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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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Ptsd Once Again Denied

24 posts in this topic

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Friday morning I recieved the dreaded white envelope..It was my latest round of rubber stamped denials....There were more than one but the PTSD one concerns me and my VA psyche that I saw for a monthly appt on Friday afternoon....In the write up for the denial they conceded my stressor...

I quote" Review of your file showed that your combat stressor has been conceeded.Service medical records avaliable for review were negative for a diagnosis of posttraumitic stress disorder.

At your VA examination, the doctor reviewed your avaliable medical records.The examiner reported that although you have symptoms of posttraunitic stress disorder there was no evidence of persistently avoiding situations which remind you of the traumitic event.(I don't knoe what they want, I told the examiner that I detested the 4th of July, avoided crowds and would not join local Volunteer Fire Department because I couldn't face the possibility of encountering the smell of burnt human again..Plus no friends and spending hours alone).No diagnosis of post traumitic stress disorder was rendered.The diagnosis of major depressive disorder was supported by finding on examination.Service medical records were negative for a diagnosis of depression.

The claim for service connection for post traumitic stress disorder with depression is considered reopened.However, the evidence continues to show service connection is not shown by the service medical records or demonstrated by evidence following service.Therefore, service connection continues to be denied" end quote...

This has to be the biggest load of double talk and BS I have ever seen...My VA psychiatrist was astounded...And this is with a clear diagnosis of PTSD from her with a GAF of 55 2 days after my C&P and was 50 the month before...She said that my PTSD may be partially controlled but without the 3 antidepressants and sleep aids and lets not forget the nightmare medication that it is rampant and will probably always require medication.............I guess the good news is the conceding of my stressor..I don't think they even looked at my VA treatment records...Next week I will request a copy of my C-file and the C&P exam..Thinking about a lawyer for appeal..Also psyche suggested if I can get off worrk the 4 week inpatient course at Little Rock..Off the record said it would help claim and appealNow just seeing if I can get 4 weeks..Can't afford missing pay..Have enough leave to cover abot 2 1/2 weeks...Work for Feds so really don't have to worry about losing job with Docs note.......ANY HELP AND GUIDANCE WILL BE GREATLY APPRECIATED.......Grid

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Posted · Report post

Grid,

Yes, It is good that at least VBA states your stressor to combat

has been conceded.

Perhaps you can get your VA MH (psychiatrist) provider to write an addendum letter

that you can submit for reconsideration.

Keep in mind this does not stop the clock for the submission of a NOD.

carlie

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Posted · Report post

Carlie, thanks for the reply...i am already working on it..I have an appt. tommorow with my DAV rep to discuss options with him...Already getting paperwork together....Hopefully will be sending them paperwork within a month..Still considering getting a lawyer involved as I am not impressed with my DAV rep.....He never seems to have time to see me..Will talk to Shrink again in about a month..GRID

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Posted · Report post

Glad that you are making progress.

Never give up you earned the benefits

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If you have current DX of PTSD and the VA conceded stessor then it should only be a matter of rating effective date and %. Just hang in there and keep jumping throught hoops.

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Grid,

This sounds like the classic case of one medical opine versus the other. In my experiences as a VSR--and I stress "my experiences"--I can't tell you how many times I've seen a vet get his/her claim denied just because one medical opinion is believed to hold more "weight" against the other. I'm not sure what your psychiatrist is annotating in your records, but you should make sure he/she is properly documenting your condition. Get copies of your records from the hospital and check. If everything appears to be kosher, get a third medical opinion to support your claim and your psychiatrist's assessment. I instructed my father-in-law to do this, which he did, and he was finally approved for PTSD. Ask your psychiatrist if he/she can arrange this with one of his/her peers.

Hope this helps,

Mike

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Thanks for the support and advice folks..Really appreciate it..Sorry haven't been around for a week or so..Lost my Father, had to attend funeral and feel so down, no energy just want to sleep and rest..plus the mirtazapine my psych put me on for sleep is making me very tired and groggy...Once again THANKS...I am getting things together to keep up the good fight...Gridi

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You need an IMO/IME to bolster your claim. You don't have to have every symptom of PTSD to get a claim approved. The VA is just dancing around. Appeal this denial and ask for a DRO Hearing. Get some more medical evidence to DX you with PTSD. Nobody has all the listed PTSD symptoms.

