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  • 14 Questions about VA Disability Compensation Benefits Claims

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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Most Common VA Disabilities Claimed for Compensation:   

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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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MKAH

Finally got a C&P after filing a BVA appeal, what does it mean?

Question

I am completely at a loss as to what it all means and just want it all to end.  The more interesting parts I highlighted with BOLD text, to make reading easier.

I am currently 60% SC with hearing loss/tinutus.

 

Any insight would be great.

 

Thank You

 

***************** see below *****************

Medical Opinion
Disability Benefits Questionnaire

LAST NAME, FIRST NAME, MIDDLE NAME (SUFFIX): SOCIAL SECURITY
NUMBER/FILE NUMBER:

TODAY’S DATE:
MARK XXXXX XXX-XX-XXXX 08/09/2019
HOME ADDRESS: EXAMINING LOCATION AND ADDRESS:
XXXXXXXXXXX
Redding, CA 96001

VES

HOME TELEPHONE:
XXXXXXXXXX
CONTRACTOR: VES NUMBER: VA CLAIM NUMBER:
VES 22619376754
IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES OR
COST INCURRED IN THE PROCESS OF COMPLETING AND/OR SUBMITTING THIS FORM. PLEASE READ THE
PRIVACY ACT AND RESPONDENT BURDEN INFORMATION ON REVERSE BEFORE COMPLETING FORM.
NOTE TO PHYSICIAN - The Veteran is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will
consider the information you provide on this questionnaire as part of their evaluation in processing the Veteran’s claim.
For the Claimed Compensation Condition of - ACQUIRED PSYCHIATRIC DISORDER TO INCLUDE MAJOR
DEPRESSIVE DISORDER AND OBSESSIVE COMPULSIVE DISORDER
ACCEPTABLE CLINICAL EVIDENCE (ACE)
INDICATE METHOD USED TO OBTAIN MEDICAL INFORMATION TO COMPLETE THIS DOCUMENT:
[] Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE)
process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination
will likely provide no additional relevant evidence.
[] Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth
examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided
sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence.
[] Examination via approved video telehealth
[X] In-person examination
EVIDENCE REVIEW
[] Not requested [] No records were reviewed
[] VA claims file (hard copy paper C-file)
[X] VA e-folder (VBMS or Virtual VA)
[] CPRS
[] Other (please identify other evidence reviewed):
Evidence comments:
The veteran's file was reviewed.
STATEMENT OF VETERAN RECEIPT DATE 1/26/16
BVA DECISION RECEIPT DATE 6/4/19- (REMAND ORDER)
VAMC TX RECS RECEIPT DATE 5/28/19

Medical Opinion Name: MARK XXXXXXX
Disability Benefits Questionnaire VA Claim Number:

Page 2 of 5 Contractor: VES
SERVICE TREATMENT RECORDS RECEIPT DATE 2/22/16
SERVICE TREATMENT RECORDS RECEIPT DATE 3/25/11
STRESSOR STATEMENT RECEIPT DATE 3/10/16
PERSONNEL RECS RECEIPT DATE 2/22/16
PERSONNEL RECS RECEIPT DATE 2/22/16
BUDDY STATEMENTS WITH RECEIPT DATES, 2/28/19, 12/27/16, 12/19/16, 6/20/16, 6/6/16, 5/9/16, 1/26/16, 3/24/11, 3/10/11,
3/3/11
SECTION I - DEFINITIONS
Aggravation of preexisting nonservice-connected disabilities. A preexisting injury or disease will be considered to have been
aggravated by active military, naval, or air service, where there is an increase in disability during such service, unless there is a
specific finding that the increase in disability is due to the natural progress of the disease.
Aggravation of nonservice-connected disabilities. Any increase in severity of a nonservice-connected disease or injury that is

proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-
connected disease, will be service connected.

