A Retired Rater, Retired C&P Examiner and a Retire Psychiatris
review this C&P Exam, and see 100% Rating
I will need to see it in Writing!!!

Axis I
PTSD (309.81)
Bipolar II Disorder (296.89
Sexual Sadism (302.84) is this under a mental disorder ???
PTSD includes symtoms of anxiety, panic attacks and obsessive compulsive behaviors. Bipolar Disorder includes his mood symtoms-despression hypomania, impulsitivity, racing thoughts. His sexual abberations are included in his paraphilla
AxisII
Personality Disorder with antiSocial disorder (301.7)
Axis III, Many Medical problems
AxisIV Problems with primary support group, Problems related to the social enviroment, Occupational problems, problems related to interaction with the legal system
Current GAF 35
The claimant is technically empolyed but doing no work. He has been sent to an office in a distant city from where his last trouble were. He is being investigated and sued for sexual harassment and various other complaints. In my opinion his mental disorders would preclde him from employment in any other company

Effects of PTSD on Occupational and Social Functioning
X in box: Total occupational and social impairment due to PTSD signs and Symtom
and also due to Bipolar Disorder and his sexual paraphila. He insomnia and nightmares, ritualistic and checking behaviors includong his sexual aberrations, depression, anxiety, panic attacks, history of assaultive behavior, grandiosity, poor marital and family relationship, restricted range of emotions, hypomania, no social friends, poor memory, poor self care, racing thoughts. With these symptoms and with his records he likely unemployable. He has no real relationship with friend or even family.

Psychosocial functional status and quality of life: After his return from Vietnam, he has almost consistently unable to function in a work enviroment and has no social involvement, even with his wife and kids.. His problems have become steadily worse over the years. There were many complaints about work behaviors and has had many jobs the past several years. This last group of incidents appears to be the end of the line for his working career as he is facing lawsuits for sexual harassment. He is not taking basic care of his hygiene. He is homeless and is living in the office that is own by the company.

PTSD symptoms require continous medications
PTSD symptoms are severe enough to interfere with occupational and social functioning.

Prognosis for PTSD
I do not see any hope for improvement for this claimant. He is suffering from severe PTSD, for which he has received little treatment over these many years. In addition, he meets criteria for Bipolar Disorder and sexual paraphilla. All these are futher complicated by long standing maladaptive personality characteristics.



Your opinion, no matter how harsh, will be repected

I see PTSD, A gaf of 35 which is low, You may not be able to handle your finances if that low. I also see the dreaded Personality Disorder that the RO often sees and uses against Veterans since it is not a rateable disability.

Otherwise it is a good C and P exam. I do see a 70 plus rating. Do you get SS?


Hang in there.

J

The examiner said I can handle my Finances, No SS,
the write up is strong about PTSD,
I hope the personality disorder doesn't get in the way

Jbasser
Personality Disorder with Anti Social Disorder code (301.7)
Is it rated under the criteria, I don't know where the C&P examiner got that from, it was new to me
I compare this C&P to friends rating at 70%, mine is much stronger of a C&P exam

The PTSD diagnosis is strong.
Which RO are you dealing with?

I have seen a very few 100 percent PTSD awards. mostly 70 and added IU.
You should go ahead and submit the IU paperwork now.
It May save you some time.

J

I dealing with Indianapolis, you have already or others gave me their opinion of that VARO
Theres nothing I can do with that. I wish I was down your way at Louisville VARO
Is the Personality Disorder I cited a ratable one

Was there any psychological or personality testing done?

C&P Exam Stated,
Diagnostic Tests:
Is any psychological testing necessary? NO, enter by the C&P examiner

I like this statement:

Prognosis for PTSD

I do not see any hope for improvement for this claimant. He is suffering from severe PTSD, for which he has received little treatment over these many years. In addition, he meets criteria for Bipolar Disorder and sexual paraphilla. All these are futher complicated by long standing maladaptive personality characteristics.

He states characteristics of. I do not consider this is not a personality disorder.

Do turn in the TDIU form immediately if you have not, for without it

the VA will not grant you unemployable.

This is what happened to me.

I can apply for TDIU before the rating
The examiner stated that she doesn't feel I can be employed anywhere

Yes, the sooner the better.

