Another question concerning PTSD rating

[thegat]

Good afternoon, Have a question regarding PTSD.  I was rated at 30% for it about 7 months ago.  I think I should have been rated higher, but who cares what I think.... My question is I was offered counseling by a V.A doctor,   but I have yet to take them up on it. Does this hurt me because I'm going to put in for an increase in the next few months. Should I take them up on this offer? Bonus Question, should I  appeal the first decision or just apply for an increase? Thanks  in advance!

[Christie]

6 hours ago, USMC_VET said:

 This is anecdotal but i have heard of the VA using the fact you didnt refill say back pain meds or other meds as a sign your condition is "improving" since in their minds if you dont need them as often to refill regularly it MUST mean youre "getting better".

 

 

Actually, that is wrong. You can deny any med without repercussion. They cant force you to take medication. And they cannot hold it against you. I refuse meds as I have kidney disease (as do 1 in 5 adults). Therefore most meds are dangerous, and after forced anthrax vaccines, and the opioid crisis, it is your choice. And, they do not trully know what harm any med can do til YEARS later. Look at zantac.

[shrekthetank1]

It depends on how much time you have to do this, but they are typically very good.  I go to the vet center here and they are good.  I think it is good just to show them where you are at and the issues you are having.

As for the appeal, if you feel it is not right then you should!  If you are within a year appeal!  Keep that original date alive as back pay can be big

 

 

[broncovet]

By declining "counseling", you dont necessarily hurt your chances at getting an increase.  I will give 2 examples which may help.

Example 1.  You get a rating for PTSD and then "discontinue" all treatment..you never set foot in a VAMC again.  This doesnt bode well..it could be interpreted that you are a malingerer and, once you got your benefits you were cured.  No, Im not accusing you of this, but its best to remain in treatment, but not necessarily counseling.  

Example 2.  You get a rating for PTSD but dont feel counseing will help.  So you keep seing the doc, and he prescribes pills and you take them and keep yoru appointments.  You should still be able to get an increase if you meet the criteria for a higher rating.  

    Generally, Va requires "continuity of SYMPTOMS" not continuitiy of treatment.  Treatments vary, and they change over time.  You may change meds, go off them, get back on, try other stuff.  

Bonus question:  If you are in the 1 year appeal period, by all means appeal.  It could mean a nice retro check.  If you apply for an increase but do not appeal, then you could still get an increase but at a later effective date and, thus, a smaller retro check.  

[Buck52]

1 hour ago, thegat said:

Good afternoon, Have a question regarding PTSD.  I was rated at 30% for it about 7 months ago.  I think I should have been rated higher, but who cares what I think.... My question is I was offered counseling by a V.A doctor,   but I have yet to take them up on it. Does this hurt me because I'm going to put in for an increase in the next few months. Should I take them up on this offer? Bonus Question, should I  appeal the first decision or just apply for an increase? Thanks  in advance!

On your 30% you need to check the rating criteria and look at the boxes beside the rating percentage's  check each symptom that you have and line it up with the rating criteria   ask a MH Dr to fill out a PTSD  DBQ,  And see what he checks off...some VA Doc's wil do that and some won"t  but the thing is you need to see if you have more symptoms have increase since your last rating at 30%.

IF you put in for an increase they will send you to a C&P  the examiner will check your past medical records to see if your symptoms have increase or have got worse.

Here is a rating formula for PTSD  (below)

Remember they rate Mental Disorders  (PTSD) by  your symptoms , the more severe your symptoms the higher they rate. 

70% and 100% are fairly close = 70% you  comb your hair and brush your teeth and wear clean clothes...ect,,,ect,, that is only the basic difference.=100% you don't do the above  (Hygiene) and Total occupational and social impairment                                                                         : gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others.

Also you may want to file on secondary conditions your MH condition may cause or related to  example  ''sleep apnea'' if they do a sleep study on you and diagnose you for S.A. and your required medically to use a C-pap machine and the VA prescribes one for you to use..that's normally a 50% rating and depending on how severe your apnea's are?

  if you have severe sleep apnea  or  higher  that's 100% ,  once they grant the sleep apnea secondary to your PTSD or Medications it becomes part of your MENTAL HEALTH CONDITION  but they rate them separate.

General Rating Formula for Mental Disorders

   Rating

Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name.100%

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 work like 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.0%

 

 

Edited August 14, 2020 by Buck52 (see edit history)

[MikeR]

I think it helps to evaluate yourself with the information with the post above.

I was on the meds, but realized at some point I was on borrowed time. I quit my last job after dealing with a real fun boss. I told him in writing that if he can't handle a few F bombs that perhaps he should hand in his "Man Card." I was working for the Government at the time, and had applied for FERS Disability. I did get that as well, but my boss had a brick on his desk because he thought he might have to use it against me. I did get SSDI so fast my head spun around. I was lucky to work alone most of the time, and even then I had the hallucinations,  disorientation, memory loss, etc. I have had huge issues with relationships. I have wanted to end my life more than I care to admit, and when I am angry I am dangerous. So I spend a lot of time in my garage away from people. I have trouble with hygiene at times.  