SECTION II – RESTATEMENT OF REQUESTED OPINION
2A. Insert requested opinion from general remarks:
THE EXAMINER IS ADVISED THAT THE VETERAN IS COMPETENT TO ATTEST TO OBSERVABLE SYMPTOMS. IF
THERE IS A MEDICAL BASIS TO SUPPORT OR DOUBT THE VETERANS REPORTS OF SYMPTOMATOLOGY, THE
EXAMINER SHOULD PROVIDE A FULLY REASONED EXPLANATION.
PLEASE NOTE THIS IMO IS TO ACKNOWLEDGE THAT RECORDS HAVE BEEN REVIEWED AS WELL AS
ADDRESSING ANY ADDITIONAL QUESTIONS NOTED AT THE BOTTOM OF THE DBQ.
POTENTIALLY RELEVANT EVIDENCE:
STATEMENT OF VETERAN RECEIPT DATE 1/26/16
BVA DECISION RECEIPT DATE 6/4/19- (REMAND ORDER)
VAMC TX RECS RECEIPT DATE 5/28/19
SERVICE TREATMENT RECORDS RECEIPT DATE 2/22/16
SERVICE TREATMENT RECORDS RECEIPT DATE 3/25/11
STRESSOR STATEMENT RECEIPT DATE 3/10/16
PERSONNEL RECS RECEIPT DATE 2/22/16
PERSONNEL RECS RECEIPT DATE 2/22/16
BUDDY STATEMENTS WITH RECEIPT DATES, 2/28/19, 12/27/16, 12/19/16, 6/20/16, 6/6/16, 5/9/16, 1/26/16, 3/24/11, 3/10/11,
3/3/11
2B. Indicate type of exam for which opinion has been requested (e.g. skin diseases):
Mental Disorder DBQ
SECTION III – MEDICAL OPINION FOR DIRECT SERVICE
CONNECTION
Choose the statement that most closely approximates the etiology of the claimed condition.

3A. [] The claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-
service injury, event, or illness.

Provide rationale in section c.
3B. [] The claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service
injury, event, or illness.
Provide rationale in section c.
3C. Rationale:

Medical Opinion Name: MARK NICHOLSON
Disability Benefits Questionnaire VA Claim Number:

Page 3 of 5 Contractor: VES
SECTION IV - MEDICAL OPINION FOR SECONDARY SERVICE
CONNECTION
4A. [] The claimed condition is at least as likely as not (50 percent or greater probability) proximately due to or the result of the
Veteran’s service connected condition.
Provide rationale in section c.
4B. [] The claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s
service connected condition.
Provide rationale in section c.
4C. Rationale:
SECTION V - MEDICAL OPINION FOR AGGRAVATION OF A
CONDITION THAT EXISTED PRIOR TO SERVICE
5A. [] The claimed condition, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression
by an in-service injury, event, or illness.
Provide rationale in section c.
5B. [] The claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated
beyond its natural progression by an in-service injury, event, or illness.
Provide rationale in section c.
5C. Rationale:
SECTION VI - MEDICAL OPINION FOR AGGRAVATION OF A
NONSERVICE CONNECTED CONDITION BY A SERVICE CONNECTED
CONDITION
6A. Can you determine a baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to
aggravation or the earliest medical evidence following aggravation by (service connected condition)?
[] Yes [] No
If “Yes” to question 6A, answer the following:
I. Describe the baseline level of severity of (claimed condition/diagnosis) based upon medical evidence available prior to
aggravation or the earliest medical evidence following aggravation by (service connected condition):
II. Provide the date and nature of the medical evidence used to provide the baseline:
III. Is the current severity of the (claimed condition/diagnosis) greater than the baseline?
[] Yes [] No
If yes, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond its natural progression by
(insert “service connected condition”)?
[] Yes (provide rationale in section 6B.)
[] No (provide rationale in section 6B.)
If “No” to question 6A, answer the following:

Medical Opinion Name: MARK NICHOLSON
Disability Benefits Questionnaire VA Claim Number:

