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    • A bit about Tbird and HadIt.com for those who've asked...

      The following is on my About page, but some have been asking how this all happened. So here is my little story. Tbird US Navy 1983 – 1990 E-6 HadIt.com the website domain registered Jan 20, 1997 the domain is registered and paid for through Jan 21, 2023 at which time I plan to register it for another 15 years Lord willing and the creek don't rise. I guess the best place to start is Jan 1991; I had gotten out of the navy Dec 1990. At my separation seminar, there was a DAV rep Jim Milton he told us to bring our medical records in and he would look through them for us and let us know if we should file a claim with the VA. Well, bless his heart, he opened my medical file, reads the first insert, looks me straight in the eye, and says you will be 50% for the rest of your life and he would file the claim for me. 50% was for surgery I had in the service. True to his word he met with me and talked with me for a long time filled out my paper work and urged me to file for PTSD. I would not file the PTSD claim, nor even discuss it. By Feb 1991 I had moved to the San Francisco bay area and was staying at a friends apartment and pretty much I was just a puddle. In desperation one night I called suicide hot line, I had no job, no idea about going to the VA. They talked with me for a long time and explained to me that I could go to the local VA hospital even if I did not have insurance. Now, I know what you are thinking if I was 50% why didn't I just go to the VA in the first place, two reasons 1, this was Feb 1991 and the 50% didn't come till May and 2, even if it had come through it is unlikely that I would have had the mental acuity at the time to put the two together. I relate this here because it is where so many of our brothers and sisters are coming from, perhaps where you started. Fuzzy and unsure, in pain and sometimes homeless they come to the VA hospital for help. And that is where I ended up. Up to the pysch ward I went, blah, blah, blah, a few days later I was released with a promise of a call from the out patient program, which I would soon be entering. Blah, blah, blah, after many missed communications, and no call backs I was at the Day Hospital everyday M-F. And this brothers and sisters is where I began to learn and formulate my plan for HadIt.com. Veterans, veterans everywhere…I spent a year in the day hospital and about another year at a sheltered workshop before I got back on my feet. So I just talked to veterans everyday waiting for appointments, waiting for prescriptions, waiting for a vet rep and I started to learn the system. While in the navy I was data analyst and had to learn a 5 volume manual and just about anything you were suppose to do was in that manual. So I figured there must be a manual on how to do a VA claim or at the very least regulations. So I found out about the Code of Federal Regulations, United States Code, Veterans Affairs Manuals and so on and so forth. Of course this was 1991/1992 I was living in a tiny studio apartment in a particularly bad neighborhood, working in a sheltered workshop making a nickel per envelope I stuffed throw in PTSD and you will see that it was a difficult task for me to get somewhere where they had copies of these, let alone that they would let me look at. And there was so much knowledge around me, it was like the gold rush in those days, I could just sit on a bench a veteran would sit down next to me a little conversation later I had another nugget, I made copious notes. Phone numbers to call, ask for this guy or that guy he'll give you the straight scoop and they'd slip me a piece of paper with a number on it. You want to read this regulation or that one and another slip of paper into my hand. I spent a lot of time on those benches watching the squirrels they gathered their nuts and I gathered mine :) So I'm thinking I could put a little handbook together print it out and hand it out at the VA. Or perhaps fliers. Still formulating, time goes by, 1994/1995 I am being treated for PTSD regularly and doing and feeling much better and I go to work for a company as a marketing systems analyst and I discover the internet. Well let me tell you that was perhaps one of the most significant life changing events I have ever experienced. And I might add finally a positive one :) It seemed only natural to me that surely there must be a website that contained all the knowledge I wanted, well as it turned out not so much, lots of stuff but I wanted to get straight to the claims information and there was a lot of stuff to wade through to get to it. So taking my lesson from the squirrels earlier I started to gather, gather, gather…and learn HTML and work as a marketing systems analyst and work my claim. 1996/1997 major PTSD cork blows and unemployed. Working my claim, working the website. 20 Jan 1997 register HadIt.com domain name right after getting off the phone with the VA and saying I've had it with this. As fate would have it the old DAV board goes down just as mine opens up and folks start to wander in. So HadIt.com has two main components the website which supports the discussion board with links, articles, research resources etc. The website starts to grow, I can't tell you how many times I had to switch servers for space and features. I continue on a downward trend and in 1998 ended up back home in St Louis living in my sisters basement in therapy and working it, I swear I would have swung a dead chicken around my head at midnight naked if I thought it would have helped. The website continued to do great during this time, I just stayed in the basement bought new software, new books, and learned how to make things work and I continued to use this knowledge to make HadIt.com better. My 100% finally came through from the VA and I had a friend who is an advocate who helped me thru my SSDI claim, he was literally at my side thru the entire process and that came through for me. My therapist and sister continued to try and get me to leave the basement, but to no avail. At some point in 1998 or 1999 I put a counter on the website and was shocked to discover how many visitors we were getting. Time goes by my sister gets married and I move from the basement to the upstairs, there is much celebration that Aunt T is living in the light again. More time goes by and I settle into my life in St Louis and spend more time on the site trying new things, finding more information. 2003 I buy my own home VA loan. For years now I have just considered HadIt.com my job and I get up every morning go to the office and work for several hours, take an afternoon break and see where the rest of day takes me. I have a place in the office to use the computer and a comfortable to place to read journals and articles and take notes. Blah, blah, blah so that is my story and HadIt.com's intertwined.
    • HadIt.com Pass It On Cards

