2019 by Buck52 (see edit history)

[vetquest]

I just mentioned to another vet the if you are in danger of losing your home or being homeless you can apply for hardship with the VA.  Your case is supposed to be stepped up in the que.

[Oceanbound]

Sometimes you have to crack eggs to make an omelet.

I lawyered up and not paying anything upfront as Buck said. Also made steps to leave the rotten VA because this isn't new and there is even a song for it because of it born in the usa. Read the lyrics to the catchy tune.   She'd get 20% of almost 20 years of retro of how the VA ruined my life. So you can read the current status here - 

 

 

[Oceanbound]

I would suggest getting a VA attorney or agent INSTEAD of a VSO.

VSO are over worked and have averages of 1200 to 1500 other vets they have to help while attorney/agents have a tenth of that.  

The known ones here at Hadit are GloverLuck (mine), Asknod, Katrina Eagle, Dr David Anaise.

[SameOldSong]

I found a link to a snippet that might be of interest on the "r/o PTSD" commentary:

https://www.mentalhelp.net/ptsd/why-the-va-doesn-t-want-to-diagnose-iraq-war-veterans-ptsd/

It discusses the refusal to put PTSD on medical records in the Veterans Health system.

 

[Hyrb]

Remember, under VA Policy you are not locked in to PTSD.  You can receive the same ratings for Depression as you do for PTSD.

With MH issues it is the impact of the issue on your Life.  Not the "name" of the issue.  The VA should (yea I know...) automatically rate for any other MH issue that is diagnosed other than PTSD as part of the same claim.

So your current therapist records are viable no mater what the diagnosis is.  As long as the records document the impact on work and lifestyle you should be fine.

 

[LightningFan75]

Since my last post I think I've pretty much become persona non grata to the entire Orlando MH staff with the exception of my PTSD therapist who has been purposely remaining out of it in order to keep treating me with objectivity, which I can appreciate.  The chief of MH and the AO's no longer return my calls and the MST coordinator is vehemently sticking to the story of "the VA does NOT write nexus letters".  My primary provider went so far as to state that since I didn't report the incident that there is nothing in my record to prove that it happened so he can't give an opinion.  He stopped responding when I reminded him that his job was to help me and that the VA mandated that statements from someone you served with backing up the events and witnessing changes in behavior, etc. are as good as reporting and should be counted as such.  He stopped responding to my messages.  At this point I'm honestly ready to call the IG and let them explain why they're causing they're veterans anxiety and demeaning them when they ask for help.

 

The bright spot in this is that I started my prolonged exposure on Thursday and even though it was just informational to begin with, the notes were uploaded to MHV and it looks like my PTSD doc dropped the r\o and may have inadvertently given connection?  Below is the excerpt...can I upload this and use it as evidence of diagnosis and SC along with my buddy letter?

VA Notes
Source: VA
Last Updated: 04 Nov 2019 @ 0707
 

Sorted By: Date/Time (Descending)
 

VA Notes from January 1, 2013 forward are available 3 calendar days after they have been completed
and signed by all required members of your VA health care team. If you have any questions about your
information please visit the FAQs or contact your VA health care team.
 

Date/Time: 31 Oct 2019 @ 1425
 

Note Title: MH PSYCHOTHERAPY NOTE
Location: ORLANDO VAMC
Signed By:
Co-signed By:
Date/Time Signed: 31 Oct 2019 @ 1540
 

Note
LOCAL TITLE: MH PSYCHOTHERAPY NOTE
STANDARD TITLE: MENTAL HEALTH NOTE
DATE OF NOTE: OCT 31, 2019@14:25 ENTRY DATE: OCT 31, 2019@14:25:19
AUTHOR: 
EXP COSIGNER:
URGENCY:

STATUS: COMPLETED
 

PROLONGED EXPOSURE: INITIAL SESSION
Time in session (in minutes): 70
Session Number: 1
SESSION FORMAT
Face-to-face session

 

SESSION LOCATION
PTSD clinical team
DIAGNOSIS:
Primary (focus of treatment): Unspecified Trauma-Related Disorder
 

Assessment:
PCL-5
A PCL-5 was performed and was positive. The score was 64.
PHQ-9
A PHQ-9 screen was performed. The score was 18 which is suggestive of
moderately severe depression.
 

