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1. Filed for increase on mental health condition (Depression 2nd to Tinnitus)
2. VES exam, didnt go well, got reduced. Examiner said I had another condition, it wasn't service related, etc, etc.
3. Filed a supplemental with a DBQ from a private psychologist (looked like 50-70 percent)
4. New exam from QTC, went well, probably around 70 percent
5. VSO told me a few weeks ago they sent it back to examiner for medical opinion. I know the QTC examiner had mentioned that they did not ask for one in which he thought was odd during my exam in August.
6. VSO told me today that they sent it back to the VES examiner from May, and the examiner basically regurgitated the same thing he already said. He already provided a medical opinion previously in May. Examiner said I had OCD (never been diagnosed by anyone in 5 years).
I am confused to why they sent it back to the VES examiner and not my most recent examiner? Could this be a mistake? Thanks. Not sure how this will pan out.
So my story is that I filed for an increase, ended up getting reduced from 50 to 30. Overall rating wasn't effected. I filed a supplemental with a DBQ from my private doctor so now I have an upcoming CP exam with QTC. I have read that some people on the forums say " tell them about all your mental health issues (PTSD, anxiety, etc..). However, I am only S/C for depression secondary to tinnitus. So should I just only talk about depression? For my last exam in May I elaborated on all my mental health issues and it got me reduced. Thanks
For Starters, I want to thank anyone who takes the time to read this and give me a little perspective. I just got my final C&P results after a series of claims. Currently I am 94% combined rating if I include my Sleep apnea claim (The Dr. wrote it was medically neccesary to use the CPAP, so I do expect the 50%. This C&P below was conducted to separate my anxiety disorder from my TBI disorder. Currently I have a 70% rating for Anxiety with residuals of TBI. I was wondering if anyone could read this and tell me if they think I can expect a separate rating for TBI memory loss based on the Dr's opinion stating that my issue is 80% anxiety and 20% TBI (see note 2b below). If I can get at least a 10% for TBI in addition to the 70% for anxiety, It should push me over the threshhold of 100% schedular. The only edits I made to this was to remove names. Again, thank you for your time and expertise
70% Anxiety (Trauma with TBI residuals)
50% Sleep Apnea
20% Degenerative Disc Disease
20% Upper Neuropathy Right / 20% Upper Neuropathy Left
10% Lower Radiculopathy Right / 10% Lower Radiculopathy Left
0% TBI Migraines
LOCAL TITLE: COMP AND PEN NOTE
STANDARD TITLE: C & P EXAMINATION NOTE
DATE OF NOTE: JAN 28, 2019@14:30 ENTRY DATE: JAN 30, 2019@11:11:26
AUTHOR: *********** E EXP COSIGNER: URGENCY: STATUS: COMPLETED
(other than PTSD and Eating Disorders)
Disability Benefits Questionnaire Name of patient/Veteran: *****
Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination
[X] Yes [ ] No
SECTION I: ----------
a. Does the Veteran now have or has he/she ever been diagnosed with a mental
disorder(s)? [X] Yes [ ] No
ICD code: 300.00
If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses:
Mental Disorder Diagnosis #1: Unspecifed Anxiety disorder, chronic, severe
ICD code: 300.00 Comments, if any:
Vet had been seen initially on 2/11/18 for Mental Health C+P exam done
by Dr. *****(which proposed "Anxiety disorder, NOS" then, while f/u
C+P exam on 2/16/14 had proposed Other specified trauma and stressor related disorder(as vet had been in IED blast in 2006 - see Mental Disorder diagnosis #2 below.
Unspecified anxiety disorder is synonymous with Neurosis - which vet is
already 70% SC for, in combination with residuals of TBI apparently). I
am therefore not intending to change his Neurosis condition now, but Unspecified anxiety disorder is most accurate diagnosis consistent with DSM-V, as I see it now.
