Well Today I Learned...

[Sgt. Wilky]

I had a C&P exam this morning that went two whole hours and then some, with a mental health professional via video conference from the Cheyenne VA. She was very nice and seemed to be thorough. She confirmed what I already knew, and that was that I had PTSD, for which I have been rated 50% since 2015. Anyway, I learned that although my symptoms have gotten worse, that since I struggled to keep my job of 18 years and having not been fired multiple times throughout my "career", and since I wasn't a complete turd to my employer and to their customers, and I rarely showed up late to work and since I didn't hassle my coworkers and behave inappropriately, and since I didn't get so angry that I hit my spouse or beat my kids (despite the fact I stated quite clearly [and my wife confirmed] that I've ruined my relationship with my oldest son), and since I can brush my teeth on my own that I "probably" wouldn't qualify for the 70% requested increase.

So, I found out that if I had put my employer and my family through the proverbial wringer and I didn't cost them a bunch of money, and since that I haven't yet ruined my reputation in the neighborhood or at my church, and since that I was proactive to the point that the pain made it unbearable to work anymore, so I quit, rather than force them to fire me, I can't get the help that I need. I've been fighting the VA since 2008. I'm tired.

Awesome.

Sgt. Wilky

[brokensoldier244th]

Based solely only on what you posted, you don't meet the 70% criteria, unfortunately, unless your CAPRI or private treatment notes show something different, and that sucks. But you obviously feel differently- which leads me to believe that subconsciously there may be more to it that didnt come out at the examination.

If things around the house or work or in social situations are not as hunky dorey as they might seem have your sig other (if you have one) write up something, or a close friend. Believe me, I do know about this- I thought things were swimming along nicely about 10 yrs ago until I had my wife write up HER observations of me at home; my habits, and based on my conversations about work, people, politics, life in general, etc- THAT, and an anger episode where I had stewed for days and finally punched a hole in a wall- is what got me to go to counseling, and ultimately got my MH rating changed. I don't notice that I avoid the mail man and UPS, and I have a Ring doorbell because I think its convenient (when really it means I don't have to answer the door at all!). She and the kids DO notice those things. 

 We all tend to put on a good face for exams, and our brains naturally and reflexively recall good before bad. So, we are not always the best reliable narrator of our symptoms to someone else, especially in a one time setting. Your treatment notes may reflect something your examiner didn't see in the time they were in exam with you that will come out after further review by them when they write the report. You also can still submit evidence up to the point of a decision. 

 

Honestly, she/they shouldn't have been opining at all at the exam because they wouldn't have had time to process what you said vs. whatever your medical says. Her opinion is 1 opinion. If your day to day clinician sees otherwise, then that will have more probative weight than the C&P examiner. They are not the End all Be All, even if some of them think they are. I see a lot of opinions that don't go the way of the C&P examiner (both ways, unfortunately, and I hate reading those) BUT the record in total is what's considered and not just their opinion.

I order conflicting opinion exams all the time for stuff like this. I read the exam opinions before the rater does, and If I see something that looks way out there from what the rest of the record is showing me I dont just send it to rate and let them deal with it. I bounce it off another VSR, and my boss, and usually a rater or two that I'm conversant with first. I can order exams and re-exams if I can justify it before a rater even sees it- and I do, because I like my job and I give a shit- more than whether or not I get docked on 'efficiency' or something for spending 2 hours reading through a claim file that could have been more simply punted forward with an 'easy' note or adjustment. I also find a lot of things that way, missed steps, minor errors that weigh in 'your' favor, that couple pages of scrawl from someone at Womack Army Hosp 8 yrs ago......I was internet translating Greek today on one claim because someone had had a posting near Athens, and gone to a Greek clinic and the doc wrote up the notes- in Greek-lish. 

Edited June 23, 2021 by brokensoldier244th

[Sgt. Wilky]

6 minutes ago, brokensoldier244th said:

Based solely only on what you posted, you don't meet the 70% criteria, unfortunately, unless your CAPRI or private treatment notes show something different, and that sucks.But you obviously feel differently- which leads me to believe that subconsciously there may be more to it that didnt come out at the examination.

If things around the house or work or in social situations are not as hunky dorey as they might seem have your sig other (if you have one) write up something, or a close friend. Believe me, I do know about this- I thought things were swimming along nicely about 10 yrs ago until I had my wife write up HER observations of me at home; my habits, and based on my conversations about work, people, politics, life in general, etc- THAT, and an anger episode where I had stewed for days and finally punched a hole in a wall- is what got me to go to counseling, and ultimately got my MH rating changed. I don't notice that I avoid the mail man and UPS, and I have a Ring doorbell because I think its convenient (when really it means I don't have to answer the door at all!). She and the kids DO notice those things. 

 We all tend to put on a good face for exams, and our brains naturally and reflexively recall good before bad. So, we are not always the best reliable narrator of our symptoms to someone else, especially in a one time setting. Your treatment notes may reflect something your examiner didn't see in the time they were in exam with you that will come out after further review by them when they write the report. You also can still submit evidence up to the point of a decision. 