Where did you have this exam? indy?

If you did, you should shoot Yoggie2 a PM. You may have had the same Doctor.

As far as the PD, your PTSD diagnosis will overpower it. I dont think the VA likes to rate any PD.

You should be fine and you will be rated soon.

Keep an eye on the Indy RO they are full of surprises. I have seen several on claims as strong as yours.

J

Thanks, yes I have heard about Indy, and Yoggie has warned me also.
So I not getting my hopes up. I have read the exam a couple times, I can't see them rating low,
obviously the write up will cause a rate increase or a NOD approval. I also been told that TDIU, and SSDI is in good shape with this report. Again I have been in the system since 6/2/2009, I am a novice
and have lost lots of sleeps over worry about this

I would also file for SSD now and start by turning a copy of this report in. This report, in itself, will jumpstart the SSD process.

He stated PTSD as "SEVERE" and that is normally efficient for a 70% rating and I would think IU.

The only bump in the road I read would be where he stated, "All these are futher complicated by long standing maladaptive personality characteristics." The other way around would have been better but this might not matter to the rater since anything in AXIS I trumphs AXIS II disorders unless specifically stated otherwise.

dh

Thank you Darkhorse

No problem,

The only time a Personality Disorder should nix a claim is when there is overwhelming evidence that the PD is the predominate feature in your mental health history. Since you have been diagnosed with PTSD and it appears to be the predominate disorder, then it trumps a PD in all cases. Every human being carries some characteristics of Personality Disorders. But in order for it to be the predominate disorder it must interfere with characteriological ability to function in society.

hope this sheds more light,

dh

That excellent information, my PTSD is documented strongly and it is the cause of the other DX
so I can't see how the rater can spin it other then Severe PTSD

Well, you need to get all the help you can. Meds, psychotherapy, and keep away from stressfull situations. My Dad had PTSD/Bi-polar and can't work because he scares people, he has adjusted to being retired. It's not soo bad.

Thanks Mike for the concern
That was my reason for going to Mental Health, the Claim was secondary.
Now I am looking for advice on the next step

What % would you say the C&P exam holds in making the rating.
The rater is going to see:
My evidence
Mental Health DX
C&P examiner finding

What items do they most look at to determine their rating????

Look you are going to drive yourself nuts about this and what rating you are getting. You got to get away and relax from all this stress. This whole process makes a person crazy. You can't change what happened in your C&P and you must move on. If you get screwed you just have to appeal your rating. Its not the end of the world. I have found that looking for answers on the internet can also send you over the edge.

Best of luck, hang in there,

Bill

Thanks Billy, I think I have all the answers for now.
Hadit has been such a great resource, the advice and experience of other has guided me to this point.
I started this 6/2/2009, and everybody says time wise, it is moving very fast

I would be just a little bit careful about what I tell those SOB's at the VA. Sexual sadims?? Trouble over lawsuits for sexual harrassment? You don't want to tell them that kind of stuff. Assultive behavior? That is what lead to the anti-social personality disorder DX. If they don't have a record of anti-social behavior don't tell them. You can be honest, but not about use of illegal drugs, or criminal record if they don't know already.

Thanks John, I remember that advice, I hope it don't effect my rating for PTSD, it is now understand to root of most of my problems

What's done is done so I wouldn't worry about it too much now.


I agree with John that some things should be omitted if they are never asked by the examiner but I know you were just trying to do the right thing.

And the examiner clearly states that your'e totally unemployable due to PTSD.

dh

Yes she did say unemployable, so I guess in the world of filing claims and C&P examiner results it is strong report on my behalf for PTSD. I really can't rebutt some of her claims. I don't want to go there

Ryan,
While everyone tries to help you increase or figure out backpay. i will say congrads on winning a huge battle. Going from 10% to 70% is awesome.

Sit tight. You have more than you need and some of it is contradictory. Wait for an answer is best advice I can give.

Thank you Pete for the Advice

Thank you to all the Hadit members that help me get through my C&P
The advice was spot on, and I followed all your guidance
There is more to do, and when I need a answer, I know now where to go

Darryle

I recieve three e mails from professionals with a tremedous amount of experience in reading and rating PTSD C&Ps
I hope they are correct. I won't get my hope up until its final, and I read the rating for myself