Mental Disorder Diagnosis #2: Cognitive disorder due to Closed Head
iInjury(CHI), due to 6/1/2006 "double-attacked anti-tank mine" IED blast.
ICD code: 294.9 Comments, if any:
Vet was in 2nd Iraq combat deployment - out of 3 tours he served there -
when 6/1/06 IED hit his heavy equipment vehicle(which vet had referred to as 'palitizing loading system').
b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Vet is already 0% SC for
Comments, if any:
Vet is already SC for migraine headaches. Vet is already 20% SC for Intervertebral DIsc Syndrome, 20% SC for Paralysis of musculospiral nerve(x2), 10% SC fo paralysis of sciatic nerve(x2).
Vet also apparently had a 2/15/18 sleep study done that indicated a mild
sleep apnea condition.
2. Differentiation of symptoms
a. Does the Veteran have more than one mental disorder diagnosed?
[X] Yes [ ] No
b. Is it possible to differentiate what symptom(s) is/are attributable to each diagnosis?
[X] Yes [ ] No [ ] Not applicable (N/A)
If yes, list which symptoms are attributable to each diagnosis and discuss whether there is any clinical association between these diagnoses Symptoms(i.e., anxiety, sleep problmes) are due to Unspecified
anxiety disorder, while symptoms(memory problems, headaches) are due
to Cognitive disorder due to CHI.
c. Does the Veteran have a diagnosed traumatic brain injury (TBI)? [X] Yes [ ] No [ ] Not shown in records reviewed
d. Is it possible to differentiate what symptom(s) is/are attributable to TBI
and any non-TBI mental health diagnosis? [X] Yes [ ] No [ ] Not applicable (N/A)
If yes, list which symptoms are attributable to TBI and which symptoms
are attributable to a non-TBI mental health diagnosis see 2b above.
3. Occupational and social impairment -------------------------------------
a. Which of the following best summarizes the Veteran's level of
and social impairment with regards to all mental diagnoses? (Check only one)
[X] Occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking and/or
b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [X] Yes [ ] No [ ] Not Applicable (N/A)
If yes, list which occupational and social impairment is attributable to each diagnosis
About 80% of vet's current occupational and social impairment is due
to Unspecified anxiety disorder while about 20% is due to Cognitive disorder due to CHI.
c. If a diagnosis of TBI exists, is it possible to differentiate which occupational and social impairment indicated above is caused by the TBI? [X] Yes [ ] No [ ] Not Applicable (N/A)
If yes, list which impairment is attributable to TBI and which is attributable to any non-TBI mental health diagnosis see 3b above.
----------- Clinical Findings: ------------------
1. Evidence Review
Evidence reviewed (check all that apply):
[X] VA e-folder
[X] Other (please identify other evidence reviewed):
Vet broiught a 4 page typed letter 1/12/19 done by himself describing
in detail his current ongoing issues("I did not want to forget to tell
you something important"), and vet admits it took him severalhours to
complete(and which he kept revising many times). He brought a 2 page
letter dated 1/27/19 done by his wife ******, a 2 page typed letter dated
1/17/19 done by mother ********, and a 1 page typed letter dated
1/27/19 done by vet's friend/combat comrade(served together in Iraq)
named *******, and all 4 letter were reviewed by me.
CPRS was reviewed by me and included my(***** MD) 12/5 18 Review TBI C+P exam report, as well as 5/16/14 C+P exam report done by Dr *****(sa
as Initial 2/18/11 MH C+P exam aslo done by Dr. ******.
