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Thoughts on C&P exam


Chalman

Question

I’m currently rated at 50% for ptsd and anxiety. This C&P exam is for a ratings increase, insomnia, drug abuse disorder, and IU

1. Diagnosis

a. Does the veteran now have or has he ever been diagnosed with a mental disorder?

[x]yes

icd code: f43.8

if the the veteran currently has one or more mental disorders that conform to dsm-5 criteria, provide all diagnoses:

#1 other specified trauma and stressor related disorder. Icd code f43.8

#2 cannabis use disorder, moderate icd code f12.12

2. differentiation of symptoms

a. Does the veteran have more than one mental disorder diagnosed?

[x]yes

b. Is it possible to differentiate what symptoms are attributable to each diagnosis?

[x]no

Which of the following best summarizes the veterans level of occupational and social impairment with regards to all mental diagnoses?

[x] occupational and social impairment with reduced reliability and productivity 

b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder?

[x]no

3. symptoms

For VA rating purposes, check all symptoms that actively apply to the veteran’s diagnosis:

[x] anxiety

[x]panic attacks more than once a week

[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 work like setting 

There is much more to the file I left out somethings that I didn’t think were as important in order to save time. If needed I can answer questions or enter whatever else is needed. I know the VA doesn’t think like we do and any opinions given are just that but would still be greatly appreciated . Thanks in advance for any and all reply’s

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From this limited view it does look like you should be rated higher!  That being said they will do everything they can to not let this rating go up.  They do have to follow the rules, but they do tend to leave things out all the time.  

So if you do not get bumped up I would post it here minus your information and we can give some guidance on how to proceed.  

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On 3/26/2020 at 12:12 AM, Chalman said:

occupational and social impairment with reduced reliability and productivity 

What killed you is this statement.  You are looking for the following language for the specified rating.  Compare the 70 percent rating instructions and the 50 percent instructions to what the examiner wrote.  If you want to move up in rating you will most likely need an IMO that refutes what the VA examiner said about you.

 

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 ..10

 


 

 

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Thanks for the replies. I was reading through my C&P exam and found what is probably a key statement from the examiner. 
 Based on the current examination and a review of vbms/va records, it is this examiner’s opinion that the veteran continues to meet criteria for other specified trauma and stressor related disorder. He continues to experience mental health symptoms, including sleep impairment, panic attacks, and anxiety in social situations. The veteran reported that he currently uses cannabis to manage his anxiety and sleep problems. His use of cannabis may affect his ability to obtain and maintain gainful employment.

 Overall , the veteran’s mental health symptoms will likely impact his vocational functioning. His ability to understand and follow instructions is not considered impaired. His ability to retain instructions as well as sustain concentration to perform simple task is considered mildly impaired. His ability to sustain concentration to task persistence and pace is considered moderately impaired. His ability to accept supervision is considered mildly impaired. His ability to accept criticism is considered mildly impaired. His ability to be flexible in the work setting is considered moderately impaired. His ability to work in groups is considered moderately impaired. His ability for impulse control in a work setting is considered mildly impaired. His ability to maintain a logical thinking process appeared adequate and would not likely impact his vocational functioning. He did not suffer from gross impairment in thought processes, delusions, or hallucinations. He was not a danger to himself or others.

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