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Posted · Report post

Sorry for your loss. May be a good idea to take a short break if you can.

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You are dealing with a lot and I too am sorry for the loss of youir father.

"Off the record said it would help claim" I am former VA PTSD volunteer. That statement is correct.

The VA also will do the paper work for you in the inhouse program for Temp 100% for the 21 days you attending this program.

I have only known of one vet who attended the inhouse program and was denied the 100% temp comp. He did not have PTSD and no vald stressor at all.

John 999 is right.

BTW did the VA give you the MMPI or any psyche testing?

They validates the stressor which is great, you have the diagnosis which no one wants but that is great too-but the C & P doc was wrong.

Was this an actual shrink or a PA or a nurse who did the C & P?

Ther credentials coul;d be one point of attacdk on this decision.

Do you have copy of the actual C & P exam?

Sometimes the actual exam is parsed by the raters- I have proof of that.The SOC leaves out the positive parts of the exam. I dont know if this is the case here but a real doctor, preferably psychiatrist would give a more definitive picture of your PTSD as to how it affects you and hopefully an IMO would help.

Did the VA at least give you a SC "0" Rating for PTSD?

What diagnostic code have they used?

What did the SOC say about the affect of the SC meds to your employability?

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Berta thanks for some great answers......You have brought up some great things that may help....I am in the process of requesting a copy of my C&P and my claims file...This was just one of the claims they denied in the same letter......They said that they had origionally denies my claim in 1994 but that the new evidence submitted WAS MATERIAL....It just does read right and does not fall in line with everything I have read about PTSD especially since they conceded my stressor and I have a valid DX from both my VA PC and my VA PSYCH....They also denied my insomnia claim and combined my Sleep Apnea claim with it together...Plus other numerous claims some that go back to 1994............The meds are becoming a serious problem......They are causing weight gain,Sexual Disfunction, grogginess and problems with waking up....The Ambien no longer works, the mirtazapine that my psych has prescribed to help with the sleep is turning me into a zombie that wants to sleep all the time...I am using the time I am off from work to try to adjust to it..Am seriously considering asking my psych to start the paperwork for SSI because I am to the point that I cannot function at the workplace anymore..........................................Plus I am going to talk to my counseler about the inpatient facility as my psych suggested....If I get fired then I will draw unemployment and file for SSI and continue my fight...I am not giving up....I have been put off,had my honesty and character tested by the VA, had them Flat Out Lie...No, now they have one large, very upset Texan on their hands who has proof of most of the things they have denied and the support of a loving wife and family and a wonderful extended internet brother and sisterhood who have the knowledge and give me support everyday I see great advice coming from them............Once again thanks to Berta and all the others for your wonderful guidance and help.............Grid

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Posted · Report post

I took mirtazapaine one time and I did not really wake up for three days. That stuff is horrible. Worse than neurontin for me. It knocks me out.

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If you do become unemployed by all means apply for SSDI ( SSI is Supplemental Income-and not same as SSDI- the SSA web site has info on this.

And also apply for TDIU. Total Disability due to unemployability.

The meds you take for SC are a factor in determining unemployability.If one cannot get a decent night's sleep they cannot work poroductively.

."I have been put off,had my honesty and character tested by the VA, had them Flat Out Lie..." I know how low the VA can go as far as lying.

We are on a battlefield- a war of the words.

If a vet has the diagnosis of PTSD and validated stressor- what is their problem?

Can you possibly scan and attach the actual wording of their reasons and bases part of the PTSD denial? (Cover any personal info)

When you get copy of the actual C & P we can help more when we know what that says.

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Posted · Report post

Friday morning I recieved the dreaded white envelope..It was my latest round of rubber stamped denials....There were more than one but the PTSD one concerns me and my VA psyche that I saw for a monthly appt on Friday afternoon....In the write up for the denial they conceded my stressor...

I quote" Review of your file showed that your combat stressor has been conceeded.Service medical records avaliable for review were negative for a diagnosis of posttraumitic stress disorder.

At your VA examination, the doctor reviewed your avaliable medical records.The examiner reported that although you have symptoms of posttraunitic stress disorder there was no evidence of persistently avoiding situations which remind you of the traumitic event.(I don't knoe what they want, I told the examiner that I detested the 4th of July, avoided crowds and would not join local Volunteer Fire Department because I couldn't face the possibility of encountering the smell of burnt human again..Plus no friends and spending hours alone).No diagnosis of post traumitic stress disorder was rendered.The diagnosis of major depressive disorder was supported by finding on examination.Service medical records were negative for a diagnosis of depression.