SESSION CONTENT

Veteran completed session 1 of Prolonged Exposure therapy for PTSD. The
following occurred during the session:
Facilitated a good therapeutic relationship.
Provided psychoeducation and introduced PE treatment for PTSD to
Veteran, including:
-Information about PE as a treatment option.
The following information was given:
-Readiness to engage in treatment.
-Addressing Veteran's questions or concerns about treatment.
Veteran expressed the following concerns: Veteran discussed fear associated
with imaginal exposures. Her fears were validated and discussed within the
context of the rationale for treatment.
Presented treatment rationale, focusing on describing factors that
maintain trauma-related fears and symptoms (i.e., avoidance and
unhelpful thoughts and beliefs). Also, described key therapeutic
elements of PE: imaginal and in-vivo exposure procedures. Veteran's
response to rationale involved: The Veteran was able to discuss
acknowledgement of the rationale for treatment.
 

INDEX TRAUMA to be addressed in PE is related to:
MST
Sexual assault while in the military
 

HOMEWORK
Veteran is to complete the following practice items between sessions:
Listen to audiotape of therapy session one time.
Read "Rationale for Treatment" handout and note questions.
 

PLAN
Next session planned for agreed upon date/time of: November 5, 2019
****************************************
 

PAIN SCREEN:
Veteran reports:
Significant pain or changes in pain.
Pain level reported = 5, on 0-10 scale with 0 indicating no pain
and 10 most pain imaginable.
Location(s): Back, wrist, shoulder.
 

Veteran receiving treatment for pain: Yes

 

 

[LightningFan75]

On 10/23/2019 at 10:54 AM, SameOldSong said:

I found a link to a snippet that might be of interest on the "r/o PTSD" commentary:

https://www.mentalhelp.net/ptsd/why-the-va-doesn-t-want-to-diagnose-iraq-war-veterans-ptsd/

It discusses the refusal to put PTSD on medical records in the Veterans Health system.

 

I think that's the email referenced in an IG report I read....where of course they found no evidence that the providers heeded the "suggestion".  However that article is my story almost verbatim...my MH primary even told my they didn't have time to diagnose PTSD. 

[LightningFan75]

On 10/23/2019 at 11:30 AM, Hyrb said:

Remember, under VA Policy you are not locked in to PTSD.  You can receive the same ratings for Depression as you do for PTSD.

With MH issues it is the impact of the issue on your Life.  Not the "name" of the issue.  The VA should (yea I know...) automatically rate for any other MH issue that is diagnosed other than PTSD as part of the same claim.

So your current therapist records are viable no mater what the diagnosis is.  As long as the records document the impact on work and lifestyle you should be fine.

 

While that's true, my C&P examiner was clever enough to tie EVERY....SINGLE...Mental diagnosis I have to childhood trauma, negating service connection for all of it.  So one doctor, who never served, who I had never met before and talked to for 90 minutes and never looked me in the eyes, falsifying ALL of what I said, took away all of my SC issues with one stroke of the keyboard.  While I did write a scathing letter of impeachment, I have yet to hear whether it was received or if the appointment is still being used in my claim.  My file is flagged for hardship but they're still dragging their feet.  I have a claim in for IU as well, but they sent a request back to my outside examiner for migraines for clarification on Oct 2nd and still haven't received a response.  He's 12 days past his deadline and they've put no pressure on him to close it out.  They just don't care...I feel like as long as you're not suicidal they get to check off a box and move on.  Yet they don't see that what they're doing is causing veterans to lose everything and BECOME suicidal.  It's all about reacting and putting out fires instead of preventing it from happening.  I'm just fortunate I have a husband who loves me and would do anything to make sure I'm ok...and 2 dumb dogs that are natural service dogs, who can sense my panic attacks well before they hit me.