It's been about two years since I've posted here. I received a 70% rating for PTSD in 2017. These forums were very helpful to me. Recently I've had another inpatient stay in the psych ward at the VAMC (my third in 15 months) and I'm having more and more difficulty coping with everything. My symptoms are kind of out of control, despite multiple medication changes, and work is becoming more and more difficult every day. I tend to hide in my office, don't talk to people, have breakdowns crying during the day, and generally "exist" and not much else. My work quality has suffered and I'm at the point now where I'm thinking I'm not going to make it to retirement in seven years. I'm burning thru my FMLA hours this year with leaving early, taking days off for being "sick", and the two weeks from this last hospitalization, plus all the appointments I have to attend.
My 70% is "static" so there are no future exams scheduled. I turn 55 this year. My PTSD claim was a bit complicated in that it involved something that happened to me in childhood (abuse) that was brought to the surface while in the service (a traumatic flashback) that led to an extended hospital stay and a medical discharge. I remember Berta mentioning my C&P exam was very unusual in that the examiner did an exceptional job writing a favorable opinion. I have a VA psychiatrist along with a private psychiatrist and private therapist and am generally happy with my care (although I'm still waiting on that cure).
I'm considering filing for an increase to my PTSD rating (and also filing for IU at the same time). I know if I meet the schedular they'll go that route over IU so 100% is the way I hope it goes. I'm planning to obtain a vocational expert report on myself as part of the increase application process. My private psychiatrist completed a new DBQ for me (she did one in 2017 too). With these DBQ items I'd like to get some feedback on where you think I'll end up? I'm still working (although not well) so I'm thinking I wouldn't get IU. But what about 100%?
Thank you.
SECTION IV - OCCPUATIONAL AND SOCIAL IMPAIREMENT
Occpuational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and/or mood.
SECTION VII - SYMPTOMS
- Depressed mood
- Anxiety
- Suspiciousness
- Panic attacks more than once a week
- Near continuous panic or depression affecting the ability to function independently, appropriately and effectively
- Chronic sleep impairment
- Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks
- Flattend affect
- Difficulty in understanding complex commands
- Gross impairment in thought processes or communication
- Difficulty in establishing and maintaining effective work and social relationships
- Difficulty in adapting to stressful circumstances, including work or a work like setting
- Inability to establish effective relationships
- Suicidal ideation
- Persistent delusions or hallucinations
- 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
SECTION VIII - OTHER SYMPTOMS
PATIENT SUFFERS A MULTITUDE OF SYMPTOMS RESULTING FROM MAJOR DEPRESSION WITH PSYCHOTIC FEATURES AND PTSD. PATIENT SUFFERS FROM AUDITORY HALLUCINATIONS WHICH ARE AT TIMES COMMANDING TO SELF-HARM. HALLUCINATION FREQUENCY HAS INCREASED SINCE LAST EXAMINATION IN 2017. PATIENT HAS SUFFERED FROM AUDITORY HALLUCINATIONS SINCE 2008 WHEN FIRST DOCUMENTED BY DR. XXXXXXX.
PATIENT TENDS TO AVOID SOCIAL INTERACTION AND ENGAGES IN ISOLATION ORIENTED ACTIVITIES. PATIENT HAS BEEN WORKING WITH THERAPIST XXXXX ON EFFORTS TO EXPAND SOCIAL ACTIVITIES. PATIENT EXPERIENCES GREAT CHALLENGES IN THIS REGARD AND STATES HE IS MORE COMFORTABLE "BEING ALONE" AND "BEING AWAY FROM PEOPLE".
PATIENT CURRENTLY WORKS FULL-TIME BUT IS MISSING WORK ON A REGULAR BASIS DUE TO HIS CONDITION. PATIENT OFTEN WILL LEAVE WORK EARLY DUE TO NOT FEELING WELL (NOT TOLERATING STRESS AT WORK). HE HAS HAD SEVERAL RECENT OCCASIONS OF MISSING MULTIPLE DAYS OF WORK ON FMLA FOR SYMPTOM EXACERBATION. PATIENTS ABILITY TO WORK IS GREATLY IMPAIRED BY HIS ILLNESS AND HE IS UNABLE TO TOLERATE STRESSORS AT WORK. PATIENT REPORTS AN INABILITY TO "TOLERATE" OTHERS AT WORK, AN INABILITY TO REMAIN CALM AT WORK, AND REPORTS DAILY DIFFICULTIES CONCENTRATING AT WORK. HE HAS FREQUENT EPISODES AT WORK OF TEARFULNESS AND "LOSING IT" AND WILL HIDE IN HIS OFFICE WITH THE DOOR CLOSED.
PATIENT SUFFERS FROM BOUTS OF SELF-HARM DIRECTED THINKING, SUICIDAL IDEATION, AND RUMMINATIONS OF DYING. PATIENT HAS HAD A RECENT EXACERBATION OF THESE SYMPTOMS RESULTING IN HOSPITALIZATION AT THE VA IN XXXXXX.
