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Long Post: Please Advise.

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Border

Question

I need some assistance.

I was medically separated from the military in 2002 due to a non-combat parachute jump. I incurred a head injury and was dischared with post-concussive syndrome and right sural nerve damage. I received a 20% disability rating.

I presented to my current internist fatigue, difficulty with concentration and short-term memory, polyuria with 3-4 per hour voiding, and polydypsia to the point of near continuous thirst.

I have acquired paperwork from this board-certified internist (medical school at Yale, published, and 30+ plus years experience) and an endocrinologist stating that I have diabetes insipidus. I have extensive paperwork stating that I have this condition.

I was also referred to a memory disorder clinic. The clinic did an extensive neuropsychological work-up concluding that I have difficulty finishing tasks, recalling recent events, concentrating, focusing, neuropathic pain, change in behavior, masked facies, headaches, bilateral gaze-evoked nystagmus, and diabetes insipidus. My intellectual functioning was all above expectations, except for working memory. Memory was below expectations in most areas. Of particular concern was immediate and delayed recall of pictured events. Also, my performance on visual motor constructional tasks was well below expectations given my IQ (which has actually dropped almost 8 points since the military's doctor conducted the same testing). The final diagnosis was closed head injury with post concussive syndrome.

The internist also wrote a letter for my file stating that I face lifelong limitations due to this (the military accident) traumatic brain injury, including: 1) any situation in which he becomes unable to sense thirst or unable to respond by drinking, 2) the memory deficit has created a lack of confidence and profoundly effects inter-personal relationships, 3) treatment with vasopressin for one year at higher than expected doses has produced less than opitimal responses, cannot drink coffee, tea, colas, and any other diruretic beverage, restrictions within my diet that also effect my ability to socialize, 4) career choices will be limited to positions that allow frequent absence from the desk/workstation and close proximity of fluids and restrooms. She continued by stating that I have attempted to maintain functionality with exercise, no alcohol or tobacco, etc. She concludes that since the accident that created the traumatic brain injury, is likely as not that there will be a continued decline in function and working memory which will impact my way of life, potential livihood and inter-personal relationships. She including supporting attachments.

The neurologist at the memory disorder clinic recommended provigil to counter the chronic fatigue and referred me to a research study group at the local universty aimed at helping folks like me improve daily functioning. I also received documentation from that professor. Another neurologist recently placed me on depakote, though the internist took me off of it immediately because I gained almost 20 pounds within a week and half. I recently visited a psychiatrist to get documentation to support the existence of emotional problems. She thinks I have major depression with anxiety and wants me to take the MMPI-II and begin psychotherapeutic work.

Oh. I was also referred to a VA research group.

Part of my problem is that some of the paperwork is inconsistent. One doctor states this or that about me and my condition, and another doctor states something else. My internist and psychiatrist attest to serious effect on my daily life, while the memory disorder clinic's neurologist states otherwise, though notes the short-term memory, etc.

Also, while I have many symptoms with decent documentation, the results on the physical signs are negative or inconclusive (which contributed to the initial VA rating), other than the diabetes insipidus stuff and some results from a PET scan reporting decreased uptake in the cerebellum and thalmi (which I have no clue what it means). But all the doctors acknowledge that there is something going on that they cannot completely figure out. Read: I have no actual brain lesion.

I also have the real problem that I am attractive, fit, very articulate, employed (though this requires a lot of additional work - mnemonic devices, extreme difficulties with coworkers and consequential lower performance ratings), and have graduate education. I think this will potential hamper my claim despite the documentation that I have collected. And you know what, I am very fortunate compared to many folks, but my level of intellectual functioning has decreased (>99th to 91st) and most probably will continue to decrease, not to mention that my working memory is currently around the 50th percentile, which is far removed from where I should be given my intellectual functioning. So, I still function far better than the majority of healthy folks, but it is a real decline for me darnnit! and frustrates me to no end because I find that I am unable to perform or remember the way I once was.

I don't really know how to proceed in regard to completing my file for a claim. I requested and received miltary and personnel records via the Privacy Act. I am doing my best to collect more documentation for the emotional component of this claim, but am virtually clueless how to proceed.

Please help. Advice? Thoughts?

Border

Edited by Border
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Josephine,

I am sorry but I must point out that Testvet is completely correct. YOU MUST APPEAR FOR A C&P. Otherwise the VA can and will dismiss your claim, or claims.