Page 4 of 5 Contractor: VES
I. Provide rationale as to why a baseline cannot be established (e.g. medical evidence is not sufficient to support a determination of
baseline level of severity):
II. Regardless of an established baseline, was the Veteran’s (claimed condition/diagnosis) at least as likely as not aggravated beyond
its natural progression by (insert “service connected condition”)?
[] Yes (provide rationale in section 6B.)
[] No (provide rationale in section 6B.)
6B. Provide rationale:
SECTION VII - OPINION REGARDING CONFLICTING MEDICAL
EVIDENCE
7. I have reviewed the conflicting medical evidence and am providing the following opinion:
Is there a need for the Veteran to follow up with his/her primary care provider regarding any life threatening findings in this
examination (not limited to claimed condition(s))?
[] Yes [X] No
Additional Question 1: PLEASE PROVIDE AN OPINION AS TO WHETHER IT IS AT LEAST AS LIKELY AS NOT (50
PERCENT OR GREATER PROBABILITY) THAT THE VETERANS MAJOR DEPRESSIVE
DISORDER AND OBSESSIVE COMPULSIVE DISORDER WERE INCURRED DURING, CAUSED
BY OR ARE OTHERWISE RELATED TO HIS ACTIVE SERVICE.

Answer Question 1: It is at least as likely as not (50 percent or greater probability) that the veterans major depressive disorder
and obsessive compulsive disorder were incurred during, caused by or are otherwise related to his active
service.

Additional Question 2: PLEASE PROVIDE YOUR MEDICAL RATIONALE.
Answer Question 2: The veteran had no prior history of mental health issues before serving in the military. He reported learning
the value of routine and ritual while serving and reported this seemed to become maladaptive in response to
stress. He reported becoming very depressed after leaving the service and being unable to pursue a career
in medicine. He appears to have developed Obsessive Compulsive Disorder and Major Depressive
Disorder in response to an in-service stressor (MST.) Though there are not apparently sufficient markers to
support a claim for PTSD due to MST, the evidence in the record and presented by the veteran appear
sufficient to this examiner to conclude that a serious stressor occurred during his service in Germany. This
stressor appears to be the proximate cause of his subsequent Major Depressive Disorder and Obsessive
Compulsive Disorder. The Obsessive Compulsive Disorder appears to have developed as a way to maintain
control and ensure that he could not be victimized again and the Major Depressive Disorder developed
when his experience prevented him pursuing further education.

SECTION VIII - PHYSICIAN'S CERTIFICATION AND SIGNATURE
CERTIFICATION - To the best of my knowledge, the information contained herein is accurate, complete and current.

8A. PHYSICIAN’S SIGNATURE:
8B. PHYSICIAN’S PRINTED NAME: JAMIE L. XXXXXXX, PsyD

Medical Opinion Name: MARK NICHOLSON
Disability Benefits Questionnaire VA Claim Number:
Page 5 of 5 Contractor: VES

 

 

Mental Disorders (other than PTSD and Eating Disorders) – DSM V

Disability Benefits Questionnaire

LAST NAME, FIRST NAME, MIDDLE NAME (SUFFIX): SOCIAL SECURITY NUMBER: TODAY’S DATE:
MARK XXXXXX  XXX-XX-XXXX 08/09/2019
HOME ADDRESS: EXAMINING LOCATION AND ADDRESS:
XXXXXXXXXXXXXXX,
Redding, CA 96001

VES

HOME TELEPHONE:
XXX-XXX-XXXX
CONTRACTOR: VES NUMBER: VA CLAIM NUMBER:
VES 22619376754
Your patient is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will consider the information
you provide on this questionnaire as part of their evaluation in processing the Veteran’s claim. Please note that this questionnaire is for
disability evaluation, not for treatment purposes. This evaluation should be based on DSM-5 diagnostic criteria.
NOTE: If the Veteran experiences a mental health emergency during the interview, please terminate the interview and obtain help,
using local resources as appropriate. You may also contact the Veterans Crisis Line at 1-800-273-TALK (8255). Stay on the Crisis
Line until help can link the Veteran to emergency care.

NOTE: In order to conduct an initial examination for mental disorders, the examiner must meet one of the following criteria: a board-
certified or board-eligible psychiatrist; a licensed doctorate-level psychologist; a doctorate-level mental health provider under the

close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; a psychiatry resident
under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; or a clinical or
counseling psychologist completing a one-year internship or residency (for purposes of a doctorate-level degree) under close
supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist.
In order to conduct a review examination for mental disorders, the examiner must meet one of the criteria from above, OR be a
licensed clinical social worker (LCSW), a nurse practitioner, a clinical nurse specialist, or a physician assistant, under close
supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist.
This Questionnaire is to be completed for both initial and review mental disorder(s) claims.
For the Claimed Compensation Condition of - ACQUIRED PSYCHIATRIC DISORDER TO INCLUDE MAJOR
DEPRESSIVE DISORDER AND OBSESSIVE COMPULSIVE DISORDER
Is this DBQ being completed in conjunction with a VA21-2507, C&P Examination request?
[X] Yes [] No