 

Honestly, she/they shouldn't have been opining at all at the exam because they wouldn't have had time to process what you said vs. whatever your medical says. Her opinion is 1 opinion. If your day to day clinician sees otherwise, then that will have more probative weight than the C&P examiner. They are not the End all Be All, even if some of them think they are. I see a lot of opinions that don't go the way of the C&P examiner (both ways, unfortunately, and I hate reading those) BUT the record in total is what's considered and not just their opinion. I order conflicting opinion exams all the time for stuff like this. I read the exam opinions before the rater does, and If I see something that looks way out there from what the rest of the record is showing me I dont just send it to rate and let them deal with it. I bounce it off another VSR, and my boss, and usually a rater or two that Im conversant with first. I can order exams and re-exams if I can justify it before a rater even sees it- and I do.

I thought of what you said brokensoldier, I did make the mistake of putting on a good face. I do this all the time at nearly every dang C&P exam and it always screws me over. My post was largely sarcastic in nature, but from what I read (and I'm no expert) from here, from several of the law firms quoted here often times, I meet the criteria, it's just I "didn't make it bad enough". Don't get me wrong, it is that bad, and my wife would attest to it. I seriously don't hurt people physically. But what comes out is hurtful many times.

I will ask her to write down her observations of me and those things you suggested. Her testimony helped me (us) before, and so I'll work on that this evening. Largely, I was venting, and I don't really know for sure, although based on what she said, I'm assuming, and when I assume in this area, I bat close to 1000.

One of the biggest keys that I don't have, is traditional treatment records. I see a counselor, but not a certified mental health counselor. I see my pastor on a regular basis, and I'll ask him for a letter too. The examiner said that was fine and that it's not exactly detrimental to my claim that I haven't been in mental health treatment. But I figure, regardless, I better start going to seek some kind of help in this MH condition.

Thank you for your patience.

[brokensoldier244th]

Pastoral notes are just as admissible as your wife's statements, and even the counselor- as long as they are certified in something its medical. If its a friend that isn't a counselor (in the traditional sense) Its lay evidence- still, evidence. I figured you were venting some, but I know from my personal issues that I wake up every morning and put on a face- and its exhausting. It depends on the day how long I can keep it up, and physically it takes its toll, too- I'm constantly physically and mentally exhausted and in a fog by the end of the day. That's why I start work at 0600- I have 2-3 hours before anyone is around, emailing me, Teams Meetings, whatever, where I can just sit and read casefile and commiserate with whomever's file im reading. By the mid afternoon when people would be getting off work, going to the gym, hanging out at Best Buy, whatever- I literally take a nap that ends up being 2-3 hours- and if I don't set an alarm I can literally sleep until the early AM and start all over again. The worse a day is for me mentally, the more I physically hurt - it exacerbates my physical issues. SOmetimes when I was getting C&Ps I would deliberately ask for later appointments when I could get them- sure I was physically on hold during the day longer because exams creep through the clock just like any doctors office-but then I knew by that point I would be pissed off and hurting enough that my mask would drop easier. 

[Sgt. Wilky]

As I continue to think about today's events, I'm reminded how the end of the discussion (hence my original post) revolved largely around what part of the 70% criteria I didn't qualify for, but absolutely none of the 70% I did qualify for. I think I'll be looking quite closely at my exam when it posts and begin formulating a NOD response directed at those items, or maybe I just need to talk to an attorney to help me with my claim.

[brokensoldier244th]

Perhaps. Or you just need to look at the list (or the people around you) and articulate better how you are affected. It's publicly available for a reason.  While there is a lot of weirdness at the VA, as far as making things available to the veteran they do a lot better than, say, a disability insurance company. Thats why the M 21-1 and DBQs are online, along with all the CFRs (well, those are public anyway- thats Congress). Try getting insurance companies to let you see the criteria they are comparing you against.

I tried about 8 yrs ago when I FMLA'd out of my last full time job before this one. First it took them almost the entire three months of my FMLA to pay me at all for STD that I had already paid into for 2+ yrs, then they tried to act like I was ungrateful that I was three months behind on all my bills and almost kicked out of my rental (family, too) and pissed about it, and calling them every few days, and using the internet to get direct extensions to people, along with sending them parts of their own benefits manuals that I could find parts of online to counter some of the bullshit they came up with. They seems shocked that I demanded them to release evaluative notes so that I could have my own doctors (VA and non) look them over. I could hear the hand wringing over the phone and the pearl clutching. 

[El Train]

17 hours ago, Sgt. Wilky said:

maybe I just need to talk to an attorney to help me with my claim.

Or better yet, find a forensic Psychologist to look at any treatment records, support statements from your pastor, wife, supervisor at work, mental health medications, past mental health C&P's, etc.  Have them submit a DBQ.  It helps if they are familiar with the VA lingo.  Maybe someone like a former C&P examiner (they're out there).  That's the route I took.  Went from 50% to 100% without a lawyer dragging it out for years.  Besides, 'IF' they took your case, they're going to find this forensic Psych. DR. and do what I just suggested.  Then they'll take 20 to 30% of any back pay (plus charge you for the Psych. DR. opinion).  File a NOD.  You have a year to gather additional evidence.