I understand we all have differing opinions, but this isn't an opinion... it's fact.

DO NOT ADVISE VETERANS NOT TO GO TO THEIR C&P EXAMS.

The statement you make:

I advise Never go for a C&P examination at any VAMC, even ordered by the VA by any Psychologist, as there word is not accepted by the VA.

Can and will cause damage to a veterans claim if followed. That simply is wrong... the veteran is required to attend their scheduled C&P exams, for rating purposes...

VETERANS MUST GO TO THEIR C&P EXAMS, IF THEY WANT THEIR CLAIMS PROPERLY RATED..........

Bob Smith

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  • HadIt.com Elder

now Bob tell the truth it does not matter if it's rated properly or improperly the vet still has to show up, many of us feel like Joesephine and WISH we hadn't wasted the time going, I have had 3 heart C&P's with the same result every time DENIED not because of my problems, they refuse to look at the toxic materials I was exposed to while in service, or as a secondary condition to my SC PTSD, come on I am 100% schedular the stressor happened in 1975 I had a stroke at 36, heart attack at 39 I was a mailman and walked 17 miles a day I was not a candidate for a heart attack but it happened anyway, so I keep appealing lucky I live close to the VARO and the Hospital where they do the exams.

Edited by Testvet

100% SC P&T PTSD 100% CAD 10% Hypertension and A&A = SMC L, SSD
a disabled American veteran certified lol
"A journey of a thousand miles must begin with a single step."

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I did tell the truth...

Veterans MUST go to their C&P exams if they want their claims rated ... perhaps PROPERLY was a poor choice of words... but the VA will not even render a rating if they require a C&P...

Certainly they can and DO misinterpret, and imprperly rate the C&P, but they will not rate the claim at all without the C&P if they decided they require one...

So, while I wish MANY things.... like the VA would properly rate claims from the beginning perhaps.... I will not stand for anyone offering advise which could damage a claim...

I already went round and round with this...

If someone is offering an opinion fine, but if they use the word advise, then they better be correct, and that includes myself. I've done the 5:30am C&P exam, and I've done the C&P exam that they ignored and about every other combination... thats NOT what I am taking exception to... heck, I KNOW they mess them up... BUT... it doesnt matter

Nobody should offer advise, that will damage a claim... period.

We have a great many people who offer a great deal of advise based on knowlege of the system, and the regulations. We are blessed in that we have vetrans who are willing to do this... and I thank them all. Yet we MUST be careful of the advise we offer...

I'm sorry but I have NO leeway on this... consider it my "thing", I suppose, but when I see advise which is offered that is patently wrong... I have to correct it. Perhaps sometimes it is meant as a joke... if so, I dont see the humor.

Bob Smith

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  • HadIt.com Elder

I feel that if the VA is going to send you for a C&P, and it is for a Mental Condition, then you may wish to ask for a Medical Doctor Psychiatrist.

This would be if the C&P notice states that you are having your first C&P with a Psychologist.

I believe that I am correct in the post by Berta that a Psychiatrist has weight with the VA, but a Psychologis may not.

If I am incorrect, please let me know.

I will remove my earlier post and trust this is acceptable.

Josephine

Edited by Josephine
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Border I meant by SMRS- Service Medical Records-

I dont feel a vet should depend on the VA to get them- you can get them yourself---

go to this site and follow the links to Military Records.

If your personnel records might help ask for those records too--

Unless the format has changed there-you request on line for the records-the SF 180- and then print out the Bar coded thing, sign, make copy for your self, and then mail it to where they direct you to at NARA.

Takes about 4-5 weeks usually to get SMRs.

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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  • HadIt.com Elder

Josephine:

I can see how you feel after being stung by a bad C&P but like Testvet and Six have said you cannot turn down a C&P. Requesting a shrink for a mental exam is certainly not out of bounds but even that contains risks.

The C&P may be the most critical event in the claim process cause so much is held in balance by it. That is why it is critical to get a copy as soon as possible in order to decide what needs to be done next.

Even a good C&P does not guarantee anything and a bad one does not mean you can't overcome it.

By the way your contributions to Hadit are greatly appreciated by me. Your willingness to share I am sure has helped others who lurk or do not ask questions on the Board.

Veterans deserve real choice for their health care.

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