The claim for service connection for post traumitic stress disorder with depression is considered reopened.However, the evidence continues to show service connection is not shown by the service medical records or demonstrated by evidence following service.Therefore, service connection continues to be denied" end quote...

This has to be the biggest load of double talk and BS I have ever seen...My VA psychiatrist was astounded...And this is with a clear diagnosis of PTSD from her with a GAF of 55 2 days after my C&P and was 50 the month before...She said that my PTSD may be partially controlled but without the 3 antidepressants and sleep aids and lets not forget the nightmare medication that it is rampant and will probably always require medication.............I guess the good news is the conceding of my stressor..I don't think they even looked at my VA treatment records...Next week I will request a copy of my C-file and the C&P exam..Thinking about a lawyer for appeal..Also psyche suggested if I can get off worrk the 4 week inpatient course at Little Rock..Off the record said it would help claim and appealNow just seeing if I can get 4 weeks..Can't afford missing pay..Have enough leave to cover abot 2 1/2 weeks...Work for Feds so really don't have to worry about losing job with Docs note.......ANY HELP AND GUIDANCE WILL BE GREATLY APPRECIATED.......Grid

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We can appreciate your frustration with the VA. You are not alone.

I had the luck to find a contact at the local VA hospital who gave me a short list of good inclusions in your applications or appeals. Some of those you already have, like the stressor and the diagnosis. Did you also include letters from your wife or kids to describe their lives as spouses and children of a PTSD vet? What about from your family doctor? Along with the positive aspect of having myself checked in to the sixth floor for some cool out time the letters from others seemed to have a great deal of power. The time on the sixth floor let them have records of my bad attitudes and the letters gave them a wider canvas to view. I promised the wife and kids not to read the letters because I needed their full honesty.

A final point. I first went to the VA for my hearing many years ago and tried to pass the damn hearing tests. At the time my hearing was as bad as it is now. It took years to get past a zero rating. You are not in any examination to pass the test. You want them to find what is wrong and acting brave is not the way to go. If you can't hear the tone don't push the button; if you are PTSD don't walk in as a strac soldier, we aren't. We have parts missing or damaged and we need the VA to help us out.

Everything you wrote says you are on the ball.

Hadit has the point.

We've got your back.

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Gridsmasher11,your stressor was comfirmed,but when you had your C&P,the examiner reviewed your medical records and reported that although you have symptoms of ptsd,but no evidence of the traumatic event that ocur. When the rated receive your medical report from C&P examiner.he/she couldn't coroborate the traumatic event that happen to you inservice.In other words the traumatic event that happen to you while you was inservice,you have to be pretty specific, when you see your psychiatrist,psychologists,of C&P examiner,tell he/she exactly how that traumatic event that happen to you inservice make you feel,for example,you can't sleep, how you avoid situations,no friends and etc all because of the traumatic event (explain) that cause you to be this way.This should get you service connected for PTSD.

mobie16r

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What I'm seeing is no actual diagnosis of PTSD or record of it. I believe you'll need to get an IMO, that gives you that diagnosis. Perhaps being seen by a Vet Center would help? It is also possible that your current therapists haven't made that entry in your records or that the records are not with your c-file and therefore not viewed by the adjudicator. You'll also note the following statement: "At your VA examination, the doctor reviewed your avaliable medical records." It doesn't sound to me like your complete medical records or c-file was present for the C&P exam/review. jmo

pr

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phillip i understand what you are saying,but he got to let the examiner no that the traumatic event that ocur in service cause his problems.If he is having nightmares,intrusive thoughts,avoidance and etc,and the traumatic event that happen to him while he was in service,this is ptsd, just have to be coroborate with inservice stressor

mobie

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mobie - they've conceded the stressor, so now he needs the PTSD diagnosis, which is required. If he doesn't meet the required minimum criteria, for PTSD, he won't get the diagnosis. It could be that his doctor isn't specifying PTSD, in his medical records, or that they don't have his medical records in his c-file. Many times claimants assume since it's all the "VA" that their medical records are present, which is rarely true. I believe the Service Center still needs to request those records from the VAMC medical records dept. jmo

pr

phillip i understand what you are saying,but he got to let the examiner no that the traumatic event that ocur in service cause his problems.If he is having nightmares,intrusive thoughts,avoidance and etc,and the traumatic event that happen to him while he was in service,this is ptsd, just have to be coroborate with inservice stressor

mobie

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"I have a valid DX from both my VA PC and my VA PSYCH....They also denied my insomnia claim and combined my Sleep Apnea claim with it together...Plus other num"

I dont get this a diagnosis froma VA shrink that the C & P doc is trying to ignore or overturn?