VBMS was reviewed by me and included vet's Army DD-214 signed b *****
which included MOS(88M30) Mortor Vehicle Operator,as well as E-6 discharge
rank. His medals included CAB - among others, and he had Iraq combat dates
of 1/03 - 7/03, 8/05 - 8/06, and 3/08 - 6/09 - for his 3 seperate Iraq combat tours.
a. Relevant Social/Marital/Family history (pre-military, military, and
Vet is married ****(and they have 2 sons(around ages 5 and nearly 7).
b. Relevant Occupational and Educational history (pre-military, military, and
post-military): Vet has been working in his current Passport Agency job since 2015(was at an administrative clerk(for a different agency) before that.
c. Relevant Mental Health history, to include prescribed medications and family mental health (pre-military, military,
Vet has been on sertraline 150mg since 9/10/18 - it takes the "edge" off
my problems, but he apparently has been having some sexual side effects(delayed ejaculation) related to that .
d. Relevant Legal and Behavioral history (pre-military, military, and post-military):
Vet has had no legal problems(and no jail time) since the 5/14/16 C+P exam report date.
e. Relevant Substance abuse history (pre-military, military, and post-military):
Vet has had no alcohol misuse disorder problems sicne 5/16/14. He has used no street drugs since 16/14.
f. Other, if any:
No response provided.
For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses:
[X] Panic attacks that occur weekly or less often
[X] Chronic sleep impairment
[X] Mild memory loss, such as forgetting names, directions or recent
[X] Impairment of short- and long-term memory, for example, retention of
only highly learned material, while forgetting to complete tasks
[X] Disturbances of motivation and mood
[X] Difficulty in establishing and maintaining effective work and social
[X] Difficulty in adapting to stressful circumstances, including work or
[X] Obsessional rituals which interfere with routine activities
4. Behavioral observations
Vet was totally genuine at the 1/28/19 Review Mental Health C+P exam.
5. Other symptoms
Does the Veteran have any other symptoms attributable to mental disorders that are not listed above?
[X] Yes [ ] No
If yes, describe:
Vet admits to having anger difficulties, 'spacing out' at times, and
general feeling of being confused/overwhelmed. He reports having lost
his social "filter" abilities. He reports previously having been very
"easygoing" prior to the military.
Vet still gets nervous if seeing sandbags lying on the side of the road -
left by construction crew(as that is what he looked for over in Iraq as being a potential IED.)
He has to reorganize plates/trays a certain way, either at home or when leaving a restaurant, respectively.
He denies having any suicidal thoughts("No, I'm addicted to life, I love
Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No
7. Remarks (including any testing results), if any: ---------------------------------------------------
Vet owns a pistol. He does not hunt - only tried it once, but did not get anything then.
He denied having any current active suicidal or homicidal ideation.
Hi there! Long time member here but been MIA for awhile. Life has been busy and I have been dealing with health issues. Long story short, I went through a battery of tests to find out what is wrong with me. I did an ANA-TITER test, and it was positive for an auto immune disease. Was referred to the RA doctor for further testing to see if I had lupus. The RA doctor did blood tests and determined I don't have lupus. We did additionally physical exam at the VA back in May and he determined I had Fibromyalgia and diagnosed me with it. We discussed that my Fibromyalgia co-exists with PTSD/MST and IBS. We also discussed that Fibromyalgia can be secondary to my already service-connected PTSD/MST or even maybe my IBS. I discussed this with my representative and we decided to file a claim for Fibromyalgia (non-service connected disability) to an already service-connected disability. Either PTSD/MST or IBS and we asked that they evaluate either causation or aggravation.
We filed in July and I had my C&P exam in September. The examiner was asked by the rater to give his medical opinion as to the Fibro being secondary to my PTSD/MST. The rater did not ask if it was possible to be secondary to my IBS like we requested. The examiner did a C&P DBQ for Fibro and that was positive. I do have Fibro, that isn't the issue. The medical opinion is what was disturbing. I was with the examiner for less than 5 minutes. He stated he physically examined me when he did not and he seemed very unknowledgeable about Fibro/PTSD-MST/IBS as co-existing and determining either causation or aggravation. Of course the medical opinion stated, "less likely than not". I was floored, so I went to work for my claim.