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    • VA Training and Fast Letter Forum Index

      VA Training and Fast Letter Forum Index The following is the index with links to the various Training and Fast Letters plus a few miscellaneous. These letters are not necessarily in the original formatting. I have tried to present them in an easy-to-read form instead of some forms as originally presented. Some of the paragraphs were WAAAAYYY too long. lol - HadIt.com Member fanaticbooks Something to be aware.... Some of these letters may be rescinded, outdated, or otherwise no longer viable. I have still included them because sometimes they provide additional insight or just plain more information than the newest version. Use them wisely. The oldest letters will display at the bottom with the latest letters displayed at the top, all in sequential numbers. Coding of the letters... FL = Fast Letter TL = Training Letter First two numbers = last two digits of year of origin Training Letter http://www.hadit.com/forums/index.php?/topic/40694-va-tl-00-07/ http://www.hadit.com/forums/index.php?/topic/40693-va-tl-00-06/ Fast Letter Number Title http://www.hadit.com/forums/index.php?/topic/44262-va-fl-11-15/ http://www.hadit.com/forums/index.php?/topic/44260-va-fl-11-13/ http://www.hadit.com/forums/index.php?/topic/44261-va-fl-11-11/ http://www.hadit.com/forums/index.php?/topic/44310-va-fl-11-09/ http://www.hadit.com/forums/index.php?/topic/42151-va-fl-11-03/ http://www.hadit.com/forums/index.php?/topic/40957-va-fl-10-49/ http://www.hadit.com/forums/index.php?/topic/40958-va-fl-10-46/ http://www.hadit.com/forums/index.php?/topic/40959-va-fl-10-45/ http://www.hadit.com/forums/index.php?/topic/40960-va-fl-10-42/ http://www.hadit.com/forums/index.php?/topic/40961-va-fl-10-39/ http://www.hadit.com/forums/index.php?/topic/40962-va-fl-10-35/ 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How Are Axis Figured In To Decisions?

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Posted · Report post

I'm trying to help someone do a notice of disagreement for depression. The veteran was increased from 10% to 30% but we believe it should be higher.

We were reading over the physical exam at the doctor diagnosis.

This is what it states in the diagnosis section.

Multiaxial diagnosis:

Axis I: Adjustment disorder with mixed anxiety and depressed mood (309.28)

Axis II: Defered 799.9

Axis III Deferreed to medical evaluation

Axis IV: Social isolation, unemployment, chronic concerns about pain and the negative impact of this on their energy level, low energy, health difficulties, marital conflicts

Axis V: GAF 52

How does the Axis figure into the decision? I wonder if the GAF score is what made it 30%.

Within the diagnostic impression section they say "it would appear that these distresses is chronic and would appear that the veteran would have a difficult time obtaining and maintaining employment given their physical complaints and current level of distresses.

Do you believe this is grounds for a notice of disagreement and request a higher rating? I also wonder if they bothered to read the notes in detail.

Opinions Please

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2 answers to this question

Posted · Report post

I have borrowed this wonderful information from

another web site, authored by Patrick428, who also

posts at Hadit on rare occassions.

I do not think he will mind me sharing this information

with you and I take no credit for writing it.

Hope this helps a vet.

carlie

So to start with I will describe many common terms needed to be understood and given examples when warranted.

R/O (Rule Out): Is a term found on either Axis I or II saying that there is not enough evidence to support the diagnosis at this time.

Deferred: Is a way of a clinician saying, "I just met you and I am not sure if you have this or not." Usually found when the patient has first entered the mental health system or has been out of the mental health system for a long period of time.

Secondary: Disorders that have manifested because of the first or primary disorder and also contribute to the severity of the primary disorder.

A full diagnostic example is as follows. There are varieties of how they are written, but this is the universally accepted model:

Axis I: Major depression, recurrent without psychotic features (Primary)

Generalized Anxiety Disorder (Secondary)

Axis II: Borderline Personality Disorder or None

Axis III: Ulcers and heart problems (usually medical problems that contribute to the mental disorder)

Axis IV: Psychosocial Stressors: Lose of employment and child abuse

Severity: 1 None; 2 Mild; 3 Moderate; 4 Severe; 5 Chronic

Axis V: Current GAF: 50

Highest GAF past year 60

GAF : Is referred to as Global Assessment of Functioning. This is a scale from 1 - 100 suggesting a pattern of behavior at any given movement in time. GAF is a fluid score and is never static (think of your blood pressure when applying GAF). The lower the score more problematic behavior becomes.