Are you a VA employee? reason I asked is my husband was and his shrink PTSD records were in one case poorly documented (because he was VA employee) and then when he switched from VA psychologist to VA psychiatrist, his treatment was well documented but I had to obtain the records myself from his VA shrink for his claim as they were not-for some reason-in his regular medical file.

If you have these definitive diagnoses of PTSD in your med recs, send the VA copy of those records and ask them to CUE themselves.

"My VA psychiatrist was astounded...And this is with a clear diagnosis of PTSD from her " I bet she was- the VA ignored evidence that was clearly critical to your claim.

Do you have a vet rep to help fight this ?

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Berta, no I am not a VA employee but do work for the Federal GVT...Am a DEP of Defense/Army Civilian..........My VA PC had put in my notes from our initial appt. that I Had sign and symptoms of PTSD from my Gulf War exeriences and gave me a Psych referal.....I went to my psych referal and talked to the VA counseler and she referred my to my VA psych who I have been Telemed with once a month....She has given me a clear Diagnosis of PTSD with Major Depressive Disorder......It is the diagnosis in my AXIS IV.....Over the last 4 months I have had a GAF ranging from 50 to 58.......Am getting everything together to fight this...I haven't decided if I will just appeal or gor for a DOR...I am convinced that they did not look at my treatment records.........Thanks for all the help and support

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Gridsmasher11 - I can see it's a waste of my time to assist you! You haven't provided the necessary answers . . . just what you "think." Sorry!

pr

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The Evidence list they used in the denial letter will show you what they used.(and then you can determine what they didn't use and should have)

If they did list something as evidence but failed to mention it at all in the narrative , then they didn't consider it.

Even if the VA diagnosed you with PTSD and then confirmed the stressor- they might not have found the level of PTSD as a ratable level.

Is there a rating sheet or something with the decision that shows PTSD as NSC "0" or as SC "0" ?

How does the VARO get copies of or any documentation of the Telemed treatment sessions?

."I am convinced that they did not look at my treatment records." That looks to me as the case here too.

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Berta, the treatment notes from the Telemed sessions appear in my treatment records just like if I had seen her live...When I go to the local VA clinic that I go to for treatment, group sessions and to see my VA PC about once a month I get a copy of my treatment records for the previous month or since I last pulled them...They include my PC docs notes from my visit (If I saw her in that time frame), notes from the counseler from group and the Psych notes from my Psych Telemed sessions......It is is all computer based now....So the notes are avaliable....................................As to any reference to a SC at 0% or a NSC they are not there...They just denied PTSD again.....You asked about a service officer to help me..The DAV rep that is supposed to be helping me never seems to have time for me and has been absolutely worthless, am lookinf for other assistance..............Thank you Berta for your help and suggestions

Phillip Rogers, I appreciate your help and concern........I have a clear diagnosis of PTSD from my VA PSYCH, I have been conceeded a stressor from the VA...The notes from my VA PSYCH include the traumitic events and experiences I experienced and that I dream about and the images that stay in my mind...I have submitted statements from my wife about the nightmares and the sleep issues and the anger and avoidance...I have sent in statements about my experiences, what I saw and the traumitic events that happened......I DO NOT KNOW if my complete medical record was reviewed by the Doc that did my C&P, I did not even know what the C&P was for until I got in her office..I just recieved a appt letter from VA telling me when and where to go that day..I had 2 C&P exams that day and neither stated what for....I am doing the best I can to put this all together and get it right...I am sorry that you feel that you cannot help me...If you will look back over my past posts you will see where I posted about my psych visit that includes my DSM IV and GAF score...

I once again thank all that are trying to assist me in my claim..I will continue to drive forward and will not give up........Thanks for all the help and advice.....GRID

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