If you are like me, you need to get an advocate and fight this. The VA lowballs almost every Vet.

[USMC_VET]

On 8/14/2020 at 3:46 PM, thegat said:

Good afternoon, Have a question regarding PTSD.  I was rated at 30% for it about 7 months ago.  I think I should have been rated higher, but who cares what I think.... My question is I was offered counseling by a V.A doctor,   but I have yet to take them up on it. Does this hurt me because I'm going to put in for an increase in the next few months. Should I take them up on this offer? Bonus Question, should I  appeal the first decision or just apply for an increase? Thanks  in advance!

i am currently at 50% but have filed for an increase as well.  I am not an expert and this is my subjective experience so take it for what its worth.

The VA wont necessarily hold no treatment against you but first, being in treatment and having medications does help.  I do believe that medications such as SSRI's vs. say what i was on years ago Hydroxyzine Pamoate (a glorified anithistamine for panic attacks).  Its a clear indication that symptoms are severe enough to warrant this medication helps vs having the same symptoms and "i do yoga to keep myself calm" even though i think that diet, exercise and other alternatives in many (not all) cases works better and hes ZERO vs some/many side effects associated with them.  If you do get medications make SURE you keep up with refills.  This is anecdotal but i have heard of the VA using the fact you didnt refill say back pain meds or other meds as a sign your condition is "improving" since in their minds if you dont need them as often to refill regularly it MUST mean youre "getting better".

Secondly i can say wtih 100% certainty that if you are having issues with PTSD you need to seek treatment in one way or another. I first sought treatment at the vet center and while she was well intentioned and wanted to help it just didnt click. In my experience a therapist is like a intimate relationship in that things need to click and a trust needs to develop so dont feel like you have to stick to the one you get assigned, shop around if you can. I have good insurance through my job so have gone to multiple therapists over the years off and on.  It does help.

Every C&P i have done for mental health has always asked if im currently in treatment so i do think it matters. and remember the VA CANT REDUCE YOU OR DENY AN INCREASE BASED ON HOW MEDICATIONS HELP YOU. in the physical realm if your back keeps you from bending over cause immense pain and issues at work but the meds make it so you can do so pretty well they have to rate you based on how you are without the meds and conversely cant decrease you because now you arent in pain all the time.  With PTSD they cant reduceyou because a medication makes it so you arent as angry all the time.  This doesnt mean they cant try but it does mean you can fight it effectively.  The one caveat is that if the rating specifically mentions medications as part of the rating criteria say "30% severe pain in back, 50% severe pain in back treated with narcotics for daily funciton" and when you were rated you needed to the medication to function and were rated at 50% and now you got off the medication and can function they can reduce you to 30%.  There is nothing in the PTSD rating criteria that says this.

[USMC_VET]

17 hours ago, Christie said:

Actually, that is wrong. You can deny any med without repercussion. They cant force you to take medication. And they cannot hold it against you. I refuse meds as I have kidney disease (as do 1 in 5 adults). Therefore most meds are dangerous, and after forced anthrax vaccines, and the opioid crisis, it is your choice. And, they do not trully know what harm any med can do til YEARS later. Look at zantac.

i didnt say it was right i said, like many things in the VA, they do the wrong thing. Your situation is not the same as someone who is prescribed cyclobenzaprine for their back, says its debilitating but hasnt refilled a pain reduction medication in 18 months.

[Buck52]

Sometimes the R.O. will conduct random audits on any veteran, they can and will check his/her medical records...they read these medical records called progress notes  you can find them in'' Myhealthevet'' 3 days after your appointments with these VA Doctors.  ...

OK R.O. Reads these medical notes and if the Dr's or therapist or pain Dr's & SPECIALIST DR  ect,,,ect,,, and if these Dr's write in their report you show to have improved  ....>that can prompt the R.O. to send out a proposal to reduced benefit's if it is a service connected benefit 

(if your caught in the random aduit)?

 If you receive one of these porposal letters from your R.O. you have 30 days to respond back   as to what you want to do    normally the Veteran needs to request a Hearing with a DRO to dispute what these Dr's mention in their medical reports.  FAILURE TO RESPOND BACK TO YOUR R.O. will and can lead to the reduction of said benefit's.

So it is better that you keep these appointments and keep up with what the Dr's write in their reports...you can send a secure message and ask this Dr what he mention what he did  or confront this Dr to solve this issue that may not be true...or make copies of this report and confront this Dr face to face about the issue   maybe on your next appointment with this same Dr.

They can amend or correction made on these issues or make them right .

They may not can take it out of your records  once something is entered into your records it has to stay there  but it can be amended. OR A CORRECTION MADE.

I agree we do not have to take any medications that the VA Docs prescribe us but to save a lot of confinement  its better to let the VA Dr's know that you can't take a certain med and he won't be prescribing it for you  it saves a lot of problems if you do.

but remember if you do not let a VA Dr prescribe you med's  the Dr will note that in his/her medical reports.

Actually Myhealthevet is a great tool and benefits us veterans.