If no, how was the examination completed (check all that apply)?
[] In-person examination
[] Records reviewed
[] Other, please specify:
Comments:
SECTION I: DIAGNOSIS
1. DIAGNOSIS
1A. Does the Veteran now have or has he or she ever been diagnosed with a mental disorder(s)?

Mental Disorders Disability Benefits Questionnaire Name: MARK NICHOLSON

Page 2 of 7 VA Claim Number:
Contractor: VES

[X] Yes [] No
ICD code: F33

NOTE: If the Veteran has a diagnosis of an eating disorder, complete the Eating Disorders Questionnaire, in lieu of this
questionnaire.
NOTE: If the Veteran has a diagnosis of PTSD, the Initial PTSD Questionnaire must be completed by a VHA staff or VA contract
examiner in lieu of this questionnaire.
If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1:
Major Depressive Disorder, Severe, Recurrent
ICD code: F33

Comments, if any:
Mental Disorder Diagnosis #2:
Obsessive Compulsive Disorder

ICD code: F42
Comments, if any:
Mental Disorder Diagnosis #3:
ICD code:
Comments, if any:
If additional diagnoses, list using above format:
1B. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI):
None relevant
ICD code:
Comments, if any:
2. DIFFERENTIATION OF SYMPTOMS
2A. Does the Veteran have more than one mental disorder diagnosed?
[X] Yes [] No

(If “Yes,” complete the following question 2B)
2B. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?
[X] Yes [] No [] Not applicable (N/A)

(If “No,” provide reason):
(If “Yes,” list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between
these diagnoses):
His obsessional rituals and compulsions are due to his Obsessive Compulsive Disorder. His suicidal ideation and prominent
depressed mood are due to his Major Depressive Disorder.

Mental Disorders Disability Benefits Questionnaire Name: MARK NICHOLSON

Page 3 of 7 VA Claim Number:
Contractor: VES
There is a clinical association as the disorders tend to exacerbate each other.
2C. Does the Veteran have a diagnosed traumatic brain injury (TBI)?
[] Yes [X] No [] Not shown in records reviewed
Comments, if any:
(If “Yes,” complete the following question 2D)
2D. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis TBI and any non-TBI mental health
diagnosis?
[] Yes [] No [X] Not applicable
(If “No,” provide reason):
(If “Yes,” list which symptoms are attributable to each diagnosis TBI and which symptoms are attributable to a non-TBI mental
health diagnosis):
3. OCCUPATIONAL AND SOCIAL IMPAIRMENT
3A. Which of the following best summarizes the Veteran’s level of occupational and social impairment with regards to all mental
diagnoses? (Check only one)
[] No mental disorder diagnosis
[] 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
[] 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
[] 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
[] Occupational and social impairment with reduced reliability and productivity
[X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking
and/or mood

[] Total occupational and social impairment
3B. For the indicated level of occupational and social impairment, is it possible to differentiate which impairment is caused by each
mental disorder?
[] Yes [X] No [] Not applicable
(If “No,” provide reason):
The symptoms and relative impairment overlap and exacerbate each other to such an extent that differentiation is not possible.

(If “Yes,” list which occupational and social impairment is attributable to each diagnosis):
3C. 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
(If “No,” provide reason):
(If “Yes”, list which impairment is attributable to TBI and which is attributable to any non-TBI mental health diagnosis):

Mental Disorders Disability Benefits Questionnaire Name: MARK NICHOLSON

Page 4 of 7 VA Claim Number:
Contractor: VES

SECTION II: CLINICAL FINDINGS:
1. EVIDENCE REVIEW
Evidence reviewed (check all that apply):
[] Not requested
[] VA claims file (hard copy paper C-file)
[X] VA e-folder
[] CPRS
[] Other (please identify other evidence reviewed):