91 - 100 Not much happening and you can tolerate most stress very easily. (Blood pressure normal)

81 - 90 Some minor setbacks, maybe late bill that was not paid causing a flurry of minor stress, but is usually resolved. (Blood pressure slight elevated, but returns to normal rapidly)

71 -80 Minor problems within the home (work) and some stress that is enduring, but usually dealt with. They called about the bill that you forgot to pay (Blood pressure slightly elevated).

61 - 70 Minor to moderate problems such as not having the money to pay the bill and you are under pressure by your creditor to pay it. (Blood pressure is elevated and in need of attention).

51 - 60 Your being sued for not paying your bill, and your wife or husband has announced they are tired of living this way. Your kids do not know who you are anymore. (Blood pressure above 140/90 and dual medications are needed).

41 - 50 Wife or husband announces they are leaving and the bill collector has placed a lien on your property. You have called your creditor and your spouse idiots and you say to hell with them. (Blood pressure is severe and strong doses of medication are needed)

31 - 40 You threaten to kill your creditor and your spouse and everyone around you is against you. (Blood pressure is in the stroke range).

21 - 30 You bought a weapon and can of gas and your going to resolve the issue once and for all. It causes you to be either incarcerated or committed. (Blood pressure is causing severe chest pains and your stroking).

11 - 20 The best you can do is verbally babble and drool on yourself. (Blood pressure has caused a stroke).

0 - 10 You are no longer with us as you now live in a parallel universe. (It does not matter now).

It is not my intention to make light of the scale, but I wish to show the reality of the levels.

Axis I. A grouping of mental syndromes from a common etiology or pathology. What is usual found on Axis I disorders are: Mood, Sexual, Psychotic Substance Abuse, Child Disorders (except Mental Retardation), and Organic Syndromes (e.g.,Depression caused by a stroke).

Axis II. Are disorders of the Personality and Mental Retardation. Here Personality Disorders in Cluster A, B, and C are found.

Cluster A. Disorders deemed to be problems associated with peculiar behaviors(Schizoid).

Cluster B. Disorders where the individual violates the right of other people and often has little regard for others (Antisocial).

Cluster C. Disorders where dependency and inability to fit in socially with others is the common theme(Avoidant).

Personality is how one perceives, relates, and thinks about the environment and of oneself.

Personality Disorder is a maladaptive problem with the personality that causes extensive interference and ability to function in society. This is a pervasive pattern of behavior manifesting itself in the early development of an individual and prevents the individual from functioning normally in society.

Illusion: An illusion is a visual perception or misinterpretation of something real.

Hallucination: A hallucination is a false perception of a sensory experience (tactile, visual, auditory, taste, smell, or in body experience).

Delusion: Is a false belief carried to an extreme.

Psychotic. Loss of touch with reality

Depersonalization: Feelings of detachment from others. Feelings like being one's own dream.

Affect: Mood behaviors. Moods can be blunted, flat, inappropriate, labile (frequent mood changes), and restricted.

PTSD: Post-traumatic Stress Disorder. Can come in forms of mild, moderate, severe, chronic and delayed. May be seen on Axis I written as: PTSD, Chronic and Delayed.

Psychiatrist: Is Medical Doctor who specializes in mental illness and uses medications for its' treatment.

Psychologist: Is a person who performs psychological testing, assessment, and therapy.

M.S.W. Master's in Social Work and usually coordinates community-based programs and also performs therapy. But is restricted to therapy only.

Psychological Battery includes:

Personality Inventory (MMPI, etc)

Intelligence Scale (IQ test Wechsler or Stanford-Binet)

Neurological Tests (Bender-Gestalt, Wechsler Memory Test, etc).

Mood Inventories (Depression Scale; Anxiety Scales)

Trauma Scales (Mississippi, TSI)

Mental Status Examination

History

Mental Status Examinations:

Mini Mental Status exam - 20 minutes

Full Mental Status Examination - 1 hour

Specialized Tests as warranted for the purpose of narrowing the cause of many problems.

I am sure I left a few things out, but wanted you to have a general idea of the COMMON terms seen. In 98% of cases this is the information seen by the patient. Therapy modalities vary with each practitioner and as is often the case a practice or clinic is staffed with practitioners with like ideas of therapy. It should not be construed simply because a Psychiatrist or Psychologist is licensed that they are specialist in every aspect of mental illness. This is not true.

When either suggests they can handle any your problems regardless of your disorders, then seek other help. To find a good therapist this is a good rule of thumb:

1. Ask around

2. Ask your medical physician who is good at what you need to deal with.

3. Ask the local Psychology or Psychiatric Association for a referral

4. Call the respective State Board and check for Board Certification and Credentials.

5. Call the national associations ( both APA's) and get advice

6. If you are in the VA system and do not like the practitioner you have, request another.

7. Talk to other vets about their experience if they share it. Remember this is probably the most unreliable referral.

8. READ AND DON'T ASSUME

9. RESEARCH YOUR DISORDER

10. ASK QUESTIONS (Practitioners are not mind readers).

I hope this will help out in many ways. It is not all inclusive and I will from time-to-time add information that is either brought to my attention or comes to light..

Patrick

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Posted · Report post

Carlie,

Great find, that really makes it easy for us JARHEADS to understand.

Thanks, SGT Sandman

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