SECTION X - REMARKS
THE PATIENT HAS EXPERIENCED SEVERAL UPS AND DOWNS WITH HIS TREATMENT SINCE THE LAST DBQ FILLED OUT IN 2017. OVERALL THE PATIENTS CONDITION HAS NOT IMPROVED. SYMPTOMS INCLUDING AUDITORY HALLUCINATIONS, SUICIDIAL IDEATION, NIGHTMARES, FLASHBACKS, AND ANXIETY HAVE INCREASED ON OCCASION. THESE SYMPTOMS ARE GREATLY AFFECTING THE PATIENTS ABILITY TO FUNCTION ON A DAY TO DAY BASIS. HIS ABILITY TO WORK IS HINDERED WITH THESE DAILY SYMPTOMS AND HE HAS MISSED WORK ON MULTIPLE OCCASIONS DUE TO HIS DIAGNOSES. HE REPORTS AN INCREASED DIFFICULTY BEING ABLE TO FUNCTION AT HIS JOB DUE TO THESE ISSUES. THE PATIENTS MOOD FLUCTUATES FROM CALM TO SAD ON A DAILY BASIS. PATIENT HAS MADE USE OF THE VETERANS CRISIS LINE ON SEVERAL OCCASIONS WHEN FEELING THE NEED TO REACH OUT FOR HELP. OVERALL IT IS MY OPINION THAT THE PATIENTS CONDITION IS DEBILITATING FOR HIM IN THE AREAS OF LIVING INCLUDING WORK, SOCIAL, AND PERSONAL. PATIENT CONTINUES TO STRUGGLE IN ALL AREAS OF LIVING. PATIENT ATTENDS BIWEEKLY THERAPY VISITS WITH LPC UTILIZING TALK THERAPY AND EMDR. PATIENT ALSO HAS FREQUENT MEDICATION MANAGEMENT ENCOUNTERS WITH PSYCHIATRIST. PATIENT FOLLOWS UP WITH GROUPS AT THE VA HOSPITAL IN XXXXX. PATIENT UNDERSTANDS THE IMPORTANCE OF CONTINUING THERAPY VISITS AND PSYCHIATRIC MEDICATION MANAGEMENT VISITS AND PLANS TO CONTINUE THEM. PATIENT HAS BEEN VERY PROACTIVE IN SEEKING TREATMENT.
Question
JWMN89
It's been about two years since I've posted here. I received a 70% rating for PTSD in 2017. These forums were very helpful to me. Recently I've had another inpatient stay in the psych ward at the VAMC (my third in 15 months) and I'm having more and more difficulty coping with everything. My symptoms are kind of out of control, despite multiple medication changes, and work is becoming more and more difficult every day. I tend to hide in my office, don't talk to people, have breakdowns crying during the day, and generally "exist" and not much else. My work quality has suffered and I'm at the point now where I'm thinking I'm not going to make it to retirement in seven years. I'm burning thru my FMLA hours this year with leaving early, taking days off for being "sick", and the two weeks from this last hospitalization, plus all the appointments I have to attend.
My 70% is "static" so there are no future exams scheduled. I turn 55 this year. My PTSD claim was a bit complicated in that it involved something that happened to me in childhood (abuse) that was brought to the surface while in the service (a traumatic flashback) that led to an extended hospital stay and a medical discharge. I remember Berta mentioning my C&P exam was very unusual in that the examiner did an exceptional job writing a favorable opinion. I have a VA psychiatrist along with a private psychiatrist and private therapist and am generally happy with my care (although I'm still waiting on that cure).
I'm considering filing for an increase to my PTSD rating (and also filing for IU at the same time). I know if I meet the schedular they'll go that route over IU so 100% is the way I hope it goes. I'm planning to obtain a vocational expert report on myself as part of the increase application process. My private psychiatrist completed a new DBQ for me (she did one in 2017 too). With these DBQ items I'd like to get some feedback on where you think I'll end up? I'm still working (although not well) so I'm thinking I wouldn't get IU. But what about 100%?
Thank you.
SECTION IV - OCCPUATIONAL AND SOCIAL IMPAIREMENT
Occpuational and social impairment with deficiencies in most areas, such as work, school, family relations, judgement, thinking and/or mood.
SECTION VII - SYMPTOMS
- Depressed mood
- Anxiety
- Suspiciousness
- Panic attacks more than once a week
- Near continuous panic or depression affecting the ability to function independently, appropriately and effectively
- Chronic sleep impairment
- Impairment of short and long term memory, for example, retention of only highly learned material, while forgetting to complete tasks
- Flattend affect
- Difficulty in understanding complex commands
- Gross impairment in thought processes or communication
- Difficulty in establishing and maintaining effective work and social relationships
- Difficulty in adapting to stressful circumstances, including work or a work like setting
- Inability to establish effective relationships
- Suicidal ideation
- Persistent delusions or hallucinations
- 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
SECTION VIII - OTHER SYMPTOMS
PATIENT SUFFERS A MULTITUDE OF SYMPTOMS RESULTING FROM MAJOR DEPRESSION WITH PSYCHOTIC FEATURES AND PTSD. PATIENT SUFFERS FROM AUDITORY HALLUCINATIONS WHICH ARE AT TIMES COMMANDING TO SELF-HARM. HALLUCINATION FREQUENCY HAS INCREASED SINCE LAST EXAMINATION IN 2017. PATIENT HAS SUFFERED FROM AUDITORY HALLUCINATIONS SINCE 2008 WHEN FIRST DOCUMENTED BY DR. XXXXXXX.