[] No records were reviewed

Evidence Comments:
The veteran's file was reviewed.
STATEMENT OF VETERAN RECEIPT DATE 1/26/16
BVA DECISION RECEIPT DATE 6/4/19- (REMAND ORDER)
VAMC TX RECS RECEIPT DATE 5/28/19
SERVICE TREATMENT RECORDS RECEIPT DATE 2/22/16
SERVICE TREATMENT RECORDS RECEIPT DATE 3/25/11
STRESSOR STATEMENT RECEIPT DATE 3/10/16
PERSONNEL RECS RECEIPT DATE 2/22/16
PERSONNEL RECS RECEIPT DATE 2/22/16
BUDDY STATEMENTS WITH RECEIPT DATES, 2/28/19, 12/27/16, 12/19/16, 6/20/16, 6/6/16, 5/9/16, 1/26/16, 3/24/11, 3/10/11,
3/3/11
2. HISTORY
NOTE: Initial examinations require pre-military, military, and post-military history. If this is a review examination only indicate any
relevant history since prior exam.
2A. Relevant Social/Marital/Family history (pre-military, military, and post-military) :
Pre-military
He reported being raised in an intact family until age 8 when his parents divorced. He initially lived with his mother, but was
then raised by his father. He reported having strict, but fair parents. He has an older sister. He reported having good relationships
with his family growing up. He endorsed an abuse attempt by a stepbrother, but denied anything actually occurred.
Military
He denied any changes to his marital or family status while in the service.
Post-military
He met his wife after he was discharged and they married in 1989. He had daughters born in 1994 and 1997.
2B. Relevant Occupational and Educational history (pre-military, military, and post-military):
Pre-military
He graduated high school before joining.
Military
He was an Army medic.
Post-military
He did not continue his education following the military. He got his EMT license and worked at a waterpark for 13 years.

2C. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military, and post-
military):

Mental Disorders Disability Benefits Questionnaire Name: MARK XXXX

Page 5 of 7 VA Claim Number:
Contractor: VES

Pre-military
He denied any personal or family mental health history.
Military
He reported feelings of guilt and self-blame following the reported MST.
Post-military
He reported feeling distrustful of others. He has a hard time being around strangers. He reported beginning to have rituals and
processes in the military. This appears to have come about due to his blaming himself for having poor judgment and being
victimized. He is currently in therapy for PTSD and takes prazosin, duloxetine, and trazadone. He reported being irritable with
his family. He reported feeling sad and disappointed with himself since leaving the service. He endorsed frequent suicidal
ideation and has been placed on two psychiatric holds due to danger to self.
2D. Relevant Legal and Behavioral history (pre-military, military, and post-military)
Pre-military
He denied any disciplinary issues
Military
He denied any disciplinary issues.
Post-military
He denied any legal issues
2E. Relevant Substance Abuse history (pre-military, military, and post-military)
Pre-military
He denied any substance abuse issues.
Military
He denied any excessive substance use.
Post-military
He reported a history of taking micro doses of narcotic medication to function on a day to day basis. He reported a history of
alcohol abuse up until a few years ago. He currently only drinks a few times per year. He no longer uses narcotic medication.

2F. Other, if any:
SECTION III: SYMPTOMS
For VA rating purposes, check all symptoms that actively apply to the Veteran’s diagnoses
[X] Depressed mood
[X] Anxiety
[X] Suspiciousness
[X] Panic attacks that occur weekly or less often
[] Panic attacks more than once a week
[] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively
[X] Chronic sleep impairment
[] Mild memory loss, such as forgetting names, directions or recent events
[] Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete
tasks
[] Memory loss for names of close relatives, own occupation, or own name
[] Flattened affect
[] Circumstantial, circumlocutory or stereotyped speech