I contacted my RA doctor and we talked with my representative on the phone as well. By the end of the call he was confident enough to link my PTSD/MST as aggravation to my Fibromyalgia. He wrote a one/two paragraph letter on my behalf. We sent that to the rater. Then I spoke to my MH provider last week and she too wrote me a very good NEXUS letter. That was sent to the rater yesterday. Both my doctor's are at the VA and both stepped out on a limb for me. I am hoping their medical opinions outweigh the negative C&P medical opinion.
I am attaching the C&P exams (redacted), the two medical opinions (redacted) - I am hoping I am successful because this will make me 100% scheduler. I am currently 94% overall rated.
So recently I called the VA to make a mental health appointment. Up to now, I had been using a private psychiatrist, but now I'm dirt poor so I have to rely on the VA. Well, I called them up to make the appointment and the lady (turned out to be an RN) asked me, "Okay, so, any thoughts of suicide, any self-harm, stuff like that?" I took that to mean recently, as in, am I in a dire state right now. I answered "no" because I haven't had any of that going on in the last few months. The records I looked at state that she asked that to determine how soon I should be seen. It was then signed off on by a psychologist. So I was right about the whole "dire state" thing, right? When I read my records however, the entry said,
"Have you ever had thoughts of suicide? No."
"Have you ever engaged in self-harm? No."
That is not what I was asked! Both of those are completely wrong! Those questions were not asked! Instead, her question was phrased ambiguously. I also needed transportation to the VA, and she said "We don't do that but maybe I can get you some help" and gave me two phone numbers, and nobody answered either one. I then googled it and found the transportation person for my local VA (different phone number) and had a ride scheduled within 10 seconds. Can I include this as evidence of her incompetence? I'm about to submit my claim for a decision (but not until this is taken care of). How should I handle this? Should I put in a statement in support of claim mentioning this?
broncovet posted an answer to a question,While the BVA has some discretion here, often they "chop up claims". For example, BVA will order SERVICE CONNECTION, and leave it up to the VARO the disability percent and effective date.
I hate that its that way. The board should "render a decision", to include service connection, disability percentage AND effective date, so we dont have to appeal "each" of those issues over then next 15 years on a hamster wheel.
Ztmiller8 posted a question in Appealing Your Veterans Compensation Disability Claims NOD, DRO, BVA, USCAVC,Finally heard back that I received my 100% Overall rating and a 100% PTSD rating Following my long appeal process!
My question is this, given the fact that my appeal was on the advanced docket and is an “Expedited” appeal, what happens now and how long(ish) is the process from here on out with retro and so forth? I’ve read a million things but nothing with an expedited appeal status.
Anyone deal with this situation before? My jump is from 50 to 100 over the course of 2 years if that helps some. I only am asking because as happy as I am, I would be much happier to pay some of these bills off!
Joey Ross posted an answer to a question,I told reviewer that I had a bad C&P, and that all I wanted was a fair shake, and she even said, that was what she was all ready viewed for herself. The first C&P don't even reflect my Treatment in the VA PTSD clinic. In my new C&P I was only asked about symptoms, seeing shit, rituals, nightmares, paying bills and about childhood, but didn't ask about details of it. Just about twenty question, and nothing about stressor,
Picked ByJoey Ross,
This is the latest Compensation & Pension (C&P) Clinicians Guide dated 20180719. The only other one I've seen is dated 2002, including the one on this website and the VA website. I got this from my claims agent, who got it from the VA.
VA Compensation & Pension (C&P) Clinicians Guide 2 Final Corrected 20180719.pdf
Tbird posted a question in VA Disability Compensation Benefits Claims Research Forum,You, yes you, are the reason HadIt.com has remained a resource-rich resource. Thousands come each month to read, ask questions, or to feel a sense of community.
Last month June 2020, we over 50k visitors they viewed over 160k pages. Veterans and their advocates, spouses, children, and friends of veterans come looking for answers. Because we have posts dating back 15 years and articles on the home page, they usually can find an answer or at least get pointed in the right direction.
You all made that possible. Thank you.