PATIENT TENDS TO AVOID SOCIAL INTERACTION AND ENGAGES IN ISOLATION ORIENTED ACTIVITIES. PATIENT HAS BEEN WORKING WITH THERAPIST XXXXX ON EFFORTS TO EXPAND SOCIAL ACTIVITIES. PATIENT EXPERIENCES GREAT CHALLENGES IN THIS REGARD AND STATES HE IS MORE COMFORTABLE "BEING ALONE" AND "BEING AWAY FROM PEOPLE".
PATIENT CURRENTLY WORKS FULL-TIME BUT IS MISSING WORK ON A REGULAR BASIS DUE TO HIS CONDITION. PATIENT OFTEN WILL LEAVE WORK EARLY DUE TO NOT FEELING WELL (NOT TOLERATING STRESS AT WORK). HE HAS HAD SEVERAL RECENT OCCASIONS OF MISSING MULTIPLE DAYS OF WORK ON FMLA FOR SYMPTOM EXACERBATION. PATIENTS ABILITY TO WORK IS GREATLY IMPAIRED BY HIS ILLNESS AND HE IS UNABLE TO TOLERATE STRESSORS AT WORK. PATIENT REPORTS AN INABILITY TO "TOLERATE" OTHERS AT WORK, AN INABILITY TO REMAIN CALM AT WORK, AND REPORTS DAILY DIFFICULTIES CONCENTRATING AT WORK. HE HAS FREQUENT EPISODES AT WORK OF TEARFULNESS AND "LOSING IT" AND WILL HIDE IN HIS OFFICE WITH THE DOOR CLOSED.
PATIENT SUFFERS FROM BOUTS OF SELF-HARM DIRECTED THINKING, SUICIDAL IDEATION, AND RUMMINATIONS OF DYING. PATIENT HAS HAD A RECENT EXACERBATION OF THESE SYMPTOMS RESULTING IN HOSPITALIZATION AT THE VA IN XXXXXX.
SECTION X - REMARKS
THE PATIENT HAS EXPERIENCED SEVERAL UPS AND DOWNS WITH HIS TREATMENT SINCE THE LAST DBQ FILLED OUT IN 2017. OVERALL THE PATIENTS CONDITION HAS NOT IMPROVED. SYMPTOMS INCLUDING AUDITORY HALLUCINATIONS, SUICIDIAL IDEATION, NIGHTMARES, FLASHBACKS, AND ANXIETY HAVE INCREASED ON OCCASION. THESE SYMPTOMS ARE GREATLY AFFECTING THE PATIENTS ABILITY TO FUNCTION ON A DAY TO DAY BASIS. HIS ABILITY TO WORK IS HINDERED WITH THESE DAILY SYMPTOMS AND HE HAS MISSED WORK ON MULTIPLE OCCASIONS DUE TO HIS DIAGNOSES. HE REPORTS AN INCREASED DIFFICULTY BEING ABLE TO FUNCTION AT HIS JOB DUE TO THESE ISSUES. THE PATIENTS MOOD FLUCTUATES FROM CALM TO SAD ON A DAILY BASIS. PATIENT HAS MADE USE OF THE VETERANS CRISIS LINE ON SEVERAL OCCASIONS WHEN FEELING THE NEED TO REACH OUT FOR HELP. OVERALL IT IS MY OPINION THAT THE PATIENTS CONDITION IS DEBILITATING FOR HIM IN THE AREAS OF LIVING INCLUDING WORK, SOCIAL, AND PERSONAL. PATIENT CONTINUES TO STRUGGLE IN ALL AREAS OF LIVING. PATIENT ATTENDS BIWEEKLY THERAPY VISITS WITH LPC UTILIZING TALK THERAPY AND EMDR. PATIENT ALSO HAS FREQUENT MEDICATION MANAGEMENT ENCOUNTERS WITH PSYCHIATRIST. PATIENT FOLLOWS UP WITH GROUPS AT THE VA HOSPITAL IN XXXXX. PATIENT UNDERSTANDS THE IMPORTANCE OF CONTINUING THERAPY VISITS AND PSYCHIATRIC MEDICATION MANAGEMENT VISITS AND PLANS TO CONTINUE THEM. PATIENT HAS BEEN VERY PROACTIVE IN SEEKING TREATMENT.
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vetquest
Broncovet gives some very good advice. My TDIU claim took ten years, that seems to be unusual though. Saving up for this type of occurrence is a must. Also do you have long term disability insuranc
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