Mental Disorders Disability Benefits Questionnaire Name: MARK NICHOLSON

Page 6 of 7 VA Claim Number:
Contractor: VES

[] Speech intermittently illogical, obscure, or irrelevant
[] Difficulty in understanding complex commands
[] Impaired judgment
[] Impaired abstract thinking
[] Gross impairment in thought processes or communication
[X] Disturbances of motivation and mood
[] Difficulty in establishing and maintaining effective work and social relationships
[X] Difficulty in adapting to stressful circumstances, including work or a work like setting
[] Inability to establish and maintain effective relationships
[X] Suicidal ideation
[X] Obsessional rituals which interfere with routine activities
[] Impaired impulse control, such as unprovoked irritability with periods of violence
[] Spatial disorientation
[] Persistent delusions or hallucinations
[] Grossly inappropriate behavior
[] Persistent danger of hurting self or others
[] Neglect of personal appearance and hygiene
[] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene
[] Disorientation to time or place
SECTION IV: BEHAVIORAL OBSERVATIONS
He was alert and oriented. His affect was dysthymic and congruent with the conversation. He communicated his ideas clearly. He
denied any current suicidal or homicidal ideation. He denied any perceptual disturbance. There were no cognitive or memory deficits
apparent during the interview.

SECTION V: OTHER SYMPTOMS
5. Does the Veteran have any other symptoms attributable to mental disorders that are not listed above?
[] Yes [X] No
(If “Yes,” describe):
SECTION VI: COMPETENCY
Is the Veteran capable of managing his or her financial affairs?
[X] Yes [] No
(If “No”, explain):
SECTION VII: REMARKS
Remarks (Including any testing results), if any:
Additional comments regarding suicidal ideation, if any:
In the text box below please provide specific details on whether you feel the veteran is considered to be a current imminent risk
(active ideation with current plan and/or intent) or increased but not current imminent risk (no current plan or intent to take
action) of harm to him/herself.
NOTE: If you believe the veteran is a current imminent risk please contact your local authorities (police, 911, etc) and document
in the Remarks section that you have done so.
He reported feeling frequent suicidal ideation without intent. He denied any current plan or intent. He discussed protective
factors including his concern about negatively impacting his family.
[] I believe this Veteran/Service Member should be considered a CURRENT IMMINENT RISK.
[X] I believe this Veteran/Service Member should be considered an INCREASED but not current imminent risk.
[] I do not believe this Veteran/Service Member should be considered a current imminent or increased risk.

Mental Disorders Disability Benefits Questionnaire Name: MARK NICHOLSON

Page 7 of 7 VA Claim Number:
Contractor: VES
Please advise whether the Veteran was equipped with the VA crisis line (800-273-TALK):
He was provided the crisis line.
Is there a need for the Veteran to follow up with his/her primary care provider regarding any life threatening findings in this
examination (not limited to claimed condition(s))?
[] Yes [X] No
SECTION VIII: PSYCHIATRIST/PSYCHOLOGIST/EXAMINER
CERTIFICATION AND SIGNATURE
CERTIFICATION - To the best of my knowledge, the information contained herein is accurate, complete and current.

8A. PSYCHIATRIST/PSYCHOLOGIST/EXAMINER
SIGNATURE:
8B. PSYCHIATRIST/PSYCHOLOGIST/EXAMINER

PRINTED NAME:

Edited by MKAH
remove personal info

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I agree with the D and A abuse.

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      A disabled veteran in Alabama may receive a full property tax exemption on his/her primary residence if the veteran is 100 percent disabled as a result of service and has a net annual income of $12,000 or less.
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    • Thanks everyone for their answers and advise and yes Ido have a VSO American legion but unfortunately I still have to manage to work and call times are mornings only almost impossible to talk with him.

       I am gonna try to get ahold of him tomorrow but u have to call right at 0730 eastern OR call list fills and never get on his list sucks!

      The worst thing I’m going through is that I’m stuck in limbo I can’t file on my other things I can’t add nothing I can’t do anything basically my hands are tied, this is complete wearing on me mentally Not to mention I’ve been out of the service since 95 was six service-connected disabilities and then thrown to the wayside as a young adult with no knowledge of how what or when by the VA  now that I’m middle-aged my service-connected disabilities Have gotten so severe that I have multiple secondaries until I came across by chance a VSO in my county that helped me out back in 15 I’d still be at a loss and left at the wayside forgotten about now that I’ve been back in the system And have a 80% rating the VA now is trying to drop two of my ratings because I feel that this DRO rview is going to put me at 100% or really close  in a way to just keep us down and out and causing worse injuries by forcing ourselves to do what we have to as humans to survive in the workforce that you can’t really physically do anymore sucks all the way around! 
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